HCA healthcare journal of medicine最新文献

{"title":"Organizational Psychology Theories in Graduate Medical Education: A Narrative Review.","authors":"Mohamad S Saad, Naim El-Aswad, Zeina Ghossoub, Relly Nadler, Serena Wasilewski","doi":"10.36518/2689-0216.2314","DOIUrl":"10.36518/2689-0216.2314","url":null,"abstract":"<p><p>Description Physicians and educators tend to be more versed in recognizing disease patterns and medical problems than in identifying malfunctioning patterns in the psychological aspects of their mentees and work environments. Just as hypertension and diabetes are the common soil for many acute medical problems, agency problems and organizational silos can lead to many acute managerial problems in graduate medical education (GME) settings. Data show that most workers are lonely at work, which leads to negative emotions and undermines performance. Organizational problems seem to stem from an individual's inability to align one's motivation with the organization's shared value. This can cause an individual to feel their agency is under attack. Once this happens, misalignment prevails, and organizational silos form. This is why every organization needs to create optimal conditions to align its individuals. This requires a culture of learning and positive organizational psychology that nurtures safety. Here, we reviewed the literature on the role of emotional intelligence in the GME workplace and present science-backed approaches to solve current issues with worker disengagement, including employee loneliness, a lack of shared values, and limited autonomy. In a GME organization, everyone is continuously managing some circle of influence, whether in a patient room or a classroom. Mentorship is the most effective way to manage learners, especially in the medical field, where most stakeholders are fundamentally learners. A key requirement for effective mentorship is emotional intelligence, which requires awareness and management of both oneself and one's relationships. Through these internal and external factors, emotional intelligence plays critical roles in cognitive biases, narrative identity, memory, patient care, job satisfaction, motivation, and performance. Organization psychology approaches, such as job demands-resources (JDR) theory, self-determination theory (SDT), and stress management, can be used to improve worker and organizational wellbeing. The JD theory proposes the need for appropriate resources for an individual's workplace demands, with the consequence of the imbalance being employee burnout and disengagement. The SDT operates on the principles of autonomy, relatedness, and competency, which can help mentors and mentees identify barriers to motivation. Stress management theory proposes balancing challenges and skills to avoid anxiety and boredom. We have outlined a blueprint for stakeholders to identify factors needing improvement, so they can understand their roles and develop awareness of where, when, and how they can influence those factors positively or negatively.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 3","pages":"263-271"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Medicine: Barriers, Solutions, and Strategies.","authors":"Anil Harrison, Melissa Stradley Moreno, Caroline E Williams, Munevver Mine Subasi, Ersoy Subasi","doi":"10.36518/2689-0216.2311","DOIUrl":"10.36518/2689-0216.2311","url":null,"abstract":"<p><p>Description The integration of artificial intelligence (AI) and machine learning (ML) into health care holds the potential to revolutionize patient care by enhancing clinical decision-making, improving diagnostic accuracy, and reducing costs. Despite this promise, adoption remains limited due to a range of technical, regulatory, educational, and cultural barriers. This paper examines these challenges and proposes strategies to support safe and effective implementation of AI in clinical practice. Key barriers include the lack of model interpretability, often referred to as the \"black box\" problem, which undermines clinician trust and accountability in clinical settings, evolving regulatory frameworks and unresolved questions surrounding liability, and persistent concerns regarding data quality, access, and privacy. In addition, bias in AI models remains a critical issue with implications for health equity. Beyond these established challenges, emerging barriers include a disconnect between academically developed models and real-world clinical development, as well as the need for substantial transformation in medical education to address AI assisted clinical workflows. The increasing use of AI in core clinical tasks, such as documentation and diagnostic support, also raises concerns regarding the potential erosion of fundamental clinical skills. Without deliberate training strategies, reliance on AI may compromise the development and maintenance of independent clinical reasoning. To address these challenges, this paper emphasizes the importance of interdisciplinary collaboration, transparent and interpretable model development, modernization of medical education, and the establishment of adaptive regulatory and ethical frameworks. Ultimately, the successful integration of AI in health care will depend on aligning technological innovation with clinical trust, education, and patient centered care.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"247-254"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Innovative Interprofessional Practice and Education Intervention Led by Graduate Medical Education Resident Physicians With School-Based Nursing in 32 School Districts.","authors":"Christoffer A Amdahl, Hans Drawbert, Sadra Forati, Tyler Fields, James Mantil, Afsha Rais Kaisani, Marci Ayers, Michele L McCarroll","doi":"10.36518/2689-0216.2218","DOIUrl":"10.36518/2689-0216.2218","url":null,"abstract":"<p><strong>Background: </strong>School nurses play a critical role in student well-being, underscoring their growing importance in both education and health care systems. Research consistently demonstrates their contributions to individual student care and broader population health.</p><p><strong>Methods: </strong>This resident-led project explored community-based partnerships to facilitate mutual learning between school nurses and graduate medical education (GME) physicians. Conducted during the 2023-2024 academic year, this quality initiative (QI) involved the Medical City Healthcare (HCA Healthcare) GME programs and North Texas school districts. Educational resources were delivered through in-person teaching sessions led by resident physicians and hands-on medical simulations. School nurses who attended the Continuing Nursing Education (CNE) event completed program evaluations including Net Promotor Score, Likert-style, and open-ended questions. The program evaluation follows Kirkpatrick's levels of evaluation: Reaction, Learning, Behavior, and Results.</p><p><strong>Results: </strong>A total of 1183 school nursing staff from 32 North Texas school districts received training on musculoskeletal (MSK) injuries and concussions at 22 events within 12 Medical City Healthcare locations. At the conclusion of the sessions, 85% (n = 914) of participants reported that they would implement changes in their clinical practice or apply the knowledge gained. Nurses rated the presentations highly, with an average score of 4.2 out of 5, and the program achieved a Net Promoter Score of 91%, equating to a \"World Class\" designation. A 1-year post-event follow-up yielded an overall positive outcome of 91.3%, exceeding the 85% goal.</p><p><strong>Conclusion: </strong>These findings underscore the potential for GME programs to support community-based initiatives such as school nurse education, improving nursing application of recent evidence-based approaches to care, and strengthening interdisciplinary collaboration. Additionally, this model offers GME trainees valuable opportunities to apply evidence-based medicine in real-world settings, reinforcing their knowledge and professional development.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"145-151"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Simulation in General Surgery Residency: Advancing Technical Proficiency and Clinical Confidence.","authors":"Matthew A Daniel, Alyssa McMandon, Rachel Daley, Andrew Gustetic, Alexis Howarth, Meghana Jacob, Holden Lewis, Kushali Patel, Taylor Locklear, Saptarshi Biswas","doi":"10.36518/2689-0216.2394","DOIUrl":"10.36518/2689-0216.2394","url":null,"abstract":"<p><p>Description Surgical training has changed significantly over the past several decades, largely due to advances in technology. After the introduction of laparoscopic and robotic surgery into residency programs, simulation-based training (SBT) has become an important addition to surgical education. Simulation-based training offers a safe and structured environment to practice skills, receive feedback, and develop technical and non-technical abilities. While its benefits are well recognized, wider use of SBT continues to face challenges, including high costs, limited faculty availability, and time constraints within residency schedules. New technologies such as artificial intelligence, virtual and augmented reality, and standardized simulation frameworks may help address these barriers and further improve training. This review outlines the history, current applications, and future directions of SBT, highlighting its role in improving surgical education and patient care.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"239-246"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Education as Both Process and Environment for Innovation.","authors":"Gerald Wickham","doi":"10.36518/2689-0216.2525","DOIUrl":"https://doi.org/10.36518/2689-0216.2525","url":null,"abstract":"<p><p>Description The promise of better medicine, better health outcomes, and better lives depends on a culture of innovation and implementation in medical education. HCA Healthcare Graduate Medical Education continually strives to achieve this environment, to identify the health breakthroughs of tomorrow by fostering innovation in the daily work of the residents, scientists, and physicians of our enterprise. This special issue highlights some of this important work and shares actionable programs to elevate and inspire the next generation of physicians.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"117-118"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Innovative Model for Graduate Medical Education Faculty Development Through Physician-in-Training Delivery.","authors":"Daniel A Nguyen, Dustin Wilkes, Marshall Hall, Michael Carletti, Stephen E Weis","doi":"10.36518/2689-0216.2446","DOIUrl":"10.36518/2689-0216.2446","url":null,"abstract":"<p><strong>Background: </strong>Faculty development is a core requirement for Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs. Successfully delivering content to faculty can be challenging. This pilot study aimed to assess expert-developed sessions delivered by resident physicians to faculty at the completion of their clinical rotations.</p><p><strong>Methods: </strong>A prospective cohort project was conducted, involving precepting faculty and resident physicians in a dermatology residency program. Each resident, at the end of their rotation, delivered a faculty development program to their attending physician. Each resident participated in the program for 1-3 years. The faculty development programs were based on faculty development programs developed by various academic centers, including HCA Healthcare, Mayo Clinic, and the University of Toronto. The primary endpoint of this project was faculty participation in the faculty development session. Secondary endpoints were participation status by faculty or residents' personal characteristics. Residents documented attendance and the topic of each presentation. This data was used to assess faculty participation, the number of presentations delivered, and the topics covered during faculty development sessions. Descriptive statistics were used for data analysis.</p><p><strong>Results: </strong>Over 60 months, 8 dermatology residents delivered 86 presentations to 19 faculty members with 93.2% faculty participation. The topics covered included teaching during the COVID-19 era, faculty wellness, case-based collaborative learning, burnout, precepting, and depression. This initiative successfully recruited faculty members who had not previously participated in any faculty development programs.</p><p><strong>Conclusion: </strong>This model of resident physician-delivered faculty development content successfully addressed barriers in recruiting faculty for participation, which may have been facilitated through relationships formed during rotations, between the residents and attending physicians. Further research is recommended to validate the effectiveness of the model in diverse settings and explore its impact on faculty development outcomes and medical education quality. This model has the potential to improve participation in graduate medical education faculty development programs.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"229-238"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"iCare Compassionately: An Innovative Approach to Improving Nursing Education.","authors":"Lori M Brodie","doi":"10.36518/2689-0216.2381","DOIUrl":"10.36518/2689-0216.2381","url":null,"abstract":"<p><p>Description Historically, compassionate care has been briefly introduced in nursing education, without a sustained focus throughout nursing programs. Compassionate care models define the essential qualities needed to deliver meaningful care. Many of the traditional compassionate care models rely on high-level concepts that can be difficult to operationalize in academia. Further, current compassionate care models are typically limited to specific settings and are taught separately from other parts of the nursing curriculum. To address these concerns, a single purpose nursing college created and implemented the iCare Compassionately Model, which emphasizes both measurable behaviors and concepts related to compassion. As a result of this model, compassionate care is being integrated into the curriculum of every course in every program across the college. This article serves as an introduction to the iCare Compassionately Model and includes an overview of its theoretical underpinnings as well as a discussion of the curriculum integration efforts.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"201-204"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Use of Artificial Intelligence for Clinical Vignettes.","authors":"Henna Iqbal, Jennifer Jihae Park, Yelena Burklin","doi":"10.36518/2689-0216.2240","DOIUrl":"10.36518/2689-0216.2240","url":null,"abstract":"<p><p>Description The purpose of this report is to introduce a systematic process model for publishing clinical vignettes through vignette-based learning (VBL), with an emphasis on the ethical use of artificial intelligence (AI). We have provided a comprehensive walk-through outlining the process from initial case identification to the final dissemination of clinical vignettes, and we have highlighted how AI tools can support each step. This guide is intended to be especially beneficial for clinicians and early-career medical professionals aiming to develop and submit their cases for presentations, publications, and other avenues of knowledge sharing.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"255-260"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Strategies to Optimize Individual Performance on the In-Service Training Exam: A Case Series.","authors":"Julie Zemaitis DeCesare, Christina DeAngelis, Ana I DeCesare, Elizabeth Teets","doi":"10.36518/2689-0216.2488","DOIUrl":"10.36518/2689-0216.2488","url":null,"abstract":"<p><strong>Background: </strong>Obstetrics and gynecology residents in the United States take the Council on Residency Education in Obstetrics and Gynecology (CREOG) in-service training exam on an annual basis. Performance on the exam is essential to assess any deficits in a resident's knowledge as well as to evaluate the probability of passing the American Board of Obstetrics and Gynecology (ABOG) qualifying board exam. Given the substantial number of residents who experience performance issues during the exam, residency programs and individual learners benefit from the development of personalized learning plans to ensure trainee success. Test-taking anxiety is a big part of these performance issues. Eye movement desensitization and reprocessing (EMDR) therapy is a psychological method used to treat trauma symptoms and to also improve performance anxiety. Thus far, there have not been reports in literature of utilizing EMDR in residency programs to help learners struggling with test anxiety.</p><p><strong>Case presentations: </strong>We describe a series of cases in which EMDR therapy was utilized to enhance learner performance. The first case describes a resident who started with a CREOG score in lowest percentile, but with additional support, including EMDR therapy, improved their score to 60% in their second year and improved to 70% in their third year. In the second case, a resident with very inconsistent CREOG scores passed their qualifying exam on the first attempt after EMDR therapy. In the third case, a resident had consistently declining CREOG scores throughout their program, but with the help of an EMDR therapist ultimately passed the ABOG qualifying exam on the first attempt.</p><p><strong>Conclusion: </strong>This article highlights that EMDR can be an effective strategy to improve CREOG scores for residents with poor performance. The results we have seen in our residency program validate that EMDR is a successful tool for learners who experience test anxiety.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"173-178"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Scholarly Activity Through a Bundled Intervention of Resident-Faculty Connection and Research Ideas.","authors":"Katie Suleta, Norman W Gill","doi":"10.36518/2689-0216.2044","DOIUrl":"10.36518/2689-0216.2044","url":null,"abstract":"<p><strong>Background: </strong>Residents report barriers to engaging in scholarly activity despite this being a common requirement across residency programs. Two commonly reported barriers are a lack of mentorship by faculty and a lack of ideas for projects that meet the criteria for scholarly activity. The study objective is to describe the effect of an intervention to address a lack of mentorship and a lack of ideas for scholarly activities.</p><p><strong>Methods: </strong>A retrospective cohort design was utilized to investigate changes in scholarly activity between 2 academic years. An internal medicine residency program with 30 residents and 17 faculty members participated in an educational innovation in the 2022/2023 academic year. Residents in the previous academic year (n = 30) served as the comparison group. The faculty brainstormed ideas for new projects and provided sign-up sheets with quick response (QR) codes. First-year residents had to either sign up for a project or have their own protocol developed within 3 months of beginning residency.</p><p><strong>Results: </strong>The intervention group participated in more original research projects, presentations, and publications in PubMed indexed journals than the comparison group. The most notable increase was in presentations at regional and national conferences, which rose from 3 to 7. Participation in projects across other post-graduate year groups also increased.</p><p><strong>Conclusion: </strong>Faculty members brainstorming ideas, providing a hard deadline for first year residents, and the use of a QR code to recruit residents to existing research teams provided a cheap, easily implemented scholarly activity intervention. Other programs may benefit from adopting a similar program if possible.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"7 2","pages":"125-131"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}