Issue Preview – AM Rounds http://academicmedicineblog.org Beyond the pages of Academic Medicine, journal of the AAMC Wed, 26 Jul 2017 11:15:03 +0000 en-US hourly 1 https://wordpress.org/?v=4.4.10 What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-25/ http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-25/#respond Mon, 03 Jul 2017 19:20:27 +0000 http://academicmedicineblog.org/?p=3457 acmedipadjournaljuly2014

What’s New: A Preview of the July Issue

The July issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

Well-Being in Graduate Medical Education: A Call for Action
Ripp and colleagues find that physician wellness programs, though costly, may promote greater patient satisfaction, long-term physician satisfaction, and increased physician productivity. Recommendations are made at national, hospital, program, and non-work levels.

The Net Present Value and Other Economic Implications of a Medical Career
Commenting on Marcu et al, Reinhardt explains how the NPV is calculated then discusses other issues concerning the economics of a medical career, including medical school tuition, residents’ salaries, and investments in human capital as tax deductible.

The Use of Social Media in Graduate Medical Education: A Systematic Review
Sterling and colleagues describe the effect of social media platforms on residency education, recruitment, and professionalism as mixed, and the quality of existing studies as modest at best.

Considerations for Medical Students and Advisors after an Unsuccessful Match
Bumsted and colleagues discuss medical schools’ responsibilities to unmatched students and to society, outline various pathways for unmatched students to secure a GME or other non-clinical position in the future, and share guidelines for advising unmatched students following an unsuccessful Match.

Enhancing Student Empathetic Engagement, History-Taking, and Communication Skills During Electronic Medical Record Use in Patient Care
LoSasso and colleagues suggest a simple intervention providing specialized training in electronic medical record–specific communication can improve medical students’ empathic engagement, history-taking skills, and communication skills.

What’s In the Queue: A Sneak Peek

Here’s a preview of an upcoming research report by Baker and colleages.

Exploring Faculty Developers’ Experiences to Inform Our Understanding of Competence in Faculty Development
Lindsay Baker, MEd, Karen Leslie, MEd, MD, Danny Panisko, MD, Allyn Walsh, MD, Anne Wong, MD, PhD, Barbara Stubbs, MD, and Maria Mylopoulos, PhD

Abstract

Purpose

Now a mainstay in medical education, faculty development has created the role of the faculty developer. However, faculty development research tends to overlook faculty developers’ roles and experiences. This study aimed to develop an empirical understanding of faculty developer competence by digging deeper into the actions, experiences, and perceptions of faculty developers as they perform their facilitator role.

Method

A constructivist grounded theory approach guided observations of faculty development activities, field interviews, and formal interviews with 31 faculty developers across two academic institutions from 2013 to 2014. Analysis occurred alongside and informed data collection. Themes were identified using a constant comparison process.

Results

Consistent with the literature, findings highlighted the knowledge and skills of the faculty developer and the importance of context in the design and delivery of faculty development activities. Three novel processes (negotiating, constructing, and attuning) were identified that integrate the individual faculty developer, her context, and the evolution of her competence.

Conclusions

These findings suggest that faculty developer competence is best understood as a situated construct. A faculty developer’s ability to attune to, construct, and negotiate her environment can both enhance and minimize the impact of contextual variables as needed. Thus, faculty developers do not passively experience context; rather, they actively interact with their environment in ways that maximize their performance. Faculty developers should be trained for the adaptive, situated use of knowledge.

]]>
http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-25/feed/ 0
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-24/ Tue, 02 May 2017 17:57:40 +0000 http://academicmedicineblog.org/?p=3376 journal club2

What’s New: A Preview of the May Issue

The May issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

Role Modeling and Regional Health Care Intensity: U.S. Medical Student Attitudes Toward and Experiences With Cost-Conscious Care
Leep Hunderfund and colleagues found that medical students endorsed barriers to cost-conscious care and reported encountering conflicting physician role-modeling behaviors. Students in higher-health-care-intensity regions reported observing significantly fewer cost-conscious role-modeling behaviors. A blog post related to this article is available.

Building a Global, Online Community of Practice: The OPENPediatrics World Shared Practices Video Series
Wolbrink and colleagues, each month, the OPENPediatrics World Shared Practices video series releases a 30–45 minute video featuring an expert in pediatric critical care medicine, interspersed with questions for the audience. Viewers contribute to the community discussion by leaving comments that display alongside the video.

Making Management Skills a Core Component of Medical Education
Management skills are largely undeveloped in medical education. To address this, Myers and Pronovost argue that medical schools should partner with organizational scholars to offer a “Management 101” course in the medical curriculum.

Assessment for Systems Learning: A Holistic Assessment Framework to Support Decision-Making Across the Medical Education Continuum
Bowe and Armstrong propose three levels of systems-based assessment of medical education: assessment of individual component performance, for improvement in system performance, and to prepare the system for future change.

The Development of an Indigenous Health Curriculum for Medical Students
Lewis and Prunuske describe efforts at the University of Minnesota Medical School, Duluth campus, to develop an Indigenous health curriculum using collaborative and decolonizing methods to gather ideas and opinions from multiple stakeholders. A blog post providing an update on the program is available.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming perspective by Dow and colleagues.

Rethinking the Match: A Proposal for Modern Match-Making
Alan Dow, MD, MSHA, Chris Ray, and Steven Bishop

Abstract

Since the 1950s, the National Resident Matching Program, or “the Match,” has governed the placement of medical students into residencies. The Match was created to protect students in an era when residency positions outnumbered applicants and hospitals pressured students early in their academic careers to commit to a residency position. Now, however, applicants outnumber positions, applicants are applying to increasing numbers of programs, and the costs of the Match for applicants and programs are high. Meanwhile, medical education is evolving toward a competency based approach, a U.S. physician shortage is predicted, and some researchers describe a “July effect”–worse clinical outcomes correlated with the mass entry of new residents.

Against this background, the authors argue for adopting a more modern, free-market approach to residency match-making that might better suit the needs of applicants, programs, and the public. They propose allowing students, who have been identified by their medical schools as having achieved graduation-level competency, to apply to residency programs at any point during the year. Residency programs would set their own application timetables and extend offers in an ongoing fashion. Students, counseled by their schools, would accept or decline offers as desired. The authors argue this approach would better support competency-based education while allowing applicants and programs more choice regarding how they engage and adapt within the selection process. The approach’s staggered start times for new residents might attenuate the July effect and improve outcomes for patients. Medical students might also enter and thereby complete residency earlier, increasing the physician workforce.

]]>
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-23/ Tue, 04 Apr 2017 11:00:57 +0000 http://academicmedicineblog.org/?p=3340 AM Rounds Slider Master-22

What’s New: A Preview of the April Issue
The April issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

Engaging Learners to Advance Medical Education
Burk-Rafel and colleagues, all medical students, contextualize themes discussed in a collection of learner-authored letters to the editor and conclude with recommendations to engage learners in leadership, advocacy, and scholarship. Check back throughout the month for additional content on this topic.

Creating 21st-Century Laboratories and Classrooms for Improving Population Health: A Call to Action for Academic Medical Centers
DeVoe and colleagues argue for strengthening bidirectional connections between disease-based approaches to managing health and community-based approaches to promoting health through studying social and population determinants of health.

From Communication Skills to Skillful Communication: A Longitudinal Integrated Curriculum for Critical Care Medicine Fellows
Communication with patients and families in critical care medicine (CCM) can be complex and challenging. Roze des Ordons and colleagues develop and implement a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication.

Bringing Rounds Back to the Patient: A One-Year Evaluation of the Chiefs’ Service Model for Inpatient Teaching
Bennett and colleagues found the Chiefs’ Service model was viewed as valuable by residents and associated with positive outcomes in terms of residents’ perceptions of learning, interdisciplinary communication, and patient care.

Do Medical Students’ Narrative Representations of “The Good Doctor” Change Over Time? Comparing Humanism Essays From a National Contest in 1999 and 2013
Rutberg and colleagues performed an analysis of essays written 14 years apart in response to the prompt, “Who is the good doctor?The findings suggest that medical students understand the “good doctor” as a relational being who especially values the doctor-patient relationship.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming innovation report by Cofrancesco and colleagues.

Creating an “Education Shark Tank” to Encourage and Support Educational Scholarship and Innovation
Joseph Cofrancesco Jr, MD, MPH, Scott M. Wright, MD, Eric Vohr, MA, and Roy C. Ziegelstein, MD

Abstract

Problem
Creating and supporting opportunities for innovation that showcase and reward creativity in medical and biomedical education is critically important for academic institutions, learners, and faculty.

Approach
In 2014, the Institute for Excellence in Education, Johns Hopkins University School of Medicine, created a small grant program called Education Shark Tank, in which two to five finalist teams present their proposals on innovative initiatives to improve education to four or five senior educator “sharks” at an educational conference, with an audience. The sharks then “grill” the presenters, considering which if any to fund, focusing on the rationale, feasibility, appropriateness of the outcome measures, evaluation and assessment plan, and proposed method of dissemination. They also make suggestions that challenge the presenters to assess and improve their designs.

Outcomes
In the program’s first year (2014), funds were divided equally between two projects, both of which were successfully completed and one of which led to a journal publication; this led to increased funding for the program in 2015. Participants have called Education Shark Tank a “challenging and rewarding experience.”

Next Steps
Education Shark Tank can facilitate educational innovation and scholarship via engaging and challenging interactions between grant applicants and reviewers in a public venue. The authors plan to conduct a 5-year survey (after 2018) of all Education Shark Tank finalists to determine the success and challenges the funded projects have had, what scholarly dissemination has occurred, if non-funded projects were able to move forward, and the value of the feedback and mentoring received.

]]>
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-22/ Tue, 28 Feb 2017 12:00:09 +0000 http://academicmedicineblog.org/?p=3320 journal club2

What’s New: A Preview of the March Issue
The March issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. This issue includes a collection of article about structural competency (check back throughout the month for additional blog content related to this collection of articles). Highlights from the issue include:

Surveying Resident and Faculty Physician Knowledge, Attitudes, and Experiences in Response to Public Lead Contamination
After lead contamination in Flint, Michigan, physicians needed to respond to patient needs and supply appropriate information. Taylor and colleagues describe just-in-time supplementary training for graduate medical education programs.

Remembering Freddie Gray: Medical Education for Social Justice
Wear and colleagues propose two approaches—anti-racist pedagogy and structural competency—to develop a curriculum oriented toward appropriate care for patients who are victimized by and present with health concerns related to extremely challenging social and economic disadvantages. A blog post by a fourth-year medical student on this article is available.

Helping Basic Scientists Engage With Community Partners to Enrich and Accelerate Translational Research
Kost and colleagues describe the community-engaged research navigation program, which facilitates basic science-community partnerships and the development and conduct of joint research protocols to advance and accelerate translational science. A blog post by a clinical investigator on this article is available.

Supporting the Call to Action: A Review of Nutrition Educational Interventions in the Health Professions Literature and MedEdPORTAL
Dang and Maggio review articles and examine MedEdPORTAL resources that describe nutrition educational interventions for undergraduate-level health professionals. The heterogeneity of interventions and the content areas covered highlight the lack of adopted curricular standards for teaching clinical nutrition.

Teaching Population Health: Community-Oriented Primary Care Revisited
Liaw and colleagues provide a one-page primer on community-oriented primary care, a model that marries public health and primary care, represents a powerful framework for teaching and improving population health.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming article by Schmutz and Eppich.

Promoting Learning and Patient Care Through Shared Reflection: A Conceptual Framework for Team Reflexivity in Health Care
Jan B. Schmutz, PhD, and Walter J. Eppich, MD, MEd

Abstract
Health care teams represent groups of highly skilled individual experts who may often form inexpert teams due to a lack of collective competence. Because teamwork and collaboration form the foundation of effective clinical practice, factors that promote collective competence demand exploration. This article reviews team reflexivity (TR), a concept from the psychology and management literatures, and how it potentially contributes to the collective competence of health care teams. TR captures a team’s ability to reflect collectively on group objectives, strategies, goals, processes, and outcomes of past, current, and future performance in order to process key information and adapt accordingly. As an overarching process that promotes team functioning, TR builds shared mental models as well as triggers team adaptation and learning. The authors present a conceptual framework for TR in health care describing three phases in which TR may occur: pre-action TR (briefing before patient care), in-action TR (deliberations during active patient care), and post-action TR (debriefing after patient care). Depending on the phase, TR targets either goals, taskwork, teamwork, or resources and leads to different outcomes (i.e., optimal preparation, shared mental model, adaptation, or learning). This new conceptual framework incorporates various constructs related to reflection and unites them under the umbrella of TR. Viewing reflection through a team lens may guide future research about team functioning, optimize training efforts, and elucidate mechanisms for workplace learning.

]]>
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-21/ Tue, 31 Jan 2017 12:00:57 +0000 http://academicmedicineblog.org/?p=3283 AM Rounds Slider Master-23

What’s New: A Preview of the February Issue
The February issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

Expanding Group Peer Review: A Proposal for Medical Education Scholarship
Dumenco and colleagues share their experience with a group-peer review exercise and suggest expanded use of team reviews could enhance the quality of medical education scholarship. A podcast on this article is available in iTunes.

A Case Suspended in Time: The Educational Value of Case Reports
Packer and colleagues discuss how case reports can be an effective teaching tool with a broad range of benefits that include allowing students to contribute to the medical literature and learn useful scholarly skills.

Knowledge Syntheses in Medical Education: Demystifying Scoping Reviews
In this Perspective, Thomas and colleagues examine the nature, purpose, value, and appropriate use of one particular knowledge synthesis method: the scoping review. They present a brief description and explore the advantages and disadvantages of scoping reviews, and offer lessons learned and suggestions for those considering conducting scoping reviews.

Why Medical Schools Should Embrace Wikipedia: Final-Year Medical Student Contributions to Wikipedia Articles for Academic Credit at One School
Azzam and colleagues describe how through a credit-bearing course, fourth-year medical students edited a health-related Wikipedia article. Students improved the articles, enjoyed the flexibility of the course, and gained a deeper respect for Wikipedia. A blog post on this article by a fourth-year medical student is available.

The Impact of Administrative Burden on Academic Physicians: Results of a Hospital-Wide Physician Survey
Rao and colleagues find higher administrative duties related to lower career satisfaction and higher burnout. Administrative burden occupied one-quarter of working hours, and most respondents reported negative effects on delivering high-quality care. A blog post on this article by a member of the Council of Faculty and Academic Societies administrative board is available.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming perspective by Bonham and Alberti.

From Inputs to Impacts: Assessing and Communicating the Full Value of Biomedical Research
Ann Bonham, PhD, and Philip M. Alberti, PhD

Abstract
Assessing and communicating the full value of biomedical research is essential to answer calls from the government and the public for 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 that confers benefits to patients, communities, and the health care system in ways that accrue after a paper is published. In this context, in 2012 the Association of American Medical Colleges, in collaboration with RAND Europe, initiated a program to provide resources and guidance for medical schools and teaching hospitals interested in evaluating the outcomes and impacts of their research in novel ways complementary to traditional methods. This perspective provides context for this initiative and delineates the process through which researchers, evaluation experts, and other stakeholders—including legislators, health system leaders, and community members—identified and vetted novel “metrics that matter” in advance of a pilot test at the University of Wisconsin-Madison which sought to assess and communicate its community-engaged science and scholarship.

]]>
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-20/ Tue, 03 Jan 2017 12:00:49 +0000 http://academicmedicineblog.org/?p=3250 journal club2

What’s New: A Preview of the January Issue
The January issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

Five Tactics to Quickly Build Quality Improvement and Patient Safety Capacity at Academic Health Centers
Stevens addresses the five challenges to strengthening quality improvement and patient safety capacity identified by Coleman and colleagues and outlines practical short-term measures to mitigate them.

Procedural Competence Among Faculty in Academic Health Centers: Challenges and Future Directions
Procedural retraining for faculty remains non-standardized across most academic health centers despite the challenges to the maintenance of procedural competence. In this Perspective, Vaisman and Cram discuss the nature of the current problem of faculty procedural competence and the challenges it poses. They then suggest strategies to delineate and resolve this problem. Blog posts to this article are available here and here.

Becoming a Doctor in Different Cultures: Toward a Cross-Cultural Approach to Supporting Professional Identity Formation in Medicine
In this New Conversations piece, Helmich and colleagues aim to address medical professional identity formation from a polyvocal, multidisciplinary, cross-cultural perspective, and broaden the developing professional identity formation discourse to include non-Western approaches and notions. A blog post to this article written by one of the authors is available.

Comparing Trainee and Staff Perceptions of Patient Safety Culture
Bump and colleagues found trainees had comparable to more favorable perceptions of patient safety culture compared to staff. Hospitals then can use perceptions of patient safety culture to complement Clinical Learning Environment Review visit reports to improve patient safety.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming innovation report by Adam and colleagues.

The Use of Short, Animated, Patient-Centered Springboard Videos to Underscore the Clinical Relevance of Preclinical Medical Student Education
Maya Adam, MD, Sharon F. Chen, MD, Manuel Amieva, MD, Jennifer Deitz, MA, Heeju Jang, PhD, Aarti Porwal, and Charles Prober, MD

Abstract

Problem
Medical students often struggle to appreciate the clinical relevance of material taught in the preclinical years. The authors believe videos could be effectively used to interweave a patient’s illness script with foundational basic science concepts.

Approach
In collaboration with four other U.S. medical schools, educators at the Stanford University School of Medicine created 36 short, animated, patient-centered springboard videos (third-person, narrated accounts of authentic patient cases conveying foundational pathophysiology) in 2014. The videos were used to introduce students to 36 content modules, created as part of a microbiology, immunology, and infectious diseases curriculum. The videos were created with input from faculty content experts and in some cases medical students, and were piloted using a flipped-classroom pedagogical approach in academic year 2015–2016.

Outcomes
Student feedback from course evaluations and focus groups was analyzed using a mixed-methods approach. On the course evaluations, the majority of students rated the patient-centered videos positively, and the majority of comments on the videos were positive, highlighting both enhanced engagement and enhanced learning and retention. Comments from focus groups mirrored the course evaluation comments and highlighted different usage patterns for the videos.

Next Steps
The authors will continue to gather and analyze data from schools using the videos as part of their core preclinical curriculum, and will produce similar videos for use in other areas of undergraduate medical education. These videos could support students’ review of content taught previously and be repurposed for use in continuing and graduate medical education, as well as patient education.

 

]]>
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-19/ Thu, 01 Dec 2016 17:00:59 +0000 http://academicmedicineblog.org/?p=3234 AM Rounds Slider Master-23

 

What’s New: A Preview of the December Issue
The December issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

Embracing Medical Education’s Global Mission
In this New Conversations piece, Farmer and Rhatigan describe how U.S. academic medicine can contribute to global health by strengthening medical education in low- and middle-income countries and urge the U.S. medical education community to embrace this challenge.

Parting the Clouds: Three Professionalism Frameworks in Medical Education
Irby and Hamstra describe the three dominant frameworks used to describe professionalism in medical education, including the assumptions and contributions of each, to provide greater insight into the nature of professionalism.

A Framework for Understanding Lapses in Professionalism Among Medical Students: Applying the Theory of Planned Behavior to Fitness to Practice Cases
To demonstrate the practical use of the theory of planned behavior (TPB) in fitness to practice cases, Jha and colleagues present four complex, anonymized case studies in which they employed the TPB to help deal with serious professionalism lapses among medical students.

Grant Success for Early-Career Faculty in Patient-Oriented Research: Difference-in-Differences Evaluation of an Interdisciplinary Mentored Research Training Program
Libby and colleagues found institutional investment in mentored research training for junior faculty provided significant grant award gains that began after one year of program participation and persisted over time.

Conducting Research in Health Professions Education: From Idea to Publication
The December issue also has a listing of the online-only AM Last Pages included in Academic Medicine’s latest e-book, Conducting Research in Health Professions Education: From Idea to Publication. The e-book, consisting entirely of AM Last Pages, provides over 40 one-page primers on topics related to medical education research, exploring every stage of research from developing research questions, finding secondary data sources, and working in collaborations, to defining response rate, writing revisions, and promoting your published work.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming perspective by Jones and colleagues.

The Almost Right Word: The Move from Medical to Health Humanities
Therese Jones, PhD, Michael Blackie, PhD, Rebecca Garden, PhD, and Delese Wear, PhD

Abstract
Since the emergence of the field in the 1970s, several trends have begun to challenge the original assumptions, claims, and practices of what became known as the medical humanities. In this article, the authors make the case for the health humanities as a more encompassing label because it captures recent theoretical and pedagogical developments in higher education such as the shift from rigid disciplinary boundaries to multi- and interdisciplinary inquiry, which has transformed humanities curricula in health professions. Calling the area of study health humanities also underscores the crucial distinction between medicine and health. Following a brief history of the field and the rationales that brought humanities disciplines to medical education in the first place—the “why” of the medical humanities—the authors turn to the “why” of the health humanities, using disability studies to illuminate those methodologies and materials that represent the distinction between the two. In addition, the authors make note of how humanities inquiry has now expanded across the landscape of other health professions curricula; how there is both awareness and evidence that medicine is only a minor determinant of health in human populations alongside social and cultural factors; and finally, how the current movement in health professions education is towards interdisciplinary and interprofessional learning experiences for students.

]]>
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-18/ Tue, 01 Nov 2016 11:00:39 +0000 http://academicmedicineblog.org/?p=3193 AM Rounds Slider Master-23

 

What’s New: A Preview of the November Issue
The November issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

Holistic Review in Medical School Admissions and Selection: A Strategic, Mission-Driven Response to Shifting Societal Needs
Conrad and colleagues argue that holistic review is a strategic, mission-driven, evidence-based process that recognizes diversity as critical to excellence, offers a flexible framework for selecting future physicians, and facilitates achieving institutional mission and addressing societal needs.

The Standardized Letter of Evaluation for Postgraduate Training:  A Concept Whose Time Has Come?
Love and colleagues argue that specialty-specific standardized letters of evaluation would increase the likelihood that programs could effectively identify applicants who would not only be a “good fit” for their programs, but also graduate to become successful physicians.

A Hybrid Interview Model for Medical School Interviews: Combining Traditional and Multisampling Formats
Bibler Zaidi and colleagues discuss the University of Michigan Medical School’s implementation of a hybrid interview model with six short-form interviews and two long-form interviews, as well as early reactions to and outcomes of this model. Two blog posts on this article are available here and here.

How Prevalent Are Potentially Illegal Questions During Residency Interviews? A Follow-up Study of Applicants to All Specialties in the National Resident Matching Program
Hern and colleagues found that in 20122013, two-thirds of residency applicants reported being asked potentially illegal questions about gender, age, marital status, parental status, plans for childrearing, ethnicity, religion, or sexual orientation.

Enrollment Management in Medical School Admissions: A Novel Evidence-Based Approach at One Institution
Burkhardt and colleagues compared factors related to enrollment at the University of Michigan versus competing peer institutions. A predictive analytic “dashboard” was created, allowing better management of targeted recruitment and admissions.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming innovation report by Holt and colleagues.

The Addiction Recovery Clinic: A Novel, Primary Care-Based Approach to Teaching Addiction Medicine
Stephen R. Holt, MD, MS, Nora Segar, MD, Dana A. Cavallo, PhD, and Jeanette M. Tetrault, MD

Abstract
Problem
Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine.

Approach
In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist. Residents spend one half day per week for four consecutive weeks at the ARC seeing new and returning patients. Services provided include pharmacological and behavioral treatments for opioid, alcohol, and other substance use disorders, with direct referral to local addiction treatment facilities as needed. Visit numbers, a patient satisfaction survey, and an end-of-rotation resident evaluation were used to assess the ARC.

Outcomes
From 2014 to 2015, 611 patient encounters occurred, representing 97 new patients. Sixty-one (63%) patients were seen for opioid use disorders. According to patient satisfaction surveys, 29 (of 31, 94%) patients reported that the ARC probably or definitely helped them to cope with their substance use. Twenty-eight residents completed the end-of-rotation evaluation; all rated the rotation highly.

Next Steps
The ARC offers a unique primary care-based approach to exposing internal medicine residents to the knowledge and skills necessary to diagnose, treat, and prevent unhealthy substance use. Future research will examine other clinical and educational outcomes.

]]>
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-17/ Tue, 04 Oct 2016 11:00:14 +0000 http://academicmedicineblog.org/?p=3172 AM Rounds Slider Master-23

What’s New: A Preview of the October Issue
The October issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

How Can Physicians Educate Patients About Health Care Policy Issues?
In this New Conversations piece, Gordon shares observations and lessons from riding a bicycle across the country and asking people their understanding of the Affordable Care Act and the impact it has had on their lives.

When Assessment Data Are Words: Validity Evidence for Qualitative Educational Assessments
Cook and colleagues articulate the role of qualitative assessment as part of a comprehensive program of assessment, and translate the concept of validity to apply to judgments arising from qualitative assessments.

Choosing Wisely for Medical Education: Six Things Medical Students and Trainees Should Question
Lakhani and colleagues present a Choosing Wisely list that highlights medical student behaviors and aspects of the academic environment that drive overuse. The list is also relevant to faculty, whose behaviors influence trainees.

How Residents Develop Trust in Interns: A Multi-Institutional Mixed-Methods Study
Sheu and colleagues find residents form trust based on primarily intern- and context-specific factors. Residents seem to consider trust in interns in a way that prioritizes safe execution of essential patient care tasks.

The Impact of Project ECHO on Participant and Patient Outcomes: A Systematic Review
From their review, Zhou and colleagues concluded that Project ECHO is an effective and potentially cost-saving model that increases participant knowledge and patient access to health care in remote locations, but further research examining its efficacy is needed.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming article by Rutberg and colleagues.

Do Medical Students’ Narrative Representations of “The Good Doctor” Change Over Time? Comparing Humanism Essays from a National Contest in 1999 and 2013
Pooja C. Rutberg, MD, Brandy King, MLIS, Elizabeth Gaufberg, MD, MPH, Pamela Brett-MacLean, PhD, Perry Dinardo, and Richard M. Frankel, PhD

Abstract

Purpose
To explore medical students’ changing conceptions of the “good doctor” at two points in time separated by a decade and a half.

Method
Qualitative analysis of narrative-based essays was conducted. Following a constant comparative method, an emergent relational coding scheme was developed and used to characterize a total of 110 essays submitted to the Arnold P. Gold Foundation Humanism in Medicine Essay Contest in 1999 and 2013 in response to the prompt “Who is the good doctor?”

Results
Five relational themes were identified as guiding the day-to-day work and lives of physicians described in the essays: doctor-patient, doctor-self, doctor-colleague, doctor-learner, and doctor-system/society/profession. A highly similar distribution of primary and secondary relational themes was found for essays from 1999 and 2013. The majority of the essays emphasized the centrality of the doctor-patient relationship. Little focus was placed on teamwork, systems innovation, and technology use, all important developments in contemporary medicine.

Conclusions
Medical students’ narrative reflections are increasingly being used as a rich source of information about the lived experience of medical education. Our findings suggest that medical students understand the “good doctor” as a relational being, with an enduring emphasis on the doctor-patient relationship. Medical education would benefit from including an emphasis on the relational aspects of and ways of being in medicine. Future research should focus on relational learning as a pedagogical approach that may support the formation of caring, effective physicians embedded in a complex array of relationships within clinical, community, and larger societal contexts.

]]>
What’s New and In the Queue for Academic Medicine http://academicmedicineblog.org/whats-new-and-in-the-queue-for-academic-medicine-16/ Thu, 01 Sep 2016 11:00:01 +0000 http://academicmedicineblog.org/?p=3146 journal club2

What’s New: A Preview of the September Issue
The September issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. This issue includes a collection on resilience, wellness, and burnout. Highlights from the issue include:

The Missing Link: Connection Is the Key to Resilience in Medical Education
In this Commentary, McKenna and colleagues propose that connection to colleagues, patients, and profession is fundamental to medical learners’ resilience, highlighting “social resilience” as a key factor in overall well-being. 

Peer Support for Clinicians: A Programmatic Approach
Shapiro and Galowitz describe the origin, structure, and basic workings of the one-on-one peer support program at the Center for Professionalism and Peer Support, Brigham and Women’s Hospital, and describe the important components for a peer support conversation.

In Their Own Words: An Analysis of the Experiences of Medical Interns Participating in a Prospective Cohort Study of Depression
Mata and colleagues compared the subjective experiences of interns with and without symptoms of depression to explore what made the year difficult, easy, and memorable, and how they had changed.

Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students
In a national survey of more than 4,000 students, Jackson and colleagues found that 32.4% met criteria for alcohol abuse/dependence, with connections between debt, burnout, depression, other factors, and alcohol abuse/dependence.

Recognizing Patients’ Emotions: Teaching Health Care Providers to Interpret Facial Expressions
Ragsdale and colleagues found participants showed substantial improvement in skill and knowledge scores, and modest improvement in importance and confidence ratings, after a 90-minute workshop to teach physicians and physicians-in-training to interpret facial expressions and to use that skill in the context of patient care. A blog post to this article written by the author is available.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming perspective by Baker and colleagues.

Using National Health Care Databases to Inform Curriculum Development
Amy J. Baker, MA, Mark R. Raymond, PhD, Steven A. Haist, MD, and John R. Boulet, PhD

Abstract
One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments, clinics, and hospitals.

Selected data from the National Hospital Ambulatory Medical Care Survey: Emergency Department illustrate how instructional materials can be derived from the results of such public-use health care data. Using fever as the reason to visit the emergency department, the patient management path is depicted in the form of a case drill-down by exploring the most common diagnoses, blood tests, diagnostic studies, procedures, and medications associated with fever.

Although these types of data are quite useful, they should not serve as the sole basis for determining which instructional cases to include. Additional sources of information should be considered to ensure the inclusion of cases that represent infrequent but high-impact problems and those that illustrate fundamental principles that generalize to other cases.

]]>