Academic Medicine最新文献

{"title":"Secondary Traumatic Stress in Medical Students During Clinical Clerkships.","authors":"Kira A Grush, Wendy Christensen, Tai Lockspeiser, Jennifer E Adams","doi":"10.1097/ACM.0000000000005940","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005940","url":null,"abstract":"<p><strong>Purpose: </strong>Health care workers exposed to traumatic events while working with patients are at risk for secondary traumatic stress (STS). Data on this phenomenon in medical students are limited. This prospective study examines the trajectory and prevalence of STS among medical students at clerkship year end.</p><p><strong>Method: </strong>The study at The University of Colorado School of Medicine was conducted in 2 phases: the first evaluated STS across multiple time points in a single year (n = 187); the second assessed STS prevalence at the end of the clerkship year in 3 separate cohorts (2020-2023) (n = 496). The study used a validated Secondary Traumatic Stress Scale (STSS). Multilevel growth curve modeling was used to explore the change trajectory of STSS scores across the clerkship year after controlling for covariates.</p><p><strong>Results: </strong>In phase 1, the quadratic trend coefficient was negative (-1.56), indicating a predicted trajectory in STSS total scores that started lower at clerkship year start, reached an apex during the year, and decreased by clerkship year end (P < .001). The intercept (32.73) and linear (5.17) coefficient estimates together (37.90) predicted a total score increase indicating mild STS to a total score at the cutoff for moderate STS between July and October (P < .001). The only statistically significant covariate was reporting an influential psychiatric condition (4.86, P < .001). Phase 2 revealed an end-of-year prevalence of moderate to severe STS of 35.7%, stable across all 3 cohorts. In phase 2, STS categories were significantly different for those reporting a psychiatric condition (P = .007).</p><p><strong>Conclusions: </strong>Medical student STS symptoms increase during clerkship year and do not return to baseline for many students by the year's end. More research is warranted to understand risk and protective factors for STS, strategies to mitigate symptom development, and how much of the observed STS is attributable to the COVID-19 pandemic.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787740","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":"Ecological Psychology: A Framework for Mentoring and Career Development in Academic Medicine.","authors":"John C Penner, Steven J Durning, Joseph J Rencic, Anthony A Donato, Jennifer A Cleland","doi":"10.1097/ACM.0000000000005941","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005941","url":null,"abstract":"<p><strong>Abstract: </strong>Effective mentoring can help individuals navigate the complex, dynamic environment of academic medicine as they work to develop meaningful and fulfilling careers. Despite robust research into the characteristics of effective mentoring relationships and successful mentoring programs, resources that support mentors and mentees in engaging in career development in academic medicine are limited. Ecological psychology, a theory focusing on how the dynamic interplay between individuals and their environment influences cognition and behavior, offers a promising framework for exploring how mentors and mentees can support positive career development outcomes. In this article, the authors introduce selected principles derived from ecological psychology and supplement these principles with practical, hypothetical examples that demonstrate the use of ecological psychology across the continuum of career development (e.g., from early to middle to late career decisions). By focusing on interactions between individuals and their environment, ecological psychology offers a valuable and practical complement to other theories and frameworks that address career development, such as social cognitive career theory and landscapes of practice. By centering on the dynamic interactions between individuals and their professional environments, ecological psychology offers mentors, mentees, and academic medical centers a practical structure for navigating the intricacies and challenges of career development in academic medicine.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787737","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 Medical Education to Improve Patient Safety.","authors":"Laura J Fochtmann","doi":"10.1097/ACM.0000000000005945","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005945","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787738","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 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":"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":"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":"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}