What’s New and In the Queue for Academic Medicine

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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.

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