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Academic Medicine
Journal Prestige (SJR): 2.53  Citation Impact (citeScore): 2 Number of Followers: 80  Hybrid journal (It can contain Open Access articles)ISSN (Print) 1040-2446 - ISSN (Online) 1938-808X Published by LWW Wolters Kluwer  [330 journals]
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- Genetics Lessons From Rare Patients
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Authors: Falah; Nadia
Abstract: No abstract available
PubDate: Wed, 25 Oct 2023 00:00:00 GMT-
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- Easing the Transition From Undergraduate to Graduate Medical Education
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Authors: Roberts; Laura Weiss
Abstract: No abstract available
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Asians Are Not Interchangeable
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Authors: Llanes; Aaron Cedric; Yung, Anthony
Abstract: No abstract available
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Reframing Physician Assistant Student Mistreatment Through the Lens of
Intersectionality-
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Authors: Frias; Dominique; Miles, Monica
Abstract: No abstract available
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Reconciling LCME Diversity With Federal Law Mandates for Affirmative
Action on the Basis of Disability, Gender, Race/Ethnicity, and Veteran
Status-
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Authors: Lawson; Nicholas D.
Abstract: No abstract available
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Leveraging Social Media Analytics for Physicians
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Authors: Woo; Benjamin K.P.; Lu, Hanson T.
Abstract: No abstract available
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Using Podcasts to Study Efficiently and Increase Exposure to Medical
Specialties-
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Authors: Wang; Leonard Kuan-Pei; Paidisetty, Praneet Sai; Sathyanarayanan, Sairandri
Abstract: No abstract available
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Academic Medicine’s Fourth Mission: Building on Community-Oriented
Primary Care to Achieve Community-Engaged Health Care-
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Authors: Savage Hoggard; Courtney L.; Kaufman, Arthur; Michener, J. Lloyd; Phillips, Robert L. Jr
Abstract: A 2021 article, “Now is our time to act: Why academic medicine must embrace community collaboration as its fourth mission,” by Association of American Medical Colleges (AAMC) authors, including AAMC president and CEO Dr. David J. Skorton, offers 2 aims that are highly related: community collaboration and health equity. The AAMC’s call to prioritize community collaboration and health equity as pillars of the academic medicine mission echo earlier work on community-oriented primary care (COPC) and an even more robust model that builds on COPC, community-engaged health care (CEHC). COPC is a tested, systematic approach to health care by which a health clinic or system collaborates with a community to reshape priorities and services based on assessed health needs and determinants of health. COPC affirms health inequities’ socioeconomic and political roots, emphasizing health care as a relationship, not a transaction or commodity. Communities where COPC is implemented often see reductions in health inequities, especially those related to socioeconomic, structural, and environmental factors. COPC was the foundation on which community health centers were built, and early models had demonstrable effects on community health and engagement. Several academic health centers build on COPC to achieve CEHC. In CEHC, primary care remains critical, but more of the academic health center’s functions are pulled into community engagement and trust building. Thus, the AAMC has described and embraced a care and training model for which there are good, longitudinal examples among medical schools and teaching hospitals. Spreading CEHC and aligning the Community Health Needs Assessment requirements of academic health centers with the fourth mission could go a long way to improving equity, building trust, and repairing the social contract for health care.
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- The Undergraduate to Graduate Medical Education Transition as a Systems
Problem: A Root Cause Analysis-
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Authors: Swails; Jennifer L.; Angus, Steven; Barone, Michael A.; Bienstock, Jessica; Burk-Rafel, Jesse; Roett, Michelle A.; Hauer, Karen E.
Abstract:
The transition from undergraduate medical education (UME) to graduate medical education (GME) constitutes a complex system with important implications for learner progression and patient safety. The transition is currently dysfunctional, requiring students and residency programs to spend significant time, money, and energy on the process. Applications and interviews continue to increase despite stable match rates. Although many in the medical community acknowledge the problems with the UME-GME transition and learners have called for prompt action to address these concerns, the underlying causes are complex and have defied easy fixes. This article describes the work of the Coalition for Physician Accountability’s Undergraduate Medical Education to Graduate Medical Education Review Committee (UGRC) to apply a quality improvement approach and systems thinking to explore the underlying causes of dysfunction in the UME-GME transition. The UGRC performed a root cause analysis using the 5 whys and an Ishikawa (or fishbone) diagram to deeply explore problems in the UME-GME transition. The root causes of problems identified include culture, costs and limited resources, bias, systems, lack of standards, and lack of alignment. Using the principles of systems thinking (components, connections, and purpose), the UGRC considered interactions among the root causes and developed recommendations to improve the UME-GME transition. Several of the UGRC’s recommendations stemming from this work are explained. Sustained monitoring will be necessary to ensure interventions move the process forward to better serve applicants, programs, and the public good.
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Artist’s Statement: Moment of Reflection
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Authors: Bottger; Erica H.
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No abstract available
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Program Evaluation in Health Professions Education: An Innovative Approach
Guided by Principles-
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Authors: Balmer; Dorene F.; Anderson, Hannah; West, Daniel C.
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Problem Program evaluation approaches that center the achievement of specific, measurable, achievable, realistic, and time-bound goals are common in health professions education (HPE) but can be challenging to articulate when evaluating emergent programs. Principles-focused evaluation is an alternative approach to program evaluation that centers on adherence to guiding principles, not achievement of goals. The authors describe their innovative application of principles-focused evaluation to an emergent HPE program.Approach The authors applied principles-focused evaluation to the Children’s Hospital of Philadelphia Medical Education Collaboratory, a works-in-progress program for HPE scholarship. In September 2019, the authors drafted 3 guiding principles. In May 2021, they used feedback from Collaboratory attendees to revise the guiding principles: Advance Excellence, Build Bridges, and Cultivate Learning.Outcomes In July 2021, the authors queried participants about the extent to which their experience with the Collaboratory adhered to the revised guiding principles. Twenty of the 38 Collaboratory participants (53%) responded to the survey. Regarding the guiding principle Advance Excellence, 9 respondents (45%) reported that the Collaboratory facilitated engagement in scholarly conversation only by a small extent, and 8 (40%) reported it facilitated professional growth only by a small extent. Although some respondents expressed positive regard for the high degree of rigor promoted by the Collaboratory, others felt discouraged because this degree of rigor seemed unachievable. Regarding the guiding principle Build Bridges, 19 (95%) reported the Collaboratory welcomed perspectives within the group. Regarding the guiding principle Cultivate Learning, 19 (95%) indicated the Collaboratory welcomed perspectives within the group and across disciplines, and garnered collaboration.Next Steps Next steps include improving adherence to the principle of Advancing Excellence, fostering a shared mental model of the Collaboratory’s guiding principles, and applying a principles-focused approach to the evaluation of multi-site HPE programs.
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Bullying in Academic Medicine: Experiences of Women Physician Leaders
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Authors: Iyer; Maya S.; Way, David P.; MacDowell, Doug J.; Overholser, Barbara M.; Spector, Nancy D.; Jagsi, Reshma
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Purpose Bullying is defined as offenders abusing positions of authority and intentionally targeting individuals through persistent negative behaviors to impede education or career growth. This study sought to estimate the prevalence and nature of bullying experienced by women physician leaders in academic medicine.Method In this survey-based study, 547 physician graduates of an executive women’s leadership training program were invited to complete a survey that measured workplace bullying in 2021. Participants were asked whether and when they had been bullied, how it impacted their careers, and remedies for bullying. Descriptive statistics were used to profile mistreatment and bullying experienced by the respondents during their professional careers and the nature of bullying. Content analysis of open-ended comments was used to describe how bullying impacted women physicians and outline recommendations for bullying prevention and mitigation.Results The survey response rate was 64.7% (354/547). Most women (302/354 [85.3%]) had experienced mistreatment during their careers, with more than half experiencing bullying while an attending physician (198/302 [65.6%]). Many women (187/302 [61.9%]) who screened positive for mistreatment also reported that they had been bullied at work. Of these 187 respondents, 173 (92.5%) experienced bullying from men and 121 (64.7%) reporting bullying from women (effect size = 0.34, P ≤ .001), and 115 (61.5%) reported that bullies were their immediate supervisors. Qualitative findings suggested that bullying harmed individuals’ career advancement, mental health, reputation, and relationships with others. Many had to change roles or leave jobs. Participants proposed that initiatives by top-level leaders, clear definitions of bullying behavior, reporting mechanisms, and upstander training for faculty and staff could mitigate bullying.Conclusions Most women physician leaders have experienced bullying. These results highlight the need to address bullying in academic medicine so that women can reach their full career potential.
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- The Association Between USMLE Step 2 Clinical Knowledge Scores and
Residency Performance: A Systematic Review and Meta-Analysis-
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Authors: Shirkhodaie; Camron; Avila, Santiago; Seidel, Henry; Gibbons, Robert D.; Arora, Vineet M.; Farnan, Jeanne M.
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Purpose With the change in Step 1 score reporting, Step 2 Clinical Knowledge (CK) may become a pivotal factor in resident selection. This systematic review and meta-analysis seeks to synthesize existing observational studies that assess the relationship between Step 2 CK scores and measures of resident performance.Method The authors searched MEDLINE, Web of Science, and Scopus databases using terms related to Step 2 CK in 2021. Two researchers identified studies investigating the association between Step 2 CK and measures of resident performance and included studies if they contained a bivariate analysis examining Step 2 CK scores’ association with an outcome of interest: in-training examination (ITE) scores, board certification examination scores, select Accreditation Council for Graduate Medical Education core competency assessments, overall resident performance evaluations, or other subjective measures of performance. For outcomes that were investigated by 3 or more studies, pooled effect sizes were estimated with random-effects models.Results Among 1,355 potential studies, 68 met inclusion criteria and 43 were able to be pooled. There was a moderate positive correlation between Step 2 CK and ITE scores (0.52, 95% CI 0.45–0.59, P < .01). There was a moderate positive correlation between Step 2 CK and ITE scores for both nonsurgical (0.59, 95% CI 0.51–0.66, P < .01) and surgical specialties (0.41, 95% CI 0.33–0.48, P < .01). There was a very weak positive correlation between Step 2 CK scores and subjective measures of resident performance (0.19, 95% CI 0.13–0.25, P < .01).Conclusions This study found Step 2 CK scores have a statistically significant moderate positive association with future examination scores and a statistically significant weak positive correlation with subjective measures of resident performance. These findings are increasingly relevant as Step 2 CK scores will likely become more important in resident selection.
PubDate: Fri, 20 Jan 2023 00:00:00 GMT-
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- Rejecting Reforms, Yet Calling for Change: A Qualitative Analysis of
Proposed Reforms to the Residency Application Process-
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Authors: Dacre; Michael; Branzetti, Jeremy; Hopson, Laura R.; Regan, Linda; Gisondi, Michael A.
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Purpose Annual increases in the number of residency applications burden students and challenge programs. Several reforms to the application process have been proposed; however, stakeholder input is often overlooked. The authors examined key stakeholders’ opinions about several proposed reforms to the residency application process and identified important factors to guide future reforms.Method Using semistructured interviews, the authors asked educational administrators and trainees to consider 5 commonly proposed reforms to the residency application process: Match to obtain residency interviews, preference signaling, application limits, geographic preference disclosure, and abolishing the Match. The authors conducted a modified content analysis of interview transcripts using qualitative and quantitative analytic techniques. Frequency analysis regarding the acceptability of the 5 proposed reforms and thematic analysis of important factors to guide reform were performed. Fifteen-minute interviews were conducted between July and October 2019, with data analysis completed during a 6-month period in 2020 and 2021.Results Participants included 30 stakeholders from 9 medical specialties and 15 institutions. Most participants wanted to keep the Match process intact; however, they noted several important flaws in the system that disadvantage students and warrant change. Participants did not broadly support any of the 5 proposed reforms. Two themes were identified: principles to guide reform (fairness, transparency, equity, reducing costs to students, reducing total applications, reducing work for program directors, and avoiding unintended consequences) and unpopular reform proposals (concern that application limits threaten less competitive students and signaling adds bias to the system).Conclusions Key stakeholders in the residency application process believe the system has important flaws that demand reform. Despite this, the most commonly proposed reforms are unacceptable to these stakeholders because they threaten fairness to students and program workload. These findings call for a larger investigation of proposed reforms with a more nationally representative stakeholder cohort.
PubDate: Tue, 15 Nov 2022 00:00:00 GMT-
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- Medical Schools Must Improve Trauma-Informed Care Education
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Authors: Burns; Courtney Julia
Abstract: No abstract available
PubDate: Tue, 25 Oct 2022 00:00:00 GMT-
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- Outcomes of a Peer Mentoring Circle: An Innovation to Improve Academic
Physician Career Advancement in a Community Hospital Setting-
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Authors: Kaushik; Ruchi; McCallin, Tracy; Sedillo, Daniel J.; Wolfe, Adam D.
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Problem Faculty retention is a prominent topic in academic medicine. Investment in faculty career development supports faculty vitality, advancement, and retention. Academic physicians in community-based settings far from their academic affiliate may find identifying local career advancement mentorship challenging.Approach In June 2018, a career advancement in-service day at The Children’s Hospital of San Antonio and Baylor College of Medicine in Houston was convened to design a peer mentoring circle (PMC). Using self-determination theory, this program aimed to help PMC members develop goals; schedule and attend regular meetings; format, review, and critique member curricula vitae and portfolios; and hold one another accountable to submitting award and promotion applications.Outcomes Eleven inaugural PMC cohort members attended regular monthly meetings from July 2018 to June 2019 (median, 6 members per meeting). All members were competent in accessing the PMC repository of materials. Statistically significant improvement (P < .01) was seen in self-reported knowledge and skills relevant to award or academic promotion support and resources. Compared with no patient care or teaching awards and 1 academic promotion among non-PMC faculty, 5 PMC members (45.5%) earned a patient care award, 4 (36.4%) earned a teaching award, and 5 of 10 faculty members (50.0%) achieved academic promotion (P < .001 for all). On the retrospective pre–post survey, members endorsed several PMC strengths, including personal and emotional support, professional support, and accountability.Next Steps Next steps include establishing a local faculty development office, convening a second cohort, revising evaluation methods, expanding membership, and offering 1-on-1 career counseling. Community-based academicians who aim to replicate this program should organize a career advancement and faculty development in-service day, identify local faculty members to manage meetings, retain a repository of resources, set deadlines and hold one another accountable to them, and celebrate achievements and support one another in failure.
PubDate: Tue, 25 Oct 2022 00:00:00 GMT-
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- Prayers and Tuna Melts
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Authors: Rahman; Zarin I.
Abstract: No abstract available
PubDate: Tue, 25 Oct 2022 00:00:00 GMT-
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- Virtual Communication Across Differences: Development of a Workshop on
Managing Patient Bias-
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Authors: Zewdie; Monica; Duval, Margaret; Liu, Chang; Bachman, Sharon L.; Moore, L. Gordon; Mohess, Denise; Kapadia, Muneera R.; Dort, Jonathan; Newcomb, Anna B.
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Problem Despite the prevalence and detrimental effects of racial discrimination in American society and its health care systems, few medical schools have designed and implemented curricula to prepare medical students to respond to patient bias and racism.Approach During the summer of 2020, a virtual communication class was designed that focused on training medical students in how to respond to patient bias and racism. Following brief didactics at the start of the session, students practiced scenarios with actors in small groups and received direct feedback from faculty. For each scenario, students were instructed to briefly gather a patient’s history and schedule an appointment with the attending whose name triggered the patient to request an “American” provider. In one scenario, the patient’s request was motivated by untreated hearing loss and difficulty understanding accents. In another, it was motivated by racist views toward foreign physicians. Students were to use motivational interviewing (MI) to uncover the reasoning behind the request and respond appropriately. Students assessed their presession and postsession confidence on 5 learning objectives that reflect successful communication modeled after MI techniques.Outcomes Following the session, student skills confidence increased in exploring intentions and beliefs (P = .026), navigating a conversation with a patient exhibiting bias (P = .019) and using nonverbal skills to demonstrate empathy (P = .031). Several students noted that this was their first exposure to the topic in a medical school course and first opportunity to practice these skills under supervision.Next Steps The experience designing and implementing this module preparing students in responding to patient bias and racism suggests that such an effort is feasible, affordable, and effective. With the clear need for such a program and positive impact on student confidence navigating these discussions, including such training in medical school programs appears feasible and is strongly encouraged.
PubDate: Tue, 11 Oct 2022 00:00:00 GMT-
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- Interview Without Harm: Reimagining Medical Training’s Financially and
Environmentally Costly Interview Practices-
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Authors: Hampshire; Karly; Shirley, Hugh; Teherani, Arianne
Abstract: The looming threat of climate change urgently calls for reimagining unsustainable systems and practices, including academia’s culture of emissions-intensive travel. Given that medical educators are uniquely invested in the future of the trainees they represent, this reimagination can and should begin with medical education. Making significant reforms to the application process has historically been challenging, but the COVID-19 pandemic catalyzed an abrupt shift from in-person to virtual interviews for medical school, residency, and fellowship. Programs and applicants alike demonstrated resilience, innovation, and satisfaction in adapting to virtual interviews during 2 full application cycles. This restructuring has prompted consideration of the necessity of environmentally costly, expensive, and time-consuming cross-country travel for single-day interviews. However, evolving conversations about the future of medical training interviews have not prioritized environmental impact, despite the sizeable historical emissions generated by interview-related travel and the incompatibility between ecological damage and population health. Beyond environmental impact, virtual interviews are more equitable, with significantly fewer financial costs, and they are more efficient, requiring less time off from school or work. Many concerns associated with virtual interviews, including interview inflation and limited applicant exposure to programs and their surrounding areas, can be addressed via creative and structural solutions, such as interview caps and in-person second-look programs. The medical training interview process underwent a forced restructuring due to the unprecedented disruption caused by COVID-19. This moment presents a strategic inflection point for medical education leadership to build on the momentum and permanently transform the process by focusing on sustainability and equity.
PubDate: Tue, 27 Sep 2022 00:00:00 GMT-
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- Blue Skies With Clouds: Envisioning the Future Ideal State and Identifying
Ongoing Tensions in the UME–GME Transition-
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Authors: Hauer; Karen E.; Williams, Pamela M.; Byerley, Julie S.; Swails, Jennifer L.; Barone, Michael A.
Abstract:
The transition from medical school to residency in the United States consumes large amounts of time for students and educators in undergraduate and graduate medical education (UME, GME), and it is costly for both students and institutions. Attempts to improve the residency application and Match processes have been insufficient to counteract the very large number of applications to programs. To address these challenges, the Coalition for Physician Accountability charged the Undergraduate Medical Education to Graduate Medical Education Review Committee (UGRC) with crafting recommendations to improve the system for the UME–GME transition. To guide this work, the UGRC defined and sought stakeholder input on a “blue-skies” ideal state of this transition. The ideal state views the transition as a system to support a continuum of professional development and learning, thus serving learners, educators, and the public, and engendering trust among them. It also supports the well-being of learners and educators, promotes diversity, and minimizes bias. This manuscript uses polarity thinking to analyze 3 persistent key tensions in the system that require ongoing management. First, the formative purpose of assessment for learning and growth is at odds with the use of assessment data for ranking and sorting candidates. Second, the function of residents as learners can conflict with their role as workers contributing service to health care systems. Third, the current residency Match process can position the desire for individual choice—among students and their programs—against the workforce needs of the profession and the public. This Scholarly Perspective presents strategies to balance the upsides and downsides inherent to these tensions. By articulating the ideal state of the UME–GME transition and anticipating tensions, educators and educational organizations can be better positioned to implement UGRC recommendations to improve the transition system.
PubDate: Tue, 09 Aug 2022 00:00:00 GMT-
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- Self-Assessment in Feedback Conversations: A Complicated Balance
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Authors: Robb; Katharine A.; Rosenbaum, Marcy E.; Peters, Lauren; Lenoch, Susan; Lancianese, Donna; Miller, Jane L.
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Purpose Learner-centered feedback models encourage educators to ask learners to self-assess at the start of feedback conversations. This study examines how learners perceive and respond to self-assessment prompts during feedback conversations and assesses medical students’ perceptions of and approach to self-assessment used as the basis for these conversations.Method All rising second-, third-, and fourth-year medical students at a midwestern U.S. medical school were invited to participate in this study. Students participated in 1-on-1 interviews between June and August 2019 during which they were asked open-ended questions about their experiences with self-assessment and feedback during medical school. The interviews were audio recorded and transcribed, and comments related to self-assessment in feedback conversations were extracted. Thematic analysis was used to identify recurrent ideas and patterns within the transcripts, and all excerpts were reviewed and coded to ensure that the identified themes adequately captured the range of student responses.Results A total of 25 students participated in the study. Although some students noted improvement in their self-assessment abilities with increasing experience, no consistent gender, race, or training-level differences were found in reported attitudes or preferences. Students identified many benefits of self-assessment and generally appreciated being asked to self-assess before receiving feedback. Students had varied responses to specific self-assessment prompts, with no clear preferences for any particular self-assessment questions. Students described weighing multiple factors, such as image concerns and worries about impact on subsequent evaluations, when deciding how to respond to self-assessment prompts.Conclusions The process by which learners formulate and share self-assessments in feedback conversations is not straightforward. Although educators should continue to elicit self-assessments in feedback discussions, they should recognize the limitations of these self-assessments and strive to create a safe environment in which learners feel empowered to share their true impressions.
PubDate: Tue, 09 Aug 2022 00:00:00 GMT-
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- Culinary Medicine as Innovative Nutrition Education for Medical Students:
A Scoping Review-
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Authors: Newman; Courtney; Yan, Justin; Messiah, Sarah E.; Albin, Jaclyn
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Purpose Lifestyle-related disease substantially impacts health, but physicians lack adequate nutrition education to discuss behavioral change with patients. Many medical schools have developed culinary medicine programs as a nutrition education strategy, but common elements of success have not been defined.Method The authors conducted a scoping review of the literature on culinary medicine programs for medical students. They searched PubMed, Ovid MEDLINE, and MedEdPORTAL databases to identify English-language studies published between January 1, 2012, and October 15, 2021. Multiple search terms were used to identify medical student–focused culinary medicine programs. The authors focused inclusion criteria on medical student learners, curricular description, hands-on cooking components, reflection or application to patient care, and assessment. Additionally, the authors reviewed 2 online databases which list programs delivering culinary medicine education for U.S. medical students.Results
Authors identified 251 studies, of which 12 met inclusion criteria. These studies described programs that used a kitchen or similar space adaptable for food preparation to enable hands-on learning, and some programs provided opportunities for practical application. Most programs administered surveys to assess course impact, but the type of survey and cohort size varied. Culinary medicine programs for medical students varied in learner level, number of participants, course length and structure, and instructor background but consistently improved student knowledge in key areas of nutrition application and changed knowledge and attitudes about food and nutrition. Funding was often noted as a barrier to program sustainability. When funding source was provided, it derived from philanthropic or academic sources. When the authors reviewed the 2 online databases, they identified 34 programs offering medical student-focused culinary medicine courses.Conclusions As culinary education programs emerge across academic centers, standardizing programmatic and curricular elements, best practices, and assessment strategies will be vital for quality control, sustainability, and optimal population health impact.
PubDate: Tue, 02 Aug 2022 00:00:00 GMT-
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- Learning Together: Co-Learning Among Faculty and Trainees in the Clinical
Workplace-
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Authors: Haddock; Lindsey; Rivera, Josette; O’Brien, Bridget C.
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Purpose Studies of workplace learning largely focus on how individuals (clinicians and trainees) learn in the clinical workplace. By focusing on individuals, these studies miss opportunities to explore the co-constructive nature of learning that may result in clinician–educators and trainees learning alongside each other (co-learning). The purpose of this study was to explore whether and how co-learning occurs in the workplace and what value co-learning holds.Method Using a constructivist grounded theory approach, the authors interviewed 34 faculty clinician–educators from 10 specialties at one academic institution to explore whether and how co-learning occurred in their practice and how faculty perceived its value for faculty and for trainees. Interviews were conducted and recorded June to December 2019. Through iterative analysis, the authors refined a conceptual model of co-learning.Results In a 3-part model of co-learning derived from faculty interviews, faculty and trainees jointly identify learning opportunities during work-related activities and choose learning strategies for learning that lead to interpretation and construction of meaning; these activities produce learning outcomes, such as understanding or insight. The model also accounts for asymmetry in experience and position between faculty and trainees. All faculty participants valued co-learning and elucidated barriers and facilitators to using it in the workplace. How faculty managed asymmetries shaped the nature of the co-learning. When faculty worked to lessen asymmetry between teacher and trainee, co-learning was often collaborative.Conclusions The model of co-learning makes explicit the concept of asymmetry in workplace learning and aids consideration of how related dynamics affect the nature of learning. Faculty must be intentional in managing asymmetries to fully leverage learning opportunities afforded by the workplace.
PubDate: Thu, 21 Jul 2022 00:00:00 GMT-
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- Can Rater Training Improve the Quality and Accuracy of Workplace-Based
Assessment Narrative Comments and Entrustment Ratings' A Randomized
Controlled Trial-
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Authors: Kogan; Jennifer R.; Dine, C. Jessica; Conforti, Lisa N.; Holmboe, Eric S.
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Purpose Prior research evaluating workplace-based assessment (WBA) rater training effectiveness has not measured improvement in narrative comment quality and accuracy, nor accuracy of prospective entrustment-supervision ratings. The purpose of this study was to determine whether rater training, using performance dimension and frame of reference training, could improve WBA narrative comment quality and accuracy. A secondary aim was to assess impact on entrustment rating accuracy.Method This single-blind, multi-institution, randomized controlled trial of a multifaceted, longitudinal rater training intervention consisted of in-person training followed by asynchronous online spaced learning. In 2018, investigators randomized 94 internal medicine and family medicine physicians involved with resident education. Participants assessed 10 scripted standardized resident–patient videos at baseline and follow-up. Differences in holistic assessment of narrative comment accuracy and specificity, accuracy of individual scenario observations, and entrustment rating accuracy were evaluated with t tests. Linear regression assessed impact of participant demographics and baseline performance.Results Seventy-seven participants completed the study. At follow-up, the intervention group (n = 41), compared with the control group (n = 36), had higher scores for narrative holistic specificity (2.76 vs 2.31, P < .001, Cohen V = .25), accuracy (2.37 vs 2.06, P < .001, Cohen V = .20) and mean quantity of accurate (6.14 vs 4.33, P < .001), inaccurate (3.53 vs 2.41, P < .001), and overall observations (2.61 vs 1.92, P = .002, Cohen V = .47). In aggregate, the intervention group had more accurate entrustment ratings (58.1% vs 49.7%, P = .006, Phi = .30). Baseline performance was significantly associated with performance on final assessments.Conclusions Quality and specificity of narrative comments improved with rater training; the effect was mitigated by inappropriate stringency. Training improved accuracy of prospective entrustment-supervision ratings, but the effect was more limited. Participants with lower baseline rating skill may benefit most from training.
PubDate: Thu, 21 Jul 2022 00:00:00 GMT-
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- Development, Implementation, and Meta-Evaluation of a National Approach to
Programmatic Assessment in Canadian Family Medicine Residency Training-
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Authors: Ross; Shelley; Lawrence, Kathrine; Bethune, Cheri; van der Goes, Theresa; Pélissier-Simard, Luce; Donoff, Michel; Crichton, Thomas; Laughlin, Thomas; Dhillon, Kiran; Potter, Martin; Schultz, Karen
Abstract:
The growing international adoption of competency-based medical education has created a desire for descriptions of innovative assessment approaches that generate appropriate and sufficient information to allow for informed, defensible decisions about learner progress. In this article, the authors provide an overview of the development and implementation of the approach to programmatic assessment in postgraduate family medicine training programs in Canada, called Continuous Reflective Assessment for Training (CRAFT). CRAFT is a principles-guided, high-level approach to workplace-based assessment that was intentionally designed to be adaptable to local contexts, including size of program, resources available, and structural enablers and barriers. CRAFT has been implemented in all 17 Canadian family medicine residency programs, with each program taking advantage of the high-level nature of the CRAFT guidelines to create bespoke assessment processes and tools appropriate for their local contexts. Similarities and differences in CRAFT implementation between 5 different family medicine residency training programs, representing both English- and French-language programs from both Western and Eastern Canada, are described. Despite the intentional flexibility of the CRAFT guidelines, notable similarities in assessment processes and procedures across the 5 programs were seen. A meta-evaluation of findings from programs that have published evaluation information supports the value of CRAFT as an effective approach to programmatic assessment. While CRAFT is currently in place in family medicine residency programs in Canada, given its adaptability to different contexts as well as promising evaluation data, the CRAFT approach shows promise for application in other training environments.
PubDate: Wed, 08 Jun 2022 00:00:00 GMT-
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- Debunking the Learning-Styles Hypothesis in Medical Education
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Authors: Artino; Anthony R. Jr; Zafar Iqbal, Muhammad; Crandall, Sonia J.
Abstract:
No abstract available
PubDate: Tue, 10 May 2022 00:00:00 GMT-
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- Waiting for my foot to ring
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Authors: Hicok; Bob
Abstract: No abstract available
PubDate: Tue, 03 May 2022 00:00:00 GMT-
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- Commentary on “Waiting for my foot to ring”
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Authors: Nash; Woods; Childress, Andrew
Abstract: No abstract available
PubDate: Tue, 03 May 2022 00:00:00 GMT-
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- The Lipstick
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Authors: Rapp; Lucie; Vergnes, Jean-Noel
Abstract: No abstract available
PubDate: Tue, 29 Mar 2022 00:00:00 GMT-
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- Commentary on “The Lipstick”
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Authors: Rapp; Lucie; Vergnes, Jean-Noel
Abstract: No abstract available
PubDate: Tue, 29 Mar 2022 00:00:00 GMT-
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- Reimagining the Transition to Residency: A Trainee Call to Accelerated
Action-
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Authors: Lin; Grant L.; Guerra, Sylvia; Patel, Juhee; Burk-Rafel, Jesse
Abstract: The transition from medical student to resident is a pivotal step in the medical education continuum. For applicants, successfully obtaining a residency position is the actualization of a dream after years of training and has life-changing professional and financial implications. These high stakes contribute to a residency application and Match process in the United States that is increasingly complex and dysfunctional, and that does not effectively serve applicants, residency programs, or the public good. In July 2020, the Coalition for Physician Accountability (Coalition) formed the Undergraduate Medical Education-Graduate Medical Education Review Committee (UGRC) to critically assess the overall transition to residency and offer recommendations to solve the growing challenges in the system.
PubDate: Tue, 08 Mar 2022 00:00:00 GMT-
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