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Academic Medicine: Journal of the Association of American Medical Colleges

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https://www.readbyqxmd.com/read/30398993/teaching-critical-thinking-a-case-for-instruction-in-cognitive-biases-to-reduce-diagnostic-errors-and-improve-patient-safety
#1
Celeste S Royce, Margaret M Hayes, Richard M Schwartzstein
Diagnostic errors account for up to 70% of medical errors. Prevention of diagnostic errors is more complex than building safety checks into health care systems; it requires an understanding of critical thinking, of clinical reasoning, and of the cognitive processes through which diagnoses are made. When a diagnostic error is recognized, it is imperative to identify where and how the mistake in clinical reasoning occurred. Cognitive biases may contribute to errors in clinical reasoning. By understanding how physicians make clinical decisions, and examining how errors due to cognitive biases occur, cognitive bias awareness training and de-biasing strategies may be developed to decrease diagnostic errors and patient harm...
November 5, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30398992/leading-practices-and-future-directions-for-technical-standards-in-medical-education
#2
Laura B Kezar, Kristi L Kirschner, Daniel M Clinchot, Elisa Laird-Metke, Philip Zazove, Raymond H Curry
The medical profession first addressed the need for technical standards (TS), defining the non-academic requirements deemed essential for participation in an educational program, in guidelines published by the Association of American Medical Colleges in 1979. Despite many changes in the practice of medicine and legal, cultural, and technological advances that afford greater opportunities for people with disabilities, the profession's approach to TS largely has not changed over the ensuing four decades. Although physicians with disabilities bring unique perspectives to medicine and contribute to a diverse physician workforce of culturally-competent practitioners, they remain underrepresented in the profession...
November 5, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30398991/developing-tomorrow-s-leaders-a-medical-student-distinction-track-in-health-system-transformation-and-leadership
#3
Luan Lawson, Donna Lake, Suzanne Lazorick, Timothy Reeder, Jenna Garris, Elizabeth G Baxley
PROBLEM: Calls for medical education reform focus on preparing physicians to meet the challenges of today's complex health care system. Despite implementing curricula focused on health systems science (HSS), including quality improvement (QI), patient safety, team-based care, and population health, a significant gap remains in training students to meet the system's evolving needs. APPROACH: Brody School of Medicine redesigned its curriculum to prepare leaders to effect health system change...
November 5, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30398990/reconfiguring-a-one-way-street-a-position-paper-on-why-and-how-to-improve-equity-in-global-physician-training
#4
James C Hudspeth, Tracy L Rabin, Bradley A Dreifuss, Mylo Schaaf, Michael S Lipnick, Christiana M Russ, Amy Meg Autry, Michael B Pitt, Virginia Rowthorn
Large numbers of U.S. physicians and medical trainees engage in hands-on clinical global health experiences abroad, where they gain skills working across cultures with limited resources. Increasingly, these experiences are becoming bidirectional, with providers from low- and middle-income countries traveling to experience health care in the United States, yet the same hands-on experiences afforded stateside physicians are rarely available for foreign medical graduates or postgraduate trainees when they arrive...
November 5, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30379665/is-it-time-to-be-more-explicit-about-the-purpose-of-a-hospital-admission
#5
Mark Goldszmidt, Lisa Faden, Katherina Baranova
PURPOSE: Patient care suffers when teaching teams fail to achieve a shared understanding of problems to be addressed during a hospital admission. In academic contexts where attending physicians take turns supervising, practice variability may contribute to undermining this shared understanding. Exploring variability around what constitutes the purpose of admission to hospital was the focus of this study. METHOD: Constructivist grounded theory was used to inform data collection and analysis of this two-phase study, conducted at London and Hamilton, Ontario, 2012...
October 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30379664/a-philosophical-approach-to-addressing-uncertainty-in-medical-education
#6
Mark R Tonelli, Ross E G Upshur
Conveying the uncertainty inherent in clinical practice has rightly become a focus of medical training. To date, much of the emphasis aims to encourage trainees to acknowledge and accept uncertainty. Intolerance of uncertainty is associated with medical student distress and a tendency in clinicians toward overtreatment. The authors argue that a deeper, philosophical understanding of the nature of uncertainty would allow students and clinicians to move beyond simple acceptance to explicating and mitigating uncertainty in practice...
October 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30379663/centro-sol-a-community-academic-partnership-to-care-for-undocumented-immigrants-in-an-emerging-latino-area
#7
Sarah Polk, Lisa R DeCamp, Mónica Guerrero Vázquez, Kathryn Kline, Adriana Andrade, Barbara Cook, Tina Cheng, Kathleen R Page
PROBLEM: From 2000 to 2014, the Latino population in Baltimore city, an emerging Latino settlement area, has experienced rapid growth. Many of these individuals are undocumented and not eligible for coverage. Academic medical centers often lead the way in addressing the health needs of undocumented immigrants, however, examples from emerging immigrant areas are limited. APPROACH: In October 2013, Johns Hopkins Medicine clinicians established the Center for Salud/Health and Opportunities for Latinos (Centro SOL) to better address the health needs of Baltimore's growing Latino community...
October 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30379662/medical-student-deaths-by-suicide-the-importance-of-transparency
#8
Benjamin M Laitman, David Muller
In this Invited Commentary, the authors present a call to action regarding the paucity of data related to medical student deaths by suicide. They review the limited literature on medical student suicide and suggest that no comprehensive study has ever occurred. They believe that the available data are too limited to conclude what the rate of death by suicide is among medical students compared to their age-matched peers. The authors speculate that the lack of accurate data may be related both to reluctance on the part of schools to report deaths by suicide, and to the failure of national organizations like the Association of American Medical Colleges, Accreditation Council for Graduate Medical Education, and Liaison Committee on Medical Education to mandate reporting...
October 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30379661/validity-evidence-for-a-brief-online-key-features-examination-in-the-internal-medicine-clerkship
#9
Valerie J Lang, Norman B Berman, Kirk Bronander, Heather Harrell, Susan Hingle, Amy Holthouser, Debra Leizman, Clifford D Packer, Yoon Soo Park, T Robert Vu, Rachel Yudkowsky, Sandra Monteiro, Georges Bordage
PURPOSE: Medical educators use key features examinations (KFEs) to assess clinical decision making in many countries, but not in U.S. medical schools. The authors developed an online KFE to assess third-year medical students' decision-making abilities during internal medicine (IM) clerkships in the United States. They used Messick's unified validity framework to gather validity evidence regarding response process, internal structure, and relationship to other variables. METHOD: From February 2012 through January 2013, 759 students (at 8 U...
October 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30379660/time-to-reevaluate-the-away-rotation-improving-return-on-investment-for-students-and-schools
#10
Max Griffith, Stephanie C DeMasi, Abigail J McGrath, Jeffrey N Love, Joel Moll, Sally A Santen
Away rotations are common among senior medical students preparing to apply for residency. For competitive specialties, multiple away rotations may be viewed as a de facto requirement for a strong application. Although away rotations are often valuable learning experiences, a variety of noneducational factors motivate students to enroll, including the need for letters of recommendation, students' uncertainty regarding their strength as applicants, perceived competitiveness of residency applications, and conflicting guidance from advisors...
October 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30379659/leadership-development-in-postgraduate-medical-education-a-systematic-review-of-the-literature
#11
Nabil Sultan, Jacqueline Torti, Wael Haddara, Ali Inayat, Hamza Inayat, Lorelei Lingard
PURPOSE: To evaluate and interpret evidence relevant to leadership curricula in post-graduate medical education (PGME) to better understand leadership development in residency training. METHOD: The authors conducted a systematic review of peer-reviewed, English-language articles from four databases published between 1980 and May 2, 2017 that describe specific interventions aimed at leadership development. They characterized the educational setting, curricular format, learner level, instructor type, pedagogical methods, conceptual leadership framework (including intervention domain), and evaluation outcomes...
October 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30334843/advocacy-training-for-residents-insights-from-tulane-s-internal-medicine-residency-program
#12
Jane Andrews, Catherine Jones, Jeanette Tetrault, Kris Coontz
PROBLEM: Physicians have unique insights into the impact of government policies on vulnerable populations. Sharing these with legislators can help them design policy solutions to address public health challenges such as the opioid epidemic, drug pricing, and gun violence. However, despite widespread interest among residents in advocacy and systems-based change, most physicians receive no formal training in the skills needed to become effective physician-advocates. Advocacy training curricula for residents can equip trainees with skills to bridge this gap...
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30334842/transforming-resident-assessment-an-analysis-using-deming-s-system-of-profound-knowledge
#13
Eric J Warm, Benjamin Kinnear, Matthew Kelleher, Dana Sall, Eric Holmboe
W. Edwards Deming, in his System of Profound Knowledge, asserts that leaders who wish to transform a system should understand four essential elements: appreciation for a system, theory of knowledge, knowledge about variation, and psychology. The Accreditation Council for Graduate Medical Education (ACGME) introduced the milestones program as a part of the Next Accreditation System to create developmental language for the six core competencies and facilitate programmatic assessment within graduate medical education systems...
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30334841/the-social-media-editor-at-medical-journals-responsibilities-goals-barriers-and-facilitators
#14
Melany Lopez, Teresa M Chan, Brent Thoma, Vineet M Arora, N Seth Trueger
PURPOSE: To determine the responsibilities of journal social media editors (SMEs) and describe their goals and barriers and facilitators to their position. METHOD: The authors identified SMEs using an informal listserv and snowball sampling. Participants were interviewed (June-July 2016) about their position, including responsibilities, goals, barriers and facilitators, and attitudes and perceptions about the position. Themes were identified through a thematic analysis and consensus building approach...
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30334840/the-power-of-subjectivity-in-the-assessment-of-medical-trainees
#15
Olle Ten Cate, Glenn Regehr
Objectivity in the assessment of students and trainees has been a hallmark of quality since the introduction of multiple-choice items in the 1960s. In medical education, this has extended to the structured examination of clinical skills and workplace-based assessment. Competency-based medical education, a pervasive movement that started roughly around the turn of the century, similarly calls for rigorous, objective assessment to ensure that all medical trainees meet standards to assure quality of health care...
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30334839/the-association-between-residency-learning-climate-and-inpatient-care-experience-in-clinical-teaching-departments-in-the-netherlands
#16
Alina Smirnova, Onyebuchi A Arah, Renée E Stalmeijer, Kiki M J M H Lombarts, Cees P M van der Vleuten
PURPOSE: To examine the association between residency learning climate and inpatient care experience. METHOD: The authors analyzed 1,201 evaluations of the residency learning climate (using the Dutch Residency Educational Climate Test questionnaire) and 6,689 evaluations of inpatient care experience (using the Consumer Quality Index Inpatient Hospital Care questionnaire) from 86 departments across 15 specialties in 18 hospitals in the Netherlands between 2013 and 2014...
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30334838/learning-how-to-build-illness-scripts
#17
Katherine Gavinski, Yvonne N Covin, Palma J Longo
No abstract text is available yet for this article.
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30334837/social-determinants-of-health-training-in-u-s-primary-care-residency-programs-a-scoping-review
#18
Lauren A Gard, Jonna Peterson, Corrine Miller, Nilasha Ghosh, Quentin Youmans, Aashish Didwania, Stephen D Persell, Muriel Jean-Jacques, Paul Ravenna, Matthew J O'Brien, Mita Sanghavi Goel
PURPOSE: Medical training has traditionally focused on the proximate determinants of disease, with little focus on how social conditions influence health. The authors conducted a scoping review of existing curricula to understand the current programs designed to teach primary care residents about the social determinants of health (SDH). METHOD: In January and March 2017, the authors searched seven databases. Eligible articles focused on primary care residents, described a curriculum related to SDH, were published between January 2007 and January 2017, and were based in the United States...
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30334836/the-medical-education-partnership-initiative-strengthening-human-resources-to-end-aids-and-improve-health-in-africa
#19
Peter H Kilmarx, Flora Katz, Myat Htoo Razak, John Palen, Laura W Cheever, Roger I Glass
Faced with a critical shortage of physicians in Africa, which hampered the efforts of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Medical Education Partnership Initiative (MEPI) was established in 2010 to increase the number of medical graduates, the quality of their education, and their retention in Africa. To summarize the accomplishments of the initiative, lessons learned, and remaining challenges, the authors conducted a narrative review of MEPI-from the perspectives of the U.S. government funding agencies and implementing agencies-by reviewing reports from grantee institutions and conducting a search of scientific publications about MEPI...
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/30303815/socially-accountable-academic-health-centers-pursuing-a-quadripartite-mission
#20
Herbert C Smitherman, Richard S Baker, M Roy Wilson
Academic health centers (AHCs) in the United States have had a leading role in educating the medical workforce, generating new biomedical knowledge, and providing tertiary and quaternary clinical care. Yet the health status of the U.S. population lags behind that of almost every other developed world economy. One reason is that the health care system is not organized optimally to address the major driver of health status, the social determinants of health (SDOH). The United States' overall poor health status is a reflection of dramatic disparities in health that exist between communities and population groups, and these are associated with variations in the underlying SDOH...
October 9, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
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