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 include:

Making Value-Based Payment Work for Academic Health Centers
In this New Conversations piece, Miller discusses how academic health centers (AHCs) could provide the leadership needed to improve care for patients, lower costs for health care purchasers, and maintain the financial viability of both AHCs and community providers.

Three Things to Do With Stories: Using Literature in Medical, Health Professions, and Interprofessional Education
Blackie and Wear argue that, by modeling a close reading of a text, faculty can demonstrate how this skill, which courts rather than resists ambiguity, can assist students in making ethical and compassionate judgments.

Course Offerings in the Fourth Year of Medical School: How U.S. Medical Schools Are Preparing Students for Internship
Elnicki and colleagues reviewed current literature and Web sites of U.S. medical schools for information on current course offerings for the fourth year, summarizing temporal trends and outcomes when available.

The Importance of Situational Awareness: A Qualitative Study of Family Members’ and Nurses’ Perspectives on Teaching During Family-Centered Rounds
In Beck and colleagues’ study, family members and nurses who participate in family-centered rounds at a children’s hospital reveal what they believe constitutes effective teaching behaviors on the part of the attending physician. A blog post on this article written by the author is available.

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

The Urban Medicine Program: Developing Physician-Leaders to Serve Underserved Urban Communities
Jorge A. Girotti, PhD, MA, Gary L. Loy, MD, MPH, Joanna L. Michel, PhD, and Vida A. Henderson, PharmD, MPH, MFA

Abstract

Purpose
Medical school graduates are poorly prepared to address health care inequities found in urban, underserved communities. The University of Illinois College of Medicine developed the Urban Medicine Program (UMed) to prepare students for the roles of advocate, researcher, policymaker, and culturally competent practitioner through a four-year curriculum integrating principles of public health with direct interventions in local, underserved communities. This study assessed the program’s effectiveness and evaluated early outcomes.

Method
The authors analyzed data for UMed students (classes 2009–2013) from pre- and postseminar assessments and longitudinal community project progress reports. They also compared UMed and non-UMed outcomes from the same classes, using graduation data and data from two surveys: Medical Students’ Attitudes Toward the Underserved (MSATU) and the Intercultural/Professional Assessment.

Results
UMed students were more likely than non-UMed students to endorse MSATU constructs (“Universal medical care is a right” [P = .01], “Access to basic medical care is a right” [P = .03], “Access is influenced by social determinants” [P = .03]); to be selected for the Gold Humanism Honor Society (P < .0001); to complete joint degrees (P = < .0001); and to enter primary care residencies (P = .002).

Conclusions
Early outcomes reveal that a longitudinal, experiential curriculum can provide students with competencies that may prepare them for leadership roles in advocacy, research, and policymaking. Contact with diverse communities inculcates—in medical students with predispositions toward helping underserved populations—the self-efficacy and skills to positively influence underserved, urban communities.

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