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

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Innovation. Is it just an overused buzzword or are there actually new, exciting initiatives percolating that will change the way we think and practice? The latest content from Academic Medicine will convince you it’s the latter. New online-first articles describe efforts at academic health centers across the country to improve education, research, and patient care, using new ways of teaching, thinking, organizing care, communicating, analyzing information, and managing medical schools and teaching hospitals. Keep reading below for more details.

Commentaries

Medical Education Reimagined: A Call to Action
Driven by the need to reimagine medical education based on the current climate of technology, science, and medical practice, Prober and Khan propose a new model of medical education based on the “flipped classroom” design. 

Changing the Culture of Academic Medicine to Eliminate the Gender Leadership Gap: 50/50 by 2020
To close the gender leadership gap and meet the needs of the next generation, Valantine and Sandborg argue that the culture of medicine must change to one in which flexibility and work-life integration are core to the definition of success.

Sponsorship: A Path to the Academic Medicine C-suite for Women Faculty? 
Travis and colleagues suggest sponsorship, in which individuals with power and position act as advocates for the advancement of talent, is needed to help women attain top leadership positions.

Perspectives

Just Imagine: New Paradigms for Medical Education 
Mehta and colleagues discuss two potentially disruptive innovations facing medical education—massive online open courses and digital badges—as well as their implications for the future of academic medicine.

Fostering Innovation in Medicine and Health Care: What Must Academic Health Centers Do?
Dzau and colleagues review the essential elements and environmental factors that enable health-related innovations to flourish in academic health systems.  

A Logic Model for Community Engagement within the CTSA Consortium: Can We Measure What We Model?
Eder and colleagues propose a typology of three relationship types—engagement, collaboration, and shared leadership—to provide a foundation for investigating community–academic contributions to the new CTSA research paradigm.

Articles

Aligning Academic Continuing Medical Education with Quality Improvement: A Model for the 21st Century
Davis and colleagues describe the development of the Aligning and Educating for Quality (ae4Q) pilot, which set out to better align the continuing medical education and quality improvement efforts at academic medical centers.

The Design of a Medical School Social Justice Curriculum
Coria and colleagues describe a new multidisciplinary undergraduate medical school social justice curriculum at the Geisel School of Medicine at Dartmouth, which was designed to help students recognize and redress adverse social determinants of disease. 

Managing Conflicts of Interest in Clinical Care: The “Race to the Middle” at U.S. Medical Schools
Chimonas and colleagues argue that schools have made great progress toward national COI standards, yet room for improvement remains—the data reveal not a race to the top but a shift from the bottom to the middle. 

Innovation Reports

Reduction of Venous Thromboembolism (VTE) in Hospitalized Patients: Aligning Continuing Education with Interprofessional Team-based Quality Improvement in an Academic Medical Center
Pingleton and colleagues describe a successful quality improvement initiative at one AMC that used an innovative, interdisciplinary approach to CME to improve patient outcomes. 

It’s Academic: Public Policy Activities Among Faculty Members in a Department of Medicine
With the purpose of reporting some baseline data about faculty members’ advocacy activities, Jacobs and colleagues share the results of a survey about public policy involvement in one department. 

Research Reports

Assessing the Impact of Electronic Health Records as an Enabler of Hospital Quality and Patient Satisfaction
Jarvis and colleagues found that advanced EHR use was associated with higher process of care scores but did not detrimentally affect quality of care, in support of the investment in information technology infrastructure. 

Clinical Spanish Use and Language Proficiency Testing Among Pediatric Residents
Lion and colleagues found that pediatric residents use Spanish in the clinic regardless of their actual proficiency. Self-reported ability is inaccurate, so language credentialing is important to improve care. 

Caring for Patients With Limited English Proficiency: Are Residents Prepared to Use Medical Interpreters?
Thompson and colleagues found that, among pediatrics residents surveyed at seven residency programs, receipt of training on using professional interpreters was associated with high self-efficacy in interpreter use.

Practice Indicators of Suboptimal Care and Avoidable Adverse Events: A Content Analysis of a National Qualifying Examination
Bordage and colleagues searched the literature and surveyed experts to compile a list of practice indicators that contribute to causing or preventing suboptimal care and avoidable adverse events.

The Development of Scientific Communication Skills: A Qualitative Study of the Perceptions of Trainees and Their Mentors
In this qualitative study, Cameron and colleagues examined the process by which mentored junior researchers learn scientific communication skills, their feelings about the challenges, and their mentor’s role in the process.

RIME

RIME Foreword: A Behind-the-Scenes Look at This Year’s Research in Medical Education Program
Lotte Dyrbye, MD, MHPE

Are We All on the Same Page? A Discourse Analysis of Interprofessional Collaboration
Haddara and Lingard argue that interprofessional collaboration includes at least two different discourses—a utilitarian discourse, employing words such as “evidence” and “validity” and an emancipatory discourse characterized by language including “power” and “dominance.”

Understanding Clinical Uncertainty: What Is Going On When Experienced Surgeons Are Not Sure What To Do?
Cristancho and colleagues offer vocabulary for conceptualizing uncertainty in surgery. Its explanatory power remains untested, but it offers implications for discussion and training in management of surgical uncertainty. 

Primary Care, the ROAD Less Traveled: What First-Year Medical Students Want in a Specialty
Clinite and colleagues found that, among first-year students, enjoying work is a value and the importance of financial compensation is inversely associated with their interest in primary care.

To Stay or Not to Stay? A Grounded Theory Study of Residents’ Post-call Behaviors and Their Rationalizations for Those Behaviors
Taylor and colleagues found that values are central to residents’ rationalizations but appear to be versatile, amenable to multiple, even conflicting, applications. Organizational changes are needed for duty hour reforms to succeed. 

The Third-Year Medical Student “Grapevine”: Managing Transitions Between Third-Year Clerkships Using Peer-to-Peer Handoffs 
Masters and colleagues found that advice about workplace culture, content learning, and logistics described informal norms not addressed by clerkship orientations. Peer-to-peer handoffs may help transitions between clerkships with dissimilar cultures and expectations. 

Do In-Training Evaluation Reports Deserve Their Bad Reputations? A Study of the Reliability and Predictive Ability of ITER Scores and Narrative Comments
Ginsburg and colleagues found that both written comments and numerical ITER scores were reliable and predictive of PGY3 performance, according to this three-year study from the University of Toronto Faculty of Medicine. 

Comparing Diagnostic Performance and the Utility of Clinical Vignette-Based Assessment Under Testing Conditions Designed to Encourage Either Automatic or Analytic Thought
Ilgen and colleagues found that instructions to trust one’s first impressions result in similar performance when compared to instructions to systematically consider clinical information but yield considerable advantage in terms of the utility in assessment.  

Validity Evidence for a Patient Note Scoring Rubric Based on the New Patient Note Format of the United States Medical Licensing Examination
Park and colleagues present initial validity evidence for use of their rubric (designed to measure the dimensions of documentation, justified differential diagnosis, and workup) in scoring local clinical exams. 

Assessing Residents’ Written Learning Goals and Goal Writing Skill: Validity Evidence for the Learning Goal Scoring Rubric 
Lockspeiser and colleagues present preliminary validity evidence indicating their scoring rubric with four criteria can be used to assess the quality of learning goals as well as goal writing skill. 

Educating Future Physicians to Track Health Care Quality: Feasibility and Perceived Impact of a Health Care Quality Report Card for Medical Students 
O’Neill and colleagues tested the feasibility and perceived impact of a quality metric report card as part of an Education-Centered Medical Home longitudinal curriculum. 

“I AM a Doctor”: Negotiating the Discourses of Standardization and Diversity in Professional Identity Construction  
Frost and Regehr conducted a critical review of seminal publications to highlight the discourses of diversity and standardization in the medical education literature and how these discourses are in tension. 

Cognition Before Curriculum: Rethinking the Integration of Basic Science and Clinical Learning 
Kulasegaram and colleagues argue that one way of understanding the integration of basic and clinical science is as a cognitive activity occurring within learners, which suggests that learner-centered, content-focused, session-level-oriented strategies can achieve cognitive integration.

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One Comment

  1. Kemi Tomobi
    September 11, 2013 at 4:38 PM

    Awesome!  Innovation and creativity are key.  We learn best in times of enjoyment.  We should embrace being in and creating an environment where uniqueness  and differences are valued, and we are celebrated (not ridiculed) for being ourselves.  Finally, simulation and mentorship build confidence in being ourselves and in making progress.

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