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Purpose There has been scant scholarly attention paid to characterizing how the numerous definitions of terms associated with compassion and humanism have been mobilized or what the organizational implications of pursuing different constructs might be. This study explored the uses and implications of the terminology associated with humanistic medicine in the work of the Associated Medical Services (AMS) Phoenix Project. Method This study involved two phases (2014-2015). First, two pilot group workshops with AMS Phoenix Project participants and stakeholders were conducted to explore ways of parsing and interpreting core concepts used in the project. The authors then assembled an archive of texts associated with the project, comprising the project website and blog posts, conference proceedings, and fellowship and grant applications. Informed by critical discourse analysis, the authors identified, described, and analyzed core terms related to the project's mission and explored the type of health care practices and reforms implied by their use. Results Two recurring core terms, care/caring and compassion, and eight clusters of terms related to these core terms were identified in the archive. Caring and compassion as terms were articulated in various psychological, sociological, and political configurations. This polysemy reflected a diverse array of health care reform agendas. Conclusions Understanding how different interpretations of caring and compassion cluster around core topics and concerns of humanistic medicine offers scholars an entry point for comparing and appraising the quality and direction of reform agendas, including multilevel strategies that involve systems-level changes.

There has been a widespread shift to competency-based medical education (CBME) in the United States and Canada. Much of the CBME discourse has focused on the successful learner, with relatively little attention paid to what happens in CBME systems when learners stumble or fail. Emerging issues, such as the well-documented problem of "failure to fail" and concerns about litigious learners, have highlighted a need for well-defined and integrated frameworks to support and guide strategic approaches to the remediation of struggling medical learners.This Perspective sets out a conceptual review of current practices and an argument for a holistic approach to remediation in the context of their parent medical education systems. The authors propose parameters for integrating remediation into CBME and describe a model based on five zones of practice along with the rules of engagement associated with each zone. The zones are "normal" curriculum, corrective action, remediation, probation, and exclusion.The authors argue that, by linking and integrating theory and practice in remediation with CBME, a more integrated systems-level response to differing degrees of learner difficulty and failure can be developed. The proposed model demonstrates how educational practice in different zones is based on different rules, roles, responsibilities, and thresholds for moving between zones. A model such as this can help medical educators and medical education leaders take a more integrated approach to learners' failures as well as their successes by being more explicit about the rules of engagement that apply in different circumstances across the competency continuum.