Academic Medicine最新文献

{"title":"To Empty a Wheelchair: Looking Beyond the Hospital Doors.","authors":"Madeline Blatt","doi":"10.1097/ACM.0000000000006016","DOIUrl":"10.1097/ACM.0000000000006016","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"871"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558657","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":"Using Generative Artificial Intelligence When Writing Letters of Recommendation.","authors":"Juliana Coraor Fried, Natasha R Johnson, Andrea Pelletier, Adam Landman, Deborah Bartz","doi":"10.1097/ACM.0000000000006047","DOIUrl":"10.1097/ACM.0000000000006047","url":null,"abstract":"<p><strong>Abstract: </strong>Artificial intelligence (AI) provides an opportunity to streamline tasks within academic medicine. Generative AI (genAI) models, specifically, have the capacity to generate new written content, follow detailed instructions for product improvement, and incorporate content from supplemental data sources. While a part of the professional responsibility of faculty in academic medicine, writing letters of recommendation (LORs) is often time consuming and repetitive candidate to candidate. Yet, crafting these letters well is paramount to convey an applicant's unique attributes in a time when pass/fail grading and remote interviews are increasingly common.In this article, the authors provide an approachable framework for the ethical use of genAI to assist with writing LORs in academic medicine. They briefly discuss the fundamental structure of genAI, the advantages between several genAI models specifically for the task of letter writing, privacy concerns that can develop when using genAI, iterative methods to develop effective prompts to craft letter drafts, personalization of finalized content, genAI use to identify bias, and appropriate documentation of AI usage.Once practiced, this process can prevent the need for shortcuts, such as copying and pasting from CVs or reusing previously written letters between candidates, that currently sacrifice letter quality to reduce writing time. Ethical use, privacy, and disclosure necessitate a deliberate framework for the use of genAI in letter writing. Future research is needed to inform the development of a specific AI model to generate LORs. The framework presented here provides faculty with the steps needed to begin incorporating genAI into their letter writing practice.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"769-775"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702022","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":"Commentary on \"The Story We Are Not Telling\".","authors":"Nneka Ede","doi":"10.1097/01.ACM.0001122864.74492.d4","DOIUrl":"10.1097/01.ACM.0001122864.74492.d4","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 7","pages":"787"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486860","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":"Facilities and Administrative Cost Rates at Historically Black Colleges and Universities: Strategies for Building Research Competitiveness.","authors":"James E K Hildreth, Aramandla Ramesh, Anil Shanker","doi":"10.1097/ACM.0000000000006067","DOIUrl":"10.1097/ACM.0000000000006067","url":null,"abstract":"<p><strong>Abstract: </strong>In a funding landscape marked by dwindling traditional revenue streams, research programs at historically Black colleges and universities (HBCUs) face heightened financial strain. The article by Hauschildt and colleagues brings to light the differences in the facilities and administrative (F&A) cost rates between HBCUs and non-HBCU institutions, spotlighting persisting, long-standing differences in sponsored research funding. F&A costs (previously referred to as indirect costs)-research dollars that are not readily assignable to a specific project or activity but are incurred by the institution for the joint benefit of research and development projects and activities-help to absorb the costs associated with the upkeep of facilities, infrastructure, and administrative support required to sustain research operations. Yet, HBCUs often receive lower F&A rates than their non-HBCU counterparts. Given the unique role HBCUs play in training African American physicians, dentists, scientists, engineers, etc., appropriately optimized F&A cost rates are critical to strengthen the resource-limited sponsored research enterprises at HBCUs. This commentary examines the underlying gaps in funding between HBCUs and non-HBCU institutions and explores differences in F&A cost calculation methods, often using Meharry Medical College-one of the nation's oldest historically Black medical schools-as a case example. The authors offer strategies across policy, government, corporate, and institutional levels to establish fairer F&A cost structures and facilitate research capacity-building at HBCUs, enabling them to fully realize their untapped potential and contribute to research excellence, innovation, and national competitiveness.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"764-768"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047152","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":"Perceptions of Ad Hoc Entrustment, the Need for Supervision, and Coping Strategies in Clinical Residents: A Qualitative Study.","authors":"Seraina Petra Lerch, Sören Huwendiek, Mathieu Nendaz, Stefan Klöppel, Severin Pinilla","doi":"10.1097/ACM.0000000000006019","DOIUrl":"10.1097/ACM.0000000000006019","url":null,"abstract":"<p><strong>Purpose: </strong>Negotiating the balance between clinical residents' roles as health care practitioners and learners is a struggle in postgraduate medical education. Although ad hoc entrustment has been studied in this context, little is known about residents' perceptions of ad hoc over- and underentrustment, the need for supervision, and their coping strategies. Therefore, this study explored residents' perspectives concerning these topics.</p><p><strong>Method: </strong>The authors conducted semistructured, in-depth interviews with 12 purposively sampled residents in the graduate medical educational phase of residency who were involved in geriatric psychiatry rotations from different training sites and settings in Switzerland. The interviews were conducted between January and March 2022. Researchers used a thematic analysis to explore and interpret the data within a constructivist research paradigm.</p><p><strong>Results: </strong>Four overarching themes were identified: ad hoc and default entrustment in the workplace, perceptions of supervision, applied coping strategies to over- and underentrustment, and suggestions for improvement. Residents described entrustment decisions in the workplace as a default, often covert process and as an explicit, ad hoc delegation of clinical tasks. Perceived optimal supervision entailed sufficient time, frequency, and availability of the supervision, supervisors referring to scientific evidence in their reasoning, trustworthiness, and a psychologically safe learning environment. Residents described suboptimal supervision as lacking appropriate feedback timing, having little or nonexistent time in general, using an ambivalent communication style, and clinical decision-making by the supervisor that is not explicit. Residents applied instrumental, appraisal-focused, and emotion-focused coping strategies. Their suggestions for improvement included instructional design of the workplace-based curriculum, supervision, teaching content, and contextual factors.</p><p><strong>Conclusions: </strong>Within postgraduate training, addressing the organizational and contextual factors of entrustment and resident supervision is essential. Default entrustment decisions need to be explored and explicitly addressed to prevent overentrustment, meet residents' need for supervision, and effectively coach residents to maintain their well-being.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"844-851"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574591","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":"Comparative Evaluation of Self-Learning Versus Instructor-Guided Cardiac Ultrasonography Training.","authors":"Omer Ilan, Amit Perlin, Ido Peles, Itamar Ben-Shitrit, Lior Fuchs","doi":"10.1097/ACM.0000000000006020","DOIUrl":"10.1097/ACM.0000000000006020","url":null,"abstract":"<p><strong>Purpose: </strong>Point-of-care ultrasonography (PoCUS) has improved the diagnostic capacity of medical conditions; however, integrating it into medical curricula is constrained by cost, time, accessibility, and teaching style variability. This study examines whether simulator-based self-learning for cardiac PoCUS is noninferior to instructor-guided teaching.</p><p><strong>Method: </strong>This randomized controlled trial, conducted at Ben-Gurion University of the Negev, enrolled 116 medical students as part of the medical school's PoCUS curriculum. Participants were randomly assigned to a simulator-based self-learning or conventional instructor-guided teaching group. After training, which took place January 29 to February 22, 2023, participants completed exams on February 23, 2023, assessing their abilities to obtain specific cardiac views, capture images of quality, and correctly identify common cardiac pathologies.</p><p><strong>Results: </strong>Of 116 participants, 57 (49.1%) were categorized into the instructor-guided group and 59 (50.9%) the self-learning group. Participants in the self-learning group had higher total test scores compared with the instructor-guided group (81.6% vs 77.2%, P = .30), with only the apical 2-chamber view reaching statistical significance in favor of the self-learning group (81.3% vs 68.3%, P = .04). The self-learning group also scored higher on image quality, but the difference was not statistically significant (59.5% vs 55.6%, P = .26). There was no significant difference in total scores for cardiac pathology identification (93.5% in the self-learning group vs 94.7% in the instructor-guided group, P = .81). A multivariable logistic regression presented no significant difference in achieving an above median score when adjusted for gender, chest anatomy academic grade, and prior PoCUS training (adjusted odds ratio, 1.55; 95% CI, 0.69-3.53; P = .30).</p><p><strong>Conclusions: </strong>This study suggests that the self-learning approach is noninferior to instructor-guided teaching for cardiac ultrasonography training. Incorporating these programs into medical curricula may enhance the quantity and proficiency of PoCUS operators, improving diagnostic capabilities and treatment outcomes across medical specialties.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"810-819"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626777","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":"Questioning the Value of Prompt Engineering in Medical Education.","authors":"Nam Tran, Devika Patel, Amanda B Cooper","doi":"10.1097/ACM.0000000000006030","DOIUrl":"10.1097/ACM.0000000000006030","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"761"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626025","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":"Anne and her Nurse.","authors":"Mary Cassatt","doi":"10.1097/ACM.0000000000006007","DOIUrl":"10.1097/ACM.0000000000006007","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"788-789"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460490","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":"Qualities Medical Students Value in Resident Educators: A Mixed-Methods Analysis of Medical Student Nominations for Teaching Awards.","authors":"Dana G Rowe, Alexandria L Soto, Megan N Happ, Shannon M Barter, Susanna S Hill","doi":"10.1097/ACM.0000000000006062","DOIUrl":"10.1097/ACM.0000000000006062","url":null,"abstract":"<p><strong>Purpose: </strong>Resident physicians play a pivotal role in undergraduate medical education, serving as stewards of the academic and clinical learning environment. However, limited data exist on qualities valued by medical students in resident educators. This study explores the qualities medical students perceive as most valuable in resident educators and whether these qualities differ by resident gender or specialty.</p><p><strong>Method: </strong>A mixed-methods analysis of medical student nominations for resident teaching awards at a single U.S. academic institution (January 2014 to May 2022) was conducted. A thematic codebook was developed through iterative review to identify relevant themes, with coding discrepancies resolved through discussion. The research team decided a priori to analyze whether differences in thematic frequency existed based on resident gender and resident specialty.</p><p><strong>Results: </strong>Analysis of 747 nominations across 8 specialties revealed 4 thematic categories emphasized by student nominators: teaching qualities, admirable skills, personality, and general praise. Prioritizing teaching (375 [50.2%]) and creating a safe learning environment (269 [36.0%]) were the most frequently cited qualities. Being supportive (165 [22.1%]) and welcoming (136 [18.2%]) were recurring personality traits. Themes were largely consistent across genders. Clinical and leadership skills were mentioned more frequently in nonsurgical resident nominations (150 [30.8%] vs 50 [19.2%], P < .001, and 47 [9.7%] vs 14 [5.4%], P = .04, respectively), whereas patience was mentioned more frequently in surgical resident nominations (25 [9.6%] vs 24 [4.9%], P = .01).</p><p><strong>Conclusions: </strong>This study highlights 3 key qualities that medical students consistently lauded in resident educators: fostering a safe learning environment, prioritizing teaching, and demonstrating effective teaching skills. These qualities were universally emphasized across genders and specialties, underscoring their fundamental role in medical education.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"828-835"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812848","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":"Advancing Disability Equity and Inclusion in Undergraduate Medical Education: Proceedings From the Access in Medicine Summit.","authors":"Maggie Salinger, Mytien Nguyen, Allison Kessler, Sarah Triano, Rylee Betchkal, Emily C Cleveland Manchanda, Pilar Ortega, Zoie C Sheets, Nalinda Charnsangavej, Christine Low, Gabe Abrams, Preetha Basaviah, Liz Bowen, Zainub Dhanani, James M Cooke, Ifeoma Ikedionwu, Aggie McGrane, Suchita Rastogi, Leslie L Rydberg, Samantha L Schroth, Erika Theiler, Amelia M Wallace, Peter Poullos, Raymond H Curry, Lisa Meeks","doi":"10.1097/ACM.0000000000006157","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006157","url":null,"abstract":"<p><strong>Abstract: </strong>The Access in Medicine (AIM) Summit, held in April 2024, convened 60 delegates from across the United States to generate practicable solutions for dismantling accessibility barriers in medical education. These proceedings outline the Summit's objective and present the resulting insights and actionable recommendations. The Summit featured an innovative design that engaged diverse delegates in collaborative, idea-generating activities that elevated the lived experiences of learners with disabilities. Inspired by guiding principles of social justice and accessibility, delegates recommended a bundle of action-oriented strategies for addressing social and structural barriers to disability equity and inclusion. The proposed action steps identified critical intervention points that span the continuum of undergraduate medical education (UME), from improving support of disabled learners in recruitment and admissions processes through to their residency application and post-graduation transition stages. Though medical education was the AIM Summit focus, delegates emphasized the generalizability of themes to broad training contexts (e.g., residency and other health professions education training), both in the socio-structural challenges they confronted and in the solutions they proposed. These proceedings highlight the vital steps necessary to build more equitable and inclusive learning environments for learners with disabilities.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512693","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}