Academic Medicine最新文献

{"title":"This Academic Life.","authors":"Julia Meade","doi":"10.1097/ACM.0000000000006077","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006077","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004450","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 \"Uninsured\" Patient.","authors":"Sujal Manohar","doi":"10.1097/ACM.0000000000006078","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006078","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052124","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 Anatomy of Gratitude.","authors":"David Vishnu Deshpande, Alexandra Diaz-Barbe, Alia Abiad, Aysenur Musaogullari, Nicholas LoRocco","doi":"10.1097/ACM.0000000000006079","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006079","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993685","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":"Teaching What We Have Learned About the Care of the Dying Patient: One Physician's Journey.","authors":"Matthew S Ellman","doi":"10.1097/ACM.0000000000006076","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006076","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048448","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":"Curriculum Research Solutions: Shifting From \"Did It Work Locally?\" to Contributing to a Scholarly Conversation.","authors":"David A Cook, Karen E Hauer, Arianne Teherani, Andrea N Leep Hunderfund, Steven J Durning, Jorie M Colbert-Getz","doi":"10.1097/ACM.0000000000006072","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006072","url":null,"abstract":"<p><strong>Abstract: </strong>Health professions educators frequently seek to study their curriculum (e.g., a new or revised curriculum for a degree-granting program, a component of that curriculum, or a stand-alone course). Despite local enthusiasm, curriculum-focused studies are often hard to publish and have been repeatedly discouraged. Yet few authors have proposed practical solutions. The purpose of this article is to articulate common problems with curriculum research and to propose specific ways in which curriculum research can be accomplished (and published) successfully. The authors define \"research\" as the rigorous, systematic pursuit of new knowledge with intent to disseminate findings in a peer-reviewed forum. They delineate 5 problems with curriculum-focused research as it is typically done: redundancy (failing to build on prior research); context-specificity; confounding and dilution; superficiality (using data sources of convenience); and conceptual obscurity (failing to employ a relevant conceptual framework). To address these problems, they encourage researchers to stop focusing on their local curriculum and instead join and contribute meaningfully to a global scholarly conversation. Engaging in a scholarly conversation involves listening to the conversation (the literature) to understand what is already known, identifying a gap the researcher can fill with a useful observation, and asking and answering a question that other people will find relevant (to their own local needs), novel (not already known), insightful (shedding light on future action), and credible (well-supported by chosen methods). The authors outline 6 prototypical potentially successful curriculum-focused research studies, including quantitative and qualitative approaches, and cite published examples. They also highlight studies to avoid. They conclude by discussing practical considerations: appraisal of research quality; funding of education research; accessing and acquiring needed research skills; measuring provider behaviors and patient outcomes; ethical issues associated with learners as study participants; and tensions between basic and applied research.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027088","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":"Interprofessional Collaboration Between Law and Medicine: Opportunities for Health Equity Through Pathway Programs.","authors":"Nisha Chachad, Arkene Levy, Lauren Fine, Marilyn Uzdavines, Vijay Rajput","doi":"10.1097/ACM.0000000000006075","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006075","url":null,"abstract":"<p><strong>Abstract: </strong>Medical-legal partnerships may be a means of improving health inequity in the United States by offering a unique approach to health disparities among vulnerable patient populations due to their integration of 2 professional perspectives and bidirectional sharing of knowledge. The clinical side of a medical-legal partnership develops patient relationships that allow for identification of this disparity, whereas the legal side settles the underlying structural and political circumstances. Medical-legal partnerships are a rapidly increasing interventional strategy, and modern programs have been implemented within undergraduate and graduate medical education as well as at the attending physician level, thus fulfilling educational competencies while simultaneously remedying health injustice for marginalized patient populations in need. Interprofessional teachings encourage cooperation and mutual respect between soon-to-be physicians and lawyers, with the intention of inspiring engagement in collaborations, such as medical-legal partnerships, once these students begin practice in their respective fields. However, such opportunities for cooperation can be introduced even earlier. To advocate for early implementation of medical-legal partnerships within the careers of future medical and legal professionals, the authors explored both interventional strategies used by existing programs across the United States and novel approaches introduced at Nova Southeastern University, namely, interprofessional debate-based electives for medical and law students as well as pathway programs targeted to underrepresented high school students. Such early exposure to medical-legal partnerships offers experiential learning for medical and law students while introducing high school students to concepts of health equity, thus instilling in them awareness of health determinants as well as confidence in their ability to create meaningful change as future health care and legal professionals.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049679","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":"What Is Taught Versus What Is Learned: Health Advocacy in Specialist Graduate Medical Education.","authors":"Yvonne Ying, Maria Athina Tina Martimianakis, Brett Schrewe","doi":"10.1097/ACM.0000000000006074","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006074","url":null,"abstract":"<p><strong>Purpose: </strong>Health advocacy (HA) is a key component of competency frameworks in many global jurisdictions, yet how HA is taught is not well defined, particularly in specialty graduate medical education. This study explored how residents in these programs came to understand what HA is, what activities it entails, and what importance it carries.</p><p><strong>Method: </strong>This qualitative study conducted semistructured interviews of 39 specialty residents from 2 universities (University of Toronto and University of Ottawa) from July 2019 to June 2023. A reflexive thematic analysis was used, with sensitizing concepts of the formal, informal, and hidden curricula and the CanMEDS health advocate role to construct themes from this data set.</p><p><strong>Results: </strong>Most trainees struggled to define what HA means, what good HA should look like, and which kinds of activities it signifies. The lack of definitional clarity meant that many non-HA activities became conflated with HA, particularly research and quality improvement. Few could recall clear formal curricular content, whereas exposure in clinical training environments was highly variable. Many perceived HA activities as threats to clinical efficiency, of little interest to residency program leadership, and of minimal currency in being competitive for eventual staff positions. Self-identified advocates frequently engaged in self-censoring behaviors because they thought their programs and leaders were often not supportive of this kind of work.</p><p><strong>Conclusions: </strong>Trainees struggled to understand what activities comprise HA because it was not prioritized in their programs or they encountered highly variable role modeling. Trainees who participated in HA activities experienced difficulties integrating HA into their overall clinical skill set due to a lack of institutional support. Health advocacy training requires consideration of structural and cultural reinforcements, including the adoption of curricula that integrate it with daily clinical care and address hidden curriculum effects.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007505","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":"Mentoring and Partnerships for Health Equity Research: Lessons Learned and Impact of a Health Disparity Research Pilot Program for Early Investigators.","authors":"Jennifer A Wong, Rodrigo K Arce Cardozo, Rebecca G Lee, Lorna E Thorpe, Jiyuan Hu, Simona C Kwon, Chau Trinh-Shevrin, Stella S Yi","doi":"10.1097/ACM.0000000000006071","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006071","url":null,"abstract":"<p><strong>Problem: </strong>Lack of federal funding for health research explicitly referencing diverse communities has led to systematic underinvestment in efforts addressing the diverse needs of underresearched populations. This report presents an overview of the Center for the Study of Asian American Health at NYU Langone (CSAAH) Pilot Project Program, which aims to eliminate health disparities and advance health equity among Asian American populations.</p><p><strong>Approach: </strong>Established in 2003, CSAAH mentors early-stage investigators (ESIs) in performing research that builds on connections with community partners for health disparity populations. A central feature is the annual CSAAH Pilot Project Program, which mentors ESIs in health disparities research and independent funding. The program aims to increase the number of ESIs conducting health disparities research using rigorous, community-engaged, transdisciplinary approaches. This report describes the CSAAH Pilot Project Program's operations and evaluates mentee progress across 6 award cycles from September 2017 to June 2024.</p><p><strong>Outcomes: </strong>Across 6 cycles (2017-2024), CSAAH supported 45 projects: 21 by postdoctoral fellows and 24 by junior faculty. Through May 2024, awardees reported receiving 67 grant awards after their pilot funding (totaling >$15.5 million), publishing 803 articles, and receiving 20 career promotions. The program was positively received by awardees and perceived to be beneficial to their careers, with most respondents (>90%) reporting that the mentored research experience improved their capacity for collaborations and knowledge and use of equity-focused methods, provided opportunities to expand their research networks, and supported their career intentions to seek and obtain external funding.</p><p><strong>Next steps: </strong>Planned refinements to the program seek to decentralize learning through multilevel mentorship and sustained engagement across past awardees and the faculty and mentorship teams by matching future awardees by self-identified content areas to senior faculty and \"near-peer\" ESI mentors and continuing annual follow-up through evaluation survey outreach and hosting dedicated, regular touchpoints with program alumni.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057775","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":"A National Survey of Communication Skills Topics Taught in Medical School Clinical Skills Courses.","authors":"Joanne R Hojsak, Nelia Afonso, Kelvin Chang, Felise Milan, Robin K Ovitsh, Yoon Soo Park, Roshini Pinto-Powell, Priya Ramaiah, Ronald C Silvestri, Sarah Yonder, Deepthiman Gowda","doi":"10.1097/ACM.0000000000006073","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006073","url":null,"abstract":"<p><strong>Purpose: </strong>This report describes findings of a survey of clinical skills educators at U.S. Liaison Committee on Medical Education (LCME)-accredited medical schools on the topics covered and pedagogical approaches used in preclerkship communication and interpersonal skills (CIS) curricula.</p><p><strong>Method: </strong>The Directors of Clinical Skills Education, the largest professional society of U.S. preclerkship clinical skills medical educators, developed a cross-sectional survey addressing 33 CIS topics, their pedagogy, and assessment in preclerkship curricula. The survey was sent to 136 LCME-accredited medical schools between November 2020 and April 2021. Descriptive statistics were used to explore trends; bivariate and multivariate analyses were used to examine associations between factors.</p><p><strong>Results: </strong>Results from 97 medical schools (71% response rate) identified a mean (SD) of 53 (38) hours of preclerkship curricula devoted to CIS teaching, with 2 schools (25%) reporting 24 hour or less. Schools reported teaching a mean (SD) of 22 (6) CIS topics, while assessing a mean (SD) of 14 (7). A positive association was found between the duration of CIS curricula and the number of CIS topics taught (r = 0.39, P < .001), practiced (r = 0.38, P < .001), and assessed (r = 0.29, P = .005). A mean (SD) of 22 (6) of the 33 topics were taught, 16 (7) were practiced, and 14 (7) were formatively or summatively assessed. Statistically significant regional variation was found in the teaching of 5 topics.</p><p><strong>Conclusions: </strong>Compared with previous surveys, U.S. medical schools currently teach considerably more CIS topics in preclerkship curricula, reflecting a responsiveness to contemporary social and public health concerns. The expansion of CIS teaching presents challenges, including the need for more time, standardization, and assessment. Medical schools can help address these needs by adopting robust longitudinal and integrated CIS curricula.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059323","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":"Can Stress Be Good for Learning? Pediatric Resident Perspectives on the Beneficial Influence of Stress on Learning and the Role of the Supervisor.","authors":"Jimmy Beck, Kimberly O'Hara, Marieke van der Schaaf, Bridget C O'Brien","doi":"10.1097/ACM.0000000000006069","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006069","url":null,"abstract":"<p><strong>Purpose: </strong>Stress is a ubiquitous phenomenon in medical training, exerting beneficial and harmful effects on learning. The medical education literature focuses primarily on harmful effects. By overlooking beneficial effects, supervisors may miss opportunities to harness the educational value of stress. This study explores pediatric trainees' perspectives on (1) stressors that lead to learning outcomes, (2) the learning outcomes themselves, and (3) the supervisors' role in the stress pathway.</p><p><strong>Method: </strong>Using a stress learning pathway as a guiding framework, the authors conducted a qualitative study in which they interviewed residents from the University of Washington Pediatrics Residency Program from August to October 2023. The authors analyzed interview transcripts using template analysis, creating a template that included codes based on the stress pathway model and codes derived from the data. Using the template, the authors coded the transcripts and developed themes and subthemes.</p><p><strong>Results: </strong>Twenty residents across 3 training years (postgraduate years 1-3) participated. All participants shared examples of when stressful experiences served as catalysts for valuable learning outcomes. Six themes were identified from the participants' narratives: (1) work-related stressors can lead to valuable learning; (2) valuable learning can result from stressors; (3) supervisors are sources of stress when they provide autonomy, hold learners accountable, and set high expectations; (4) supervisors serve as modulators of other stressors that are inherent to being a trainee; (5) senior residents play an integral role in junior residents' stressful experiences more so than attending physicians; and (6) supervisors can use strategies to effectively harness the learning potential of stressors.</p><p><strong>Conclusions: </strong>This study sheds light on the beneficial influence of stress on learning in medical education. Trainees believe that, if properly supported by supervisors, stress can yield valuable learning opportunities. Next steps include obtaining supervisors' perspectives and elucidating supervisor behaviors that maximize learning under stressful conditions.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055039","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}