Academic Medicine最新文献

{"title":"Applications of Artificial Intelligence for Nonpsychomotor Skills Training in Health Professions Education: A Scoping Review.","authors":"Kenya A Costa-Dookhan, Zachary Adirim, Marta Maslej, Kayle Donner, Terri Rodak, Sophie Soklaridis, Sanjeev Sockalingam, Anupam Thakur","doi":"10.1097/ACM.0000000000005983","DOIUrl":"10.1097/ACM.0000000000005983","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores uses of artificial intelligence (AI) in health professions education for nonpsychomotor skills training at undergraduate, postgraduate, and continuing health professions education levels for education program development, delivery, and evaluation.</p><p><strong>Method: </strong>This scoping review was conducted in 5 stages: (1) planning and research, (2) search strategy, (3) screening and selection, (4) review and recording data, and (5) synthesis. Seven bibliographic databases were searched using terms for artificial intelligence and continuing health professional education to capture articles that used AI for the purposes of nonpsychomotor skills training for health professions education and involved health care professionals and/or trainees. Databases were searched for articles published from January 1, 2001, to March 26, 2024. The original searches were performed on July 26, 2021, and again on March 26, 2024. Two reviewers independently screened, reviewed, and extracted data. Data extraction was performed using Kern's 6-step curriculum development framework to guide analysis.</p><p><strong>Results: </strong>In total, 9,914 studies related to AI in health professions education for nonpsychomotor skills training were screened. Of these, 103 studies were identified that met the inclusion criteria. Of these 103 studies, 52 (50%) were cohort studies. The most common learner population was health care professional students (67 studies [65%]). Most studies (76 [74%]) were set in nonclinical settings. Sixty-eight studies (66%) fit under step 6 of Kern's criteria (evaluation and assessment), illustrating that AI is predominantly being used for the purposes of evaluation and assessment of learners and programs.</p><p><strong>Conclusions: </strong>Most studies in the literature illustrate that AI is being applied in a nonpsychomotor context to evaluate health professional education programs and assess learners. Additional opportunities to use AI in curriculum design and implementation could include identification of learning needs for training, personalizing learning with AI principles, and evaluating health care professional education programs.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"635-644"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061004","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":"Concordance Between Trainee Self-Assessment and Expert Assessment of Cold Snare Polypectomy Competence: Results From a Randomized Clinical Study.","authors":"Swati G Patel, Larissa Muething, Tonya Kaltenbach, Tiffany Nguyen-Vu, Carmel Malvar, Rajesh N Keswani, Matthew Hall, Eva Aagaard, Ravishankar Asokkumar, Yung Ka Chin, Hazem Hammad, Amit Rastogi, Amandeep Shergill, Violet Simon, Alan Soetikno, Roy Soetikno, Sachin Wani","doi":"10.1097/ACM.0000000000005982","DOIUrl":"10.1097/ACM.0000000000005982","url":null,"abstract":"<p><strong>Purpose: </strong>Many trainees lack competence in performing cold snare polypectomy (CSP), and longer observation periods using assessment tools, such as the Cold Snare Polypectomy Assessment Tool (CSPAT), may be required. However, these tools are not commonly used in busy academic endoscopy practices. This study evaluates the concordance between trainee self-assessment of CSP with expert assessment and assesses factors associated with concordance.</p><p><strong>Method: </strong>Consecutive CSPs performed by gastroenterology trainees from 2 institutions were video recorded and rated by 8 blinded experts from 4 different academic institutions in the United States and Singapore using the CSPAT from August 2017 to February 2020. Trainees self-assessed competence for each CSP immediately after the procedure. Concordance between trainee and trainer was reported as percentage of agreement in competence (score of 3 or 4) or not yet competent (score of 1 or 2).</p><p><strong>Results: </strong>Twenty-two trainees performed 765 colonoscopies with 2,267 CSPs. Concordance was found between expert and trainee assessment of competence for 1,380 CSPs (60.9%; 95% CI, 58.8%-62.9%; weighted κ = 0.12; 95% CI, 0.08-0.16). Trainees underassessed competence for 541 CSPs (23.9%; 95% CI, 22.1%-25.7%) and overassessed competence for 326 CSPs (15.3%; 95% CI, 13.8%-16.8%). Career plan of private practice general gastroenterology (adjusted odds ratio, 0.40; 95% CI, 0.17-0.92) and lower colonoscopy volume before study (adjusted odds ratio, 0.35; 95% CI, 0.22-0.62) were independently associated with lower likelihood of concordance between expert and trainee assessment of competence. Structured feedback was not associated with concordance, and there was no change as trainees gained experience; however, feedback decreased the proportion of overassessments.</p><p><strong>Conclusions: </strong>There is poor concordance between trainee self-assessment and trainer assessment of CSP. Self-assessment can be used as an initial part of competency assessment, which should then be reconciled with external assessments to improve concordance in assessments.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"605-613"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061065","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 Li.","authors":"William E Schwartzman, Chloe Amsterdam, Christopher R Pierson","doi":"10.1097/ACM.0000000000005992","DOIUrl":"10.1097/ACM.0000000000005992","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"528-529"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076328","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 New Formula for Teaching Health Center Graduate Medical Education Payments Based on a Comprehensive Cost Evaluation.","authors":"Marsha Regenstein, Jennifer Trott, Leighton Ku, John Snyder, Hayden Kepley, Kennita Carter, Tonya Twyman, Jacqueline Baños","doi":"10.1097/ACM.0000000000005961","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005961","url":null,"abstract":"<p><strong>Purpose: </strong>A cost evaluation of the Teaching Health Center Graduate Medical Education (THCGME) program was conducted to measure direct medical education (DME) and indirect medical education (IME) costs, assess the effect of teaching health center (THC) characteristics on residency training costs, and develop a method and formula for per-resident amount (PRA) payments in baseline and future years for the THCGME program.</p><p><strong>Method: </strong>A costing instrument was developed by George Washington University researchers to collect academic year 2018 to 2019 cost data from 50 of 55 THCs to determine DME expenses. The investigators conducted 3 rounds of review on submitted instruments and provided technical assistance to THCs as needed. Health center-based THC sites were compared with health centers without training programs to investigate IME expenses using the Uniform Data System, interviews, and data from 4 health centers with training and nontraining sites.</p><p><strong>Results: </strong>After adjustment for inflation, the THCGME program PRA for academic year 2024 to 2025 was estimated at $227,164 based on median per-resident total expenses ($328,507) and revenues ($101,343). Resident and faculty compensation represented more than half of PRA expenses, with the remaining being other educational costs and operational or administrative expenses. Patient services represented 97% of revenues. Investigations into IME costs did not yield identifiable estimates.</p><p><strong>Conclusions: </strong>The cost evaluation revealed that the PRA currently used in the THCGME program underfunds actual net training costs. The investigators offer 3 THCGME program recommendations: (1) use a payment formula to annually adjust the PRA for inflation, understanding that such a payment policy requires legislative (appropriations) and executive branch (implementation) action; (2) use a PRA that remains a single, fixed payment without adjustment for THC characteristics; and (3) provide no additional funding for IME, given limited supporting data to justify assigning additional costs to THC-based training, given its ambulatory context.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 5","pages":"628-634"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163523","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":"Moving Forward Together: Establishing an Actionable Pedagogical Approach to Ableism-Aware Medical Education.","authors":"Dorothy W Tolchin, Nethra S Ankam, Glendaliz Bosques, Ravi Kasi, Carley Sauter, Maya Therattil, Leslie Rydberg","doi":"10.1097/ACM.0000000000005931","DOIUrl":"10.1097/ACM.0000000000005931","url":null,"abstract":"<p><strong>Abstract: </strong>As a form of discrimination, ableism impacts access to and the experience of clinical care for patients with disabilities as well as the daily experiences of learners and clinicians with disabilities. Ableist beliefs and practices conflict with physicians' professional responsibilities and legal obligations to provide care that is nondiscriminatory and accessible. An actionable pedagogical approach within medical education is needed to prepare a physician workforce that is able to meaningfully identify and mitigate ableism at all levels of the health care system.In this article, the authors propose a 3-pronged approach to ableism-aware medical education, building on frameworks that have been articulated for addressing other forms of discrimination to set forth a practical framework easily adopted by educators who may not be experts in ableism and its impact. The 3-pronged approach aligns with American Medical Association and Association of American Medical Colleges perspectives on advancing health equity and is inclusive of priority areas articulated by stakeholders, including those living with disability, those teaching about disability, and those advancing equity within medicine more broadly. The authors provide strategies relevant to medical students, faculty, and institutions, recognizing that ableism exists-and can be addressed-on multiple levels.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"547-557"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774422","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":"Reimagining the Medical School Accreditation Process in a Rapidly Changing Health Care Environment.","authors":"Charles G Prober, Aarti A Porwal, James O Woolliscroft, Joseph C Kolars","doi":"10.1097/ACM.0000000000005989","DOIUrl":"10.1097/ACM.0000000000005989","url":null,"abstract":"<p><strong>Abstract: </strong>Health care is changing rapidly due to advances in biomedical science and technology, as well as an expanding body of medical knowledge. This transformation necessitates a reevaluation of medical education models. The medical school accreditation process, administered through the Liaison Committee on Medical Education (LCME) for MD-granting schools in the United States and Canada, plays a crucial role in maintaining educational standards. However, current LCME accreditation standards sometimes conflict with innovative educational practices, potentially hindering necessary progress. This Commentary considers how the accreditation process could better support medical education as it advances and adapts to the evolving needs of the health care environment. The authors propose strategies to enhance the accreditation process and better serve medical schools: align accreditation with competency-based education, share best practices identified during the accreditation process, encourage innovation, address financial burdens associated with preparing for accreditation, support institutional missions, embrace advances in science and technology, and facilitate rapid curriculum changes. Balancing compliance with innovation would help schools optimize the educational journey for future physicians and advance the shared goals of improved medical education and patient care.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"531-535"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076336","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 Center for Health Outcomes in Medicine Scholarship and Service (HOMES): Fostering and Supporting Physician-Initiated Research.","authors":"Seuli Bose-Brill, Sean R Riley, Martin Fried, Janet E Childerhose, Christopher Hanks, Karen O Moss, Laura Miles, Wendy Xu, Patrick M Schnell, J Madison Hyer, Soledad Fernandez, Sheldon Retchin, Daniel E Jonas","doi":"10.1097/ACM.0000000000005929","DOIUrl":"10.1097/ACM.0000000000005929","url":null,"abstract":"<p><strong>Problem: </strong>The U.S. physician scholar workforce, currently comprising less than 1.5% of U.S. physicians, continues to decrease, threatening national status as a global biomedical research leader. Academic medical center (AMC) trends away from tenure-track physician faculty appointments toward clinical faculty appointments have contributed to this decrease, but AMCs have limited strategies to equip clinical faculty to conduct research. Infrastructure fostering clinical faculty research may establish new mechanisms for expanding physician scholar workforce and supporting academic goals of clinical faculty. This article presents one such model, the Center for Health Outcomes in Medicine Scholarship and Service (HOMES), from the Department of Internal Medicine, The Ohio State University College of Medicine.</p><p><strong>Approach: </strong>Established in 2019, HOMES provides research infrastructure, support, and mentorship tailored to clinical faculty needs. Multidisciplinary core faculty support research across 5 cores: clinical networks, biostatistics and secondary data, qualitative methods, mixed methods, and research ethics. HOMES services include research consultation, mentorship, microgrants, a training toolkit, and symposia.</p><p><strong>Outcomes: </strong>In 4 years, HOMES supported 50 faculty on 99 projects. Forty-five (90%) of these faculty have reported scholarly output, including 127 national presentations, authorship on 41 peer-reviewed articles, and 53 grant submissions. Forty HOMES-supported grant submissions have received funding, and 4 HOMES-supported physicians in training have pursued or plan to pursue AMC research careers.</p><p><strong>Next steps: </strong>HOMES has fostered scholarly productivity among AMC physicians, competitive grant applications, and research focus among physicians in training. As demand for HOMES services increases, HOMES will prioritize projects based on their innovation and research skill development potential. Academic medical centers can apply HOMES lessons through fostering clinical faculty collaboration with multidisciplinary research teams and increasing research training opportunities for residents and fellows. National expansion of funding opportunities dedicated to building biomedical research capacity and expertise among clinical faculty can facilitate sustainable scaling of HOMES-like models.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"562-566"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Innovative Approach to Navigating Microaggressions in Medical Education Settings.","authors":"Nariell Morrison, Olutunmise Ashaye, Simisola Onanuga, Hannah Okechukwu, Kinan Wihba, Chioma Izzi-Engbeaya, Amir H Sam","doi":"10.1097/ACM.0000000000005946","DOIUrl":"10.1097/ACM.0000000000005946","url":null,"abstract":"<p><strong>Problem: </strong>Microaggressions negatively affect the experiences of medical students, especially those from minoritized groups, indicating the need for heightened awareness and open dialogue. The increasing recognition of the potential harm caused by such behaviors has led to a call for educational strategies that enable medical students to identify and address microaggressions effectively. This report details an innovative approach designed to navigate the complexities of microaggressions within medical education settings.</p><p><strong>Approach: </strong>In December 2023, 2 senior medical educators facilitated an in-person lecture, which consisted of short videos cocreated with students, interactive online surveys, and a presentation. The lecture aimed to enable third-year medical students at Imperial College School of Medicine to describe and recognize microaggressions and other forms of inappropriate behavior, understand the impact of microaggressions in medical education settings, develop problem-solving skills to challenge inappropriate behavior, and differentiate the informal and formal mechanisms to raise concerns.</p><p><strong>Outcomes: </strong>The final data set consisted of 183 participants. Participants reported increases in confidence in identifying microaggressions (median [IQR], 4.00 [3.00-4.00] before vs 4.00 [4.00-5.00] after intervention; P < .001), understanding their potential effect on affected individuals (median [IQR], 4.00 [3.00-5.00] before vs 5.00 [4.00-5.00] after intervention; P < .001), and feeling better equipped to challenge inappropriate experienced (median [IQR], 2.00 [2.00-3.00] before vs 3.00 [2.00-4.00] after intervention; P < .001) or witnessed (median [IQR], 3.00 [2.00-3.00] before vs 4.00 [3.00-4.00] after intervention; P < .001) behaviors. They also reported increases in confidence in seeking support from their peers if they experienced (median [IQR], 4.00 [3.00-5.00] before vs 4.00 [4.00-5.00] after intervention; P < .001) or witnessed (median [IQR], 4.00 [3.00-4.00] before vs 4.00 [3.00-5.00] after intervention; P < .001) microaggressions.</p><p><strong>Next steps: </strong>Next steps include integrating small group workshops on microaggressions into curricula and adapting these interventions for other health care professionals.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"567-571"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Meets Holistic Review: Promises and Pitfalls of Automating the Medical Education Admissions Process.","authors":"Jacob T Rosenthal, Frederic W Hafferty, Kulamakan Mahan Kulasegaram, Claire L Wendland, Janelle S Taylor","doi":"10.1097/ACM.0000000000005964","DOIUrl":"10.1097/ACM.0000000000005964","url":null,"abstract":"<p><strong>Abstract: </strong>Holistic review has been widely adopted in medical education as a means of promoting equity in the application process and diversity in the medical workforce. Artificial intelligence (AI) is a rapidly emerging technology already having an impact on the medical school and residency application process as students and faculty alike increasingly turn to AI tools to automate some steps in the preparation and evaluation of application materials. While AI may have the potential to improve the holistic admissions process by increasing efficiency and adding some measure of standardization among reviewers, the authors caution that this promise does not come without certain pitfalls. AI models may introduce new sources of bias and amplify existing ones, which, when combined with a lack of transparency regarding their use in the admissions process, may perpetuate the very inequities that holistic review seeks to minimize. The authors call for the medical education community to establish clear regulations to govern the acceptable use of AI in the admissions process and for a principled adoption of AI tools in a way that is sustainable for applicants and reviewers in the future.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"541-546"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Take Charge of Your Professional Network of Colleagues to Succeed in Academic Medicine.","authors":"Attila Nemeth, Neha Deshpande, Yilin Zhang, Mamta Singh","doi":"10.1097/ACM.0000000000005971","DOIUrl":"10.1097/ACM.0000000000005971","url":null,"abstract":"<p><p>Instead of relying on a single, dyadic mentor for career advice, we suggest creating and intentionally cultivating a professional network of colleagues (PNC) to guide your academic career. There are four archetypes to help clinician educators succeed in academic medicine: a traditional mentor, a sponsor, a coach, and a connector. 1 However, these roles are not discrete, and overlap occurs. For example, some mentors are great sponsors. In fact, a clinician educator's PNC is akin to a board of directors in the business world. A board of directors determines the direction and strategic plan of a company, 2 while a PNC helps a clinician educator strategically navigate academia and provides career guidance.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"648"},"PeriodicalIF":5.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958391","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}