Academic Medicine最新文献

{"title":"In Reply to Balon.","authors":"William T Mallon, Natalya Cox","doi":"10.1097/ACM.0000000000006037","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006037","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631037","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":"Appraising Simulation-Based Approaches to Addressing Microaggressions in the Clinical Environment.","authors":"Jennifer Wood, Thom O'Neill, Katie Hughes","doi":"10.1097/ACM.0000000000006033","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006033","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631034","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":"Is Tenure Available for Every Clinical Educator?","authors":"Richard Balon","doi":"10.1097/ACM.0000000000006036","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006036","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630968","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 Wood et al.","authors":"David Fernandez, Sophia Gorgens","doi":"10.1097/ACM.0000000000006034","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006034","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631038","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":"Empirical Assessment of Well-Being: The Stanford Model of Occupational Wellbeing.","authors":"Bryan D Bohman, Maryam S Makowski, Hanhan Wang, Nikitha K Menon, Tait D Shanafelt, Mickey T Trockel","doi":"10.1097/ACM.0000000000006025","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006025","url":null,"abstract":"<p><strong>Purpose: </strong>The Stanford Model of Occupational Wellbeing (Stanford Model) hypothesizes that occupational well-being is driven by 3 reciprocally related domains: workplace efficiency, culture of wellness, and individual factors. The current analysis assesses the key elements of this model with cross-sectional empirical data.</p><p><strong>Method: </strong>In fall 2020 and spring 2022, well-being surveys were distributed to all Stanford School of Medicine clinical faculty working at 50% or more of full-time equivalent. A total of 1,909 clinical faculty were invited to complete the 2020 survey and 2,251 to complete the 2022 survey. The survey assessed burnout and professional fulfillment, along with 9 hypothesized determinants, as occupational well-being outcome indicators. Exploratory factor analysis was used to determine whether these determinants grouped well into the 3 domains described by the model. Domain scores were created based on factor analysis groupings of the scores for the determinants in each domain.</p><p><strong>Results: </strong>Of 1,909 clinical faculty invited to complete the 2020 survey, 1,479 (78%) participated. Of the 2,251 clinical faculty invited in 2022, 1,552 (69%) participated. The associations of the 3 domain scores with burnout and professional fulfillment were moderate for workplace efficiency (r = 0.42-0.49; P < .001) and large for culture of wellness (r = 0.51-0.63; P < .001) and individual factors (r = 0.52-0.72; P < .001). Domain scores accounted for 45% and 50% of the variance in professional fulfillment and 56% and 59% of variance in burnout in 2020 and 2022 data, respectively.</p><p><strong>Conclusions: </strong>These results provide empirical evidence to support a widely adopted conceptual model of occupational well-being, including categorization of the hypothesized determinants of well-being into 3 domains, correlations among the domains, and association of the domain scores with burnout and professional fulfillment. Further research is needed to test causal relationships hypothesized by the model.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631036","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":"Length of Tenure of U.S. Medical School Deans Who Started in Their Position from Academic Year 1959-1960 to 2018-2019.","authors":"Archana Chatterjee, Lawrence S Chin, Hannah Connolly, Jordan S Dutterer, Charles P Mouton, Mark A Schuster, Ann Steinecke","doi":"10.1097/ACM.0000000000006028","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006028","url":null,"abstract":"<p><strong>Purpose: </strong>Medical school dean transitions can be broadly disruptive. The authors explored deans' median length of tenure and organizational characteristics that may affect that tenure.</p><p><strong>Method: </strong>The authors analyzed Association of American Medical Colleges (AAMC) Council of Deans data to calculate the median tenure of all first-time deans at AAMC-member medical schools (July 1959 to June 2019; n = 1,166). They generated survival curves for all deans in the study period and for only first-time permanent deans, including interim deans who became permanent at the same institution (n = 869). The authors calculated median tenure as the median of the median of each 5-year cohort in the curves. Additionally, they examined length of tenure by organizational characteristics: public versus private, region, financial relationship to the university, and research intensity.</p><p><strong>Results: </strong>The median length of tenure of all deans was 4.3 years, for first-time permanent deans (i.e., excluding interim-only deans) was 5.9 years, and for deans in the most recent 15 years was 6.0 years. Median length of tenure of deans at public institutions was shorter (3.9 years) than at private institutions (4.8 years); varied by region: Northeast = 5.3 years, Central = 4.8, South = 3.8, West = 3.8; was longer at institutions that are part of a university (4.8 years) versus freestanding (3.8 years); and at research-intensive (6.7 years) compared with non-research-intensive institutions (3.8 years). A histogram by year revealed a normal data distribution with a mode of 3 to 4 years.</p><p><strong>Conclusions: </strong>Length of tenure was stable over time for all dean types and when isolating for first-time permanent deans; however, the most common time for deans to leave was in 3 to 4 years. Additional research on factors related to turnover is needed, as are supportive resources and programs to improve dean development and success.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626097","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":"Alternative State Licensure and Board Certification Pathways for International Medical Graduates.","authors":"Rajeev S Iyer, Harshad Gurnaney","doi":"10.1097/ACM.0000000000006032","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006032","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626776","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 Tran et al.","authors":"Henry Bair, David J Taylor Gonzalez, Mak B Djulbegovic","doi":"10.1097/ACM.0000000000006031","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006031","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625989","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":"Implementation of a Policy for Accommodations for Physicians With Disabilities.","authors":"Camille Munro, Greg Knoll, Kathleen Gartke, Krista Hind, Michael Quon","doi":"10.1097/ACM.0000000000006027","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006027","url":null,"abstract":"<p><strong>Abstract: </strong>Although physicians with disabilities are underrepresented in medicine, their lived experiences of disability can increase empathy for patients, enrich the learning environment, and improve working conditions. However, they face barriers related to procedures, policies, clinical accommodations, disability and wellness support services, and physical environments as well as cultural barriers that affect their meaningful inclusion and ability to work at their full capacity. Despite national Canadian physician organizations recommending accommodations and inclusive policies and practices, an environmental scan of the top 10 ranked Canadian hospital institutions in April-May 2020 did not identify any existing accommodations policies.The Medical Advisory Committee and senior management team at The Ottawa Hospital (TOH) formally endorsed the first position statement in Canada supporting physicians with disabilities in 2021, which led to the establishment of a process to develop and implement an accessibility and accommodations policy for the Department of Medicine (DOM) at TOH. After careful review and an iterative development process, the DOM approved a formal Accessibility and Accommodations Policy in June 2022. The policy ensures physicians are accommodated during the recruitment, interview, and appointment phases. It outlines a process for the development of an accommodation plan, addresses funding for accommodations, protects physicians returning to work following absences due to a disability, and requires exploration of opportunities for physicians to make a meaningful contribution if they cannot practice clinically due to their disability.In this article, the authors discuss the process of developing and implementing the DOM Accessibility and Accommodations Policy, outline the key elements of the policy, discuss broader implementation of the policy, and how they are monitoring its impact. They also discuss the importance and benefits of collecting data on physicians who self-identify as having a disability and, through confidential surveys, focus groups, and interviews, monitoring the impact of accessibility and accommodations policies.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625842","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":"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":"https://doi.org/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":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-12","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}