What’s New and In the Queue for Academic Medicine

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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:

The Strategic Value of Succession Planning for Department Chairs
Rayburn and colleagues highlight the importance of succession planning—which provides institutional leaders the opportunity to optimize, renew, and revitalize their organization by ensuring successful leadership transitions—and emphasize the general need for transparency. 

Transforming the Academic Faculty Perspective in Graduate Medical Education to Better Align Educational and Clinical Outcomes
Wong and Holmboe propose a framework that closely aligns the educational and clinical contexts, such that both educational and clinical outcomes are centered around the patient. This will require a reorganization of the academic faculty perspective and educational design of graduate medical education training programs.

Improving Anesthesiologists’ Ability to Speak Up in the Operating Room: A Randomized Controlled Experiment of a Simulation-Based Intervention and a Qualitative Analysis of Hurdles and Enablers
Raemer and colleagues found an educational intervention alone was ineffective in improving the speaking-up behaviors of practicing nontrainee anesthesiologists. Other measures to change speaking-up behaviors could be implemented and might improve patient safety.

Comparing Open-Book and Closed-Book Examinations: A Systematic Review
Durning and colleagues compare the relative utility of open-book examinations (OBEs) and closed-book examinations (CBEs) given the rapid expansion and accessibility of knowledge. Given the data available, they found that there does not appear to be sufficient evidence for exclusively using CBEs or OBEs.

Health Professions Education Must Change: What Educators Need to Know about the Changing Clinical Context
In this Last Page, Lyspon and colleagues outline multiple, complex factors, including evolving demographics, health care reform, changing delivery systems, and awareness of the social determinants, that require concomitant change in medical education.

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

A Case Suspended in Time: The Educational Value of Case Reports
Clifford D. Packer, MD, Rachel B. Katz, MD, Corina L. Iacopetti, MD, Jeffrey D. Krimmel, and Mamta K. Singh, MD, MS

Abstract
Although medical case reports have fallen out of favor in the era of the impact factor, there is a long tradition of using case reports for teaching and discovery. Some evidence indicates that writing case reports might improve medical students’ critical thinking and writing skills, and help to prepare them for future scholarly work. From 2009 through 2015, students participating in the case-reporting program at a VA hospital produced 250+ case reports, 35 abstracts, and 15 journal publications. Here three medical students who published their case reports comment on what they learned from the experience. Based on their comments, the authors propose five educational benefits of case reporting: observation and pattern recognition skills, hypothesis-generating skills, understanding of patient-centered care, rhetorical versatility, and use of the case report as a rapidly publishable “mini-thesis,” which could fulfill MD thesis or scholarly concentration requirements. The authors discuss the concept of the case report as a “hybrid narrative” with simultaneous medical and humanistic significance, and its potential use to teach students about their dual roles as engaged listeners and scientists. Finally, the authors consider the limitations and pitfalls of case reports, including patient confidentiality issues, overinterpretation, emphasis on the rare, and low initial publication rates. Case reports allow students to contribute to the medical literature, learn useful scholarly skills, and participate in a tradition that links them with past generations of physicians. The authors conclude that the case report can be an effective teaching tool with a broad range of potential educational benefits.

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