Academic Medicine最新文献

{"title":"Artist's Statement: Bedside Rounds.","authors":"Ankit Mehta","doi":"10.1097/ACM.0000000000005933","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005933","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 3","pages":"287"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517212","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":"Assessment Tools for Patient Notes in Medical Education: A Scoping Review.","authors":"William F Kelly, Matthew K Hawks, W Rainey Johnson, Lauren A Maggio, Louis Pangaro, Steven J Durning","doi":"10.1097/ACM.0000000000005886","DOIUrl":"10.1097/ACM.0000000000005886","url":null,"abstract":"<p><strong>Purpose: </strong>Physician proficiency in clinical encounter documentation is a universal expectation of medical education. However, deficiencies in note writing are frequently identified, which have implications for patient safety, health care quality, and cost. This study aimed to create a compendium of tools for educators' practical implementation or future research.</p><p><strong>Method: </strong>A scoping review was conducted using the Arksey and O'Malley framework. PubMed, Embase, Ovid All EBM Reviews, Web of Science, and MedEdPORTAL were searched for articles published from database inception to November 16, 2023, using the following search terms: documentation, note-writing, patient note, electronic health record note, entrustable professional activity 5 , and other terms. For each note-writing assessment tool, information on setting, section(s) of note that was assessed, tool properties, numbers and roles of note writers and graders, weight given, if used in grading, learner performance, and stakeholder satisfaction and feasibility was extracted and summarized.</p><p><strong>Results: </strong>A total of 5,257 articles were identified; 32 studies with unique tools were included in the review. Eleven studies (34.4%) were published since 2018. Twenty-two studies (68.8%) outlined creating an original assessment tool, whereas 10 (31.2%) assessed a curriculum intervention using a tool. Tools varied in length and complexity. None provided data on equity or fairness to student or resident note writers or about readability for patients. Note writers often had missing or incomplete documentation (mean [SD] total tool score of 60.3% [19.4%] averaged over 25 studies), often improving after intervention. Selected patient note assessment tool studies have been cited a mean (SD) of 6.3 (9.2) times. Approximately half of the tools (17 [53.1%]) or their accompanying articles were open access.</p><p><strong>Conclusions: </strong>Diverse tools have been published to assess patient notes, often identifying deficiencies. This compendium may assist educators and researchers in improving patient care documentation.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"358-374"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331860","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":"Evidence of Differential Attainment in Canadian Medical School Admissions: A Scoping Review.","authors":"Thuy-Anh Ngo, Joshua Choi, Alexander McIntosh, Asiana Elma, Lawrence Grierson","doi":"10.1097/ACM.0000000000005836","DOIUrl":"10.1097/ACM.0000000000005836","url":null,"abstract":"<p><strong>Purpose: </strong>In Canada, many groups (e.g., Black, Indigenous, rural backgrounds) have historically faced and continue to encounter systemic barriers in accessing the medical profession. These barriers often manifest in performance disparities, known as differential attainment, during medical school admissions. This scoping review summarizes the nature and extent of evidence on the association of differential attainment in medical school admissions selection tools and outcomes with applicant social identity in the Canadian context.</p><p><strong>Method: </strong>The authors used Arksey and O'Malley's scoping review framework to summarize research studies published between 2000 and 2022 with empirical evidence of differential attainment in admissions selection tools and outcomes with respect to a range of applicant social identity categories. The authors recorded whether studies adopted a structuralist and/or intersectional perspective.</p><p><strong>Results: </strong>Ultimately, 15 studies were included in the review. While the evidence on differential attainment associated with social identity in Canadian medical education was heterogeneous, numerous studies highlight differential attainment in the admissions process associated with applicant race and/or ethnicity (6 studies), age (5 studies), gender (4 studies), socioeconomic status (3 studies), geographic location (4 studies), and rural or urban background (5 studies). These attainment differences were reported at 3 phases of the admissions process (invitation to interview, offer of admission, and acceptance of offer) and were driven by several admissions selection tools, including grade point average, Medical College Admission Test score, and interview performance.</p><p><strong>Conclusions: </strong>The review highlights evidence that suggests systemic, structural inequities in admissions systems manifest as differential attainment in Canadian medical school admissions. Based on this evidence, those who identify as Black or Indigenous and those with low socioeconomic status or rural backgrounds were generally more adversely affected. Admission practices must be studied and improved so medical education systems can better avow equality and human dignity and achieve equity goals.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"388-399"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898898","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":"Laugh, Listen, and Fold.","authors":"Shahaan S Razak","doi":"10.1097/ACM.0000000000005950","DOIUrl":"10.1097/ACM.0000000000005950","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"387"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830788","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":"What Drives Clinicians to Teach While Caring for Patients?","authors":"Juan N Lessing, Vineet Chopra","doi":"10.1097/ACM.0000000000005938","DOIUrl":"10.1097/ACM.0000000000005938","url":null,"abstract":"<p><strong>Abstract: </strong>Past medical education scholarship has explored what to teach, how to teach it better, and the evaluation of what these efforts provide learners. Missing from this dialogue has been the question of what clinician-educators gain from teaching. In this Invited Commentary on Frija-Gruman and colleagues' article \"Learning Through Teaching: How Physicians Learn Medicine in Authentic Clinical Contexts,\" the authors go beyond how and what clinician-educators learn through teaching to what drives clinicians to teach while caring for patients. Using a conceptual framework put forth by Daniel Pink built around the intrinsic domains of autonomy, mastery, and purpose, the authors posit that there are deep-seated psychological motivational principles underpinning the passion for teaching. The authors explore how teaching within patient care uniquely fosters and enhances autonomy (choice over what to do and how), mastery (the pursuit of betterment), and purpose (doing something that feels deeply meaningful and important), and in doing so, they present their rationale for how teaching gives back more to the teacher than is typically recognized. The authors then discuss the obstacles to the realization of teaching's full potential and conclude with a call for recognizing the intrinsic motivators as a key element for clinician-educators and clinical education to thrive.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"261-263"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774432","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":"Ecological Psychology: A Framework for Mentoring and Career Development in Academic Medicine.","authors":"John C Penner, Steven J Durning, Joseph J Rencic, Anthony A Donato, Jennifer A Cleland","doi":"10.1097/ACM.0000000000005941","DOIUrl":"10.1097/ACM.0000000000005941","url":null,"abstract":"<p><strong>Abstract: </strong>Effective mentoring can help individuals navigate the complex, dynamic environment of academic medicine as they work to develop meaningful and fulfilling careers. Despite robust research into the characteristics of effective mentoring relationships and successful mentoring programs, resources that support mentors and mentees in engaging in career development in academic medicine are limited. Ecological psychology, a theory focusing on how the dynamic interplay between individuals and their environment influences cognition and behavior, offers a promising framework for exploring how mentors and mentees can support positive career development outcomes. In this article, the authors introduce selected principles derived from ecological psychology and supplement these principles with practical, hypothetical examples that demonstrate the use of ecological psychology across the continuum of career development (e.g., from early to middle to late career decisions). By focusing on interactions between individuals and their environment, ecological psychology offers a valuable and practical complement to other theories and frameworks that address career development, such as social cognitive career theory and landscapes of practice. By centering on the dynamic interactions between individuals and their professional environments, ecological psychology offers mentors, mentees, and academic medical centers a practical structure for navigating the intricacies and challenges of career development in academic medicine.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"281-287"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787737","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":"Incorporation of Trauma-Informed Care Into Entrustable Professional Activities for Medical Student Assessment.","authors":"Lucia R I Millham, Jennifer Potter, David A Hirsh, Nhi-Ha Trinh, Celeste S Royce, Nomi C Levy-Carrick, Eve Rittenberg","doi":"10.1097/ACM.0000000000005824","DOIUrl":"10.1097/ACM.0000000000005824","url":null,"abstract":"<p><strong>Problem: </strong>Trauma-informed care (TIC) provides a medical framework for addressing and mitigating the negative consequences of trauma. In response to student and faculty advocacy, medical schools are developing trauma-informed curricular content. However, medical education literature does not present a comprehensive assessment rubric to evaluate medical students' acquisition of trauma-informed clinical skills.</p><p><strong>Approach: </strong>A committee of medical students, trainees, and faculty developed a longitudinal TIC curricular theme at Harvard Medical School (HMS). Guided by the National Collaborative on Trauma-Informed Health Care Education and Research competencies, the committee created a set of medical student TIC competencies from July to December 2019. From November 2021 to November 2022, 3 committee subgroups generated new TIC descriptors for each HMS entrustable professional activity (EPA), then circulated these to other subgroups, external experts, and stakeholders for review and feedback. From April to June 2023, the committee iteratively reviewed the materials until reaching consensus for content and pedagogy. The committee integrated TIC content into HMS's existing EPAs expected of students, provided anchoring descriptions of each level, and achieved consensus using a process of iterative review with TIC content experts.</p><p><strong>Outcomes: </strong>The committee identified 10 TIC competencies and revised all 13 general HMS EPAs to include specific items based on these competencies. The committee incorporated at least 1 trauma-informed competency into each HMS EPA.</p><p><strong>Next steps: </strong>This novel set of HMS EPAs provides a framework for assessment of TIC clinical skills. Faculty will be trained to correctly and reliably incorporate TIC competencies into patient care and to use the TIC-inclusive EPAs for student assessment, ensuring that TIC is standard medical practice at HMS. This work may facilitate the adoption of trauma-inclusive EPAs by other institutions to educate the next generation of physicians to practice TIC and thus promote a more accessible, safe, and equitable health care system.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"290-294"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749604","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 Female Mask (Unknown).","authors":"E L Langman","doi":"10.1097/01.ACM.0001108104.11203.33","DOIUrl":"https://doi.org/10.1097/01.ACM.0001108104.11203.33","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 3","pages":"289"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517223","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":"Mitigating Harm to Residency Applicants in Pursuit of Holistic Healing.","authors":"Laura Igarabuza, Kristina Laguerre, Geoffrey M Gusoff, Jenny Y Wang","doi":"10.1097/ACM.0000000000005926","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005926","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 3","pages":"260"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517321","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":"Characterizing Research Teams.","authors":"Meredith E Young, Tim Dubé, Daniel J Schumacher, Stuart Lubarsky, Anna T Ryan, Bridget C O'Brien","doi":"10.1097/ACM.0000000000005912","DOIUrl":"10.1097/ACM.0000000000005912","url":null,"abstract":"<p><p>Research in health professions education (HPE) is often executed by teams-groups of individuals working together to solve a problem, reconceptualize an issue, or conduct a study. Teams frequently involve individuals from different disciplinary backgrounds or professions1,2 who work collaboratively to accomplish specific scholarly goals. Matching team composition to research goals is critical for ensuring the team has the skills and perspectives necessary to generate, integrate, and mobilize the desired knowledge. Drawing on literature,3,4 we describe the who, what, how, and when of 4 types of research teams.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 3","pages":"402"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517220","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}