Academic Medicine最新文献

{"title":"What Drives Clinicians to Teach While Caring for Patients?","authors":"Juan N Lessing, Vineet Chopra","doi":"10.1097/ACM.0000000000005938","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005938","url":null,"abstract":"<p><strong>Abstract: </strong>Past medical education scholarship has explored what to teach, how to teach it better, and the evaluation of what these efforts provide learners. Missing from this dialogue has been the question of what clinician-educators gain from teaching. In this Invited Commentary on Frija-Gruman and colleagues' article \"Learning Through Teaching: How Physicians Learn Medicine in Authentic Clinical Contexts,\" the authors go beyond how and what clinician-educators learn through teaching to what drives clinicians to teach while caring for patients. Using a conceptual framework put forth by Daniel Pink built around the intrinsic domains of autonomy, mastery, and purpose, the authors posit that there are deep-seated psychological motivational principles underpinning the passion for teaching. The authors explore how teaching within patient care uniquely fosters and enhances autonomy (choice over what to do and how), mastery (the pursuit of betterment), and purpose (doing something that feels deeply meaningful and important), and in doing so, they present their rationale for how teaching gives back more to the teacher than is typically recognized. The authors then discuss the obstacles to the realization of teaching's full potential and conclude with a call for recognizing the intrinsic motivators as a key element for clinician-educators and clinical education to thrive.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training Health Professionals to Prevent Heat-Related Illness at Work.","authors":"Eric Persaud","doi":"10.1097/ACM.0000000000005947","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005947","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Exploration of the #MeTooMedicine Online Discourse: \"Holding Beacons of Light to Shine in the Corners They Are Hoping to Keep Dark\".","authors":"Kori A LaDonna, Emily Field, Lindsay Cowley, Shiphra Ginsburg, Chris Watling, Rachael Pack","doi":"10.1097/ACM.0000000000005828","DOIUrl":"10.1097/ACM.0000000000005828","url":null,"abstract":"<p><strong>Purpose: </strong>The MeToo movement forced a social reckoning, spurring women in medicine to engage in the #MeTooMedicine online discourse. Given the risks of reporting sexual violence, discrimination, or harassment, it is important to understand how women in medicine use platforms like Twitter to publicly discuss their experiences. With such knowledge, the profession can use the public documentation of women in medicine for transformative change.</p><p><strong>Method: </strong>Using reflexive thematic analysis, 7,983 tweets (posted between November 2017 and January 2020) associated with #WomenInMedicine, #MeTooMedicine, and #TimesUpHC were systematically analyzed in 2020-2022, iteratively moving from describing their content, to identifying thematic patterns, to conceptualizing the purpose the tweets appeared to serve.</p><p><strong>Results: </strong>The Twitter engagement of women in medicine was likened to \"holding beacons of light to shine in the corners [harassers] are hoping to keep dark,\" both reinforcing the message that \"gender bias is alive and well\" and calling for a \"complete transformation in how we approach\" the problem. The tweets of women in medicine primarily seemed aimed at disrupting complacency; encouraging bystanders to become allies; challenging stereotypes about women in medicine; championing individual women leaders, peers, and trainees; and advocating for reporting mechanisms and policies to ensure safety and accountability across medical workplaces.</p><p><strong>Conclusions: </strong>Women in medicine appeared to use Twitter for a host of reasons: for amplification, peer support, advocacy, and seeking accountability. By sharing their experiences publicly, women in medicine seemed to make a persuasive argument that time is up, providing would-be allies with supporting evidence of sexual violence, discrimination, and harassment. Their tweets suggest a roadmap for what is needed to achieve gender equity, ensure that lack of awareness is no longer an excuse, and ask bystanders to grapple with why women's accounts continue to be overlooked, ignored, or dismissed and how they will support women moving forward.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1405-1412"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Clinical Learning Environments: Strategies to Foster Belonging in Graduate Medical Education.","authors":"Holly J Humphrey, David Blumenthal, Patricia Poitevien","doi":"10.1097/ACM.0000000000005860","DOIUrl":"10.1097/ACM.0000000000005860","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"S1-S4"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 Dr. Hope Babette Tang Humanism in Healthcare Essay Contest: First-Place Nursing Student Essay: Baby J.'s Song.","authors":"Hailey Sommerfeld","doi":"10.1097/ACM.0000000000005814","DOIUrl":"10.1097/ACM.0000000000005814","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"99 12","pages":"1346-1347"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hippocrates: An Oath in Entering Medicine and Milestones: A Meditation on Growth.","authors":"Emily M Pang","doi":"10.1097/ACM.0000000000005477","DOIUrl":"10.1097/ACM.0000000000005477","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1344"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Justice in Clinical Learning Environments: Development and Validation of an Organizational Justice Measure for Medical Trainees.","authors":"Michael J Cullen, Jessica Hane, You Zhou, Benjamin K Seltzer, Paul R Sackett, Susan M Culican, Krima Thakker, John Q Young, Taj Mustapha","doi":"10.1097/ACM.0000000000005669","DOIUrl":"10.1097/ACM.0000000000005669","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop an instrument to measure medical trainees' perceptions of justice in clinical learning environments.</p><p><strong>Method: </strong>Between 2019 and 2023, the authors conducted a multiyear, multi-institutional, multiphase study to develop a 16-item justice measure with 4 dimensions: interpersonal, informational, procedural, and distributive. The authors gathered validity evidence based on test content, internal structure, and relationships with other variables across 3 phases. Phase 1 involved drafting items and gathering evidence that items measured intended dimensions. Phase 2 involved analyzing relevance of items for target groups, examining interitem correlations and factor loadings in a preliminary analysis, and obtaining reliability estimates. Phase 3 involved a confirmatory factor analysis and collecting convergent and discriminant validity evidence.</p><p><strong>Results: </strong>In phase 1, 63 of 91 draft items were retained following a content validation exercise gauging how well items measured targeted dimensions (mean [SD] item ratings within dimensions, 4.16 [0.36] to 4.39 [0.34]) on a 5-point Likert scale (with 1 indicating not at all well and 5 indicating extremely well). In phase 2, 30 items were removed due to low factor loadings (i.e., < 0.40), and 4 items per dimension were selected (factor loadings, 0.42-0.89). In phase 3, a confirmatory factor analysis supported the 4-dimensional model ( χ2 = 610.14, P < .001; comparative fit index = 0.90, Tucker-Lewis Index = 0.87, root mean squared error of approximation = 0.11, standardized root mean squared residual = 0.06), with convergent and discriminant validity evidence showing hypothesized positive correlations with a justice measure ( r = 0.93, P < .001), trait positive affect ( r = 0.46, P < .001), and emotional stability ( r = 0.33, P < .001) and negative correlations with trait negative affect ( r = -0.39, P < .001).</p><p><strong>Conclusions: </strong>Results indicate the measure's potential utility in understanding justice perceptions and designing targeted interventions.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1374-1384"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential of Using ChatGPT-4 Vision for Detecting Image Manipulation in Academic Medicine Articles.","authors":"Lingxuan Zhu, Haoran Zhang, Peng Luo","doi":"10.1097/ACM.0000000000005873","DOIUrl":"10.1097/ACM.0000000000005873","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1320-1321"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Tattooed Connection: Nurturing Curiosity in Medicine.","authors":"Rémi Esclassan, Emmanuelle Noirrit, Marie Georgelin-Gurgel, Charlotte Mansuy, Jean-Noël Vergnes","doi":"10.1097/ACM.0000000000005883","DOIUrl":"10.1097/ACM.0000000000005883","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"99 12","pages":"1451"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in Clinical Performance Assessment of Internal Medicine Residents: A Longitudinal Analysis of the Influence of Faculty and Trainee Gender.","authors":"Robin Klein, Katherine A Julian, Jennifer Koch, Erin D Snyder, Simerjot Jassal, Wendy Simon, Alex Millard, Brian Uthlaut, Sherri-Ann M Burnett-Bowie, Nneka N Ufere, Sarah Alba-Nguyen, Anna Volerman, Vanessa Thompson, Anshul Kumar, B A White, Yoon Soo Park, Kerri Palamara","doi":"10.1097/ACM.0000000000005884","DOIUrl":"10.1097/ACM.0000000000005884","url":null,"abstract":"<p><strong>Purpose: </strong>Competency-based medical education relies on equitable assessment. This study examined the influence of faculty and trainee gender on assessments of internal medicine (IM) resident performance over time.</p><p><strong>Method: </strong>A longitudinal analysis of clinical performance assessments from 7 U.S. IM residency programs (July 2014-June 2019) was conducted. Core competency scores (patient care [PC], medical knowledge [MK], practice-based learning and improvement [PBLI], systems-based practice [SBP], professionalism [PROF], and interpersonal and communication skills [ICS]) were standardized across programs. Cross-classified mixed-effects linear regression evaluated the relationship between gender and standardized competency scores within training programs, while adjusting for multiple variables including IM In Training Examination percentile rank.</p><p><strong>Results: </strong>Data included 9,346 evaluations by 1,011 faculty (552 [55%] men, 459 [45%] women) for 664 residents (358 [54%] men, 306 [46%] women). Initially, women residents' scores were significantly lower than men's in PC (estimated difference [standard error], -0.097 [0.033]; P = .004), MK (-0.145 [0.034], P < .001), and PBLI (-0.090 [0.040], P = .022). PC, MK, PBLI, and SBP scores increased more over time for women residents than men (PC: 0.050 [0.015], P = .001; MK: 0.052 [0.015], P = .001; PBLI: 0.036 [0.018], P = .048; SBP: 0.036 [0.016], P = .027). PROF and ICS scores were comparable across gender. There was a significant interaction between faculty gender and postgraduate year (PGY) across all competencies but none between resident gender, faculty gender, and PGY, indicating that men and women faculty rated residents differently over time but were consistent in how they rated men and women residents.</p><p><strong>Conclusions: </strong>Gender-based assessment differences were variable across competencies and time. Women residents had lower scores initially but greater gains in \"hard skill\" (MK, PC, and PBLI) than in \"soft skill\" (ICS and PROF) competencies, suggesting assessment inequities. Efforts to ensure equitable assessment are needed.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1413-1422"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}