Academic Medicine最新文献

{"title":"How Shame Shaped Me: Exploring the Impact of Shame on Professional Identity Formation in Medical Trainees.","authors":"Gayle Haischer-Rollo, Holly Meyer, K Christopher McMains, Lara Varpio, William E Bynum","doi":"10.1097/ACM.0000000000006048","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006048","url":null,"abstract":"<p><strong>Purpose: </strong>In medical education, the influence of shame is largely absent from current conceptualizations of professional identity formation (PIF), even though this process is susceptible to the effects of shame experiences. This study endeavors to examine how shame influences PIF among medical learners.</p><p><strong>Method: </strong>Adopting a constructivist approach and hermeneutic phenomenology, the authors interviewed 9 final-year graduate medical trainees at 2 U.S. military medical centers between September 2022 and February 2023. The authors used a semistructured interview guide and photo-elicitation to deeply explore participants' shame experiences and how these influenced participants' PIF. Data analysis focused on understanding the lived experiences of these events and their impact on PIF, yielding themes central to the phenomenon of shame-induced PIF that helped characterize its deeper meaning.</p><p><strong>Results: </strong>Participants described shame events triggered by incidents like board exam failure, patient care mistakes, and needing educational remediation. Analyzing the influence of these events on PIF revealed 2 processes that helped propel identity arcs toward-and sometimes away from-an ideal version of the self: identity disruption and identity work. Identity disruption led to a distancing from the community and could lead to isolation, anxiety, and impaired belonging. These feelings of disruption often led to significant identity work, which involved modifying self-talk, leveraging agency, and engaging in identity negotiation (often in service of growth toward a modified professional identity).</p><p><strong>Conclusions: </strong>This study uncovers the potential for shame to serve as a catalyst for meaningful identity work in medical trainees. The findings expand on existing conceptualizations of PIF by highlighting that it is a dynamic, ongoing, nonlinear, and multidimensional process. The analysis points to actions educators and learners can take to support learners' constructive navigation of shame experiences and their impact on PIF.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732564","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 Women Physicians in Academic Medicine: A Scoping Review.","authors":"Neha J Purkey, Peggy Han, Amanda Woodward, Alexis S Davis, Lindsay Johnston, Robin Klein, Catherine D Krawczeski, Kristen T Leeman, Kerri Z Machut, Meghna D Patel, Melissa Scala, Mary E McBride","doi":"10.1097/ACM.0000000000006052","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006052","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple studies have described higher rates of attrition for women in academic medicine, but actionable strategies to retain women in the field have not been well studied in the current era. This study reviewed the existing literature for studied interventions to support the advancement of women physicians in academic medicine.</p><p><strong>Method: </strong>A scoping review was conducted by searching the PubMed, Embase, and Scopus databases for articles describing interventions intended to support women physicians on September 12, 2022, and updated on August 23, 2024. All articles from inception of the databases through the search dates were included. Search terms included female physician, mentoring, leadership, career development, job satisfaction, advancement, and synonyms. Articles related to inequities in patient care, interventions related to nonphysician health care workers, and studies describing sexism without measured solutions were excluded from the analysis. Kirkpatrick's framework for the evaluation of educational programs was used to further classify results by 4 levels of evaluation for an educational or training program: reaction, learning, behavior, and results.</p><p><strong>Results: </strong>A total of 2,813 articles underwent abstract screening and full-text review, with 64 articles included in the final analysis. Seven studies (10.9%) were randomized controlled trials. Only 2 studies (3.1%) specifically examined mid- or late-career women. Career development programs (15 [23.4%]), mentorship programs (10 [15.6%]), and women's interest groups (7 [10.9%]) were the most described interventions. Outcome measures were most commonly satisfaction with the intervention (22 [34.4%]), self-perceived improvement in skills (17 [26.6%]), and representation or recruitment of women into a field (12 [18.8%]).</p><p><strong>Conclusions: </strong>This study describes 64 articles of studied interventions to support the advancement of women in medicine. Additional studies are needed and should emphasize rigorous study methods, a focus on institutional solutions, and identifying and targeting the needs of women physicians beyond their early career.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732546","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":"Snooze Control: Evidence-Based Strategies for Mastering Sleep on Night Shifts.","authors":"Brendan Freeman, Anand Swaminathan, Abbas Husain","doi":"10.1097/ACM.0000000000006051","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006051","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732503","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":"Transforming the Ecosystem of Medical Education: Community-Engaged Medical Education (CEME).","authors":"Carmela Rocchetti, Christopher Duffy, Robin O Winter, Miriam Hoffman","doi":"10.1097/ACM.0000000000006050","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006050","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732658","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":"Individualized Learning Plans for Active Lifelong Learning.","authors":"Anna Romanova, Susan Humphrey-Murto, Martin Pusic, Claire Touchie","doi":"10.1097/ACM.0000000000006049","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006049","url":null,"abstract":"<p><strong>Abstract: </strong>The Problem: Self-regulated learning (SRL) skills are required to engage in lifelong and master adaptive learning (MAL).1 Yet the skills needed to set, plan, execute, monitor, and reflect on learning goals are not innate and must be developed for learners to take an active role in their education. The fragmented nature of medical training also hinders continual assessment and performance improvement, especially across educational transitions.2Individualized learning plans (ILPs) can help.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732566","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 re-using 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":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mission-Aligned Funds Flow and the Primary Care Mission.","authors":"Richard L Kravitz, Russell S Phillips, Deborah J Cohen","doi":"10.1097/ACM.0000000000006045","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006045","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701999","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 the Exploration and Impact of ACGME Milestones on Outcomes.","authors":"Ricardo Esper Treml, Ting Sun, Pedro Tanaka","doi":"10.1097/ACM.0000000000006044","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006044","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701516","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 Excerpt of \"The Surgical Ward\".","authors":"Shruti Koti","doi":"10.1097/ACM.0000000000006043","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006043","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701988","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 Kravitz et al.","authors":"Satyan Lakshminrusimha, Susan Murin, David A Lubarsky","doi":"10.1097/ACM.0000000000006046","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006046","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701995","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}