What’s New and In the Queue for Academic Medicine

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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 include:

Nutrition Education in an Era of Global Obesity and Diabetes: Thinking Outside the Box
Eisenberg and Burgess consider how best to educate trainees about diet and how to “translate” nutrition, exercise, and behavioral science knowledge into practical advice. Several ideas for reforming nutrition education are explored. A blog post on this topic is available.

Academic Institutions and One Health: Building Capacity for Transdisciplinary Research Approaches to Address Complex Health Issues at the Animal-Human-Ecosystem Interface
In this Perspective, Allen-Scott and colleagues argue for a significant shift in academic institutions’ research capacity to achieve the added value of a transdisciplinary approach for addressing One Health problems.

Latino Physicians in the United States, 1980–2010: A Thirty-Year Overview From the Censuses
Sánchez and colleagues find the Latino physician shortage has worsened over the past 30 years.  Immediate action on the national and local level are necessary to increase the supply of Latino physicians.

The Role of Socioeconomic Status in Medical School Admissions: Validation of a Socioeconomic Indicator for Use in Medical School Admissions
Grbic and colleagues categorized 2012 American Medical College Application Service applicants into five groups based on parental education and occupation. The lower the rating, the stronger the association with markers of socioeconomic disadvantage.

What’s In the Queue: A Sneak Peek
Here’s a preview of a soon-to-be-published research report by Plews-Ogan and colleagues.

Wisdom in Medicine: What Helps Physicians After a Medical Error?

Margaret Plews-Ogan, MD, MS, Natalie May, PhD, Justine Owens, PhD, Monika Ardelt, PhD, Jo Shapiro, MD, and Sigall K. Bell, MD

Abstract

Purpose
Confronting mistakes transparently after medical error is critical to organizational learning, but less is known about what helps individual clinicians learn and adapt positively following harmful mistakes. Understanding what factors help doctors gain wisdom can inform educational and peer support programs with specific tools to assist doctors after harmful errors.

Method
Using posttraumatic growth as a model, researchers conducted semistructured interviews between 2009 and 2011 with 61 physicians from 3 U.S. regions who made a serious medical error. Interviews were recorded, professionally transcribed, and coded by 2 study team members using principles of Strauss and Corbin, and nVivo software (kappa = 0.8). Coders also scored interviews as wisdom exemplars or nonexemplars based on Ardelt’s model of wisdom.

Results
Of all physicians, 54% were male, and a mean of 8 years had elapsed since the error. Wisdom exemplars were more likely to report disclosing the error to the patient/family (69%) than nonexemplars (38%) (P < .03); although < 10% reported disclosure training. Researchers identified 8 themes reflecting “what helped” physician wisdom exemplars cope positively, including: Talking About It, Disclosure and Apology, Forgiveness, A Moral Context, Dealing With Imperfection, Learning/Becoming an Expert, Teamwork/Preventing Recurrences, and Helping Others/Teaching.

Conclusions
The path forged by doctors who coped well with medical error highlights specific ways to help clinicians move through this difficult experience so that they avoid devastating professional outcomes and have the best chance of not just recovery but positive growth. Specific recommendations for peer support and institutional programs are provided.

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