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Academic Medicine: Journal of the Association of American Medical Colleges

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https://www.readbyqxmd.com/read/29166355/restoring-faculty-vitality-in-academic-medicine-when-burnout-threatens
#1
Darshana T Shah, Valerie N Williams, Luanne E Thorndyke, E Eugene Marsh, Roberta E Sonnino, Steven M Block, Thomas R Viggiano
Increasing rates of burnout-with accompanying stress and lack of engagement-among faculty, residents, students, and practicing physicians have caused alarm in academic medicine. Central to the debate among academic medicine's stakeholders are oft-competing issues of social accountability; cost containment; effectiveness of academic medicine's institutions; faculty recruitment, retention, and satisfaction; increasing expectations for faculty; and mission-based productivity.The authors propose that understanding and fostering what contributes to faculty and institutional vitality is central to preventing burnout during times of change...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166354/smoothing-the-transition-points-in-canadian-medical-education
#2
Nick Busing, Jay Rosenfield, Kamal Rungta, Matt Raegele, Andrew Warren, Bruce Wright, Mark Walton, Ivy Oandasan, Anthony Sanfilippo, Anurag Saxena
In 2010 the Association of Faculties of Medicine of Canada, Collège des médecins du Québec, College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada launched The Future of Medical Education in Canada Postgraduate (FMEC PG) Project to examine postgraduate medical education (PGME) in Canada and make recommendations for improvement. One recommendation that emerged concerns the transitions learners experience across the undergraduate medical education-PGME-practice continuum...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166353/what-is-the-impact-of-the-underserved-pathway-program-on-graduates-entering-an-underserved-family-medicine-residency-five-year-findings-from-the-university-of-washington-school-of-medicine
#3
Amanda Kost, David Evans, Sharon Dobie, Elizabeth Sanders
PURPOSE: More primary care physicians are needed in underserved areas of the United States. Prior research indicates that medical student experiences in underserved settings increase the likelihood they will practice in underserved areas; few studies have controlled for selection bias. This study aimed to estimate the effect of the University of Washington School of Medicine's (UWSOM's) longitudinal extracurricular experience, the Underserved Pathway (UP), on graduates' choice in entering a family medicine residency with underserved training opportunities...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166352/more-learners-finite-resources-and-the-changing-landscape-of-procedural-training-at-the-bedside
#4
Michael A Gisondi, Linda Regan, Jeremy Branzetti, Laura R Hopson
There is growing competition for non-operative, procedural training in teaching hospitals, due to an increased number of individuals seeking to learn procedures from a finite number of appropriate teaching cases. Procedural training is required by students, post-graduate learners, and practicing providers who must maintain their skills. These learner groups are growing in size as the number of medical schools increase and advance practice providers expand their skills to include complex procedures. These various learner needs occur against a background of advancing therapeutic techniques that improve patient care, but also act to reduce the overall numbers of procedures available to learners...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166351/tool-for-diagnosing-gaps-within-a-competency-based-assessment-system
#5
S Beth Bierer, Colleen Y Colbert, Cecile M Foshee, Judith C French, Lily C Pien
No abstract text is available yet for this article.
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166350/competency-crosswalk-a-multispecialty-review-of-the-accreditation-council-for-graduate-medical-education-milestones-across-four-competency-domains
#6
Laura Edgar, Sydney Roberts, Nicholas Yaghmour, Andrea Leep Hunderfund, Stanley J Hamstra, Lisa Conforti, Eric S Holmboe
PURPOSE: To identify common and overlapping themes among the interpersonal and communication skills (ICS), practice-based learning and improvement (PBLI), professionalism (PROF), and systems-based practice (SBP) milestones of the transitional year and 26 specialties. METHOD: In May 2017, milestones were accessed from the Accreditation Council for Graduate Medical Education specialties website. A thematic analysis of the ICS, PBLI, PROF, and SBP milestones was performed to determine unique and common themes across these competencies and across specialties...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29166349/developing-end-of-training-entrustable-professional-activities-for-psychiatry-results-and-methodological-lessons
#7
John Q Young, Caitlin Hasser, Erick H Hung, Martin Kusz, Patricia S O'Sullivan, Colin Stewart, Andrea Weiss, Nancy Williams
PURPOSE: To develop entrustable professional activities (EPAs) for psychiatry and to demonstrate an innovative, validity-enhancing methodology that may be relevant to other specialties. METHOD: A national task force employed a three-stage process from May 2014 to February 2017 to develop EPAs for psychiatry. In stage 1, the task force used an iterative consensus-driven process to construct proposed EPAs. Each included a title, full description, and relevant competencies...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140919/collaboration-and-teamwork-in-the-health-professions-rethinking-the-role-of-conflict
#8
Quentin Eichbaum
Whereas the business professions have long recognized that conflict can be a source of learning and innovation, the health professions still tend to view conflict negatively as being disruptive, inefficient, and unprofessional. As a consequence, the health professions tend to avoid conflict or resolve it quickly. This neglect to appreciate conflict's positive attributes appears to be driven in part by (1) individuals' fears about being negatively perceived and the potential negative consequences in an organization of being implicated in conflict, (2) constrained views and approaches to professionalism and to evaluation and assessment, and (3) lingering autocracies and hierarchies of power that view conflict as a disruptive threat...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140918/integrating-social-determinants-of-health-into-graduate-medical-education-a-call-for-action
#9
Jennifer Siegel, David L Coleman, Thea James
Social determinants of health (SDH) are the major drivers of health and disparate health outcomes across communities and populations. Given this, the authors assert that competency in recognizing and mitigating SDH should become a vital component of graduate medical education in all specialties. While the most effective approaches to educating trainees about SDH are uncertain, in this Invited Commentary, the authors offer several key principles for implementing curricula focusing on SDH. These include universalization of the material, integration into clinical education, identification of space for trainee introspection, clarification of specific competencies in identification and mitigation of SDH, and creation of robust faculty development programming...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140917/medical-trainees-experiences-of-treating-people-with-chronic-pain-a-lost-opportunity-for-medical-education
#10
Kathleen Rice, Jae Eun Ryu, Cynthia Whitehead, Joel Katz, Fiona Webster
PURPOSE: Evidence suggests that physicians' opinions about chronic pain patients become progressively negative over the course of medical training, leading to a decline in empathy for these patients. Few qualitative studies have focused on this issue and thus the experiences shaping this process remain unexplored. This study addressed how medical trainees learn about chronic pain management through informal and formal curricula. METHOD: This study adopted a descriptive qualitative interview-based approach informed by the theoretical lens of the hidden curriculum...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140916/gender-disparities-in-medical-student-research-awards-a-thirteen-year-study-from-the-yale-school-of-medicine
#11
Joseph T King, Nancy R Angoff, John N Forrest, Amy C Justice
PURPOSE: Instruction in research conduct is currently required, and many U.S. medical schools require students to complete a research project. Each year all Yale School of Medicine (YSM) graduating students submit a research thesis, and ~5% are awarded highest honors. Gender disparities exist in areas related to physician research productivity, including academic rank, research funding, and publications. The authors asked whether gender disparities exist for medical student research. METHOD: The authors conducted a retrospective review of 1,120 theses submitted by graduating medical students from 2003-2015 at YSM and collected data on gender, mentoring, research type, sponsoring department, and other characteristics...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140915/the-actual-versus-idealized-self-exploring-responses-to-feedback-about-implicit-bias-in-health-professionals
#12
Javeed Sukhera, Alexandra Milne, Pim W Teunissen, Lorelei Lingard, Chris Watling
PURPOSE: Implicit bias can adversely affect health disparities. The implicit association test (IAT) is a prompt to stimulate reflection; however, feedback about bias may trigger emotions that reduce the effectiveness of feedback interventions. Exploring how individuals process feedback about implicit bias may inform bias recognition and management curricula. The authors sought to explore how health professionals perceive the influence of the experience of taking the IAT and receiving their results...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29116986/it-is-time-for-zero-tolerance-for-sexual-harassment-in-academic-medicine
#13
Carol K Bates, Reshma Jagsi, Lynn K Gordon, Elizabeth Travis, Archana Chatterjee, Marin Gillis, Olivia Means, Linda Chaudron, Rebecca Ganetzky, Martha Gulati, Barbara Fivush, Poonam Sharma, Amelia Grover, Diana Lautenberger, Terence R Flotte
While there are more women in leadership positions in academic medicine now than ever before in our history, evidence from recent surveys of women and from graduating medical students demonstrates that sexual harassment continues in our institutions. Our ability to change the culture is hampered by fear of reporting episodes of harassment, which is largely due to fear of retaliation. We describe some efforts in scientific societies that are addressing this and working to establish safe environments at national meetings...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29116985/resources-used-to-teach-the-physical-exam-to-preclerkship-medical-students-results-of-a-national-survey
#14
Toshiko Uchida, Francis I Achike, Angela D Blood, Mary Boyle, Jeanne M Farnan, Deepthiman Gowda, Joanne Hojsak, Robin K Ovitsh, Yoon Soo Park, Ronald Silvestri
PURPOSE: To examine the resources utilized in 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 resources and pedagogical methods employed in preclerkship physical exam curricula. The survey was sent to all 141 LCME-accredited medical schools in October 2015. Results were averaged across schools and data were weighted by class size. RESULTS: Results from 106 medical schools (75% response rate) identified a median of 59 hours devoted to teaching the physical exam...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29116984/speaking-up-an-ethical-action-exercise
#15
James Dwyer, Kathy Faber-Langendoen
PROBLEM: Health care professionals encounter situations in which they need to speak up to prevent harm, ensure better care, and/or address unprofessional behavior. Speaking up is often difficult, especially for medical students; nonetheless, it is a skill students must practice, so they can better advocate for patients. APPROACH: The authors have designed an ethical action exercise and incorporated it into a required bioethics course that meets concurrently with third-year clerkships...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29116983/-rising-to-the-level-of-your-incompetence-exploring-what-physicians-self-assessment-of-their-performance-reveals-about-the-impact-of-the-imposter-syndrome-in-medicine
#16
Kori A LaDonna, Shiphra Ginsburg, Christopher Watling
PURPOSE: Mistakes are ubiquitous in medicine; when confronted by error, physicians may experience anxiety, guilt, and self-doubt. Feedback may be useful for navigating these feelings, but only if it matches a physician's self-assessment; self-doubt and the imposter syndrome are examples of inaccurate self-assessments that may affect receptivity to feedback. The impact of real or imagined underperformance on seemingly competent physicians is poorly understood. This study aimed to develop a deeper understanding in order to identify strategies to support all physicians who struggle...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29116982/a-rose-by-other-names-some-general-musings-on-lawrence-and-colleagues-hidden-curriculum-scoping-review
#17
Frederic W Hafferty, Maria Athina Martimianakis
In this Commentary, the authors explore the scoping review by Lawrence and colleagues by challenging their conclusion that with over 25 years' worth of "ambiguous and seemingly ubiquitous use" of the hidden curriculum construct in health professions education scholarship, it is time to either move to a more uniform definitional foundation or abandon the term altogether. The commentary authors counter these remedial propositions by foregrounding the importance of theoretical diversity and the conceptual richness afforded when the hidden curriculum construct is used as an entry point for studying the interstitial space between the formal and a range of other-than-formal domains of learning...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29116981/the-hidden-curricula-of-medical-education-a-scoping-review
#18
Carlton Lawrence, Tsholofelo Mhlaba, Kearsley A Stewart, Relebohile Moletsane, Bernhard Gaede, Mosa Moshabela
PURPOSE: To analyze the plural definitions and applications of the term "hidden curriculum" within the medical education literature and to propose a conceptual framework for conducting future research on the topic. METHOD: The authors conducted a literature search of nine online databases, seeking articles published on the hidden, informal, or implicit curriculum in medical education prior to March 2017. Two reviewers independently screened articles with set inclusion criteria and performed kappa coefficient tests to evaluate interreviewer reliability...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29116980/rethinking-the-educator-portfolio-an-innovative-criteria-based-model
#19
Kanade Shinkai, Chen Amy Chen, Brian S Schwartz, Helen Loeser, Cynthia Ashe, David M Irby
PROBLEM: Academic medical centers struggle to achieve parity in advancement and promotions between educators and discovery-oriented researchers in part because of narrow definitions of scholarship, lack of clear criteria for measuring excellence, and barriers to making educational contributions available for peer review. Despite recent progress in expanding scholarship definitions and identifying excellence criteria, these advances are not integrated into educator portfolio (EP) templates or curriculum vitae platforms...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29116979/translating-theory-into-practice-implementing-a-program-of-assessment
#20
Karen E Hauer, Patricia S O'Sullivan, Kristen Fitzhenry, Christy Boscardin
PROBLEM: A program of assessment addresses challenges in learner assessment using a centrally planned, coordinated approach that emphasizes assessment for learning. This report describes the steps taken to implement a program of assessment framework within a medical school. APPROACH: A literature review on best practices in assessment highlighted six principles that guided implementation of the program of assessment in 2016-2017: (1) a centrally coordinated plan for assessment aligns with and supports a curricular vision; (2) multiple assessment tools used longitudinally generate multiple data points; (3) learners require ready access to information-rich feedback to promote reflection and informed self-assessment; (4) mentoring is essential to facilitate effective data use for reflection and learning planning; (5) the program of assessment fosters self-regulated learning behaviors; and (6) expert groups make summative decisions about grades and readiness for advancement...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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