Academic Medicine最新文献

{"title":"Substance Use and Pain Curriculum Innovation: Establishing a Student-Faculty Partnership for Curricular Change.","authors":"Rory Vu Mather, Helen E Jack, Katherine E Warren, Cameron Comrie, Sienna Li, Michael Liu, Erika Lynn-Green, Sydney Moore, William Oles, Shahin A Saberi, E J Jarvie, Anjali Koka, Patrick McGuire, Antje M Barreveld, Hilary S Connery, Todd Griswold","doi":"10.1097/ACM.0000000000006018","DOIUrl":"10.1097/ACM.0000000000006018","url":null,"abstract":"<p><strong>Problem: </strong>The opioid overdose crisis had progressed broadly in the United States, with an 21% increase from 2016 to 2017, and specifically in Massachusetts, with a peak rate of 1,374 deaths in 2016. In 2016, students and faculty at Harvard Medical School (HMS) established the Substance Use and Pain Curriculum Committee (SUPCC) to expand substance use and pain education. However, faculty capacity, financial resources, and administrative support were insufficient to implement changes across all phases of the medical school curriculum.</p><p><strong>Approach: </strong>The HMS SUPCC restructured in 2021 to put students at the forefront of curricular development. This restructuring was done through 3 main innovations: (1) establishment of a student-centered committee structure, ensuring that curricular changes are centered on student interests and needs; (2) student-led curricular development and implementation, reducing faculty workload; and (3) focus on clinically relevant teaching and opportunities to practice learned skill sets.</p><p><strong>Outcomes: </strong>This student-centered structure facilitated the expansion of the addiction and pain medicine curriculum to more than 30 hours of teaching by 2024. Examples of student-driven initiatives include development of an opioid use disorder management practicum equivalent to the Drug Enforcement Agency X-waiver, increased medical student access to naloxone through a hospital partnership, and integration of case-based opioid use disorder and pain medicine didactics into the clerkship year.</p><p><strong>Next steps: </strong>Although this work has established a longitudinal curriculum across all medical training stages, more must be done in clerkship rotations to help students apply their substance use and pain education in the clinical setting. The HMS SUPCC is working to incorporate teaching on nonopioid substances, such as alcohol, cannabis, and ketamine, provide longitudinal clinical experiences so students learn to care for patients with substance use disorder and chronic pain from short-term intervention to long-term recovery, and develop surveys to quantitatively and qualitatively measure curriculum outcomes.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574593","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":"Could Changing the Language From \"Social Determinants\" to \"Social Dynamics\" of Health Encourage Transformational Change?","authors":"Cheryl A Maurana, Heather Wood Ion","doi":"10.1097/ACM.0000000000006021","DOIUrl":"10.1097/ACM.0000000000006021","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574579","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 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":"https://doi.org/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":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delusions of Reference.","authors":"Lisa Gong","doi":"10.1097/ACM.0000000000006015","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006015","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558736","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 Gift: Rediscovering the Joy of Medicine Through Education.","authors":"L Elizabeth Moreno","doi":"10.1097/ACM.0000000000006014","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006014","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558737","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":"To Empty a Wheelchair: Looking Beyond the Hospital Doors.","authors":"Madeline Blatt","doi":"10.1097/ACM.0000000000006016","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006016","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-04","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":"Cooking for One.","authors":"Antonio Yaghy","doi":"10.1097/ACM.0000000000006017","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006017","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558735","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 Hologram-Based Augmented Reality in Anatomy Learning: The TEACHANATOMY Randomized Trial.","authors":"L Zingg, M Häusler, J Hein, S Jecklin, S Kottner, D Gascho, N Cavalcanti, P Voinov, T Götschi, F Carrillo, F Lagler, P Fürnstahl, M Farshad","doi":"10.1097/ACM.0000000000006012","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006012","url":null,"abstract":"<p><strong>Purpose: </strong>Augmented reality (AR) can generate realistic holograms overlaid on the real-word environment to provide an interactive learning experience. However, further research is needed to assess the impact of such technologies on knowledge acquisition. This study aims to evaluate the efficacy of an AR learning application in anatomy education.</p><p><strong>Method: </strong>TEACHANATOMY, a controlled, randomized trial, was conducted from September 14-October 24, 2022, at the University of Zurich and Federal Institute of Technology. It included first- and second-year medical students with no prior anatomy education and compared learning with an interactive hologram-based AR learning application module incorporating adaptive learning technology and gamification elements with traditional learning (TL) methods, including textbooks, videos, and online resources. Forty-eight participants were randomly allocated to the AR or TL group. The primary outcome consisted of the scores on the theoretical and practical knowledge test sections. Secondary outcomes included adverse health symptoms and user experience.</p><p><strong>Results: </strong>The AR group performed significantly better on both theoretical (median [IQR] scores: AR: 18.8 [16.6-20.0]; TL: 9.4 [7.7-11.3]; P < .001) and practical (AR: 14.0 [12.3-14.7]; TL: 5.0 [4.0-6.0]; P < .001) knowledge test sections. The most common adverse health symptoms were headache, reported by 13/24 (54.2%) TL participants and 9/24 (37.5%) AR participants, and fatigue, experienced by 13/24 (54.2%) TL participants and 2/24 (8.3%) AR participants. All participants evaluated learning with TEACHANATOMY as a positive experience, rating it as efficient and easy to understand. All participants agreed learning with AR can be beneficial in learning anatomy, with 89.6% (43/48) and 100% (48/48) expressing willingness to use AR as a learning tool for theoretical and practical anatomy learning, respectively.</p><p><strong>Conclusions: </strong>Findings show a short-term learning benefit with the use of the TEACHANATOMY learning application, thus supporting the implementation of interactive hologram-based AR technologies to improve knowledge in anatomy education.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558658","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 \"Let Me Hold Your Breath\".","authors":"Anneliese Mair","doi":"10.1097/ACM.0000000000005996","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005996","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558734","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":"More Than Body Parts: A New Ethos of Anatomy Education.","authors":"Sabine Hildebrandt, Jon Cornwall, Thomas H Champney","doi":"10.1097/ACM.0000000000005901","DOIUrl":"10.1097/ACM.0000000000005901","url":null,"abstract":"<p><strong>Abstract: </strong>A new ethos of anatomy education goes beyond the learning of body parts in the traditional curriculum. In the traditional curriculum, the focus of only providing information on the structure of the human body left certain learning opportunities overlooked, marginalized, or dismissed as irrelevant; thus, opportunities to foster and shape professional attributes in health care learners were lost. Furthermore, changes in curricula structures and reductions in anatomy teaching hours have necessitated a transformation in how anatomy education is perceived and delivered. This article presents an examination of a contemporary ethos of anatomy education that draws together concepts from teaching theory, educational trends, and emerging research to maximize the anatomy learning experience with body donors. Social constructivism, the spiral curriculum, and the hidden curriculum can be leveraged to facilitate a unique educational experience. Furthermore, contemporary perspectives on the ethics and history of anatomy that support contextual learning indicate how these subjects are well suited to authenticate and consolidate learning, while supporting the relational and humanistic delivery of health care education. When anatomy education is conceptualized as a first clinical experience in a health care curriculum, it provides the opportunity to develop and enhance professional identity formation at a foundational stage. By embracing and incorporating a wider range of considerations into educational practice, a new ethos for anatomy education fosters history-informed professional identity formation that offers transformative learning opportunities for an ethical practice in the art of healing.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"273-280"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899725","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}