Clinical reasoning is a core competency in medical practice; however, deficits in this domain among residents are often difficult to identify and remediate because of its cognitive complexity and the absence of standardized assessment approaches. This scoping review aimed to map and analyze existing evidence on strategies to remediate clinical reasoning skill deficits in underperforming medical residents. Using the Arksey and O’Malley framework as refined by Levac and his colleagues, and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we systematically searched PubMed, Scopus, MEDLINE, Web of Science, SpringerLink, ProQuest, and EBSCOhost for studies published between 2000 and 2024. Definitions of clinical reasoning, underperformance, and remediation were adopted from prior literature. Twenty studies met the inclusion criteria, comprising original research and literature reviews in multiple medical specialties. Methods for identifying clinical reasoning deficits included written, oral, and performance-based assessments, as well as routine workplace-based evaluations. Remediation strategies ranged from structured institutional programs to individualized, case-specific interventions, with coaching, deliberate practice, guided reflection, and structured thinking frameworks frequently employed. Two studies reported positive outcomes following completion of remediation for clinical reasoning deficits. Key enablers included psychological safety, learner engagement, and accessible faculty support, whereas barriers included learner resistance, inadequate baseline knowledge, faculty skill limitations, and institutional resource constraints. Effective remediation requires early identification, comprehensive diagnostic assessment, and tailored, coaching-based interventions supported by institutional commitment. Nonetheless, substantial variability in definitions, remediation protocols, and evaluation methods highlights the need for greater standardization and further research across diverse contexts to inform evidence-based frameworks for clinical reasoning remediation.

Purpose: Hybrid learning has been chosen as an alternative method in the conduction of clinical skill lectures during coronavirus disease 2019 (COVID-19) pandemic since students need to learn skills applied in emergency situations. This study aims to analyze students’ attitudes between hybrid and online learning methods. Methods: A non-randomized study was conducted between hybrid group (HG) and online group (OG) on three courses (intravenous [IV]-line insertion, nasogastric tube [NGT] insertion, and neonatal resuscitation). We developed a preformed validated questionnaire to assess students’ attitudes in five domains (willingness, understanding, capacity, self-efficacy, and intended behavior). The questionnaire was applied at the pre- and post-intervention. Results: A total of 100 participants were included (n=49 in HG, n=51 in OG). Post-course attitudes were significantly higher in online (IV-line, p=0.000; NGT, p=0.000; resuscitation, p=0.000) and hybrid (IV-line, p=0.000; NGT, p=0.000; resuscitation, p=0.000) groups compared to their pre-course. There were no significant differences in post-course attitude between groups (IV-line, p=0.072; NGT, p=0.163; resuscitation, p=0.146). Normalized-gain scores of all subjects were higher in HG (IV-line, p=0.012; NGT, p=0.085; resuscitation, p=0.033). Conclusion In conclusion, hybrid learning could be considered as a better alternative in clinical skill lectures to maximize students’ attitudes, especially during COVID-19 pandemic.