Academic Medicine最新文献

{"title":"Monet Refuses the Operation.","authors":"Lisel Mueller","doi":"10.1097/ACM.0000000000006038","DOIUrl":"10.1097/ACM.0000000000006038","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1028-1029"},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665295","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":"Adverse Childhood Experiences, Psychological Distress, and Resilience in Health Professions Students.","authors":"Andrés F Sciolla, Cara M Sandholdt, Karl E Jandrey, Margaret Rea, Elizabeth I Rice, Machelle D Wilson, Michael S Wilkes","doi":"10.1097/ACM.0000000000006093","DOIUrl":"10.1097/ACM.0000000000006093","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the relationship between adverse childhood experiences (ACEs), social disadvantage, psychological distress, and resilience in graduate health professions students.</p><p><strong>Method: </strong>This study includes cross-sectional analyses from a longitudinal survey of medical, veterinary, and advanced practice provider students at matriculation to the University of California Davis in July 2019. The survey contained an expanded Adverse Childhood Experiences Questionnaire (ACEs-14), a measure of psychological distress (the Medical Student Well-Being Index [MSWBI]), and the Brief Resilience Scale. Responses were linked to demographics, including markers of social disadvantage (female gender, underrepresented in medicine [URM] status, and first-generation college graduate [first-gen] status). The relationships between ACEs, social disadvantage, psychological distress, and resilience were tested using linear or logistic regression.</p><p><strong>Results: </strong>Complete survey responses were provided from 240 of 357 students (67% completion rate). About two-thirds of students (67%, 161/240) reported ≥ 1 ACE, while a quarter (25%, 60/240) reported ≥ 4 ACEs. URM and first-gen students had higher odds of reporting ≥ 4 ACEs (odds ratio [OR] = 1.56; P = .049 and OR = 2.63; P < .001, respectively) than their nondisadvantaged peers based on binary logistic regression analysis. Higher ACEs-14 scores were associated with higher psychological distress scores ( P < .001). The majority of students reported normal or high resilience (normal: 76%, 183/240; high: 10%, 25/240) regardless of ACEs-14 scores. There was not a statistically significant relationship between ACEs-14 scores and resilience scores ( P = .936).</p><p><strong>Conclusions: </strong>Health professions students from some socially disadvantaged backgrounds at this institution reported statistically significantly higher ACEs-14 scores than their nondisadvantaged peers. Childhood adversity was associated with increased psychological distress but not with low resilience. Implications for equity- and trauma-informed health professions education and interventions are discussed.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1051-1060"},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129338","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":"There's Hope for You.","authors":"John E Ukadike","doi":"10.1097/ACM.0000000000006230","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006230","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006846","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 Power of Human Connection.","authors":"Ilana Hayutin","doi":"10.1097/ACM.0000000000006232","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006232","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006848","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":"It Takes More Than Enthusiasm: The Missing Infrastructure to Unlock AI's Potential in Medical Education.","authors":"Laurah Turner, Christine Zhou, Jesse Burk-Rafel","doi":"10.1097/ACM.0000000000006104","DOIUrl":"10.1097/ACM.0000000000006104","url":null,"abstract":"<p><strong>Abstract: </strong>Generative artificial intelligence (AI), including large language models (LLMs), is rapidly transforming health care delivery, yet medical education remains unprepared to harness its potential or mitigate its risks. While AI holds immense potential to enhance medical education, unguided adoption of these tools without proper educational frameworks risks undermining learners' clinical reasoning development and professional growth, as was seen with the electronic health record. In this commentary, the authors argue that the primary barrier to effective AI integration in medical education is not technological sophistication, but rather 3 critical infrastructure deficiencies: institutional implementation structures, sustainable funding mechanisms, and rigorous research methodologies. The authors propose establishing dedicated educational informatics teams with executive authority, creating targeted funding streams modeled after clinical research investments, and developing rigorous assessment frameworks with clear benchmarks for educational outcomes. Without these foundational elements, AI integration risks exacerbating inequities between institutions, potentially compromising physician development, and ultimately failing to improve patient care. Recommendations developed at a Macy Foundation conference on AI and Medical Education provide a roadmap for addressing these challenges, but significant infrastructural support is required to realize their potential. The authors argue that failure to address these structural gaps would perpetuate a cycle of innovation without implementation, a challenge that has plagued medical education for decades. In an era when AI is reshaping clinical practice daily, trainees cannot afford another well-intentioned but under-resourced educational transformation. Transformative educational change demands more than enthusiasm-it requires institutional commitment, significant investment, and methodological rigor commensurate with the high stakes of physician preparation.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"S34-S38"},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210122","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":"Macy Foundation Innovation Report Part II: From Hype to Reality: Innovators' Visions for Navigating AI Integration Challenges in Medical Education.","authors":"Brian C Gin, Kate LaForge, Jesse Burk-Rafel, Christy K Boscardin","doi":"10.1097/ACM.0000000000006117","DOIUrl":"10.1097/ACM.0000000000006117","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial intelligence (AI) promises to significantly impact medical education, yet its implementation raises important questions about educational effectiveness, ethical use, and equity. In the second part of a 2-part innovation report, which was commissioned by the Josiah Macy Jr. Foundation to inform discussions at a conference on AI in medical education, the authors explore the perspectives of innovators actively integrating AI into medical education, examining their perceptions regarding the impacts, opportunities, challenges, and strategies for successful AI adoption and risk mitigation.</p><p><strong>Method: </strong>Semistructured interviews were conducted with 25 medical education AI innovators-including learners, educators, institutional leaders, and industry representatives-from June to August 2024. Interviews explored participants' perceptions of AI's influence on medical education, challenges to integration, and strategies for mitigating challenges. Transcripts were analyzed using thematic analysis to identify themes and synthesize participants' recommendations for AI integration.</p><p><strong>Results: </strong>Innovators' responses were synthesized into 2 main thematic areas: (1) AI's impact on teaching, learning, and assessment, and (2) perceived threats and strategies for mitigating them. Participants identified AI's potential to enact precision education through virtual tutors and standardized patients, support active learning formats, enable centralized teaching, and facilitate cognitive offloading. AI-enhanced assessments could automate grading, predict learner trajectories, and integrate performance data from clinical interactions. Yet, innovators expressed concerns over threats to transparency and validity, potential propagation of biases, risks of over-reliance and deskilling, and institutional disparities. Proposed mitigation strategies emphasized validating AI outputs, establishing foundational competencies, fostering collaboration and open-source sharing, enhancing AI literacy, and maintaining robust ethical standards.</p><p><strong>Conclusions: </strong>AI innovators in medical education envision transformative opportunities for individualized learning and precision education, balanced against critical threats. Realizing these benefits requires proactive, collaborative efforts to establish rigorous validation frameworks; uphold foundational medical competencies; and prioritize ethical, equitable AI integration.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"S22-S29"},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250691","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":"Beneath the Skin: A Humanistic Approach to Medical Education.","authors":"Rachael Maile Johnson","doi":"10.1097/ACM.0000000000006236","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006236","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006872","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":"Differential Professional and Personal Impacts of the COVID-19 Pandemic on Early Career Researchers.","authors":"Lucy O Alejandro, Monica Kowalczyk, Sandra A Ham, Valerie G Press, Rachel K Wolfson, Vineet M Arora, Anna Volerman","doi":"10.1097/ACM.0000000000006005","DOIUrl":"10.1097/ACM.0000000000006005","url":null,"abstract":"<p><strong>Purpose: </strong>Early career researchers (ECRs) are crucial to scientific advancement, but ECRs, particularly those from underrepresented groups, face unique challenges as they establish careers. Given the disruptions of the COVID-19 pandemic, this study aimed to identify the pandemic's professional and personal impacts on ECRs.</p><p><strong>Method: </strong>This national cross-sectional survey study assessed the effects of the COVID-19 pandemic among ECRs by gender, sexual orientation, race, and ethnicity. Between September and December 2021, the authors invited the 4,440 ECRs with National Institutes of Health training awards in 2020 to complete an online survey with measures assessing career, personal life, and demographics.</p><p><strong>Results: </strong>Of 4,440 eligible ECRs, 1,524 (34.3%) completed the survey and 1,458 (32.8%) met inclusion criteria. Most respondents reported negative impacts to in-person conference cancellations (1,355 [93.1%]), research productivity (K award, 1,148 [87.4%]; overall, 1,192 [81.8%]), career trajectory (891 [61.2%]), and mental health (1,189 [88.1%]). Respondents with childcare responsibilities commonly reported negative impacts (801 [80.1%]). On average, respondents reporting negative impacts identified with more underrepresented groups than those reporting nonnegative impacts for certain measures, such as research productivity (K award, 0.92 vs 0.73, P < .001; overall, 0.92 vs 0.79, P = .01) and mental health (0.92 vs 0.81, P = .03). In free responses, respondents expressed stress as they balanced overwhelming demands of emerging careers and personal lives. Despite setbacks, many respondents cited new opportunities, including new projects (1,156 [79.3%]), new collaborators (926 [63.5%]), and increased flexibility (894 [61.3%]).</p><p><strong>Conclusions: </strong>The pandemic had significant, largely negative, and unequal impacts on ECRs. Underrepresented ECRs were particularly susceptible to pandemic disruptions, potentially exacerbating existing challenges. Individual- and organizational-level interventions are critical to rejuvenate and sustain the early career research pathway. These interventions will foster the success of the next generation of biomedical scientists and the future of scientific advancement.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1080-1089"},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517202","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":"Creating More Reliable Large Language Models in Medical Education.","authors":"Nicholas J Cione, Malford T Pillow","doi":"10.1097/ACM.0000000000006058","DOIUrl":"10.1097/ACM.0000000000006058","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1001"},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765796","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":"10.1097/ACM.0000000000006078","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1089"},"PeriodicalIF":5.2,"publicationDate":"2025-09-01","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}