Academic Medicine最新文献

{"title":"Training Medical Students to Address Cybersecurity Threats on Health Care Systems.","authors":"Faraz Nadim Longi, Lav Patel, Jabir Ahmed","doi":"10.1097/ACM.0000000000005936","DOIUrl":"10.1097/ACM.0000000000005936","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"258"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734361","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":"Analog Serious Games for Medical Education: A Scoping Review.","authors":"Sarah L Edwards, Aryana Zarandi, Michael Cosimini, Teresa M Chan, Meilayi Abudukebier, Mikaela L Stiver","doi":"10.1097/ACM.0000000000005911","DOIUrl":"10.1097/ACM.0000000000005911","url":null,"abstract":"<p><strong>Purpose: </strong>Serious games are increasingly used in medical education to actively engage learners. Analog serious games are a nondigital subset of serious games with specific purposes that go beyond entertainment. This scoping review describes the literature pertaining to analog serious games and provides recommendations regarding gaps and emerging directions for future research.</p><p><strong>Method: </strong>The authors conducted a scoping review following the Arksey and O'Malley framework, searching 3 databases (MEDLINE, Embase, and CINAHL) for studies of analog serious games designed for physician-track learners published from January 2013 through December 2023. Two authors independently screened the titles and abstracts, whereas 1 of 5 authors screened each full text and extracted data from eligible records. The authors iteratively analyzed the data within numerous categories and coded the findings to examine how the field has evolved during the past decade.</p><p><strong>Results: </strong>The searches retrieved 3,955 records with 865 duplicates. The authors reviewed 3,090 title and abstract records and 202 full-text records. Eighty-eight records met the inclusion criteria, including research reports, conference abstracts, descriptive reports, and short innovation reports. The peak years for publications were 2019 and 2023 (15 publications each). Fewer abstracts and articles were published during the beginning of the COVID-19 pandemic (i.e., 2020-2022). The most common scholarship type was description studies (63 [72%]), whereas the dominant game formats were board games (51 [58%]) and card games (33 [38%]). Most studies tested analog serious games with medical students (60 [68%]) and/or residents and fellows (39 [44%]), with numerous studies including mixed study populations.</p><p><strong>Conclusions: </strong>This scoping review demonstrates moderate growth within the field of analog serious games, along with numerous opportunities for future research. Although analog game-based learning cannot entirely replace traditional pedagogical approaches, analog serious games have potential to meaningfully complement education for physician-track learners in all medical training stages.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"375-387"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631643","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":"Academic Medical Centers Must Lead in Firearm Injury Prevention Education.","authors":"Zulfiqar Ali Lokhandwala, Joel R Burnett","doi":"10.1097/ACM.0000000000005923","DOIUrl":"10.1097/ACM.0000000000005923","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 3","pages":"258-259"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517208","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":"Entrustment and EPAs for Artificial Intelligence (AI): A Framework to Safeguard the Use of AI in Health Professions Education.","authors":"Brian C Gin, Patricia S O'Sullivan, Karen E Hauer, Raja-Elie Abdulnour, Madelynn Mackenzie, Olle Ten Cate, Christy K Boscardin","doi":"10.1097/ACM.0000000000005930","DOIUrl":"10.1097/ACM.0000000000005930","url":null,"abstract":"<p><strong>Abstract: </strong>In this article, the authors propose a repurposing of the concept of entrustment to help guide the use of artificial intelligence (AI) in health professions education (HPE). Entrustment can help identify and mitigate the risks of incorporating generative AI tools with limited transparency about their accuracy, source material, and disclosure of bias into HPE practice. With AI's growing role in education-related activities, like automated medical school application screening and feedback quality and content appraisal, there is a critical need for a trust-based approach to ensure these technologies are beneficial and safe. Drawing parallels with HPE's entrustment concept, which assesses a trainee's readiness to perform clinical tasks-or entrustable professional activities-the authors propose assessing the trustworthiness of AI tools to perform an HPE-related task across 3 characteristics: ability (competence to perform tasks accurately), integrity (transparency and honesty), and benevolence (alignment with ethical principles). The authors draw on existing theories of entrustment decision-making to envision a structured way to decide on AI's role and level of engagement in HPE-related tasks, including proposing an AI-specific entrustment scale. Identifying tasks that AI could be entrusted with provides a focus around which considerations of trustworthiness and entrustment decision-making may be synthesized, making explicit the risks associated with AI use and identifying strategies to mitigate these risks. Responsible, trustworthy, and ethical use of AI requires health professions educators to develop safeguards for using it in teaching, learning, and practice-guardrails that can be operationalized via applying the entrustment concept to AI. Without such safeguards, HPE practice stands to be shaped by the oncoming wave of AI innovations tied to commercial motivations, rather than modeled after HPE principles-principles rooted in the trust and transparency that are built together with trainees and patients.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 3","pages":"264-272"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517312","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":"Reigniting the Flame: An Exploration of Flow in Surgery.","authors":"Sydney A McQueen, Melanie Hammond, Aidan L McParland, Ranil R Sonnadara, Carol-Anne Moulton","doi":"10.1097/ACM.0000000000005920","DOIUrl":"10.1097/ACM.0000000000005920","url":null,"abstract":"<p><strong>Purpose: </strong>Although distress and burnout in medical practice are widely acknowledged, less attention has been paid to the positive experiences that help keep physicians engaged. Cognitive flow (being \"in the zone\") is an intrinsically rewarding state in which individuals feel challenged and focused. To date, academic investigations of flow have largely been limited to the cognitive aspects of the phenomenon, limiting understanding of other elements, such as practice culture and environment. This study examines flow in surgical practice through a multifaceted lens.</p><p><strong>Method: </strong>Guided by a constructivist grounded theory approach, semistructured interviews were conducted from June 2018 to May 2021 with staff surgeons at the University of Toronto. Purposive sampling was used to include a range of surgical disciplines and experience levels to produce a conceptual framework that captures the multifaceted experience of flow.</p><p><strong>Results: </strong>Twenty staff surgeons from diverse specialties participated. A conceptual framework was developed for illustrating the different facets of flow, including the traditional view (cognitive) and an expanded view (physiologic, physical, affective, social, cultural, and environmental facets). Through the cognitive lens, participants appreciated how they could achieve the necessary mindset to experience flow and enjoy their work. The ability to feel in control, use creative approaches to solve problems, and possess the agency to continue to learn and improve invoked positive feelings about their work and practice. In the expanded view, it became evident that experiences of flow were much more multifaceted and complex. Beyond the individual, aspects such as the sociocultural environment shaped and comprised key aspects of the flow experience that surgeons found truly meaningful in their practice.</p><p><strong>Conclusions: </strong>Appreciating flow as a multifaceted phenomenon may assist in the identification and optimization of experiences that are central to encouraging lifelong career advancement and innovation while also helping protect against burnout and distress.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 3","pages":"313-318"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517338","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":"Acknowledging the Intersection of Physical Disabilities and Neurodivergence in Medical Education.","authors":"Carl A Frizell","doi":"10.1097/ACM.0000000000005935","DOIUrl":"10.1097/ACM.0000000000005935","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"259"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734358","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":"External Versus Internal Focus of Attention in Procedural Skills Learning: A Randomized Study.","authors":"Natalia Tarasova, Parvathi Wilkins, David A Cook, V Shane Pankratz, Mark M Morrey, Torrey A Laack","doi":"10.1097/ACM.0000000000005776","DOIUrl":"10.1097/ACM.0000000000005776","url":null,"abstract":"<p><strong>Purpose: </strong>The Optimizing Performance Through Intrinsic Motivation and Attention for Learning (OPTIMAL) theory postulates that directing attention to the intended movement effect or outcome (external focus) is more effective than directing attention to the internal body motion or body part (internal focus). This study compared external versus internal focus of attention as novice students learned ultrasound-guided peripheral cannulation. The authors hypothesized that conditions promoting an external (vs internal) focus of attention would result in better performance on immediate and delayed (retention) testing.</p><p><strong>Method: </strong>The authors conducted a randomized, experimental study from October 2022 to February 2023 comparing external and internal focus using ultrasound-guided peripheral venous cannulation followed by practice using an ultrasound training block. Undergraduate health science students performed 4 practice trials with instructions to focus on the needle tip (external focus) or their hands (internal focus), followed by immediate and delayed (retention) assessment 2 weeks later. The primary outcome was time to successful cannulation. Results were compared using Kaplan-Meier curves and parametric survival analysis regression (accelerated failure time) models.</p><p><strong>Results: </strong>Seventy participants completed the immediate assessment. The external focus group completed successful cannulation a mean of 2.33 times faster (95% confidence interval [CI], 1.47-3.67; P < .001) than those in the internal focus group (median time, 12.0 vs 29.5 seconds). Results also favored the external focus group during practice, with the external focus group successfully completing the task a mean of 1.83 times faster (95% CI, 1.04-3.21; P = .04) than the internal focus group. In the retention assessment, the external focus group successfully completed the task a mean of 2.37 times faster (95% CI, 1.19-4.74; P = .02) than the internal focus group.</p><p><strong>Conclusions: </strong>External focus of attention compared with internal focus of attention improves medical motor skill learning in novice learners.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"319-324"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077387","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":"Acknowledgment of Academic Medicine Reviewers.","authors":"","doi":"10.1097/ACM.0000000000005943","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005943","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 3","pages":"253-257"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804735","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":"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":"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 during clinical clerkships.</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 cohorts (2020-2023) (n = 482). 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 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 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-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 the clerkship year and do not return to baseline for many by the 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":"325-330"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","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":"Prevalence and Correlates of Prohibited Questions in Internal Medicine and Pediatrics Fellowship Interviews During 1 Appointment Year.","authors":"Katherine A Scribner, Colin P West, Angela L Myers, Elaine A Muchmore, Risë B Goldstein","doi":"10.1097/ACM.0000000000005783","DOIUrl":"10.1097/ACM.0000000000005783","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to investigate how frequently applicants to internal medicine (IM) and pediatrics fellowships are subjected to prohibited questions, how correlates of these interview questions compare between IM and pediatrics fellowship applicants, and which applicant subgroups are most affected.</p><p><strong>Method: </strong>The National Resident Matching Program (NRMP) emailed an anonymous survey to all applicants for the 2021 appointment year to the Medical Specialties Matching Program (i.e., IM fellowship Matches) and Pediatric Specialties Fellowship Match who certified rank order lists (ROLs). The survey addressed specific questions regarding the use of legally prohibited questions and questions that violate the NRMP's Match Participation Agreement during interview-related activities. Experiences of respondents were compared by preferred subspecialty and respondent demographics within IM and pediatrics.</p><p><strong>Results: </strong>The final response rates of IM and pediatrics fellowship applicants who certified ROLs, including complete and partial surveys, were 21.7% (1,483/6,847) and 23.4% (385/1,648), respectively. Of the IM and pediatrics respondents, 432/1,296 (33.3%) and 97/366 (26.5%), respectively, reported being asked at least one prohibited demographic question. The most commonly asked prohibited questions pertained to relationship or marital status (IM: 312/1,296, 24.1%; pediatrics: 69/367, 18.8%), national origin (IM: 200/1,296, 15.4%; pediatrics: 30/365, 8.2%), and family planning (IM: 104/1,288, 8.1%; pediatrics: 14/366, 3.8%). Nearly 25% of IM and pediatrics respondents reported being asked to identify other programs they applied to or interviewed with. Most often, these questions came from program faculty (IM: 238/303, 78.5%; pediatrics: 69/88, 78.4%) or program directors (IM: 84/303, 27.7%; pediatrics: 18/88, 20.5%).</p><p><strong>Conclusions: </strong>Substantial proportions of IM and pediatrics fellowship applicants reported being asked prohibited questions during fellowship interview-related activities. Additional educational efforts are needed to eradicate such questions from the interview process.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"340-350"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301993","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}