Academic Medicine最新文献

{"title":"Commentary on The Penitent Magdalen.","authors":"J Brewer Eberly","doi":"10.1097/ACM.0000000000006161","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006161","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610263","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":"Development and Validation of a Model to Predict Milestone Levels Based on Entrustable Professional Activity Entrustment-Supervision Levels.","authors":"Daniel J Schumacher, Benjamin Kinnear, Catherine Michelson, David A Stewart, Bruce E Herman, Adam D Wolfe, Ariel Winn, Jaclyn Boulais, David A Turner, Heather B Howell, Alan Schwartz","doi":"10.1097/ACM.0000000000006165","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006165","url":null,"abstract":"<p><strong>Purpose: </strong>Residency programs are increasingly interested in or required to assess residents using Accreditation Council for Graduate Medical Education (ACGME) milestones and specialty-defined entrustable professional activities (EPAs). The authors aimed to develop a model to predict individual residents' milestone levels based on their assigned EPA entrustment-supervision levels.</p><p><strong>Method: </strong>During 3 academic years from 2021 to 2024, the authors conducted a multisite prospective cohort study at 48 U.S. pediatric residency programs. Programs collected entrustment-supervision levels for the 17 general pediatrics EPAs and milestone levels for the 22 ACGME pediatric milestones for every resident biannually. EPA and milestone ratings were assigned by clinical competency committees. The first 4 of 6 biannual data reporting cycles were used to fit multilevel structural equation models and produce equations to generate, for each resident, predicted milestone levels based on EPA entrustment-supervision levels. They developed 2 models: one using 17 EPAs and one using 12 EPAs.</p><p><strong>Results: </strong>Data used for modeling represented 4,328 residents, with 164,886 total entrustment-supervision levels across the general pediatrics EPAs and 243,949 total milestone levels across the pediatric milestones. The fit of the round 1 to 4 model to the round 1 to 4 data (internal prediction) was excellent for both models, with comparative fit indexes of 0.982 (17 EPAs) and 0.981 (12 EPAs). The ability of the round 1 to 4 model to predict milestones for reporting cycles 5 and 6 (external prediction) was similar to the internal predictions, with correlation coefficients of 0.68 (17 EPAs) and 0.69 (12 EPAs) for round 5 and 0.72 (17 EPAs) and 0.68 (12 EPAs) for round 6.</p><p><strong>Conclusions: </strong>This study demonstrates a strong ability to predict milestone levels based on EPA entrustment-supervision levels in a manner that enables meaningful use of EPAs and milestones in assessment efforts at residency programs.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610180","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":"Commentary on \"My Physio-Haiku\".","authors":"An Huynh Bao","doi":"10.1097/ACM.0000000000006162","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006162","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610261","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 Landscape of Transition to Residency Courses in the United States: Results of a National Survey.","authors":"Lauren A Heidemann, Kristen E Fletcher, Diane Levine, Matthew Rustici, Genie Roosevelt, M Kathryn Mutter","doi":"10.1097/ACM.0000000000006160","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006160","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the current landscape of transition to residency (TTR) courses in the United States.</p><p><strong>Method: </strong>A nonincentivized survey was distributed electronically from October 2023 to March 2024 to contacts at 187 accredited US medical schools (153 allopathic and 34 osteopathic schools). The survey inquired about the presence of a TTR course or plans for implementation. For schools with a course, respondents were asked about course requirements, content, structure, duration, resources used, assessment framework, grading, remediation, professionalism concerns, and faculty support.</p><p><strong>Results: </strong>Of the 187 surveyed medical schools, 132 (70.6%) responded; 115 (87.1%) have a TTR course, with 8 of the 16 medical schools (50.0%) without a TTR course planning to implement one in the next 3 years. Ninety-one courses (79.1%) are required. The median (range) duration of the shared TTR course is 2 (0-10) weeks. The most commonly used external resources are MedEdPORTAL (40 [34.8%]) and the TTR compendium (37 [32.2%]). Sixty-seven schools (58.3%) structure the course using Accreditation Council for Graduate Medical Education core competencies and/or milestones. Grades are predominantly pass/fail (108 [93.9%]); 21 schools (18.3%) incorporate remediation. Topics include responding to common inpatient issues, pages from nurses, and rapid responses and codes. A total of 105 respondents (91.3%) reported at least one student in their course with professionalism concerns. Respondents with knowledge about full-time equivalent faculty support (75 [65.2%]) revealed that the total median full-time equivalent support for all TTR faculty is 0.1 (interquartile range, 0-0.3; range, 0 to >2).</p><p><strong>Conclusions: </strong>Most medical schools have a TTR course, but aspects of the course vary. Future directions to improve the national TTR experience include the creation of standardized content, validated assessments, and collaborative research examining the impact of TTR courses on interns and the programs to which they match.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610181","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":"Commentary on Anne and her Nurse.","authors":"Sam Woodworth, Katie Florescu","doi":"10.1097/01.ACM.0001122868.65809.73","DOIUrl":"10.1097/01.ACM.0001122868.65809.73","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 7","pages":"789"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486861","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":"In Reply to Tran et al.","authors":"Henry Bair, David J Taylor Gonzalez, Mak B Djulbegovic","doi":"10.1097/ACM.0000000000006031","DOIUrl":"10.1097/ACM.0000000000006031","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"761-762"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625989","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":"Establishing Consensus on the Most Important Teaching Skills for Internal Medicine Residents in Clinician Educator Tracks: A Modified Delphi Study.","authors":"Andrew J Klein, Allie Dakroub, Melissa McNeil, Rongrong Wang, Scott D Rothenberger, Sarah B Merriam","doi":"10.1097/ACM.0000000000006004","DOIUrl":"10.1097/ACM.0000000000006004","url":null,"abstract":"<p><strong>Purpose: </strong>Internal medicine (IM) residency programs with clinician educator tracks (CETs) have increased during the past decade; however, no standardized list of learning domains and competencies exists. The authors use a modified Delphi approach to determine a consensus set of teaching skills for IM CET residents.</p><p><strong>Method: </strong>A CET teaching skills list was developed from June to August 2023 via a PubMed search through July 31, 2023, by University of Pittsburgh faculty physicians. Seventy-seven potential participants were identified through professional society listservs and publications. Between January and February 2024, participants (current or former CET directors within an IM residency program) iteratively ranked teaching skills based on importance for IM CET residents from 1 (less important) to 4 (most important) for 2 online surveys. Consensus was defined a priori as 80% agreement or higher that a skill is important or most important. Participants identified the most appropriate training level for each skill and the most critical teaching skills for CET residents.</p><p><strong>Results: </strong>Forty-one experts participated, with 31 (76%) completing both surveys. Of the 29 teaching skills in round 1, 12 achieved consensus as important. In round 2 (24 teaching skills), 5 additional teaching skills achieved consensus as important. Panelists ranked the most critical teaching skills for CET residents: teaching in different settings, communicating feedback, fostering a conducive learning climate, teaching across different learner levels, creating learning goals and objectives, and developing and delivering effective chalk talks.</p><p><strong>Conclusions: </strong>This study offers national consensus on a prioritized list of teaching skills for IM CET residents. Consensus skills were foundational and intentional, important for all deliberate educators, and aligned with 2 CE milestone subcompetencies (universal pillars and educational theory and practice). Nonconsensus skills were generally more advanced. Current and aspiring CET leadership can leverage these recommendations to develop and critically appraise CET curricula.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"836-843"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575975","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":"Substance Use and Pain Curriculum Innovation: Establishing a Student-Faculty Partnership for Curricular Change.","authors":"Rory Vu Mather, Helen E Jack, Katherine E Warren, Cameron Comrie, Sienna Li, Michael Liu, Erika Lynn-Green, Sydney Moore, William Oles, Shahin A Saberi, E J Jarvie, Anjali Koka, Patrick McGuire, Antje M Barreveld, Hilary S Connery, Todd Griswold","doi":"10.1097/ACM.0000000000006018","DOIUrl":"10.1097/ACM.0000000000006018","url":null,"abstract":"<p><strong>Problem: </strong>The opioid overdose crisis had progressed broadly in the United States, with a 21% increase from 2016 to 2017, and specifically in Massachusetts, with a peak rate of 1,374 deaths in 2016. In 2016, students and faculty at Harvard Medical School (HMS) established the Substance Use and Pain Curriculum Committee (SUPCC) to expand substance use and pain education. However, faculty capacity, financial resources, and administrative support were insufficient to implement changes across all phases of the medical school curriculum.</p><p><strong>Approach: </strong>The HMS SUPCC restructured in 2021 to put students at the forefront of curricular development. This restructuring was done through 3 main innovations: (1) establishment of a student-centered committee structure, ensuring that curricular changes are centered on student interests and needs; (2) student-led curricular development and implementation, reducing faculty workload; and (3) focus on clinically relevant teaching and opportunities to practice learned skill sets.</p><p><strong>Outcomes: </strong>This student-centered structure facilitated the expansion of the addiction and pain medicine curriculum to more than 30 hours of teaching by 2024. Examples of student-driven initiatives include development of an opioid use disorder management practicum equivalent to the Drug Enforcement Agency X-waiver, increased medical student access to naloxone through a hospital partnership, and integration of case-based opioid use disorder and pain medicine didactics into the clerkship year.</p><p><strong>Next steps: </strong>Although this work has established a longitudinal curriculum across all medical training stages, more must be done in clerkship rotations to help students apply their substance use and pain education in the clinical setting. The HMS SUPCC is working to incorporate teaching on nonopioid substances, such as alcohol, cannabis, and ketamine; provide longitudinal clinical experiences so students learn to care for patients with substance use disorder and chronic pain from short-term intervention to long-term recovery; and develop surveys to quantitatively and qualitatively measure curriculum outcomes.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"790-795"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Practical Approach to Quality Improvement Education for New Educators.","authors":"Sherry Liang, Jacob Khoury","doi":"10.1097/ACM.0000000000006024","DOIUrl":"10.1097/ACM.0000000000006024","url":null,"abstract":"<p><strong>Abstract: </strong>The Accreditation Council for Graduate Medical Education's mandate for quality improvement (QI) training in residency programs has generated discussion in the literature of QI best practices and curriculum models. Despite this requirement, residents continue to report limited exposure to domains like available QI expertise, access to data collection, QI knowledge, and ability to complete all project stages.While the barriers to successful QI project implementation are numerous, the lack of experienced QI educators is also a major limitation. Educators new to QI education may not know how to approach common project pitfalls residents face, namely their tendency to jump to the \"do\" phase in a Plan-Do-Study-Act (PDSA) cycle without prior framing of the problem through process evaluation and identification of timely measures. These pitfalls can lead to many unintended consequences, including diminished physician engagement in QI work.To focus residents on learning about health systems, the authors draw on their collective experiences as learners and educators to propose a practical approach for new QI educators, consisting of 4 objectives: (1) illustrate and evaluate the process; (2) obtain meaningful and timely measures; (3) propose an intervention and obtain feedback from high-level stakeholders; and (4) reflect on lessons learned throughout the endeavor. The authors assert that by prioritizing these objectives before embarking on a PDSA cycle, residents will learn more about systems of care, gain competency in analyzing these systems, and continue QI efforts successfully in their future careers.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"776-780"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607018","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":"Fostering Global Research Collaborations: An Update on Duke-NUS Medical School, the Duke University and National University of Singapore Partnership.","authors":"May May Yeo, Patrick J Casey, R Sanders Williams, Silke Vogel, Michael L James","doi":"10.1097/ACM.0000000000006006","DOIUrl":"10.1097/ACM.0000000000006006","url":null,"abstract":"<p><strong>Problem: </strong>Navigating the complexities of international research collaborations is a challenge. This article provides a detailed examination of the international collaboration between Duke University and the National University of Singapore to establish the Duke-NUS Medical School. It explores the evolution and impact of the partnership, focusing on outcomes, knowledge advancement, and the dynamics of international collaborations in academic medicine.</p><p><strong>Approach: </strong>The partnership began in 2005 and applies a collaborative approach, including aligning research foci with Singapore's national health priorities, the formation of an academic medical center, faculty exchanges, joint funding for pilot research, and pooling of expertise, diverse and multiethnic data, and samples.</p><p><strong>Outcomes: </strong>The collaboration has led to educational and research advancements, including significant contributions to global health, such as the development of the first U.S. Food and Drug Administration-approved SARS-CoV-2 antigen test and a nasal COVID-19 vaccine candidate. Additionally, it has enhanced academic medicine capabilities within Singapore by transforming teaching hospitals into a fully integrated academic medical center. This experience suggests the following toward advancing the partnership: (1) agreement on and revisiting of the shared vision of the partnership by institutional leaders, (2) middle- and end-period reviews within multiyear funding cycles from local ministries, (3) faculty engagement through collaborative resources and spaces, and (4) similar first languages and health systems of the partners.</p><p><strong>Next steps: </strong>The Duke-NUS Medical School partnership aims to expand its research areas to address more global health challenges, such as the impact of climate change on health and the advancement of precision medicine. This article offers valuable insights for understanding the dynamics, benefits, and challenges of international collaborations in academic medicine.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"796-800"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}