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Academic Medicine: Journal of the Association of American Medical Colleges

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https://www.readbyqxmd.com/read/30211755/moving-the-united-states-medical-licensing-examination-step-1-after-core-clerkships-an-outcomes-analysis
#1
Daniel Jurich, Michelle Daniel, Miguel Paniagua, Amy Fleming, Victoria Harnik, Arnyce Pock, Aubrie Swan-Sein, Michael A Barone, Sally A Santen
PURPOSE: Schools undergoing curricular reform are reconsidering the optimal timing of Step 1. This study provides a psychometric investigation of the impact on United States Medical Licensing Examination Step 1 scores of changing the timing of Step 1 from after completion of the basic science curricula to after core clerkships. METHOD: Data from four schools that recently moved the examination were analyzed in a pre-post format using examinee scores from three years before and after the change...
September 11, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30211754/overshadowed-by-assessment-understanding-trainee-and-supervisor-perspectives-on-the-oral-case-presentation-in-internal-medicine-workplace-based-assessment
#2
Lindsay Melvin, James Rassos, Daniel Panisko, Erik Driessen, Kulamakan M Kulasegaram, Ayelet Kuper
PURPOSE: The oral case presentation (OCP) is an essential part of daily clinical practice in internal medicine (IM) and a key competency in medical education. It is not known how supervisors and trainees perceive OCPs in workplace-based learning and assessment. METHOD: Using a constructivist grounded theory approach, 26 semistructured interviews were held with trainees and supervisors (18 clinical clerks and first- through third-year postgraduate trainees, and 8 supervisors) on the IM clinical teaching unit at the University of Toronto, 2015-2016...
September 11, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30211753/improving-employee-voice-about-transgressive-or-disruptive-behavior-a-case-study
#3
Mary Dixon-Woods, Anne Campbell, Graham Martin, Janet Willars, Carolyn Tarrant, Emma-Louise Aveling, Kathleen Sutcliffe, Janice Clements, Michelle Carlstrom, Peter Pronovost
PURPOSE: Employee voice plays an important role in organizational intelligence about patient safety hazards and other influences on quality of patient care. The authors report a case study of an academic medical center that aimed to understand barriers to voice and make improvements in identifying and responding to transgressive or disruptive behaviors. METHOD: The case study focuses on an improvement effort at Johns Hopkins Medicine that sought to improve employee voice using a two-phase approach of diagnosis and intervention...
September 11, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30211752/assessing-the-effectiveness-of-using-mechanistic-concept-maps-in-case-based-collaborative-learning
#4
Krisztina Fischer, Amy M Sullivan, Edward Krupat, Richard M Schwartzstein
PROBLEM: Despite the advantages of using mechanistic concept maps (MCMs)-diagrams created individually or collaboratively by a team to foster inductive analysis of a clinical problem-in individual learning, very little is known about their benefits in collaborative learning. APPROACH: First-year medical and dental students (n = 170) were assigned to one of four learning groups in the Homeostasis I course, Harvard Medical School, February-March 2016. One group (n = 43) was randomly assigned to the MCM intervention; students in the remaining groups (n = 127) served as controls...
September 11, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30188373/the-association-between-a-holistic-review-in-admissions-workshop-and-the-diversity-of-accepted-applicants-and-students-matriculating-to-medical-school
#5
Douglas Grbic, Emory Morrison, Henry M Sondheimer, Sarah S Conrad, Jeffrey F Milem
PURPOSE: The authors tested for an association between the Association of American Medical Colleges' holistic review in admissions (HRA) workshop and the compositional diversity of medical school accepted applicants and matriculants in schools that held workshops compared to those that did not. METHOD: The authors examined school-level data from 134 medical schools accredited by the Liaison Committee on Medical Education for the years 2006-2016 using information from the American Medical College Application Service...
September 4, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30188372/developing-professionalism-and-professional-identity-through-unproctored-flexible-testing
#6
Paula T Ross, Meg G Keeley, Rajesh S Mangrulkar, Reena Karani, Peter Gliatto, Sally A Santen
The medical education community has devoted a great deal of attention to the development of professionalism in trainees within the context of clinical training-particularly regarding trainees' handling of ethical dilemmas related to clinical care. The community, however, knows comparatively less about the development of professional behavior in medical students during the preclerkship years. In medical schools with flexible testing, students take quizzes or examinations in an unproctored setting at a time of their choosing-as long as it falls within a specified window of time...
September 4, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30188371/competing-risks-analysis-of-promotion-and-attrition-in-academic-medicine-a-national-study-of-u-s-medical-school-graduates
#7
Donna B Jeffe, Yan Yan, Dorothy A Andriole
PURPOSE: Competing risk methodology was used to identify variables associated with promotion and attrition of newly appointed full-time instructors or assistant professors in U.S. LCME-accredited medical schools. METHOD: A national sample of U.S. MD-granting medical school graduates in calendar years 1997-2004, who received initial full-time instructor or assistant professor appointments from January 1, 2000 through December 31, 2012, was followed through December 31, 2013...
September 4, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30188370/do-admissions-multiple-mini-interview-and-traditional-interview-scores-predict-subsequent-academic-performance-a-study-of-five-california-medical-schools
#8
Anthony Jerant, Mark C Henderson, Erin Griffin, Theodore R Hall, Carolyn J Kelly, Ellena M Peterson, David Wofsy, Daniel J Tancredi, Francis J Sousa, Peter Franks
PURPOSE: To compare the predictive validities of medical school admissions multiple mini-interviews (MMIs) and traditional interviews (TIs). METHOD: This longitudinal observational study of 2011-2013 matriculants to five California public medical schools examined the associations of MMI scores (two schools) and TI scores (three schools) with subsequent academic performance. Regression models adjusted for socio-demographics and undergraduate academic metrics examined associations of standardized mean MMI and TI scores with United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge (CK) scores, and, for required clerkships, with mean National Board of Medical Examiners Clinical Science subject (shelf) exam score and number of honors grades...
September 4, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30188369/employing-a-root-cause-analysis-process-to-improve-examination-quality
#9
Sally A Santen, Karri L Grob, Seetha U Monrad, Caren M Stalburg, Gary Smith, Robin R Hemphill, Nikki L Bibler Zaidi
PROBLEM: Multiple-choice question (MCQ) examinations represent a primary mode of assessment used by medical schools. It can be challenging for faculty to produce content-aligned, comprehensive, and psychometrically sound MCQs. Despite best efforts, sometimes there are unexpected issues with examinations. Assessment best practices lack a systematic way to address gaps when actual and expected outcomes do not align. APPROACH: The authors propose using root cause analysis (RCA) to systematically review unexpected educational outcomes...
September 4, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30188368/using-the-clerkship-shelf-exam-score-as-a-qualification-for-an-overall-clerkship-grade-of-honors-a-valid-practice-or-unfair-to-students
#10
David C Schilling
Most clerkships require medical students to pass the National Board of Medical Examiners (NBME) subject (shelf) exam in order to pass the clerkship. Many use the NBME's recommended honors cut score on the shelf exam to determine medical student eligibility for an overall clerkship grade of honors. This use of a conjunctive scoring model for determining honors is inconsistent with the logic behind the intended use of this model for making pass/fail determinations. Further, many clerkships use grading systems that employ both this conjunctive model for honors eligibility and a compensatory scoring model for determining the overall clerkship grade...
September 4, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30188367/a-prognostic-index-to-identify-the-risk-of-developing-depression-symptoms-among-u-s-medical-students-derived-from-a-national-four-year-longitudinal-study
#11
Liselotte N Dyrbye, Natalie M Wittlin, Rachel R Hardeman, Mark Yeazel, Jeph Herrin, John F Dovidio, Sara E Burke, Brooke Cunningham, Sean M Phelan, Tait D Shanafelt, Michelle van Ryn
PURPOSE: To determine baseline individual and school-related factors associated with increased risk of developing depression symptoms by year four (Y4) of medical school, and to develop a prognostic index that stratifies risk of developing depression symptoms (Depression-PI) among medical students. METHOD: The authors analyzed data from 3,743 students (79% of 4,732) attending 49 U.S. medical schools who completed baseline (2010) and Y4 (2014) surveys. Surveys included validated scales measuring depression, stress, coping, and social support...
September 4, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30188366/ethical-use-of-student-profiles-to-predict-and-prevent-development-of-depression-symptoms-during-medical-school
#12
Grace W Gengoux, Laura Weiss Roberts
Research investigations have repeatedly shown that medical school can be a period of high stress and deteriorating mental health for many students. There is a critical need for systematic guidance on how to personalize prevention and treatment programming to help those students at highest risk. The authors of this Invited Commentary respond to the report by Dyrbye and colleagues, published in this issue of Academic Medicine, that proposes a prognostic index to predict risk of developing depression symptoms in medical students...
September 4, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30157092/you-belong-in-the-room-addressing-the-underrepresentation-of-physicians-with-physical-disabilities
#13
Charlotte M Schwarz, Marygrace Zetkulic
In this Invited Commentary, the authors use personal experiences to highlight how obstacles for qualified candidates with physical disabilities persist in medical education, especially at entry to and early stages of training. In an era when medical schools and residency programs advocate principles of diversity and inclusion, it is estimated that medical students with physical disabilities still comprise less than 1% of learners. The authors present four constructive actions to address the underrepresentation of individuals with physical disabilities in medical schools: 1) acknowledging biases 2) building networks 3) reassessing the undifferentiated model of medical education, and 4) advocating the advantages of physicians with disabilities...
August 28, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30157091/getting-real-aligning-the-learning-needs-of-clerkship-students-with-the-current-clinical-environment
#14
Debra L Klamen, Reed Williams, Susan Hingle
The authors present follow-up to a prior publication, which proposed a new model for third-year clerkships. The new model was created to address deficiencies in the clinical year and to rectify a recognized mismatch between students' learning needs and the realities of today's clinical settings. The new curricular model was implemented at Southern Illinois University School of Medicine in academic year 2016-2017.Guiding principles were developed. These were to more deeply engage students in experiential learning through clinical immersion; to pair individual faculty with individual students over longer periods of time so real trust could be developed; to provide students with a longitudinal clinical reasoning education under controlled instructional conditions; to simplify goals and objectives for the core clerkships and align them with student learning needs; and to provide students with individualized activities to help them explore areas of interest, choose their specialty, and improve areas of clinical weakness before the fourth year...
August 28, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30157090/approaches-to-teaching-the-physical-exam-to-preclerkship-medical-students-results-of-a-national-survey
#15
Toshiko Uchida, Yoon Soo Park, Robin K Ovitsh, Joanne Hojsak, Deepthiman Gowda, Jeanne M Farnan, Mary Boyle, Angela D Blood, Francis I Achike, Ronald C Silvestri
PURPOSE: To assess current approaches to teaching the physical exam to preclerkship students at U.S. medical schools. METHOD: The Directors of Clinical Skills Courses (DOCS) developed a 49-question survey addressing the approach, pedagogical methods, and assessment methods of preclerkship physical exam curricula. The survey was administered to all 141 LCME-accredited U.S. medical schools in October 2015. Results were aggregated across schools, and survey weights were used to adjust for response rate and school size...
August 28, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30157089/medical-student-suicide-rates-a-systematic-review-of-the-historical-and-international-literature
#16
Caren J Blacker, Charles P Lewis, Cosima C Swintak, J Michael Bostwick, Sandra J Rackley
PURPOSE: Physician suicide rates are reportedly higher than those of the general population, but medical student suicide rates are not well studied. It is difficult to determine whether physician suicide rates can be predicted by medical student risk factors for suicide and to identify those risk factors without knowing medical student suicide rates. The authors systematically reviewed the literature to collate data on medical student suicide rates. METHOD: The authors searched the PubMed, Web of Science, and Library of Congress databases for papers published in any language before November 11, 2017...
August 28, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30157088/predicting-performance-of-first-year-residents-correlations-between-structured-interview-licensure-exam-and-competency-scores-in-a-multi-institutional-study
#17
Brittany Marcus-Blank, Jeffrey A Dahlke, Jonathan P Braman, Emily Borman-Shoap, Ezgi Tiryaki, Jeffrey Chipman, John S Andrews, Paul R Sackett, Michael J Cullen
PURPOSE: To determine whether scores on structured interview (SI) questions designed to measure noncognitive competencies in physicians (1) predict subsequent first-year resident performance on Accreditation Council for Graduate Medical Education (ACGME) milestones and (2) add incremental validity over United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores in predicting performance. METHOD: The authors developed 18 behavioral description questions to measure key noncognitive competencies (e...
August 28, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30157087/intervention-descriptions-in-medical-education-what-can-be-improved-a-systematic-review-and-checklist
#18
Jennita G Meinema, Nienke Buwalda, Faridi S van Etten-Jamaludin, Mechteld R M Visser, Nynke van Dijk
PURPOSE: Many medical education studies focus on the effectiveness of educational interventions. However, these studies often lack clear, thorough descriptions of interventions that would make the interventions replicable. This systematic review aimed to identify gaps and limitations in the descriptions of educational interventions, using a comprehensive checklist. METHOD: Based on the literature, the authors developed a checklist of 17 criteria for thorough descriptions of educational interventions in medical education...
August 28, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30134272/changes-in-physicians-intrapersonal-empathy-after-a-communication-skills-training-in-japan
#19
Yu Yamada, Maiko Fujimori, Yuki Shirai, Hitomi Ninomiya, Takakazu Oka, Yosuke Uchitomi
PURPOSE: To investigate if physicians' intrapersonal empathy increased after a communication skills training (CST) workshop. METHOD: Participants were oncologists from across Japan with three or more years of clinical experience in oncology. They were recruited through the Internet and via direct contact by the workshop organizers. Participants attended one of 132 two-day CST workshops, held between November 2007 and March 2011. Prior to the workshop (baseline/T1), participants completed a survey with demographic questions, the Jefferson Scale of Physician Empathy (JSPE), and the Interpersonal Reactivity Index (IRI)...
August 21, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30134271/defining-empathy-to-better-teach-measure-and-understand-its-impact
#20
Anne M Dohrenwend
No consensus on the definition of empathy exists. Empathy has been described as emotional and spontaneous, cognitive and deliberate, or some combination of the two. Attentive non-verbal reactions, feeling reflections, reassurance, sympathy, and compassion all have been conflated with empathy, making it impossible to differentiate empathy from other communication skills. This confusion over the definition of empathy has affected its measurement. For example, the authors of the Interpersonal Reactivity Index see empathy as multidimensional, involving both emotional and cognitive aspects, while the authors of the Jefferson Scale of Physician Empathy see empathy as a predominately cognitive process...
August 21, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
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