Academic Medicine最新文献

{"title":"The Potential of Using ChatGPT-4 Vision for Detecting Image Manipulation in Academic Medicine Articles.","authors":"Lingxuan Zhu, Haoran Zhang, Peng Luo","doi":"10.1097/ACM.0000000000005873","DOIUrl":"10.1097/ACM.0000000000005873","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1320-1321"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143474","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 Tattooed Connection: Nurturing Curiosity in Medicine.","authors":"Rémi Esclassan, Emmanuelle Noirrit, Marie Georgelin-Gurgel, Charlotte Mansuy, Jean-Noël Vergnes","doi":"10.1097/ACM.0000000000005883","DOIUrl":"10.1097/ACM.0000000000005883","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"99 12","pages":"1451"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734294","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":"Gender Differences in Clinical Performance Assessment of Internal Medicine Residents: A Longitudinal Analysis of the Influence of Faculty and Trainee Gender.","authors":"Robin Klein, Katherine A Julian, Jennifer Koch, Erin D Snyder, Simerjot Jassal, Wendy Simon, Alex Millard, Brian Uthlaut, Sherri-Ann M Burnett-Bowie, Nneka N Ufere, Sarah Alba-Nguyen, Anna Volerman, Vanessa Thompson, Anshul Kumar, B A White, Yoon Soo Park, Kerri Palamara","doi":"10.1097/ACM.0000000000005884","DOIUrl":"10.1097/ACM.0000000000005884","url":null,"abstract":"<p><strong>Purpose: </strong>Competency-based medical education relies on equitable assessment. This study examined the influence of faculty and trainee gender on assessments of internal medicine (IM) resident performance over time.</p><p><strong>Method: </strong>A longitudinal analysis of clinical performance assessments from 7 U.S. IM residency programs (July 2014-June 2019) was conducted. Core competency scores (patient care [PC], medical knowledge [MK], practice-based learning and improvement [PBLI], systems-based practice [SBP], professionalism [PROF], and interpersonal and communication skills [ICS]) were standardized across programs. Cross-classified mixed-effects linear regression evaluated the relationship between gender and standardized competency scores within training programs, while adjusting for multiple variables including IM In Training Examination percentile rank.</p><p><strong>Results: </strong>Data included 9,346 evaluations by 1,011 faculty (552 [55%] men, 459 [45%] women) for 664 residents (358 [54%] men, 306 [46%] women). Initially, women residents' scores were significantly lower than men's in PC (estimated difference [standard error], -0.097 [0.033]; P = .004), MK (-0.145 [0.034], P < .001), and PBLI (-0.090 [0.040], P = .022). PC, MK, PBLI, and SBP scores increased more over time for women residents than men (PC: 0.050 [0.015], P = .001; MK: 0.052 [0.015], P = .001; PBLI: 0.036 [0.018], P = .048; SBP: 0.036 [0.016], P = .027). PROF and ICS scores were comparable across gender. There was a significant interaction between faculty gender and postgraduate year (PGY) across all competencies but none between resident gender, faculty gender, and PGY, indicating that men and women faculty rated residents differently over time but were consistent in how they rated men and women residents.</p><p><strong>Conclusions: </strong>Gender-based assessment differences were variable across competencies and time. Women residents had lower scores initially but greater gains in \"hard skill\" (MK, PC, and PBLI) than in \"soft skill\" (ICS and PROF) competencies, suggesting assessment inequities. Efforts to ensure equitable assessment are needed.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1413-1422"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331861","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":"Simulation Training to Interrupt Microaggressions.","authors":"Sushant Srinivasan, Claudia E Evaristo, Haroon Ali, Gina E Tranel, Shannon M DiMarco, Naomi Takahashi, Shiva Bidar-Sielaff, Emily Ruedinger","doi":"10.1097/ACM.0000000000005868","DOIUrl":"10.1097/ACM.0000000000005868","url":null,"abstract":"<p><strong>Abstract: </strong>Microaggressions in health care occur frequently and negatively impact the well-being of trainees. High-realism simulation can effectively train health care providers to communicate in emotionally difficult situations. In 2023, we developed and piloted 4 simulation scenarios for pediatric residents centered on addressing microaggressions in the clinical environment that built on an existing didactic curriculum. These scenarios included single and intersecting forms of oppression including racism, sexism, ableism, ethnocentrism, and weight bias. We also trained faculty, who had no prior simulation debriefing experience, to facilitate and debrief the simulation sessions. Thirty-three residents participated and reported an increase in confidence immediately following the simulation training; this increase was sustained at 3 months. Faculty participants reported increased empathy for residents, recognition of microaggressions, and confidence facilitating conversation after microaggressions that occur both in the simulated setting and in real life. High-realism simulation holds promise as a way to bridge the gap between classroom and real-life interruption of microaggressions, a necessary skill to improve the health care environment for learners and patients.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"S68-S72"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143472","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":"Opportunities and Risks for Telehealth in Advancing Health Equity in Academic Medicine.","authors":"Sarah L King, Jorge A Rodriguez, Scott A Shipman","doi":"10.1097/ACM.0000000000005767","DOIUrl":"10.1097/ACM.0000000000005767","url":null,"abstract":"<p><p>Academic medical centers (AMCs) have a long history of providing care to underserved communities. As telehealth has rapidly grown, AMCs are exploring how it can improve health care access and equity. Yet there is a risk that telehealth exacerbates existing disparities and has done so already with the growing \"digital divide.\" 1 To achieve the promise of telehealth while avoiding the risks, it must be implemented with a health equity focus.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1454"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917424","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":"Reports of Burnout Among Historically Marginalized and Female Graduating Medical Students During the COVID-19 Pandemic.","authors":"Liselotte N Dyrbye, Danielle E Brushaber, Colin P West","doi":"10.1097/ACM.0000000000005854","DOIUrl":"10.1097/ACM.0000000000005854","url":null,"abstract":"<p><strong>Purpose: </strong>To examine graduating medical student reports of burnout by sex, race and ethnicity, and sexual orientation and explore trends within intersectional demographic groups from 2019-2021 in a national sample.</p><p><strong>Method: </strong>The authors obtained medical student responses to the 2019-2021 Association of American Medical Colleges (AAMC) Graduation Questionnaires (GQs) linked to data from other AAMC sources. The dataset included year of GQ completion, responses to a modified Oldenburg Burnout Inventory (exhaustion subscale range: 0-24; disengagement subscale range: 0-15), and demographics previously shown to relate to the risk of burnout in medical students, residents, or physicians. Multivariable linear regression analysis was performed to evaluate independent associations between demographics and burnout.</p><p><strong>Results: </strong>Overall response rate was 80.7%. After controlling for other factors, mean exhaustion scores were higher among Asian (parameter estimate [PE] 0.38, 95% confidence interval [CI] 0.21, 0.54), bisexual (PE 0.97, 95% CI 0.76, 1.17), and gay or lesbian (PE 0.55, 95% CI 0.35, 0.75) students than those who did not identify with each of those respective groups. Mean disengagement scores were lower among female (PE -0.47, 95% CI -0.52, -0.42), Hispanic (PE -0.11, 95% CI -0.22, -0.01), and White (PE -0.10, 95% CI -0.19, 0.00) students and higher among Asian (PE 0.17, 95% CI 0.07, 0.27), Black or African American (PE 0.31, 95% CI 0.18, 0.44), bisexual (PE 0.54, 95% CI 0.41, 0.66), and gay or lesbian (PE 0.23, 95% CI 0.11, 0.35) students than those who did not identify with each of those respective groups. From 2019-2021, mean exhaustion and disengagement scores were relatively stable or improved across nearly all intersectional groups.</p><p><strong>Conclusions: </strong>Male, Asian, Black or African American, and sexual minority students had a higher risk of burnout, while female, Hispanic, White, and heterosexual or straight students had a lower risk of burnout.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1385-1395"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143471","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":"Continuity of Care Explains Disparities Between Faculty and Trainee Practice in Residency Clinics.","authors":"Bryce A Ringwald, Jennifer L Middleton","doi":"10.1097/ACM.0000000000005852","DOIUrl":"10.1097/ACM.0000000000005852","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1321-1322"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019424","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":"Relationships Between Religious Commitment, Workplace Experiences, and Professional and Psychological Outcomes Among U.S. Muslim Physicians.","authors":"Sohad Murrar, Laila Azam, Benish Baqai, Omar Davila, Aasim I Padela","doi":"10.1097/ACM.0000000000005686","DOIUrl":"10.1097/ACM.0000000000005686","url":null,"abstract":"<p><strong>Purpose: </strong>To examine relationships between religiosity, workplace discrimination, religious accommodation, and related professional and psychological outcomes among U.S. Muslim physicians.</p><p><strong>Method: </strong>In 2021, the authors surveyed 264 physicians from 3 U.S.-based Muslim clinician organizations. Religious commitment, as measured by multiple items, was evaluated as a possible predictor of workplace discrimination and accommodation; job turnover; career satisfaction; workplace motivation; and belonging, burnout, and depression. Bivariate regression models were used to identify possible significant relationships between predictor and outcome variables. Predictors with meaningful bivariate analyses were included in separate multivariate regression models for each outcome.</p><p><strong>Results: </strong>Participants' mean age was 39.5 years (standard deviation, 10.03). Most were male (160/246; 65%), were U.S.-born (146/244; 60%), completed medical school in the United States (190/243; 78%), and wore a beard/hijab (135/235; 57%). Participants identified as African American (40/247; 16%), Arab (55/247; 22%), South Asian (82/247; 33%), and White (70/247; 28%). Multivariate models demonstrated that religious importance was positively associated with discrimination from patients (odds ratio [OR] = 3.78; P = .02) and depression (OR = 5.36; P = .002), and negatively associated with prayer accommodation at work (OR = 0.20; P = .001). Engaging in congregational religious activities was negatively associated with discrimination from patients (OR = 0.64; P = .006) and job turnover (OR = 0.63; P = .02), and positively associated with accommodations for prayer (OR = 1.42; P = .008) and general religious identity accommodation (OR = 1.47; P = .01). Additionally, participant race and ethnicity were variably associated with these outcomes.</p><p><strong>Conclusions: </strong>This study demonstrates how religious identity may negatively associate with workplace experiences and well-being among U.S. Muslim physicians and highlights the buffering role of religious practice. It spotlights an urgent need for academic medical centers to ameliorate religious discrimination and implement workplace accommodation policies for Muslim physicians.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1423-1431"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040819","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":"Statement of Partnership and Humility: A Structural Intervention to Improve Equity and Justice in Medical Education.","authors":"Laura J Benoit, Jean-Marie Alves-Bradford, Jonathan Amiel, Rachel J Gordon, Monica L Lypson, Daniel J Pohl, Hetty Cunningham","doi":"10.1097/ACM.0000000000005770","DOIUrl":"10.1097/ACM.0000000000005770","url":null,"abstract":"<p><strong>Problem: </strong>Due to generational exposure to the Black Lives Matter movement, other antibias social movements, and diverse peer advocacy groups, health professions students are often more knowledgeable than their teachers about ways in which systemic racism and bias have led to scientific inaccuracies that contribute to health inequities. However, traditional hierarchies and concerns about retaliation may limit educational communities from benefiting maximally from students' contributions.</p><p><strong>Approach: </strong>In spring 2021, faculty and students at the Vagelos College of Physicians and Surgeons, Columbia University, designed a structural innovation to engage faculty and students in partnership toward decreasing bias in medical education. This article discusses development and implementation of a Statement of Partnership and Humility (SPH) disclosure slide on which faculty members acknowledge consideration of potential teaching biases and invite student feedback.</p><p><strong>Outcomes: </strong>The initial primary goal of the SPH slide was to increase faculty awareness and engagement in antibias topics; however, the unexpected dividends of decreasing faculty anxiety about receiving student feedback and promoting student engagement have proven equally powerful in promoting a healthy, inclusive learning environment.</p><p><strong>Next steps: </strong>Next steps include gathering qualitative and quantitative data to elicit both faculty and student perspectives on the use of the SPH slide, particularly with regard to psychological safety and openness to feedback.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1361-1364"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071426","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 Community Engagement to Move Upstream to Address Social Determinants of Health.","authors":"Ross Jones, Lori Bilello, Ann-Marie Knight, William C Livingood, Chardaé Whitner, Fern Webb","doi":"10.1097/ACM.0000000000005780","DOIUrl":"10.1097/ACM.0000000000005780","url":null,"abstract":"<p><strong>Abstract: </strong>Given its role as a safety net institution, the University of Florida Health (UF Health) Jacksonville has responded to the community's needs through partnerships with the community for decades. Such academic-community partnerships have a broad emphasis on population health and primary care that expands the model of care to include community engagement, which allows such partnerships to promote health and well-being and reduce health inequalities by addressing social determinants of health (SDOH).This report describes the UF Health Jacksonville and University of Florida College of Medicine-Jacksonville's creation of the Urban Health Alliance (UHA) in June 2019 due to continued poor health outcomes and inequities within the community. The mission of the UHA is to improve community health using community-focused, self-sustainable strategies and solutions to impact SDOH (i.e., more upstream interventions). Using the tenets of the collective impact model, the UHA acts as a backbone organization to achieve these objectives by empowering community partners to affect changes in policy, systems, and other structures necessary for the optimal health of the community. The UHA's work is divided across 4 pillars: services, research, education, and policy. These pillars reflect the traditional missions of academic medical centers-clinical care, research, and education-and the need to address structural changes to improve community health-namely, policy. By addressing the issues that most impact the patients and community of UF Health Jacksonville, the UHA can serve as an example of how an academic medical center can use the traditional missions to improve the community's health and move toward health equity.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1337-1342"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262827","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}