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    Collaboration and Teamwork in the Health Professions: Rethinking the Role of Conflict.
    Acad Med 2017 Nov 14. Epub 2017 Nov 14.
    Q. Eichbaum is associate professor of pathology, microbiology, and immunology; associate professor of medical education and administration; and director, Vanderbilt Pathology Education Research Group; director, Vanderbilt Pathology Program in Global Health; and clinical fellowship director, Vanderbilt University Medical Center, Nashville, Tennessee.
    Whereas the business professions have long recognized that conflict can be a source of learning and innovation, the health professions still tend to view conflict negatively as being disruptive, inefficient, and unprofessional. As a consequence, the health professions tend to avoid conflict or resolve it quickly. This neglect to appreciate conflict's positive attributes appears to be driven in part by (1) individuals' fears about being negatively perceived and the potential negative consequences in an organization of being implicated in conflict, (2) constrained views and approaches to professionalism and to evaluation and assessment, and (3) lingering autocracies and hierarchies of power that view conflict as a disruptive threat. Read More

    Integrating Social Determinants of Health Into Graduate Medical Education: A Call for Action.
    Acad Med 2017 Nov 14. Epub 2017 Nov 14.
    J. Siegel is assistant professor of medicine, Boston University School of Medicine, and associate program director, Boston Medical Center Internal Medicine Residency Program, Boston, Massachusetts. D.L. Coleman is the Wade Professor of Medicine and chair, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts. T. James is associate professor of emergency medicine, Boston University School of Medicine, and vice president of mission, Boston Medical Center, Boston, Massachusetts.
    Social determinants of health (SDH) are the major drivers of health and disparate health outcomes across communities and populations. Given this, the authors assert that competency in recognizing and mitigating SDH should become a vital component of graduate medical education in all specialties. While the most effective approaches to educating trainees about SDH are uncertain, in this Invited Commentary, the authors offer several key principles for implementing curricula focusing on SDH. Read More

    Medical Trainees' Experiences of Treating People With Chronic Pain: A Lost Opportunity for Medical Education.
    Acad Med 2017 Nov 14. Epub 2017 Nov 14.
    K. Rice is a postdoctoral fellow, Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. J.E. Ryu is a medical student, Faculty of Medicine, University of Toronto, Toronto, Canada. C. Whitehead is director and scientist, Wilson Centre, University Health Network; associate professor, Department of Family and Community Medicine, University of Toronto; vice president for education, Women's College Hospital; and BMO Financial Group Chair, Health Professions Research, University Health Network, Toronto, Canada. J. Katz is professor, and Canada Research Chair in Health Psychology, Department of Psychology, York University, Toronto, Canada. F. Webster is associate professor, Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto; scientist, Wilson Centre, University Health Network; and academic fellow, Centre for Critical Qualitative Health Research, University of Toronto, Toronto, Canada.
    Purpose: Evidence suggests that physicians' opinions about chronic pain patients become progressively negative over the course of medical training, leading to a decline in empathy for these patients. Few qualitative studies have focused on this issue and thus the experiences shaping this process remain unexplored. This study addressed how medical trainees learn about chronic pain management through informal and formal curricula. Read More

    Gender Disparities in Medical Student Research Awards: A Thirteen-Year Study From the Yale School of Medicine.
    Acad Med 2017 Nov 14. Epub 2017 Nov 14.
    J.T. King Jr is chief, Section of Neurosurgery, Surgical Service, VA Connecticut Healthcare System, West Haven, Connecticut; and associate professor, Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut. N.R. Angoff is associate dean, Student Affairs, and associate professor, Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. J.N. Forrest Jr is director, Office of Student Research, and professor, Division of Nephrology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. A.C. Justice is staff physician, Division of General Internal Medicine, VA Connecticut Healthcare System, West Haven, Connecticut; professor, Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; and professor, Yale School of Public Health, New Haven, Connecticut.
    Purpose: Instruction in research conduct is currently required, and many U.S. medical schools require students to complete a research project. Read More

    The Actual Versus Idealized Self: Exploring Responses to Feedback About Implicit Bias in Health Professionals.
    Acad Med 2017 Nov 14. Epub 2017 Nov 14.
    J. Sukhera is assistant professor of psychiatry and paediatrics and PhD candidate, Health Professions Education, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. A. Milne is a nurse, paediatric medicine and child and adolescent psychiatry, London Health Sciences Centre, London, Ontario, Canada. P. Teunissen is associate professor of medical education, Maastricht University, Maastricht, the Netherlands, and gynecologist, VU University Medical Center, Amsterdam, the Netherlands. L. Lingard is professor, Department of Medicine, and director, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. C. Watling is associate dean for postgraduate medical education, Schulich School of Medicine and Dentistry, Western University, and scientist, Centre for Education Research and Innovation, London, Ontario, Canada.
    Purpose: Implicit bias can adversely affect health disparities. The implicit association test (IAT) is a prompt to stimulate reflection; however, feedback about bias may trigger emotions that reduce the effectiveness of feedback interventions. Exploring how individuals process feedback about implicit bias may inform bias recognition and management curricula. Read More

    It is Time for Zero Tolerance for Sexual Harassment in Academic Medicine.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    Dr. Bates is associate dean for faculty affairs and associate professor of medicine, Harvard Medical School, Boston, Massachusetts. Dr. Jagsi is professor and deputy chair, Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, Michigan. Dr. Gordon is senior associate dean, Diversity Affairs, and professor of ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California. Dr. Travis is associate vice president, Women and Minority Faculty Inclusion, and professor, Department of Experimental Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas. Dr. Chatterjee is professor and chair, Department of Pediatrics, and senior associate dean for faculty development, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota. Dr. Gillis is professor, chief of division, and director of faculty advancement, Department of Humanities, Health, and Society, Herbert Wertheim,. College of Medicine, Florida International University, Miami, Florida. Olivia Means is a medical student at the University of South Alabama College of Medicine, Mobile, Alabama Dr. Chaudron is professor of psychiatry, pediatrics, and obstetrics and gynecology and associate vice president and senior associate dean for inclusion and culture development at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Dr. Ganetzky is an attending physician in the Mitochondrial Disease Clinical Center at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Dr. Gulati is professor of medicine and chief of cardiology, University of Arizona, Phoenix, Arizona. Dr. Fivush is associate dean for women in science and medicine and professor of pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland. Dr. Sharma is professor and chair, Department of Pathology, Creighton University School of Medicine and CHI Health, Omaha, Nebraska. Dr. Grover is associate professor of surgery, Surgical Oncology, VCU Health, Richmond, Virginia. Diana Lautenberger is director, Women in Medicine and Science, Association of American Medical Colleges, Washington, DC. Dr. Flotte is Dean of the School of Medicine, Provost and Executive Deputy Chancellor, and The Celia and Isaac Haidak Professor of Medical Education, University of Massachusetts, Worcester, Massachusetts.
    While there are more women in leadership positions in academic medicine now than ever before in our history, evidence from recent surveys of women and from graduating medical students demonstrates that sexual harassment continues in our institutions. Our ability to change the culture is hampered by fear of reporting episodes of harassment, which is largely due to fear of retaliation. We describe some efforts in scientific societies that are addressing this and working to establish safe environments at national meetings. Read More

    Resources Used to Teach the Physical Exam to Preclerkship Medical Students: Results of a National Survey.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    T. Uchida is associate professor of medicine and of medical education, and director, Clinical Skills Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois, ORCID: http://orcid.org/0000-0002-3251-5872. F.I. Achike is professor of pharmacology, of clinical skills, and of anesthesiology, director, Clinical Skills and Simulation Program, and associate dean, Interprofessional Education, California University of Science and Medicine School of Medicine, Colton, California. A.D. Blood is director, Curriculum and Education Management, Rush Medical College, Rush University, Chicago, Illinois, and a doctoral candidate in health professions education, University of Illinois at Chicago, Chicago, Illinois; ORCID: http://orcid.org/0000-0003-2275-923X. M. Boyle is clinical associate professor of emergency medicine, assistant dean, Clinical Formation, and course director, Patient Centered Medicine 2, Loyola Stritch School of Medicine, Maywood, Illinois. J.M. Farnan is associate professor of medicine, assistant dean, Curricular Innovation and Evaluation, and director, Clinical Skills Education, University of Chicago Pritzker School of Medicine, Chicago, Illinois. D. Gowda is associate professor of medicine, and course director, Foundations of Clinical Medicine Tutorials, Columbia University College of Physicians and Surgeons, New York, New York; ORCID: http://orcid.org/0000-0001-7124-7615. J. Hojsak is associate professor of pediatrics and of medical education, and course co-director, The Art and Science of Medicine, Years 1 and 2, Icahn School of Medicine at Mount Sinai, New York, New York. R.K. Ovitsh is assistant professor of pediatrics, and assistant dean, Clinical Competencies, SUNY Downstate College of Medicine, Brooklyn, New York. Y.S. Park is assistant professor of medical education, University of Illinois at Chicago College of Medicine, Chicago, Illinois; ORCID: http://orcid.org/0000-0001-8583-4335. R. Silvestri is assistant professor of medicine, and site director, Practice of Medicine, Harvard Medical School, Boston, Massachusetts; ORCID: http://orcid.org/0000-0001-7706-2208.
    Purpose: To examine the resources utilized in teaching the physical exam to preclerkship students at U.S. medical schools. Read More

    Speaking Up: An Ethical Action Exercise.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    J. Dwyer is professor, Center for Bioethics and Humanities, State University of New York Upstate Medical University, Syracuse, New York. K. Faber-Langendoen is professor and chair, Center for Bioethics and Humanities, State University of New York Upstate Medical University, Syracuse, New York.
    Problem: Health care professionals encounter situations in which they need to speak up to prevent harm, ensure better care, and/or address unprofessional behavior. Speaking up is often difficult, especially for medical students; nonetheless, it is a skill students must practice, so they can better advocate for patients.

    Approach: The authors have designed an ethical action exercise and incorporated it into a required bioethics course that meets concurrently with third-year clerkships. Read More

    "Rising to the Level of Your Incompetence": Exploring What Physicians' Self-Assessment of Their Performance Reveals About the Impact of the Imposter Syndrome in Medicine.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    K.A. LaDonna is assistant professor, Departments of Innovation in Medical Education and Medicine, University of Ottawa, Ottawa, Ontario, Canada. S. Ginsburg is professor, Internal Medicine (Respirology), and scientist, Wilson Centre, University of Toronto, Toronto, Ontario, Canada. C. Watling is professor, Departments of Clinical Neurological Sciences and Oncology, associate dean, Postgraduate Medical Education, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
    Purpose: Mistakes are ubiquitous in medicine; when confronted by error, physicians may experience anxiety, guilt, and self-doubt. Feedback may be useful for navigating these feelings, but only if it matches a physician's self-assessment; self-doubt and the imposter syndrome are examples of inaccurate self-assessments that may affect receptivity to feedback. The impact of real or imagined underperformance on seemingly competent physicians is poorly understood. Read More

    A Rose By Other Names: Some General Musings on Lawrence and Colleagues' Hidden Curriculum Scoping Review.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    F.W. Hafferty is professor of medical education, Division of General Internal Medicine and Program in Professionalism and Values, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0002-5604-7268. M.A. Martimianakis is associate professor and director, Medical Education Scholarship, Department of Paediatrics, and scientist and strategic lead international, Wilson Centre, Faculty of Medicine, University of Toronto; ORCID: https://orcid.org/0000-0002-2531-3156.
    In this Commentary, the authors explore the scoping review by Lawrence and colleagues by challenging their conclusion that with over 25 years' worth of "ambiguous and seemingly ubiquitous use" of the hidden curriculum construct in health professions education scholarship, it is time to either move to a more uniform definitional foundation or abandon the term altogether. The commentary authors counter these remedial propositions by foregrounding the importance of theoretical diversity and the conceptual richness afforded when the hidden curriculum construct is used as an entry point for studying the interstitial space between the formal and a range of other-than-formal domains of learning. Further, they document how tightly-delimited scoping strategies fail to capture the wealth of educational scholarship that operates within a hidden curriculum framework, including "hidden" hidden curriculum articles, studies that employ alternative constructs, and investigations that target important tacit socio-cultural influences on learners and faculty without formally deploying the term. Read More

    The Hidden Curricula of Medical Education: A Scoping Review.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    C. Lawrence is researcher, Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa, and medical student, Harvard Medical School, Boston, Massachusetts; ORCID: http://orcid.org/0000-0001-7507-5582. T. Mhlaba is public health medicine specialist, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; ORCID: http://orcid.org/0000-0002-0178-2652. K.A. Stewart is associate professor, The Practice in Global Health and Cultural Anthropology, Duke Global Health Institute, Duke University, Durham, North Carolina. R. Moletsane is professor and J.L. Dube Chair of Rural Education, Department of Rural Education, University of KwaZulu-Natal, Durban, South Africa; ORCID: http://orcid.org/0000-0002-8493-7479. B. Gaede is chair, Discipline of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa. M. Moshabela is chair, Centre for Rural Health, and Discipline of Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa, and Wellcome Trust fellow, Africa Centre for Population Health, Mtubatuba, South Africa; ORCID: http://orcid.org/0000-0002-9438-7095.
    Purpose: To analyze the plural definitions and applications of the term "hidden curriculum" within the medical education literature and to propose a conceptual framework for conducting future research on the topic.

    Method: The authors conducted a literature search of nine online databases, seeking articles published on the hidden, informal, or implicit curriculum in medical education prior to March 2017. Two reviewers independently screened articles with set inclusion criteria and performed kappa coefficient tests to evaluate interreviewer reliability. Read More

    Rethinking the Educator Portfolio: An Innovative Criteria-Based Model.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    K. Shinkai is associate professor, Department of Dermatology, and member, Academy of Medical Educators, University of California, San Francisco, School of Medicine, San Francisco, California. C. Chen is a resident, Department of Dermatology, University of California, San Francisco, School of Medicine, San Francisco, California. B.S. Schwartz is associate professor, Division of Infectious Diseases, and member, Academy of Medical Educators, University of California, San Francisco, School of Medicine, San Francisco, California. H. Loeser is professor, Department of Pediatrics, and member, Academy of Medical Educators, University of California, San Francisco, School of Medicine, San Francisco, California. C. Ashe was manager, Academy of Medical Educators, University of California, San Francisco, School of Medicine, San Francisco, California, at the time this work was completed. D.M. Irby is professor, Department of Medicine, and member, Academy of Medical Educators, University of California, San Francisco, School of Medicine, San Francisco, California.
    Problem: Academic medical centers struggle to achieve parity in advancement and promotions between educators and discovery-oriented researchers in part because of narrow definitions of scholarship, lack of clear criteria for measuring excellence, and barriers to making educational contributions available for peer review. Despite recent progress in expanding scholarship definitions and identifying excellence criteria, these advances are not integrated into educator portfolio (EP) templates or curriculum vitae platforms.

    Approach: From 2013 to 2015, a working group from the Academy of Medical Educators (AME) at the University of California, San Francisco (UCSF) designed a streamlined, criteria-based EP (EP 2. Read More

    Translating Theory Into Practice: Implementing a Program of Assessment.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    K.E. Hauer is professor, Department of Medicine, University of California, San Francisco, San Francisco, California; ORCID: http://orcid.org/0000-0002-8812-4045. P.S. O'Sullivan is professor, Department of Medicine, University of California, San Francisco, San Francisco, California; ORCID: http://orcid.org/0000-0002-8706-4095. K. Fitzhenry is manager of student assessment, School of Medicine, University of California, San Francisco, San Francisco, California. C. Boscardin is associate professor, Department of Medicine, University of California, San Francisco, San Francisco, California; ORCID: http://orcid.org/0000-0002-9070- 8859.
    Problem: A program of assessment addresses challenges in learner assessment using a centrally planned, coordinated approach that emphasizes assessment for learning. This report describes the steps taken to implement a program of assessment framework within a medical school.

    Approach: A literature review on best practices in assessment highlighted six principles that guided implementation of the program of assessment in 2016-2017: (1) a centrally coordinated plan for assessment aligns with and supports a curricular vision; (2) multiple assessment tools used longitudinally generate multiple data points; (3) learners require ready access to information-rich feedback to promote reflection and informed self-assessment; (4) mentoring is essential to facilitate effective data use for reflection and learning planning; (5) the program of assessment fosters self-regulated learning behaviors; and (6) expert groups make summative decisions about grades and readiness for advancement. Read More

    "You're Not Trying to Save Somebody From Death": Learning as "Becoming" in Palliative Care.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    F. Kilbertus is family physician and associate professor, Department of Clinical Sciences, Northern Ontario School of Medicine, Mindemoya, Ontario, Canada. R. Ajjawi is senior research fellow, Centre for Research in Assessment and Digital Learning, Deakin University, Melbourne, VIC, Australia. D.B. Archibald is assistant professor and medical education research scientist, Department of Family Medicine, University of Ottawa and Bruyère Research Institute, Ottawa, Ontario, Canada.
    Purpose: Learning can be conceptualized as a process of "becoming," considering individuals, workplace participation, and professional identity formation. How postgraduate trainees learn palliative care, encompassing technical competence, compassion, and empathy, is not well understood or explained by common conceptualizations of learning as "acquisition" and "participation." Learning palliative care, a practice that has been described as a cultural shift in medicine challenging the traditional role of curing and healing, provided the context to explore learning as "becoming. Read More

    The Evolving Purposes of Medical Revalidation in the United Kingdom: A Qualitative Study of Professional and Regulatory Narratives.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    A. Tazzyman is research associate, Alliance Manchester Business School, University of Manchester, Manchester, England. J. Ferguson is research associate, Alliance Manchester Business School, University of Manchester, Manchester, England. K. Walshe is professor of health policy and management, Alliance Manchester Business School, University of Manchester, Manchester, England. A. Boyd is research fellow, Alliance Manchester Business School, University of Manchester, Manchester, England. J. Tredinnick-Rowe is research assistant, Plymouth University, Plymouth, England. C. Hillier was research associate, Alliance Manchester Business School, University of Manchester, Manchester, England. S. Regan De Bere is lecturer, University of Plymouth, Plymouth, England. J. Archer is senior clinical lecturer and director, Collaboration for the Advancement in Medical Education Research and Assessment, Plymouth University, Plymouth, England.
    Purpose: Previous research found professionalism and regulation to be competing discourses when plans for medical revalidation in the United Kingdom were being developed in 2011. The purpose of this study was to explore how these competing discourses developed and how the perceived purposes of revalidation evolved as the policy was implemented.

    Method: Seventy-one interviews with 60 UK policy makers and senior health care leaders were conducted during the development and implementation of revalidation: 31 in 2011, 26 in 2013, and 14 in 2015. Read More

    PEARLS+: Connecting Societal Forces, Social Determinants, and Health Outcomes.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    clinical attending, Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine assistant professor (retired), Department of Public Health and Preventive Medicine, Oregon Health & Science University dean, College of Health Sciences, University of Texas at El Paso.

    Progress on a New Kind of Progress Test: Assessing Medical Students' Clinical Skills.
    Acad Med 2017 Nov 7. Epub 2017 Nov 7.
    R.H. DeMuth is associate professor of family medicine and assistant dean for clinical experiences, Michigan State University College of Human Medicine, East Lansing, Michigan. J.G. Gold is associate professor of pediatrics and learning society chief, Michigan State University College of Human Medicine, East Lansing, Michigan. B.E. Mavis is professor, Office of Medical Education Research and Development, and director, Academy and Learning Societies, Michigan State University College of Human Medicine, East Lansing, Michigan; ORCID: http://orcid.org/0000-0003-2145-3634. D.P. Wagner is professor of medicine and associate dean for undergraduate medical education, Michigan State University College of Human Medicine, East Lansing, Michigan.
    Problem: Progress testing of medical knowledge has advantages over traditional medical school examination strategies. However, little is known about its use in assessing medical students' clinical skills or their integration of clinical skills with necessary science knowledge. The authors previously reported on the feasibility of the Progress Clinical Skills Examination (PCSE), piloted with a group of early learners. Read More

    Transitioning to a High Value Health Care Model: Academic Accountability.
    Acad Med 2017 Nov 1. Epub 2017 Nov 1.
    P.T. Johnson is director, Appropriate Imaging; physician lead, Johns Hopkins Health System High Value Care Committee; vice chair, Quality and Safety; program director, Radiology Residency; and associate professor, Department of Radiology, Johns Hopkins Medicine, Baltimore, Maryland. M.D. Alvin is a second-year diagnostic radiology resident, Department of Radiology, Johns Hopkins Medicine, Baltimore, Maryland. R.C. Ziegelstein is vice dean for Education, Johns Hopkins University School of Medicine; professor, Department of Medicine, and professor, Department of Education, Johns Hopkins Medicine, Baltimore, Maryland.
    Health care spending in the United States has increased to unprecedented levels, and these costs have broken medical providers' promise to do no harm. Medical debt is the leading contributor to U.S. Read More

    Medical Education Must Move from the Information Age to the Age of Artificial Intelligence.
    Acad Med 2017 Nov 1. Epub 2017 Nov 1.
    S.A. Wartman is president and CEO, Association of Academic Health Centers, Washington, DC. C.D. Combs is vice president and dean, School of Health Professions, Eastern Virginia Medical School, Norfolk, Virginia.
    Changes to the medical profession require medical education reforms that will enable physicians to more effectively enter contemporary practice. Proposals for such reforms abound. Common themes include renewed emphasis on communication, teamwork, risk-management, and patient safety. Read More

    "The Questions Shape the Answers": Assessing the Quality of Published Survey Instruments in Health Professions Education Research.
    Acad Med 2017 Oct 31. Epub 2017 Oct 31.
    A.R. Artino Jr is professor of medicine and deputy director of graduate programs in health professions education, Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: http://orcid.org/0000-0003-2661-7853. A.W. Phillips is adjunct clinical professor of emergency medicine, Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina. A. Utrankar is a fourth-year medical student, Vanderbilt University School of Medicine, Nashville, Tennessee. A.Q. Ta is a second-year medical student, University of Illinois College of Medicine, Chicago, Illinois. S.J. Durning is professor of medicine and pathology and director of graduate programs in health professions education, Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
    Purpose: Surveys are widely used in health professions education (HPE) research, yet little is known about the quality of the instruments employed. Poorly designed survey tools containing unclear or poorly formatted items can be difficult for respondents to interpret and answer, yielding low-quality data. This study assessed the quality of published survey instruments in HPE. Read More

    Vive la Différence: The Freedom and Inherent Responsibilities When Designing and Implementing Multiple Mini-Interviews.
    Acad Med 2017 Oct 31. Epub 2017 Oct 31.
    H. Reiter is professor, Department of Oncology, McMaster University, Hamilton, Ontario, Canada. K. Eva is professor, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: http://orcid.org/0000-0002-8672-2500.
    The literature on multiple mini-interviews (MMIs) is replete with heterogeneous study results related to the constructs measured, correlations with other measures, and demographic relationships. Rather than view these results as contradictory, the authors ask, What if all of the results are correct? They point out that the MMI is not an assessment tool, but rather an assessment method. Design and implementation of locally conducted MMIs in medical school admissions processes should reflect local needs. Read More

    Medical School Applicant Characteristics Associated With Performance in Multiple Mini-Interviews Versus Traditional Interviews: A Multi-Institutional Study.
    Acad Med 2017 Oct 31. Epub 2017 Oct 31.
    M.C. Henderson is professor, Department of Internal Medicine, and associate dean for admissions, University of California, Davis, School of Medicine, Sacramento, California. C.J. Kelly is professor, Department of Medicine, and associate dean for admissions and student affairs, University of California, San Diego, School of Medicine, San Diego, California. E.J. Griffin is lead medical education evaluator, Office of Medical Education, University of California, Davis, School of Medicine, Sacramento, California. T.R. Hall is professor, Department of Radiology, and associate dean for admissions, David Geffen School of Medicine at UCLA, Los Angeles, California. A. Jerant is professor, Department of Family and Community Medicine, University of California, Davis, School of Medicine, Sacramento, California. E.M. Peterson is professor, Department of Pathology, and associate dean for admissions, University of California, Irvine, School of Medicine, Irvine, California. J. Rainwater is director of evaluation, Schools of Health and Clinical and Translational Science Center, University of California, Davis, School of Medicine, Sacramento, California. F.J. Sousa is assistant dean for admissions, University of California, Davis, School of Medicine, Sacramento, California. D. Wofsy is professor, Department of Medicine, and associate dean for admissions, University of California, San Francisco, School of Medicine, San Francisco, California. P. Franks is professor, Department of Family and Community Medicine, University of California, Davis, School of Medicine, Sacramento, California.
    Purpose: To examine applicant characteristics associated with multi mini-interview (MMI) or traditional interview (TI) performance at five California public medical schools.

    Method: Of the five California Longitudinal Evaluation of Admissions Practices (CA-LEAP) consortium schools, three used TIs and two used MMIs. Schools provided the following retrospective data on all 2011-2013 admissions cycle interviewees: age, gender, race/ethnicity (under-represented in medicine [UIM] or not), self-identified disadvantaged (DA) status, undergraduate GPA, Medical College Admission Test (MCAT) score, and interview score (standardized as z-score, mean = 0, SD = 1). Read More

    What Every Graduating Resident Needs to Know About Quality Improvement and Patient Safety: A Content Analysis of 26 Sets of ACGME Milestones.
    Acad Med 2017 Oct 31. Epub 2017 Oct 31.
    M. Lane-Fall is assistant professor of Anesthesiology and Critical Care and co-director, Center for Perioperative Outcomes Research and Transformation, Perelman School of Medicine, University of Pennsylvania; senior fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; and fellow, Harold Amos Medical Faculty Development Program, Robert Wood Johnson Foundation. ORCID: http://orcid.org/0000-0001-7050-0017. J.J. Davis is emergency medicine resident, Penn State Hershey Medical Center, Hershey, Pennsylvania; and visiting scholar, American Board of Medical Specialties, Chicago, Illinois. J. Clapp is research associate, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. J.S. Myers is associate professor of Clinical Medicine, director, Center for Healthcare Improvement and Patient Safety, Perelman School of Medicine, University of Pennsylvania, and director of Quality and Safety Education, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. L.A. Riesenberg is professor of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
    Purpose: Quality improvement (QI) and patient safety (PS) are broadly relevant to the practice of medicine, but specialty-specific milestones demonstrate variable expectations for trainee competency in QI/PS. The purpose of this study was to develop a unifying portrait of QI/ PS expectations for graduating residents irrespective of specialty.

    Method: Milestones from 26 residency programs representing the 24 member boards of the American Board of Medical specialties were downloaded from the Accreditation Council for Graduate Medical Education (ACGME) website in 2015. Read More

    Restorative Justice as the Rx for Mistreatment in Academic Medicine: Applications to Consider for Learners, Faculty, and Staff.
    Acad Med 2017 Oct 30. Epub 2017 Oct 30.
    D. Acosta is chief diversity and inclusion officer, Association of American Medical Colleges, Washington, DC. D.R. Karp is professor of sociology and director, Project on Restorative Justice, Skidmore College, Saratoga Springs, New York.
    The mistreatment of learners is an ongoing issue at U.S. medical schools. Read More

    Using a Modified A3 Lean Framework to Identify Ways to Increase Students' Reporting of Mistreatment Behaviors.
    Acad Med 2017 Oct 25. Epub 2017 Oct 25.
    P.T. Ross is director, Advancing Scholarship, University of Michigan Medical School, Ann Arbor, Michigan; ORICD: http://orcid.org/0000-0001-7751-784X. E. Abdoler is clinical educator fellow, Division of Infectious Diseases, University of California, San Francisco, San Francisco, California. L. Flygt is an intern, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; ORICD: http://orcid.org/0000-0002-4843-6802. R.S. Mangrulkar is Marguerite S. Roll Professor of Medical Education, associate dean for medical student education, and associate professor of internal medicine and learning health sciences, University of Michigan School of Medicine, Ann Arbor, Michigan. S.A. Santen is assistant dean of evaluation and assessment, and professor of emergency medicine and learning health sciences, University of Michigan School of Medicine, Ann Arbor, Michigan; ORICD: http://orcid.org/0000-0002-8327-8002.
    Problem: The proportion of students who experience mistreatment is significantly higher than the proportion of students who report mistreatment. Identifying ways to improve students' reporting of these incidents is one strategy for increasing opportunities to achieve resolution and prevent future occurrences.

    Approach: The authors applied a modified A3 Lean framework to examine medical student reporting of mistreatment behaviors at the University of Michigan Medical School (UMMS) in 2013-2016. Read More

    Health Care Organizations and Policy Leadership: Perspectives on Nonsmoker-Only Hiring Policies.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    P.A. McDaniel is associate professor, Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California. R.E. Malone is professor, Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California.
    Purpose: To explore employers' decisions to base hiring policies on tobacco or nicotine use and community perspectives on such policies, and analyze the implications for organizational identity, community engagement, and health promotion.

    Method: From 2013 to 2016, 11 executives from six health care organizations and one non-health-care organization with nonsmoker-only hiring policies were interviewed about why and how their policies were created and implemented, concerns about the policies, and perceptions of employee and public reactions. Focus groups were conducted with community members (n = 51) who lived in or near cities where participating employers were based, exploring participants' opinions about why an employer would stop hiring smokers and their support (or not) for such a policy. Read More

    Five Dimensions of Research Ethics: A Stakeholder Framework for Creating a Climate of Research Integrity.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    J.M. DuBois is Steven J. Bander Professor of Medical Ethics and Professionalism and director, Center for Clinical and Research Ethics, Washington University School of Medicine, St. Louis, Missouri. A.L. Antes is assistant professor of medicine and assistant director, Center for Clinical and Research Ethics, Washington University School of Medicine, St. Louis, Missouri.
    The authors explore five dimensions of research ethics: (1) normative ethics, which includes meta-ethical questions; (2) compliance with regulations, statutes, and institutional policies; (3) the rigor and reproducibility of science; (4) social value; and (5) workplace relationships. Each of the five dimensions is important not only because it addresses an aspect of good research done in a good manner but also because it addresses the concerns of key stakeholders in the research enterprise. The five-dimension framework can guide institutions as they answer three questions central to any research ethics program: (1) Who should champion research ethics? (2) What should interventions look like? and (3) Who should participate in the interventions? The framework is valuable because the answers to these three questions are radically different depending on the dimension under consideration. Read More

    Dilemmas of Representation: Patient Engagement in Health Professions Education.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    P. Rowland is assistant professor and scientist, Department of Occupational Science and Occupational Therapy, University of Toronto (UT) Faculty of Medicine, Toronto, Ontario, Canada. She is also cross-appointed researcher, Wilson Centre, UT, Toronto, Ontario, Canada. A.K. Kumagai is vice chair for education, Department of Medicine, University of Toronto (UT) Faculty of Medicine, and F.M. Hill Chair in Humanism Education, Women's College Hospital and UT, Toronto, Ontario, Canada. He is also cross-appointed researcher, Wilson Centre, UT, Toronto, Ontario, Canada.
    The role of the patient in bedside teaching has long been a matter of consideration in health professions education. Recent iterations of patient engagement include patients as storytellers, members of curriculum planning committees, guest lecturers, and health mentors. While these forms of patient engagement are reported to have many benefits for learners, educators, and the patients themselves, there is concern that such programs may not be representative of the diversity of patients that health care professionals will encounter throughout their careers. Read More

    Who Am I, and Who Do I Strive to Be? Applying a Theory of Self-Conscious Emotions to Medical Education.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    W.E. Bynum was attending faculty, National Capital Consortium Family Medicine Residency, Fort Belvoir Community Hospital, Fort Belvoir, Virginia, at the time this article was written. He is now assistant professor, Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina; ORCID: http://orcid.org/000-0003-3796-9301. A.R. Artino is professor, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: http://orcid.org/0000-0003-2661-7853.
    The self-conscious emotions of shame, guilt, and pride are a distinct set of cognitively complex, powerful, and ubiquitous emotions that arise when an individual engages in self-evaluation. Currently, little is known about the influence or outcomes of self-conscious emotions in medical learners. In this article, the authors present a leading theory of self-conscious emotions that outlines the appraisals and attributions that give rise to and differentiate shame, guilt, and two forms of pride. Read More

    Race/Ethnicity and Success in Academic Medicine: Findings From a Longitudinal Multi-Institutional Study.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    S.E. Kaplan is assistant professor of obstetrics and gynecology and assistant dean for diversity and multicultural affairs, Boston University School of Medicine, Boston, Massachusetts. A. Raj is professor of medicine and global public health and director, Center on Gender Equity and Health, Division of Global Public Health, School of Medicine, University of California, San Diego, San Diego, California. P.L. Carr is associate physician, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. N. Terrin is professor of medicine and director of biostatistics, epidemiology, and research design, Tufts Clinical Translational Science Institute and Tufts Medical Center, Boston, Massachusetts. J.L. Breeze is instructor of medicine and epidemiologist in biostatistics, epidemiology, and research design, Tufts Clinical Translational Science Institute and Tufts Medical Center, Boston, Massachusetts. K.M. Freund is professor and vice chair of medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts.
    Purpose: To understand differences in productivity, advancement, retention, satisfaction, and compensation comparing underrepresented medical (URM) faculty with other faculty at multiple institutions.

    Method: A 17-year follow-up was conducted of the National Faculty Survey, a random sample from 24 U.S. Read More

    An Innovative Shared Decision-Making Curriculum for Internal Medicine Residents: Findings From the University of Pittsburgh Medical Center.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    J. Rusiecki is assistant professor of medicine, Division of General Internal Medicine, University of Chicago Medical Center, Chicago, Illinois. At the time this research was conducted, she was a general internal medicine fellow, University of Pittsburgh School of Medicine and VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. J. Schell is assistant professor of medicine, Section of Palliative Care and Medical Ethics, Division of Renal-Electrolyte, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. S. Rothenberger is assistant professor of medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, and statistician, Center for Research on Health Care Data Center, Pittsburgh, Pennsylvania. S. Merriam is clinical instructor of medicine and general internal medicine fellow, University of Pittsburgh School of Medicine and VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. M. McNeil is professor of medicine and associate chief, Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. C. Spagnoletti is associate professor of medicine, director, Academic Clinician-Educator Scholars Fellowship in General Internal Medicine, and director, Mater's Program in Medical Education, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
    Purpose: Shared decision making (SDM) is a core competency in health policy and guidelines. Most U.S. Read More

    Simulation-Based Mastery Learning for Thoracentesis Skills Improves Patient Outcomes: A Randomized Trial.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    J.H. Barsuk is professor of medicine, Departments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois. E.R. Cohen is a research associate, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. M.V. Williams is professor of medicine, director, Center for Health Services Research, and vice chair, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky. J. Scher is research coordinator, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. S.F. Jones is research coordinator, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. J. Feinglass is research professor of medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. W.C. McGaghie is professor of medical education, Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois. K. O'Hara is instructor, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. D.B. Wayne is vice dean for education and Dr. John Sherman Appleman Professor of Medicine, Departments of Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
    Purpose: Physicians-in-training often perform bedside thoracenteses in academic medical centers, and complications are more common among less experienced clinicians. Simulation-based mastery learning (SBML) is one potential solution to this problem. This study evaluated the effects of a randomized trial of thoracentesis SBML on patient complications: iatrogenic pneumothorax (IP), hemothorax, and reexpansion pulmonary edema (REPE). Read More

    Broadening the Scope of Feedback to Promote Its Relevance to Workplace Learning.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    R.M. van der Leeuw is a postdoc researcher in medical education and elderly care medical resident, Department of Elderly Care Medicine, Gerion, VU University, Amsterdam, the Netherlands. P.W. Teunissen is professor of medical education, Maastricht University, Maastricht, the Netherlands, and gynecologist, VU University Medical Center, Amsterdam, the Netherlands. C.P.M. van der Vleuten is professor of education, Department of Educational Development and Research, Maastricht University, Maastricht, the Netherlands.
    The common goal in medical education is to support the health care workforce, both present and future, in becoming and remaining competent professionals. Both during and after medical training, learning takes place in the clinical workplace. Yet, how feedback is defined in medical education and how it is practiced in clinical training situations, combined with a research focus on "what works," limits its potential for learning. Read More

    Concerns and Responses for Integrating Health Systems Science Into Medical Education.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    J.D. Gonzalo is associate professor of medicine and public health sciences and associate dean for health systems education, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: http://orcid.org/0000-0003-1253-2963. K.J. Caverzagie is associate dean for educational strategy, University of Nebraska College of Medicine, Omaha, Nebraska; ORCID: http://orcid.org/0000-0001-8363-8111. R.E. Hawkins is vice president, Medical Education Outcomes, American Medical Association, Chicago, Illinois. L. Lawson is assistant dean for curriculum, assessment, and clinical academic affairs and associate professor of emergency medicine, Brody School of Medicine at East Carolina University, Greenville, North Carolina. D.R. Wolpaw is professor of medicine and humanities and vice chair for educational affairs, Department of Medicine, and director, Kienle Center for Humanistic Medicine, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: http://orcid.org/0000-0002-7567-2034. A. Chang is professor of medicine and Gold-Headed Cane Endowed Education Chair in Internal Medicine, University of California, San Francisco, School of Medicine, San Francisco, California.
    With the aim of improving the health of individuals and populations, medical schools are transforming curricula to ensure physician competence encompasses health systems science (HSS), which includes population health, health policy, high-value care, interprofessional teamwork, leadership, quality improvement, and patient safety. Large-scale, meaningful integration remains limited, however, and a major challenge in HSS curricular transformation efforts relates to the receptivity and engagement of students, educators, clinicians, scientists, and health system leaders. The authors identify several widely perceived challenges to integrating HSS into medical school curricula, respond to each concern, and provide potential strategies to address these concerns, based on their experiences designing and integrating HSS curricula. Read More

    How Effective Leaders Harness the Future.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    W. Souba is professor of surgery and adjunct professor of medical education, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. M. Souba is a PhD student, Department of Philosophy, Ohio State University, Columbus, Ohio.
    Human beings are fundamentally future oriented. Most of our decisions and undertakings are for the sake of a future to which we are committed or obligated. This future orientation is essential to effective leadership in health care, especially during this time of significant reform, when people are at risk of becoming cynical and disengaged. Read More

    The "Glocalization" of Medical School Accreditation: Case Studies From Taiwan, South Korea, and Japan.
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    M.J. Ho is professor, Department of Medical Education and Bioethics, National Taiwan University College of Medicine, and council member, Taiwan Medical Accreditation Council, Taipei, Taiwan; ORCID: http://orcid.org/0000-0003-1415-8282. J. Abbas was a research assistant, Department of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan, at the time of the study. D. Ahn is professor, Department of Medical Humanities, College of Medicine Korea University, Seoul, Korea; vice president, World Federation for Medical Education, London, United Kingdom; and immediate past president, Korean Institute of Medical Education and Evaluation, Seoul, Korea; ORCID: http://orcid.org/0000-0003-2762-0026. C.W. Lai is immediate past chairman, Taiwan Medical Accreditation Council, and chair professor, Medical Education Promotion Fund, Taipei, Taiwan. N. Nara is director, Japan Accreditation Council for Medical Education, Tokyo, Japan. K. Shaw was a research assistant, Department of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan, at the time of the study.
    Purpose: In an age of globalized medical education, medical school accreditation has been hailed as an approach to external quality assurance. However, accreditation standards can vary widely across national contexts. To achieve recognition by the World Federation for Medical Education (WFME), national accrediting bodies must develop standards suitable for both local contexts and international recognition. Read More

    The Shared Goals and Distinct Strengths of the Medical Humanities: Can the Sum of the Parts Be Greater Than the Whole?
    Acad Med 2017 Oct 24. Epub 2017 Oct 24.
    J.A. Greene is Elizabeth Treide and A. Macgehee Harvey Professor, Departments of Medicine and the History of Medicine, and director, Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. D.S. Jones is A. Bernard Ackerman Professor of the Culture of Medicine, Department of Global Health and Social Medicine, Harvard Medical School, and Department of the History of Science, Harvard University, Boston, Massachusetts; ORCID: http://orcid.org/0000-0003-0039-7784.
    Since the 1960s, faculty from diverse fields have banded together under the banner of the medical humanities, a term which unites art, literature, history, anthropology, religious studies, philosophy, and other disciplines. Arguments for the relevance of medical humanities often emphasize contributions that any of these disciplines can make to medical education, whether those involve empathy, professionalism, critical reasoning, or tolerating ambiguity. The authors argue that the constituent disciplines of the medical humanities are not interchangeable parts, but represent different perspectives and methodologies that offer their own distinct contributions to medical training. Read More

    EQual, a Novel Rubric to Evaluate Entrustable Professional Activities for Quality and Structure.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S110-S117
    D.R. Taylor is associate professor, Department of Medicine, Queen's University School of Medicine, Kingston, Ontario, Canada. Y.S. Park is assistant professor, Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois. R. Egan is assistant professor and director, Office of Health Science Education, Queen's University School of Medicine, Kingston, Ontario, Canada. M.-K. Chan is associate professor, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada, and clinician educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada. J. Karpinski is associate professor, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada, and associate director, Specialties Unit, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada. C. Touchie is associate professor, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada, and chief medical education advisor, Medical Council of Canada, Ottawa, Ontario, Canada. L.S. Snell is professor, Department of Medicine, McGill University, Montreal, Quebec, Canada, and senior clinician educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada. A. Tekian is professor, Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois.
    Purpose: Entrustable professional activities (EPAs) have become a cornerstone of assessment in competency-based medical education (CBME). Increasingly, EPAs are being adopted that do not conform to EPA standards. This study aimed to develop and validate a scoring rubric to evaluate EPAs for alignment with their purpose, and to identify substandard EPAs. Read More

    Using the Readiness for Clerkship and Residency Surveys to Evaluate the Effectiveness of Four MD Programs: A Cross-Institutional Generalizability Study.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S100-S109
    L.N. Peterson is former senior evaluation advisor, Evaluation Studies Unit, Medical Education, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, and former assistant secretary, Committee on the Accreditation of Canadian Medical Schools, Association of Faculties of Medicine of Canada, Ottawa, Ontario, Canada. S.A. Rusticus is instructor, Department of Psychology, Kwantlen Polytechnic University, Surrey, British Columbia, Canada, and former statistical analyst, Evaluation Studies Unit, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. K.W. Eva is professor and director, Education Research and Scholarship, Department of Medicine, and associate director and senior scientist, Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: http://orcid.org/0000-0002-8672-2500. D.A. Wilson is director, Evaluation Studies Unit, Medical Education, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. R.J. Pittini is associate professor, Department of Obstetrics and Gynecology, and director, Evaluations of the MD Program, University of Toronto, Toronto, Ontario, Canada. M. Schreiber is professor, Department of Medicine, and 3M National Teaching Fellow. He is former director, Undergraduate Medical Education Curriculum, and interim accreditation review coordinator, University of Toronto, Toronto, Ontario, Canada. S.E. Pinchin is educational specialist and manager, Division of Undergraduate Medical Educational Support and Development, Queens University, Kingston, Ontario, Canada. S.L. Moffatt is associate professor, Department of Medicine, and director, Clerkship Curricular Courses, Queens University, Kingston, Ontario, Canada. J.M. Sargeant is professor, Division of Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. A.E. Warren is associate professor, Department of Pediatrics, and associate dean, Postgraduate Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada. P. Alexiadis-Brown is program evaluation specialist, Dalhousie Medicine New Brunswick Program, and instructor, School of Health Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.
    Purpose: The importance of confidence for learning and performance makes learners' perceptions of readiness for the next level of training valuable indicators of curricular success. The "Readiness for Clerkship" (RfC) and "Readiness for Residency" (RfR) surveys have been shown to provide reliable ratings of the relative effectiveness of various aspects of training. This study examines the generalizability of those results. Read More

    Medical Education to Enhance Critical Consciousness: Facilitators' Experiences.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S93-S99
    Z. Zaidi is associate professor, Division of General Internal Medicine, Department of Medicine, University of Florida, Gainesville, Florida; ORCID: http://orcid.org/0000-0003-4328-5766. R. Vyas is assistant vice president, Foundation for Advancement of International Medical Education and Research (FAIMER Education), FAIMER, Philadelphia, Pennsylvania. D. Verstegen is assistant professor, Department of Educational Research and Development, Maastricht University, Maastricht, the Netherlands. P. Morahan is professor emerita, Drexel University College of Medicine, Philadelphia, Pennsylvania. T. Dornan is professor, Queen's University, Belfast, Northern Ireland.
    Purpose: To analyze educators' experiences of facilitating cultural discussions in two global health professions education programs and what these experiences had taught them about critical consciousness.

    Method: A multicultural research team conducted in-depth interviews with 16 faculty who had extensive experience facilitating cultural discussions. They analyzed transcripts of the interviews thematically, drawing sensitizing insights from Gramsci's theory of cultural hegemony. Read More

    A Multilevel Analysis of Professional Conflicts in Health Care Teams: Insight for Future Training.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S84-S92
    N. Bochatay is a research assistant, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, and PhD candidate, Institute of Sociological Research, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-6098-4262. N.M. Bajwa is residency program director, Department of General Pediatrics, Children's Hospital, University Hospitals of Geneva, and faculty member, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-1445-4594. S. Cullati is a medical sociologist, Quality of Care Unit, Medical Directorate, University Hospitals of Geneva, and Institute of Sociological Research, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-3881-446X. V. Muller-Juge is a scientific collaborator, Unit of Primary Care (UIGP), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-2346-8904. K.S. Blondon is junior faculty, Medical Directorate, University Hospitals of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-9407-8516. N. Junod Perron is coordinator, Institute of Primary Care, University Hospitals of Geneva, and faculty member, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-9124-8663. F. Maître is quality officer, Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland. P. Chopard is director, Quality of Care Unit, Medical Directorate, University Hospitals of Geneva, Geneva, Switzerland. N.V. Vu is emeritus professor, Faculty of Medicine, University of Geneva, Geneva, Switzerland. S. Kim is research professor, Department of Surgery, School of Medicine, University of Washington, Seattle, Washington. G.L. Savoldelli is associate professor and attending physician, Division of Anesthesiology, University Hospitals of Geneva, and Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-8968-6920. P. Hudelson is a medical anthropologist, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland. M.R. Nendaz is full professor and director, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, and attending physician, Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0003-3795-3254.
    Purpose: Without a proper understanding of conflict between health care professionals, designing effective conflict management training programs for trainees that reflect the complexity of the clinical working environment is difficult. To better inform the development of conflict management training, this study sought to explore health care professionals' experiences of conflicts and their characteristics.

    Method: Between 2014 and early 2016, 82 semistructured interviews were conducted with health care professionals directly involved in first-line patient care in four departments of the University Hospitals of Geneva. Read More

    Reflective Practice in the Clinical Setting: A Multi-Institutional Qualitative Study of Pediatric Faculty and Residents.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S75-S83
    J. Plant is associate professor, Department of Pediatrics, University of California, Davis, Sacramento, California. S.T. Li is associate professor, Department of Pediatrics, University of California, Davis, Sacramento, California. R. Blankenburg is associate professor, Department of Pediatrics, Stanford University, Palo Alto, California. A.L. Bogetz is associate program director and education program developer, Department of Pediatrics, Stanford University, Palo Alto, California. M. Long is associate professor, Department of Pediatrics, University of California, San Francisco, San Francisco, California. L. Butani is professor, Department of Pediatrics, University of California, Davis, Sacramento, California.
    Purpose: To explore when and in what form pediatric faculty and residents practice reflection.

    Method: From February to June 2015, the authors conducted focus groups of pediatric faculty and residents at the University of California, Davis; Stanford University; and the University of California, San Francisco, until thematic saturation occurred. Transcripts were analyzed based on Mezirow's and Schon's models of reflection, using the constant comparative method associated with grounded theory. Read More

    Study Behaviors and USMLE Step 1 Performance: Implications of a Student Self-Directed Parallel Curriculum.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S67-S74
    J. Burk-Rafel is an intern, Department of Medicine, New York University School of Medicine, New York, New York. He was previously a medical student, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: http://orcid.org/0000-0003-3785-2154. S.A. Santen is assistant dean, Educational Research and Quality Improvement, and clinical professor of emergency medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: http://orcid.org/0000-0002-8327-8002. J. Purkiss is assistant dean, Evaluation, Assessment, and Education Research, and assistant professor of internal medicine, Baylor College of Medicine, Houston, Texas. He was previously director, Evaluation and Assessment, University of Michigan Medical School, Ann Arbor, Michigan.
    Purpose: To determine medical students' study behaviors when preparing for the United States Medical Licensing Examination (USMLE) Step 1, and how these behaviors are associated with Step 1 scores when controlling for likely covariates.

    Method: The authors distributed a study-behaviors survey in 2014 and 2015 at their institution to two cohorts of medical students who had recently taken Step 1. Demographic and academic data were linked to responses. Read More

    How and Why Preclerkship Students Set Learning Goals and Assess Their Achievement: A Qualitative Exploration.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S61-S66
    P.M. Kindler is senior instructor, Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. J. Bates is professor, Department of Family Practice, and scientist, Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada. E. Hui is clinical assistant professor, Division of Physical Medicine & Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. K.W. Eva is professor, Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada.
    Purpose: Health professionals are expected to routinely assess their weaknesses, set learning goals, and monitor their achievement. Unfortunately, it is well known that these professionals often struggle with effectively integrating external data and self-perceptions. To know how best to intervene, it is critical that the health professionals community understand the cues students and practitioners use to assess their abilities. Read More

    Learning From Patients: Why Continuity Matters.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S55-S60
    S. Asgarova is a doctoral candidate, School of Social Work, University of British Columbia, Vancouver, British Columbia, Canada. M. MacKenzie is clinical associate professor, Department of Family Practice, Faculty of Medicine, British Columbia, Vancouver, British Columbia, Canada. J. Bates is professor, Department of Family Practice, and scientist, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
    Purpose: Patient continuity, described as the student participating in the provision of comprehensive care of patients over time, may offer particular opportunities for student learning. The aim of this study was to describe how students experience patient continuity and what they learn from it.

    Method: An interpretive phenomenological study was conducted between 2015 and 2016. Read More

    "You Have to Know the End of the Story": Motivations to Follow Up After Transitions of Clinical Responsibility.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S48-S54
    J.L. Bowen is professor, Department of Medicine, Oregon Health & Science University, Portland, Oregon. J.S. Ilgen is associate professor, Division of Emergency Medicine, Department of Medicine, and associate director, Center for Leadership & Innovation in Medical Education, University of Washington, School of Medicine, Seattle, Washington. D.M. Irby is professor, Department of Medicine, University of California, San Francisco, San Francisco, California. O. ten Cate is professor, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, the Netherlands, and adjunct professor, Department of Medicine, University of California, San Francisco, San Francisco, California. B.C. O'Brien is associate professor, Department of Medicine, University of California, San Francisco, San Francisco, California.
    Purpose: Physicians routinely transition responsibility for patient care to other physicians. When transitions of responsibility occur before the clinical outcome is known, physicians may lose opportunities to learn from the consequences of their decision making. Sometimes curiosity about patients does not end with the transition and physicians continue to follow them. Read More

    A Randomized Cohort Study of Diagnostic and Therapeutic Thresholds in Medical Student Clinical Reasoning.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S43-S47
    J.N. Stojan is assistant professor, Departments of Internal Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan. M. Daniel is assistant dean for curriculum and assistant professor, Departments of Emergency Medicine and Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: http://orcid.org/0000-0001-8961-7119. H.K. Morgan is clinical assistant professor, Departments of Obstetrics and Gynecology and Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan. L. Whitman is program manager, Standardized Patient Program, and standardized patient educator, University of Michigan Medical School, Ann Arbor, Michigan. L.D. Gruppen is professor, Department of Learning Health Sciences, and director, University of Michigan Master of Health Professions Education Program, Ann Arbor, Michigan; ORCID: http://orcid.org/0000-0002-2107-0126.
    Purpose: Learning to make decisions under uncertain conditions is a critical component of diagnostic and therapeutic reasoning. This study sought to determine treatment decisions medical students make when presented with different thresholds of diagnostic uncertainty and whether they appropriately adjust diagnostic probabilities with test information.

    Method: Two classes (2015, 2016) of fourth-year students (N = 342) were presented a patient with viral pneumonia and given 10%, 20%, or 50% pretest probabilities of that patient having a superimposed bacterial infection. Read More

    Quantitative and Qualitative Analysis of the Impact of Adoption of a Mobile Application for the Assessment of Professionalism in Medical Trainees.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S33-S42
    J.C. Cendán is professor and chairman, Department of Medical Education, University of Central Florida, Orlando, Florida; ORCID: http://orcid.org/0000-0002-2744-4838. A. Castiglioni is associate professor, Department of Internal Medicine and Department of Medical Education, University of Central Florida, Orlando, Florida. T.R. Johnson is director, Office of Assessment and Evaluation, and assistant professor of health sciences informatics, School of Medicine, Johns Hopkins University, Baltimore, Maryland. M. Eakins is creative lead, University of Central Florida, Institute for Simulation and Training, Mixed Emerging Technology Integration Lab, Orlando, Florida. M.L. Verduin is professor and associate dean for students, Department of Medical Education and Department of Clinical Sciences, University of Central Florida, Orlando, Florida. A. Asmar is associate professor and program director, Internal Medicine Residency Program, Department of Internal Medicine and Department of Medical Education, University of Central Florida, Orlando, Florida. D. Metcalf is director, Mixed Emerging Technology Integration Laboratory, University of Central Florida, Orlando, Florida. C. Hernandez is associate professor, Department of Internal Medicine and Department of Medical Education, University of Central Florida, Orlando, Florida.
    Purpose: Capturing either lapses or excellence in behaviors related to medical professionalism is difficult. The authors report a mixed-methods analysis of a novel mobile platform for assessing medical professionalism in a training environment.

    Method: A mobile Web-based platform to facilitate professionalism assessment in a situated clinical setting (Professional Mobile Monitoring of Behaviors [PROMOBES]) was developed. Read More

    Personalized Video Feedback and Repeated Task Practice Improve Laparoscopic Knot-Tying Skills: Two Controlled Trials.
    Acad Med 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S26-S32
    E.F. Abbott is a simulation fellow, Mayo Clinic Multidisciplinary Simulation Center, Mayo Clinic College of Medicine, Rochester, Minnesota, and adjunct instructor of internal medicine, Department of Internal Medicine, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; ORCID: http://orcid.org/0000-0001-5713-4809. W. Thompson is a medical student, University of Minnesota Medical School, Minneapolis, Minnesota. T.K. Pandian is a resident, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota. B. Zendejas is a pediatric surgery fellow, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. D.R. Farley is professor of surgery and consultant, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota. D.A. Cook is professor of medicine and professor of medical education; research chair, Mayo Clinic Multidisciplinary Simulation Center; director of research, Office of Applied Scholarship and Education Science; and Consultant in the Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota; ORCID: http://orcid.org/0000-0003-2383-4633.
    Purpose: Compare the effect of personalized feedback (PF) vs. task demonstration (TD), both delivered via video, on laparoscopic knot-tying skills and perceived workload; and evaluate the effect of repeated practice.

    Method: General surgery interns and research fellows completed four repetitions of a simulated laparoscopic knot-tying task at one-month intervals. Read More

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