Academic Medicine最新文献

{"title":"Questioning the Value of Prompt Engineering in Medical Education.","authors":"Nam Tran, Devika Patel, Amanda B Cooper","doi":"10.1097/ACM.0000000000006030","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006030","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":"143626025","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":"Structuring Well-Being Programs in Undergraduate Medical Education.","authors":"Adam Neufeld, Greg Malin, Oksana Babenko","doi":"10.1097/ACM.0000000000006029","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006029","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607056","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":"A Practical Approach to Quality Improvement Education for New Educators.","authors":"Sherry Liang, Jacob Khoury","doi":"10.1097/ACM.0000000000006024","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006024","url":null,"abstract":"<p><strong>Abstract: </strong>The Accreditation Council for Graduate Medical Education's mandate for quality improvement (QI) training in residency programs has generated discussion in the literature of QI best practices and curriculum models. Despite this requirement, residents continue to report limited exposure to domains like available QI expertise, access to data collection, QI knowledge, and ability to complete all project stages.While the barriers to successful QI project implementation are numerous, the lack of experienced QI educators is also a major limitation. Educators new to QI education may not know how to approach common project pitfalls residents face, namely their tendency to jump to the \"do\" phase in a Plan-Do-Study-Act (PDSA) cycle without prior framing of the problem through process evaluation and identification of timely measures. These pitfalls can lead to many unintended consequences, including diminished physician engagement in QI work.To focus residents on learning about health systems, the authors draw on their collective experiences as learners and educators to propose a practical approach for new QI educators, consisting of 4 objectives: (1) illustrate and evaluate the process; (2) obtain meaningful and timely measures; (3) propose an intervention and obtain feedback from high-level stakeholders; and (4) reflect on lessons learned throughout the endeavor. The authors assert that by prioritizing these objectives before embarking on a PDSA cycle, residents will learn more about systems of care, gain competency in analyzing these systems, and continue QI efforts successfully in their future careers.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607018","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":"Coaching, Too, Should Count Toward Academic Promotion and Career Advancement.","authors":"Denise H Wong, Justin K Lui","doi":"10.1097/ACM.0000000000006023","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006023","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607019","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":"Establishing a Working Group on \"Spirituality and Health\" at the Brazilian Association of Medical Education.","authors":"Giancarlo Lucchetti, Paulo Othavio de Araujo Almeida, Elena Zuliani Martin, Ana Claudia Chazan","doi":"10.1097/ACM.0000000000006026","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006026","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607052","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 Maurana and Wood Ion.","authors":"Ross Jones","doi":"10.1097/ACM.0000000000006022","DOIUrl":"10.1097/ACM.0000000000006022","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":"143574589","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":"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}