Academic Medical Environment Research Articles

Development of Secure Infrastructure for Advancing Generative AI Research in Healthcare at an Academic Medical Center.

The increasing interest in leveraging generative AI models in healthcare necessitates secure infrastructure at academic medical centers. Without an all-encompassing secure system, researchers may create their own insecure microprocesses, risking the exposure of protected health information (PHI) to the public internet or its inadvertent incorporation into AI model training. To address these challenges, our institution implemented a secure pathway to the Azure OpenAI Service using our own private OpenAI instance which we fully control to facilitate high-throughput, secure LLM queries. This pathway ensures data privacy while allowing researchers to harness the capabilities of LLMs for diverse healthcare applications. Our approach supports compliant, efficient, and innovative AI research in healthcare. This paper discusses the implementation, advantages, and use cases of this secure infrastructure, underscoring the critical need for centralized, secure AI solutions in academic medical environments.

The ecology of program director leadership: power relationships and characteristics of effective program directors

BackgroundProgram directors are often perceived as strong and independent leaders within the academic medical environment. However, they are not as omnipotent as they initially appear. Indeed, PDs are beholden to a variety of different agents, including trainees (current residents, residency applicants, residency alumni), internal influencers (departmental faculty, hospital administration, institutional graduate medical education), and external influencers (the Accreditation Council for Graduate Medical Education (ACGME), medical education community, and society-at-large). Altogether, these agents form a complex ecosystem whose dynamics and relationships shape the effectiveness of program directors.Main bodyThis perspective uses management theory to examine the characteristics of effective PD leadership. We underline the importance of authority, accessibility, adaptability, authenticity, accountability, and autonomy as core features of successful program directors. Additionally, we review how program directors can use the six power bases (legitimacy, referent, informational, expert, reward, and coercive) to achieve positive and constructive change within the complexity of the academic medical ecosystem. Lastly, we describe how local and national institutions can better structure power relationships within the ecosystem so that PD leadership can be most effective.ConclusionKeen leadership skills are required by program directors to face a variety of challenges within their educational environments. Understanding power structures and relationships may aid program directors to exercise leadership judiciously towards fulfilling the educational missions of their departments.

Are You SURE You Want to Send That? A Model for Email Professionalism in Medical Education.

Email is an essential method of communication within academic medical environments and elsewhere. There is a growing body of literature that focuses on provider-to-patient communication in addition to studies examining the intersection of social networking and professionalism. Relatively little research exists, however, regarding the components of professional email interactions or "best practices" for electronic correspondence among colleagues, faculty, and trainees. After reviewing the existing literature, the authors created a practical approach for skillful email construction; the SURE model proposes a simplified framework that teaching institutions can use to improve interdisciplinary interactions and enhance email professionalism.

The Electronic Health Record and Education: Rethinking Optimization.

The Electronic Health Record and Education: Rethinking Optimization.

Essential Paths to Life after Residency

Essential Paths to Life after Residency

Effects of a Reward System on Resident Research Productivity

With the changing academic medical environment, nontraditional methods may need to be considered to foster research and scholarly activity during the otolaryngology residency experience. To evaluate the results of a reward system on resident research activity. Retrospective review of publications and approved institutional review board (IRB) projects between July 1, 1997, and June 30, 2011, among otolaryngology residents at a single otolaryngology residency program at the University of Missouri. A resident reward system, which awards points for research efforts for each progressive step along the research path from project design to acceptance for publication, was implemented on July 1, 2004. Residents can convert points to a monetary amount to be used for academic enrichment. Publication rate and IRB approval rate were compared before and after institution of the reward system. Study design types that were published and study design types that received IRB approval were evaluated as well. We hypothesized that the reward system would increase research quantity and quality. The mean publication output per resident per year increased from 0.13 (95% CI, 0.03-0.23) before commencement of the reward system to 0.43 (95% CI, 0.26-0.60) after implementation of the reward system (P = .004). Significantly more case reports were published compared with other study design types. The number of approved IRB projects before institution of the reward system was 0.47 (95% CI, 0.18-0.75) per resident per year. After instituting the reward system, this increased significantly to 1.29 (95% CI, 0.96-1.63) per resident per year (P = .007). Significant increases in IRB-approved case reports and retrospective clinical studies were noted. After implementation of a point-based reward system, resident research activity increased. The data suggest that this system may encourage resident research, although further refinement may be required to promote higher-quality research endeavors.

Mobile computing in medical education

There is an increasing importance of incorporating mobile computing into the academic medical environment. A growing majority of physicians, residents and medical students currently use mobile devices for education, access to clinical information and to facilitate bedside care. Therefore, it is important to assess the current opportunities and challenges in the use of mobile computing devices in the academic medical environment. Current research has found that a majority of physicians, residents and medical students either own or use mobile devices. In addition, studies have shown that these devices are effective as educational tools, resource guides and aids in patient care. Although there are opportunities for medical education, issues of deployment must still be addressed, such as privacy, connectivity, standardization and professionalism. Understanding the opportunities and challenges of using mobile computing devices in the academic medical environment can help determine the feasibility and benefits of their use for individuals and institutions.

Ten Steps to Effective Teaching as a Non-Physician Educator

Ten Steps to Effective Teaching as a Non-Physician Educator

Medical humanities as tools for the teaching of patient‐centered care

The Institute of Medicine, in its 2001 report Crossing the Quality Chasm: A New Health System for the 21st Century, highlighted patient-centered care as an area for the development of quality measures. Since then, medical centers across the country have incorporated patient-centered modalities in their healthcare delivery systems. In academic medical centers, interest in patient-centered care has raised the awareness of the interactions between the humanities and medicine. This work aims to define the roles of patient-centered medicine and the medical humanities in the academic medical environment, to establish the shared values between the medical humanities and patient-centered care, and to demonstrate how the medical humanities can be a tool for the teaching of patient-centered care.