Articles from the January issue are now available online ahead of print!

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What role does spirituality play in educating trainees and practicing medicine? Find out in a recently published ahead-of-print study, part of a collection of articles on the topic in Academic Medicine. New online-first articles describe the role that patient outcomes can play in evaluating medical education, explore the learning opportunities for residents to achieve procedural competency, and compare teaching and nonteaching hospitals by the direct patient care they provide. Keep reading below for more details.

Commentaries

Spirituality and Health: The Development of A Field
Puchalski and colleagues describe the National Competencies in Spirituality and Health, which represent a cohesive framework for developing and assessing curricula and research in the expanding field of spirituality and health.

Necessity Is The Mother of Invention: Video Recording First-Hand Perspectives of Critical Medical Procedures To Make Simulated Training More Effective
To address the issues raised by Kyser and colleagues, Ericsson argues for adapting learning techniques (deliberate practice and simulator use) from other domains–chess, music, sports–for use in medicine.

MD–PhD Training: Looking Back and Looking Forward
Bonham argues that MD–PhD programs should prepare physician–scientists for future research environments, which will be closely integrated within health care delivery systems, extend into diverse communities, and employ complex technologies.

How Do You Deliver a Good Obstetrician? Outcome-Based Evaluation of Medical Education
Asch and colleagues focus on a specific clinical outcome—maternal complications of obstetrical delivery—to argue that the evaluation of medical education can become more closely tethered to clinical outcomes. 

The Accreditation System After “The Next Accreditation System”
In response to Asch’s endorsement of outcome-based assessment of medical education, Nasca and colleagues consider how changes in ACGME accreditation processes can leverage and facilitate such approaches.

De-Monopolizing Medical Knowledge

Arora and colleagues describe a new model of health care and education delivery, Project ECHO (Extension for Community Healthcare Outcomes), which brings the medical knowledge and expertise of teaching hospitals to clinicians in underserved practices.

Forging Successful Academic-Community Partnerships with Community Health Centers: The California Statewide Area Health Education Center (AHEC) Experience
Fowkes and colleagues argue that CHCs and AHECs are logical partners to prepare the health workforce for the future. The authors use their experience at the California AHEC to illustrate the possibilities of CHC-AHEC partnerships.

Perspective

The Health Sciences and Technology Academy: An Educational Pipeline to Address Health Care Disparities in West Virginia
McKendall and colleagues describe the Health Sciences and Technology Academy, its framework and philosophy, offer evidence of its success, and describe the benefits of the program’s community partnerships.

Article

The Integration of the “Spirituality in Medicine” Curriculum into the Osteopathic Communication Curriculum at Kansas City University of Medicine and Biosciences
Talley and Magie describe the Spirituality in Medicine curriculum at Kansas City University of Medicine and Biosciences, which prepares students to assess patients’ spiritual and cultural needs, use chaplain services, and understand the cultural determinants of health. 

Innovation Report

Integration of Basic Science and Clinical Medicine: The Innovative Approach of the Cadaver Biopsy Project at the Boston University School of Medicine
Eisenstein and colleagues describe the cadaver biopsy project at Boston University School of Medicine, which links students’ first basic science experiences in gross anatomy with other basic science courses and later clinical courses. 

Research Reports

“I Will Never Let That Be OK Again”: Student Reflections on Competent Spiritual Care for Dying Patients
Kuczewski and colleagues found that, in written reflections of experiences with patients who died, students reported becoming desensitized to human dimensions of care, articulated a commitment to addressing these dimensions, and identified systemic fragmentation as a barrier to doing so.

Using a Teaching OSCE to Prompt Learners to Engage with Patients Who Talk About Religion and/or Spirituality
Ledford and colleagues describe an innovation that can help learners become more skillful in dealing with difficult physician–patient communication topics, in this case, topics of religion and spirituality. 

Assessing Third-Year Medical Students’ Ability to Address a Patient’s Spiritual Distress Using an OSCE Case
McEvoy and colleagues found that, during an OSCE case, the majority of third-year students without robust training in addressing patients’ spiritual needs were able to refer the patient to a chaplain. 

Forceps Delivery Volumes in Teaching and Nonteaching Hospitals: Are Volumes Sufficient for Physicians to Acquire and Maintain Competence?
Kyser and colleagues examined whether hospitals performed a sufficient number of forceps deliveries, highlighting challenges specialties face in ensuring that physicians acquire and maintain competence in infrequently performed, highly technical procedures.

Medical Students’ Perceptions of the Physician’s Role in Not Allowing Them to Perform Gynecological Examinations
van den Einden and colleagues determined how often medical students are not allowed to perform gynecological examinations during their obstetrics-gynecology clerkship and explored the role of the supervisory physician in not allowing medical student involvement.

Educational Outcomes for Students Enrolled in MD–PhD Programs at Medical School Matriculation, 1995–2000: A National Cohort Study
Jeffe and colleagues found that most MD–PhD matriculants completed the program and that most who left were MD-only graduates. They also determined that gender, race/ethnicity, and premedical debt were not independently associated with overall program attrition.

Comparing Teaching versus Nonteaching Hospitals: The Association of Patient Characteristics with Teaching Intensity for Three Common Medical Conditions
To quantify the role of teaching hospitals in direct patient care, Shahian and colleagues compared characteristics of patients served by hospitals of varying teaching intensity.

Am I Right When I Am Sure? Data Consistency Influences the Relationship Between Diagnostic Accuracy and Certainty
Cavalcanti and Sibbald found that, for residents performing simulated cardiac physical diagnoses, the relationship between diagnostic accuracy and certainty about diagnosis was context-dependent and varied by the consistency of information given.

Why Do Doctors Make Mistakes? A Study of the Role of Salient Distracting Clinical Features
This 2012 study by Mamede and colleagues showed that attention-grabbing features typically associated with a given disease but unrelated to a particular case can misdirect residents’ diagnostic reasoning, causing errors.

How Can Students’ Diagnostic Competence Benefit Most from Practice with Clinical Cases? The Effects of Structured Reflection on Future Diagnosis of the Same and Novel Diseases
Under three different experimental conditions, Mamede and colleagues found that fourth-year medical students arrived at more correct diagnoses using structured reflection, which may enrich development of illness scripts used during diagnosis.

Script Concordance Testing: Assessing Residents’ Clinical Decision-Making Skills for Infant Lumbar Punctures
Chang and colleagues found that script concordance testing may be useful as a means of determining residents’ competency in certain clinical decision-making skills, such as whether or not to perform an infant lumbar puncture.

Teaching Medical Error Disclosure to Residents Using Patient-Centered Simulation Training
Sukalich and colleagues determined if a standardized patient encounter and self-guided tutorial would improve first year residents’ self-efficacy for disclosing medical errors.

Measuring Physicians’ Productivity: A Three-Year Study to Evaluate A New Remuneration System
Filler and colleagues evaluated a new assessment tool measuring physicians’ academic productivity and its use in a performance-based remuneration system.

Development and Verification of a Taxonomy of Assessment Metrics for Surgical Technical Skills
Schmitz and colleagues created a taxonomy of metrics for assessing surgical technical skills and determined which types of metrics, skills, settings, learners, models, and instruments were most commonly reported in the technical skills assessment literature.

Primary Care Residency Choice and Participation in an Extracurricular Longitudinal Medical School Program to Promote Practice with Medically Underserved Populations
Kost and colleagues discovered that Underserved Pathway participants from the University of Washington SOM matched at higher rates than non-participants to primary care and family medicine residencies.

Test-Enhanced Web-Based Learning: Optimizing the Number of Questions (a Randomized Crossover Trial)
In a study using eight Web-based modules with varying numbers of self-assessment questions, Cook and colleagues discovered that residents’ mean posttest knowledge scores were highest for 10- and 15-question formats.

Quantifying Federal Funding and Scholarly Output Related to the Academic Emergency Medicine Consensus Conferences
Nishijima and colleagues found that authors of consensus conference articles get cited and federally funded at significantly higher than normal rates, making consensus conferences academically worthwhile endeavors.

Connectedness, Sense of Community, and Academic Satisfaction in a Novel Community Campus Medical Education Model
Vora and Kinney found that distance learning and intermittent in-person activities can decrease students’ important senses of connectivity, community, and academic satisfaction and suggest interventions to mitigate these effects.

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One Comment

  1. Kemi Tomobi
    December 16, 2013 at 10:15 PM

    Looking forward to more research on spirituality in medicine and in educating medical trainees.  I just came across a quote:

    New York Weekly Anglo-African issued a protest stating: We find it difficult to trust white men to educate our youth. It is not because they are not abundantly qualified in the letter, but their defect is in spirit and sympathy. There are many whites among our professed friends who do not believe in the square, civilized doctrine of human equality. (Mabee, 1979, p. 96)

    Racial relations have come a long way, but some of today’s diversity’s issues are reflected in the above statement that was published, not too long after Brown vs. Board of Education was passed.  Is this statement true in medicine and medical education as well?  How do we meet the spiritual needs of trainees and patients, then?