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Academic Medicine: Journal of the Association of American Medical Colleges

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https://www.readbyqxmd.com/read/28422816/why-not-wait-eight-institutions-share-their-experiences-moving-united-states-medical-licensing-examination-step-1-after-core-clinical-clerkships
#1
Michelle Daniel, Amy Fleming, Colleen O'Conner Grochowski, Vicky Harnik, Sibel Klimstra, Gail Morrison, Arnyce Pock, Michael L Schwartz, Sally Santen
The majority of medical students complete the United States Medical Licensing Examination Step 1 after their foundational sciences; however, there are compelling reasons to examine this practice. This article provides the perspectives of eight MD-granting medical schools that have moved Step 1 after the core clerkships, describing their rationale, logistics of the change, outcomes, and lessons learned. The primary reasons these institutions cite for moving Step 1 after clerkships are to foster more enduring and integrated basic science learning connected to clinical care and to better prepare students for the increasingly clinical focus of Step 1...
April 18, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28422815/no-time-for-silence-an-urgent-need-for-political-activism-among-the-medical-community
#2
Erik Levinsohn, Karrin Weisenthal, Priscilla Wang, Andi Shahu, Matthew Meizlish, Talia Robledo-Gil, Eamon Duffy, Samara Fox, Juliana Berk-Krauss
Despite being a major stakeholder in the U.S. health care system, the medical community has remained relatively mute in the debate over the future of the Patient Protection and Affordable Care Act (ACA). If the ACA were repealed, tens of millions of Americans would be in danger of losing their insurance, resulting in a significant increase in mortality. Because misinformation about the ACA is rampant, it is imperative that health care providers explain to the public what exactly the ACA is and how repeal will affect patients...
April 18, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28422814/the-effect-of-rubric-guided-focused-personalized-coaching-sessions-and-video-recorded-presentations-on-teaching-skills-among-fourth-year-medical-students-a-pilot-study
#3
Vatche Tchekmedyian, Helen M Shields, Stephen R Pelletier, Valeria C Pazo
PROBLEM: As medical students become residents, teaching becomes an expected and integral responsibility. Yet, training-for-teaching opportunities are lacking. In 2014, the authors designed a pilot study using rubric-guided, focused, personalized coaching sessions and video-recorded presentations to improve student teaching skills among fourth-year students at Harvard Medical School. APPROACH: In 2014-2015, the authors recruited students from an elective on how to tutor preclinical students for the pilot, which consisted of four phases: a precoaching teaching presentation, a 30- to 45-minute coaching session, a postcoaching teaching presentation, and blinded reviewer ratings...
April 18, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28403005/impact-of-patient-affect-on-physician-estimate-of-probability-of-serious-illness-and-test-ordering
#4
Jeffrey A Kline, Dawn Neumann, Samih Raad, David L Schriger, Cassandra L Hall, Jake Capito, David Kammer
PURPOSE: The authors hypothesize patient facial affect may influence clinician pretest probability (PTP) estimate of cardiopulmonary emergency (CPE) and desire to order a computerized tomographic pulmonary angiogram (CTPA). METHOD: This prospective study was conducted at three Indiana University-affiliated hospitals in two parts: collecting videos of patients undergoing CTPA for suspected acute pulmonary embolism watching a humorous video (August 2014-April 2015) and presenting the medical histories and videos to clinicians to determine the impact of patient facial affect on physicians' PTP estimate of CPE and desire to order a CTPA (June-November 2015)...
April 11, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28403004/the-hidden-value-of-narrative-comments-for-assessment-a-quantitative-reliability-analysis-of-qualitative-data
#5
Shiphra Ginsburg, Cees P M van der Vleuten, Kevin W Eva
PURPOSE: In-training evaluation reports (ITERs) are ubiquitous in internal medicine (IM) residency. Written comments can provide a rich data source, yet are often overlooked. This study determined the reliability of using variable amounts of commentary to discriminate between residents. METHOD: ITER comments from two cohorts of PGY-1s in IM at the University of Toronto (graduating 2010 and 2011; n = 46-48) were put into sets containing 15 to 16 residents. Parallel sets were created: one with comments from the full year and one with comments from only the first three assessments...
April 11, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28379936/the-steps-model-a-practical-tool-for-engaging-communities-to-improve-health-outcomes
#6
Alexandra Adams, Amy Williamson, Christine Sorkness, Peggy Hatfield, Amanda Eggen, Sarah Esmond
No abstract text is available yet for this article.
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28379935/simulation-fellowship-programs-an-international-survey-of-program-directors
#7
Brenda Natal, Demian Szyld, Scott Pasichow, Zia Bismilla, Jonathan Pirie, Adam Cheng
PURPOSE: To report on the evolution of simulation-based training (SBT) by identifying the composition and infrastructure of existing simulation fellowship programs, describing the current training practices, disclosing existing program barriers, and highlighting opportunities for standardization. METHOD: Investigators conducted a cross-sectional survey study among English-speaking simulation fellowship program directors (September 2014-September 2015). They identified fellowships through academic/institutional Web sites, peer-reviewed literature, Web-based search engines, and snowball sampling...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28379934/electronic-medical-records-medical-students-and-ambulatory-family-physicians-a-multi-institution-study
#8
Jordan White, David Anthony, Vince WinklerPrins, Steven Roskos
PURPOSE: Medical students commonly encounter electronic medical records (EMRs) in their ambulatory family medicine clerkships, but how students interact with this technology varies tremendously and presents challenges to students and preceptors. Little research to date has evaluated the impact of EMRs on medical student education in the ambulatory setting; this three-institution study aimed to identify behaviors of ambulatory family medicine preceptors as they relate to EMRs and medical students...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28379933/communities-social-justice-and-academic-health-centers
#9
Philip M Alberti, Karey M Sutton, Lisa A Cooper, Wendy G Lane, Stacey Stephens, Michelle A Gourdine
In November 2015, the Association of American Medical Colleges (AAMC) held its annual meeting in Baltimore, Maryland. In response both to health and health care inequities faced by residents of Baltimore and to the imminent trial of the police officers charged with Freddie Gray's death, AAMC leaders thought it crucial to address issues of health inequity, social injustice, and the role an academic health center (AHC) can play in improving the health of the community it serves. In collaboration with community-engaged researchers from Johns Hopkins University and University of Maryland, Baltimore, AAMC staff interviewed Baltimore residents, soliciting their perspectives on how medical education, clinical care, and research can and should respond to social injustice and the social determinants of health...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28379932/toward-an-optimal-pedagogy-for-teamwork
#10
Mark A Earnest, Jason Williams, Eva M Aagaard
Teamwork and collaboration are increasingly listed as core competencies for undergraduate health professions education. Despite the clear mandate for teamwork training, the optimal method for providing that training is much less certain. In this Perspective, the authors propose a three-level classification of pedagogical approaches to teamwork training based on the presence of two key learning factors: interdependent work and explicit training in teamwork. In this classification framework, level 1-minimal team learning-is where learners work in small groups but neither of the key learning factors is present...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28379931/an-expanded-conceptual-framework-of-medical-students-primary-care-career-choice
#11
Eva Pfarrwaller, Marie-Claude Audétat, Johanna Sommer, Hubert Maisonneuve, Thomas Bischoff, Mathieu Nendaz, Anne Baroffio, Noëlle Junod Perron, Dagmar M Haller
In many countries, the number of graduating medical students pursuing a primary care career does not meet demand. These countries face primary care physician shortages. Students' career choices have been widely studied, yet many aspects of this process remain unclear. Conceptual models are useful to plan research and educational interventions in such complex systems.The authors developed a framework of primary care career choice in undergraduate medical education, which expands on previously published models...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28379930/from-inputs-to-impacts-assessing-and-communicating-the-full-value-of-biomedical-research
#12
Ann C Bonham, Philip M Alberti
Assessing and communicating the full value of biomedical research is essential to answer calls from the government and the public demanding accountability for the spending of public funds. In academic settings, however, research success is measured largely in terms of grant funding received or the number of peer-reviewed publications produced. These credible and time-tested metrics miss the full picture of the scientific process, which continues to confer benefits to patients, communities, and the health care system well after an article is published...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28379929/associations-between-physician-empathy-physician-characteristics-and-standardized-measures-of-patient-experience
#13
Alexander Chaitoff, Bob Sun, Amy Windover, Daniel Bokar, Joseph Featherall, Michael B Rothberg, Anita D Misra-Hebert
PURPOSE: To identify correlates of physician empathy and determine whether physician empathy is related to standardized measures of patient experience. METHOD: Demographic, professional, and empathy data were collected during 2013-2015 from Cleveland Clinic Health System physicians prior to participation in mandatory communication skills training. Empathy was assessed using the Jefferson Scale of Empathy. Data were also collected for seven measures (six provider communication items and overall provider rating) from the visit-specific and 12-month Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) surveys...
April 4, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28353506/a-foundation-for-vital-academic-and-social-support-in-clerkships-learning-through-peer-continuity
#14
Calvin L Chou, Arianne Teherani
Most medical students on clerkships currently experience lack of continuity of patient care, disjointed learning, and frequent changes in supervisors. Clerkship programs with continuity of care, curriculum, and supervisors appear to benefit student learning and patient-centeredness. A fourth form of continuity is proposed: continuity of peers, in which a stable cohort of students frequently meets to process their experiences on clerkships. This structure builds on benefits previously seen in peer-assisted learning, including enhanced knowledge, technical skills, and collegial peer relationships...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28353505/changes-in-resident-well-being-at-one-institution-across-a-decade-of-progressive-work-hours-limitations
#15
Michael F Krug, Anna L Golob, Pandora L Wander, Joyce E Wipf
PURPOSE: To measure changes in markers of resident well-being over time as progressive work hours limitations (WHLs) were enforced, and to investigate resident perceptions of the 2011 WHLs. METHOD: A survey study of internal medicine residents was conducted at the University of Washington's multihospital residency program in 2012. The survey included validated well-being questions: the Maslach Burnout Inventory, the two-question PRIME-MD depression screen, and career satisfaction questions...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28353504/ways-to-write-a-milestone-approaches-to-operationalizing-the-development-of-competence-in-graduate-medical-education
#16
Andrea N Leep Hunderfund, Darcy A Reed, Stephanie R Starr, Rachel D Havyer, Tara R Lang, Suzanne M Norby
PURPOSE: To identify approaches to operationalizing the development of competence in Accreditation Council for Graduate Medical Education (ACGME) milestones. METHOD: The authors reviewed all 25 "Milestone Project" documents available on the ACGME Web site on September 11, 2013, using an iterative process to identify approaches to operationalizing the development of competence in the milestones associated with each of 601 subcompetencies. RESULTS: Fifteen approaches were identified...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28353503/what-should-guide-health-policy-a-perspective-beyond-politics
#17
Darrell G Kirch, Cori Ast
As the U.S. electorate has become increasingly polarized, these divisions are poised to shape legislative and regulatory work in the years ahead. For those whose focus is on the public goods of health care for all, the advancement of science through rigorous research, and the contribution of higher education to the continual improvement of the nation's workforce, there is profound uncertainty about the future. There are several pressing questions facing the nation and academic medicine, including the future of affordable, accessible insurance; acceptance of scientific evidence; sustainable learning and teaching methodologies; and the well-being and preparation of the nation's health workforce to care for an increasingly diverse nation...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28353502/looking-under-the-streetlight-a-framework-for-differentiating-performance-measures-by-level-of-care-in-a-value-based-payment-environment
#18
James M Naessens, Monica B Van Such, Robert E Nesse, James A Dilling, Stephen J Swensen, Kristine M Thompson, Janis M Orlowski, Paula J Santrach
The majority of quality measures used to assess providers and hospitals are based on easily obtained data, focused on a few dimensions of quality, and developed mainly for primary/community care and population health. While this approach supports efforts focused on addressing the triple aim of health care, many current quality report cards and assessments do not reflect the breadth or complexity of many referral center practices.In this article, the authors highlight the differences between population health efforts and referral care and address issues related to value measurement and performance assessment...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28353501/cooperative-extension-as-a-framework-for-health-extension-the-michigan-state-university-model
#19
Jeffrey W Dwyer, Dawn Contreras, Cheryl L Eschbach, Holly Tiret, Cathy Newkirk, Erin Carter, Linda Cronk
PROBLEM: The Affordable Care Act charged the Agency for Healthcare Research and Quality to create the Primary Care Extension Program, but did not fund this effort. The idea to work through health extension agents to support health care delivery systems was based on the nationally known Cooperative Extension System (CES). Instead of creating new infrastructure in health care, the CES is an ideal vehicle for increasing health-related research and primary care delivery. APPROACH: The CES, a long-standing component of the land-grant university system, features a sustained infrastructure for providing education to communities...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28353500/how-can-medical-students-add-value-identifying-roles-barriers-and-strategies-to-advance-the-value-of-undergraduate-medical-education-to-patient-care-and-the-health-system
#20
Jed D Gonzalo, Michael Dekhtyar, Richard E Hawkins, Daniel R Wolpaw
PURPOSE: As health systems evolve, the education community is seeking to reimagine student roles that combine learning with meaningful contributions to patient care. The authors sought to identify potential stakeholders regarding the value of student work, and roles and tasks students could perform to add value to the health system, including key barriers and associated strategies to promote value-added roles in undergraduate medical education. METHOD: In 2016, 32 U...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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