Clinical Faculty Research Articles

“Having Support at Work ‘Is Different’ and Important”: A Qualitative Study of Virtual Peer Discussion Groups With Medical School Faculty

Abstract Purpose In response to the need to support health care professionals during the COVID-19 pandemic, an innovative, peer-led discussion group program for medical school faculty, called CIRCLE (Colleague Involved in Reaching Colleagues through Listening and Empathy), was developed at Rutgers Health. This article describes results of a qualitative analysis of the participants’ experiences, explores virtual communication platform use during this peer support program, and identifies the program’s beneficial elements. Method CIRCLE was inaugurated in October 2020 at Rutgers New Jersey Medical School and Rutgers Robert Wood Johnson Medical School using evidence-informed topics. The inaugural CIRCLE peer-led discussion groups included 50 physicians who met twice monthly in groups of 5 to 8 between October 2020 and April 2021. Deidentified transcript data were iteratively reviewed using conventional content analysis, including familiarization, thematic framework creation, indexing, charting, mapping, and interpretation. Themes were grouped into 4 conceptual framework categories based on social support theory in the context of work-related stress: emotional, appraisal, informational, and instrumental support. Results Themes emerged based on the framework: emotional support (connecting on a deeper level, importance of support at work, COVID-19 made virtual connections needed), relevant appraisal support (feeling “not alone,” safe space to connect and share), informational support (sharing self-care strategies), and instrumental support (incentives to join are helpful but connection leads to engagement, some structure but “not too much” is important, virtual modalities are convenient and conducive to connection). Conclusions Benefits of peer discussion groups include deeper connections at work, reduced isolation, safe sharing, and exchange of information on self-care. Connection and balancing structure and autonomy were important to engagement. Virtual modalities were viewed as feasible, convenient, and conducive to connection. This article highlights the benefits and convenience of virtual peer-led discussion groups for medical school clinical faculty and provides evidence for content development of these programs.

The Center for Health Outcomes in Medicine Scholarship and Service (HOMES): Fostering and Supporting Physician-Initiated Research

Abstract Problem The U.S. physician scholar workforce, currently comprising less than 1.5% of U.S. physicians, continues to decrease, threatening national status as a global biomedical research leader. Academic medical center (AMC) trends away from tenure-track physician faculty appointments toward clinical faculty appointments have contributed to this decrease, but AMCs have limited strategies to equip clinical faculty to conduct research. Infrastructure fostering clinical faculty research may establish new mechanisms for expanding physician scholar workforce and supporting academic goals of clinical faculty. This article presents one such model, the Center for Health Outcomes in Medicine Scholarship and Service (HOMES), from the Department of Internal Medicine, The Ohio State University College of Medicine. Approach Established in 2019, HOMES provides research infrastructure, support, and mentorship tailored to clinical faculty needs. Multidisciplinary core faculty support research across 5 cores: clinical networks, biostatistics and secondary data, qualitative methods, mixed methods, and research ethics. HOMES services include research consultation, mentorship, microgrants, a training toolkit, and symposia. Outcomes In 4 years, HOMES supported 50 faculty on 99 projects. Forty-five (90%) of these faculty have reported scholarly output, including 127 national presentations, authorship on 41 peer-reviewed articles, and 53 grant submissions. Forty HOMES-supported grant submissions have received funding, and 4 HOMES-supported physicians in training have pursued or plan to pursue AMC research careers. Next Steps HOMES has fostered scholarly productivity among AMC physicians, competitive grant applications, and research focus among physicians in training. As demand for HOMES services increases, HOMES will prioritize projects based on their innovation and research skill development potential. Academic medical centers can apply HOMES lessons through fostering clinical faculty collaboration with multidisciplinary research teams and increasing research training opportunities for residents and fellows. National expansion of funding opportunities dedicated to building biomedical research capacity and expertise among clinical faculty can facilitate sustainable scaling of HOMES-like models.

Intersection of Race and Gender in the Cardiothoracic Workforce: Study of Representation and Salary

Cardiothoracic surgery lacks gender and racial/ethnic diversity. Recent studies highlighted disparities based on gender and race/ethnicity among academic cardiothoracic surgeons. The impact of the intersection of these factors on representation and salary is unknown. A cross-sectional analysis of Accreditation Council for Graduate Medical Education and Association of American Medical Colleges data was performed on the number of trainees and clinical faculty stratified by race/ethnicity and gender using Chi-square testing. The number of women and underrepresented minorities was low in cardiothoracic surgery compared to other specialties, with lowest representation at the intersection of race/ethnicity and gender. Among trainees, 8% were Asian, 2% were Black/African American , and 1.5% were Hispanic/Latina women. Among cardiothoracic faculty, 3.4% were Asian, 0.8% were Black/African American, and 0.4% were Hispanic/Latina women. Women in academic medicine, surgery and cardiothoracic surgery earned 80-87% the salary of men of equal academic rank. White assistant professors earned more than their colleagues (all clinical faculty, surgeons and cardiothoracic surgeons), this difference was further compounded by gender. Salary disparities exist among cardiothoracic surgeons at the intersection of gender and race/ethnicity. Women experience salary disparity across all academic ranks and specialties. When considering the intersection of gender and race/ethnicity, gender is the predominant factor driving salary inequity.

A survey of US and Caribbean veterinary schools reveals strengths and opportunities in antimicrobial stewardship and infection prevention and control activities.

To understand antimicrobial stewardship (AS) and infection prevention and control (IPC) activities in veterinary schools. An online survey was completed by representatives from American Association of Veterinary Medical Colleges-accredited veterinary schools in the US and Caribbean prior to attending the Inaugural Small Animal Antimicrobial Stewardship Workshop for US Veterinary Schools. Responses were examined to identify patterns among AS and IPC activities and adherence to the AVMA core principles. Half (12 of 24) of the surveyed schools had an AS committee and most (79% [19 of 24]) had an IPC committee. Lack of dedicated staff time was a common barrier to AS (88% [21 of 24]) and IPC (75% [18 of 24]) reported by schools both with and without AS and IPC committees. Eleven of 24 schools (46%) reported performing at least 1 activity focused on each of the AVMA's 5 core principles of AS. Although 79% (19 of 24) of schools incorporate AS into preclinical curricula, training of clinical faculty (17% [4 of 24]), veterinary technicians and support staff (21% [5 of 24]), and house officers (42% [10 of 24]) is less common, despite these individuals engaging in teaching clinical-year veterinary students. Veterinary schools varied in established AS education and AS and IPC practices, though financial and human resources were a common barrier. A collaborative and cohesive approach to AS and IPC among schools to create sustainable frameworks for practice improvement will help combat the global threat of antimicrobial resistance. This is a critical action for settings where future veterinarians are trained.

Implementing Core Entrustable Professional Activities in Undergraduate Medical Education: A Psychometric Study.

This study examines the feasibility and psychometric results of an assessment of entrustable professional activities (EPAs) as a core component of the clinical program of assessment in undergraduate medical education, assesses the learning curves for each EPA, explores the time to entrustment, and investigates the dependability of the EPA data based on generalizability theory (G theory) analysis. Third-year medical students from the University of Minnesota Medical School in 7 required clerkships from May 2022 through April 2023 were assessed. Students were required to obtain at least 4 EPA assessments per week on average from clinical faculty, residents supervising the students, or assessment and coaching experts. Student ratings were depicted as curves describing their performance over time; regression models were used to fit the curves. The complete class of 240 (138 women [58.0%] and 102 men [42.0%]) third-year medical students at the University of Minnesota Medical School (mean [SD] age at matriculation, 24.2 [2.7] years) participated. There were 32,614 EPA-based assessments (mean [SD], 136 [29.6] assessments per student). Reliability analysis using G theory found that an overall score dependability of 0.75 (range, 0-1) was achieved with 4 assessors on 4 occasions. The desired level of entrustment by academic year end was met by all 240 students (100%) for EPAs 1, 6, and 7, 237 (98.8%), 236 (98.3%), and 218 (90.8%) students for EPAs 2, 5, and 9, respectively, 197 students (82.1%) for EPA 3, 178 students (74.2%) for EPA 4, and 145 students (60.4%) for EPA 12. The most rapid growth was for EPA 2 (β0 = .286), followed by EPA 1 (β0 = .240), EPA 4 (β0 = .236), and EPA 10 (β0 = .230). The study findings suggest that EPA ratings provide reliable and dependable data to make entrustment decisions about students' performance.

Barriers to Bedside Teaching: A Cross-Sectional Comparative Survey of Students and Faculty

Objective: To identify the barriers to bedside teaching among students and clinical faculty. Study Design: Cross sectional comparative study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2019 to Jun 2020. Methodology: The study participants included undergraduate students, postgraduate students and clinical faculty members. A self-designed questionnaire listing 25 common barriers to bedside teaching was distributed after pilot testing. Results: The total number of participants was 160, out of which 78(48.75%) were males, and 82(51.25%) were females. There were 40 respondents in each of the categories of consultants, postgraduate trainees and 80 in the undergraduate student category. Twenty consultants (50%) were from Medicine and Allied specialties, 10(25%) from Surgical and Allied specialties while 10(25%) did not mention their specialty. Majority of postgraduate trainees 33(82.5%) were from Medicine and Allied specialties. Significant difference (p-value=0.004) was revealed among students and faculty regarding barriers to bedside teaching. Bedside teaching was accorded more value by faculty (p-value=0.026). Faculty deemed ambiguity in curriculum as a more important barrier as compared to the students (p-value=0.037). Common barriers identified by students were inadequate time allocation (p-value<0.001), large student groups (p-value<0.001), performance pressure on faculty (p-value=0.004), lack of problem solving skill teaching (p-value=0.028) and insufficient feedback (p-value=0.044). Conclusion: Students as well as faculty value the role of bedside teaching in medical education but are cognizant of significant barriers in its execution. There are a number of common impediments that are narrated by both groups but students accord more importance to larger gro

Reinforcement of Core Foundational Science Concepts during Clinical Rotations: A Strategy to Enhance Medical Student Learning and Diagnostic Reasoning.

Cognitive science principles can facilitate integrating and retaining basic science concepts during the clinical years of undergraduate medical education. We hypothesized that reinforcing foundational science concepts during the core clerkship experiences fosters the development of clinical reasoning in medical students. A patient simulation session on diabetic ketoacidosis (DKA) in the pediatric clerkship was chosen to pilot the program. We introduced an intervention in which a team of clinical and foundational science faculty facilitates student discussions, helping them connect important physiological and pathophysiological concepts to the disorder's clinical presentation, diagnosis, and management. The student survey reported that 87% strongly agreed that it helped them reinforce their understanding of foundational science concepts related to clinical cases. The NBME subject exam results of the pediatric clerkships from the corresponding years were subjected to a cognitive diagnostic assessment called the DINA model analysis. The student content mastery in acid-base disorders was improved following the intervention (student mastery of skills, 0.73 vs 0.80, P=0.035). Similarly, analysis of the Step 2 Clinical Knowledge (CK) skills from the NBME subject exam item analysis reports showed improvement in the skill "diagnosis" on the topic of diabetes (probability value- before and after the intervention, respectively, 0.73 and 0.85, p=0.04) following implementation. Our study shows the impact of foundational science reinforcement during clinical clerkships in developing undergraduate medical students' clinical reasoning and diagnostic skills.

Exploration of Collaborative Innovation Pathways in the Development of Clinical Pharmacy Faculty Teams

Objective: To explore the collaborative innovation pathways for the development of clinical pharmacy faculty teams. Methods: Taking clinical pharmacy faculty in Shaanxi Province as the research subjects, the study investigates their current status and identifies existing issues. Based on these findings, collaborative innovation pathways for building clinical pharmacy faculty teams are proposed. The pathways are then implemented and evaluated to determine the final approach. Results: The proposed pathways include the establishment of collaborative bases for clinical pharmacy talent training, the creation of an internal mechanism for the collaborative development of clinical pharmacy faculty across multiple units, the development of a faculty training mechanism for instructors at clinical pharmacy internship bases, and the establishment of a collaborative incentive and competition mechanism combining universities and hospitals. Conclusion: This collaborative pathway meets the urgent needs of resource sharing, complementary strengths, cooperative problem-solving, and collaborative innovation. It aims to improve teaching quality and cultivate clinical pharmacy talents for society.

Collaborative Preclinical/Clinical Efforts Aimed at Strengthening a Neurology Residency Program: Challenges, Activities and Outcomes

AbstractRecent trends in medical education have included efforts to better integrate traditionally preclinical content with subject matter included in the clinical years of the curriculum. The participation of clinical faculty in preclinical courses is well established; however, involvement of biomedical science faculty in resident education is less common. We describe here a project in which a basic science faculty member participated in a neurology residency program to address specific basic science knowledge weaknesses identified by the neurology department chair. We address issues and challenges associated with planning and implementation. Benefits to both the residents and the biomedical scientist are described.

An Innovative, Collaborative, and Transformative Program to Enhance Off-Campus Clinical Faculty Engagement.

Off-campus (volunteer, community-based) clinical faculty, upon whom medical schools heavily depend, are an integral component of medical education. However, challenges hinder their involvement in medical school governance and other activities, including inadequate communication, lack of recognition, high clinical demands that may preclude teaching, and time-consuming non-clinical tasks. While faculty appointments offer benefits like free CME, access to library resources, and email communications, faculty often prioritize potential contributions to their teaching roles over these benefits. Our medical school launched a new initiative to tackle these issues head-on. We established an Office of Faculty Engagement (OFE) that leverages engagement strategies to enhance communication, broaden access to campus resources, and provide tailored rewards for clinicians. We rebranded volunteer clinical faculty as Off-Campus Faculty (OCF) to foster a more interactive relationship and innovative measures, including personalized welcome emails, a dedicated point of contact for OCF, a user-friendly website, regular orientations, faculty development programs, recognition and appreciation events, and exclusive awards. From August 2021 to December 2023, we contacted 587 OCF members; 85 faculty members experienced improved communication. This innovative approach streamlines and personalizes interactions with OCF, enhances their satisfaction, and represents a transformative opportunity to engage and involve OCF in medical education.

Development of a mobile application to increase motivation, engagement & teaching activity of clinical faculty using gamification principles

Background: Clinician teachers (CT) have historically felt undervalued and underappreciated. One technology used to increase motivation is gamification: the process of inserting elements of game-playing into activities that are not usually associated with games. We developed a mobile application that rewards CTs using in-app gamification techniques to increase CTs motivation. This program was implemented specifically in a regional campus setting, Mississauga, Ontario. Methods: A cross-platform application that rewards physicians for their clinical teaching hours was created. This consisted of a star grading criteria where each physician was awarded depending on the number of hours completed. End-user perceptions of the application were evaluated using a survey with a Likert scale and open-ended questions. Survey results were collated with descriptive statistics and thematic analysis. Results: The TutorTracker application was developed implementing a live gamification algorithm. It allows physicians to view their hours completed, rewards obtained, and add additional hours. The majority of CTs agreed or strongly agreed that the application was user-friendly, easy to navigate and enjoyed the rewards provided. Major themes that emerged were regarding additional features and full integration of such an application for rewarding teaching efforts. Conclusions: Gamification principles have been implemented in a cross-platform application allowing CTs to be rewarded for their teaching. The next steps would be to formally quantify the effects and advantages of using the application to increase the motivation of tutors.

Association of Psychological Safety with Burnout and Intent to Leave Among Physician Faculty in New York City.

Data on the potential protective effect of psychological safety (PS) on well-being and satisfaction among physicians are lacking. We sought to examine (1) prevalence of PS; (2) relationship between PS, burnout, and intent to leave one's job (ILJ); and (3) demographic and occupational factors associated with PS within our physician faculty. Participants: An institution-wide survey was sent to all faculty within our eight-hospital health system, between July and September 2022. PS was assessed using the seven-item Fearless Organization Questionnaire and burnout with the Maslach Burnout Inventory-2. Demographics and a measure of ILJ were assessed. Multivariable logistic regression analyses were conducted to determine associations between PS, burnout, ILJ, and demographic and occupational correlates of PS. A total of 867 out of 3086 total estimated clinical faculty members (28.1%) participated in the survey. The majority were 40 and older (67.4%), female (51.9%), white (60.0%), and married/partnered (80.4%); worked in ambulatory care departments (53.7%); and ranked assistant or associate professors (75.8%). On average, 57.6% of physicians evaluated their workplace as psychologically safe (range across items = 40.9-69.9%), with 35.2% screening positive for burnout and 13.4% reporting ILJ. After adjusting for demographic and occupational characteristics, each standard deviation unit increase in PS scores was associated with 27% lower odds of screening positive for burnout (odds ratio (OR) = 0.73, 95% confidence interval (CI) = 0.63-0.84) and 38% lower odds of ILJ (OR = 0.62, 95% CI = 0.52-0.74). Female gender was associated with lower scores of PS. A majority of faculty physicians reported working in a psychologically safe environment. Greater PS was associated with lower odds of burnout and ILJ. Investment in gender and diversity equity training may be one concrete step in advancing PS in the workplace.

Applying the Panarchy Framework to Examining Post-Pandemic Adaptation in the Undergraduate Medical Education Environment: A Qualitative Study

Phenomenon: The COVID-19 pandemic necessitated an abrupt shift to online medical education, disrupting learning across knowledge, skills, and social connections. Post-pandemic, medical schools must evaluate how these disruptions shaped student experiences to optimize the return to in-person learning. Approach: This cross-sectional qualitative study explored medical students’ perceptions of their learning environment during the post-pandemic reintegration period in Oman. Fifty-four preclinical and clinical students participated in six focus group interviews. Content analysis identified key topics characterizing students’ perceptions of change and change processes in the post-pandemic learning environment. The panarchy framework, developed to characterize complex adaptive systems in nature, was used to frame the results. Findings: The return to in-person environments presented a mix of renewed connectivity, involving collaborative benefits alongside transitional adjustment strains. Five major topics characterizing student perceptions of change and change processes in their post-pandemic learning environment were identified: learning skills, developing clinical competence, faculty interactions, physical atmosphere, and social connections. Managing academic schedules and cognitive load as the learning environment opened challenged students’ learning skills. Learners valued a renewed opportunity for interactive application of knowledge through collaboration, patient contact, and empathy skill-building to feel prepared for future practice. Returning to in-person instruction renewed a sense of community and peer support networks disrupted by pandemic isolation. Some students continued to struggle with study-life imbalance and felt ill-equipped to handle post-pandemic demands. Improved access to student support and wellness services was emphasized to ease transitional stresses. Students defined an ideal learning climate as supportive, active, personalized, relevant, challenging, accessible, and collaborative. Insights: While pandemic disruptions posed challenges, they provide opportunities to strengthen the educational system’s resilience moving forward. Our findings highlight an opportunity for medical educators and learners to capitalize on the innovations that emerged during this period, integrating technology with interactive learning activities and reconnecting students with the core values of the medical profession. Applying the panarchy framework to frame this adaptive process could enable the tracking of multi-level interactions within the medical education environment and the evaluation of interventions targeted at identified areas of concern. Further exploration to achieve complete mapping of specific environmental domains onto the panarchical cycles merits future investigation to build integrated resilience frameworks.

Evaluation of Clinical Education Based on Cognitive Apprenticeship Model Using Maastricht Clinical Education Questionnaire

Introduction: One of the main aspects of medical students is clinical education. The cognitive apprenticeship model is one of the principles of clinical education and contains six dimensions, including modeling, coaching, scaffolding, articulation, reflection, and exploration. This research aimed to evaluate the clinical education at Kerman University of Medical Sciences based on the cognitive apprenticeship model in 2021. Method: In this descriptive-analytical cross-sectional research, the Maastricht Clinical Education Questionnaire was separated among 150 students, and with a response rate of 74%, 112 of them completed this. Results: In the evaluation of the clinical education at Kerman University of Medical Sciences, the score of the articulation domain was higher than others, and the lowest score was given to the reflection domain. Clinical education in the internal medicine department was the most consistent with the cognitive apprenticeship model. Conclusion: Identifying the strengths and weaknesses of clinical education is the first step toward improving the quality of medical education. In the subsequent steps, the practitioners and planners of the faculty member empowerment programs should design, implement, and evaluate educational empowerment programs for clinical faculty members to improve their academic skills in the clinical education environment.

Librarian and Clinical Faculty Collaborative Use of Formative Assessment in a Longitudinal Evidence-Based Medicine Curriculum

Background The authors developed a longitudinal curriculum for teaching third- and fourth-year undergraduate medical students evidence-based medicine (EBM). This curriculum involved substantial librarian involvement, the use of formative assessment as a teaching method, and progressive repetition of skills. Methods Students in three clinical clerkships (Medicine, Pediatrics, OB/GYN) completed EBM assignments based on real-world scenarios in this quasi-experimental study. Each clerkship required students to submit an EBM plan, from which they received directed feedback from both the clerkship director and a librarian after submitting preliminary EBM plans. This study tracked student PICO and search submissions to determine if repeated exposure to EBM feedback resulted in improved summative assessments, both in isolation and longitudinally. Results Students’ PICO and searching performance improved between mid-clerkship formative feedback and end-clerkship summative assessment in all three clerkships using rubrics developed by the authors for each clerkship derived from existing literature. When examining student performance sequentially over three clerkships, there was significant improvement between the first and second clerkships, but this did not carry into the third clerkship. Discussion Our findings suggest that the significant inclusion of a librarian and feedback appears to have positive effects on student performance. While it may seem obvious that feedback results in improved outcomes, this method doesn’t appear widespread in medical education. Repetition, while not having a lasting increase in performance, may still be warranted to increase exposure to authentic cases and evidence types.

Obgyn resident research program practices and outcomes after implementation in an academically affiliated residency program

ProblemUnlike other aspects of Obstetrics and Gynecology (OBGYN) residency training, the research education curriculum and requirements are not standardized. It is unclear what constitutes core curricula in educational research programs, which components are most useful and efficacious, and how to use these findings to adapt existing programs.ApproachA multi-phase approach to (1) garner cross-sectional data from United States OBGYN Residency Program Directors and review previously published literature, (2) use Phase I and input from clinical, research and education faculty to develop a comprehensive program, and (3) evaluate the program for resident research productivity, knowledge and satisfaction.OutcomesPhase I: Sixty-one (31%) Program Directors completed the survey. Most reported ≤ 4 research didactics per year and no dedicated research rotation. Programs with post graduate year (PGY) level specific didactics, a research rotation, or allocated time for the Research Director role noted higher odds of resident research resulting in peer-reviewed publication. Phase II: A Resident Research Program was adapted to include a clinical and research faculty co-directorship and seven additional didactics (all of which were PGY-specific). A departmentally funded resident research grant and a repository to monitor completion of milestones and program requirements have been developed. Surveys were used to track residents’ research competence and satisfaction with the research program. While resident involvement in research activities and satisfaction with opportunities for scholarly activity have improved, resident self-evaluations and mentor evaluations have not. In addition, we have not seen an increase in publications or presentations.ConclusionImplementation of components of a research program associated with increased productivity did not result in increased productivity in our program, however, resident satisfaction with scholarly activity did improve.

Simulation Experiences Focusing on Addressing Culturally Based Hidden Bias and RacisM (A-CHARM).

Racism experienced by nursing students contributes to a loss of confidence and anxiety. The Addressing Culturally Based Hidden Bias and RacisM (A-CHARM) nursing project simulation experiences (SEs) provide opportunities to practice addressing racism/inappropriate comments experienced in the clinical setting. The aim is to describe the development of the A-CHARM nursing project SEs. The frameworks used in the development of the SEs include the (1) six-step approach, (2) ERASE framework, (3) SENSE debriefing model, and (4) Microaggressions Triangle model. Five SEs were created that depicted scenes where a nursing student encounters racism/inappropriate comments. Each SE aligned with one of the frameworks and users utilized the framework to navigate the SE. The A-CHARM nursing SEs may benefit nursing students by enhancing their knowledge and skills related to racism or inappropriate comments in clinical settings. Future research will evaluate the impact of the SEs on nursing students and clinical faculty. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Assessing Academic Preferential Hiring Practices in Highly Ranked Otolaryngology Departments.

Objective: To assess whether preferential hiring practices, particularly self-hiring, are present in academic otolaryngology departments. Setting: A list of academic Otolaryngology-Head and Neck Surgery (O-HNS) departments ranked #1-40 was generated from the Doximity 2021 rankings. The educational background and training information of clinical faculty members and departmental leadership was extracted from each department's online directories. Methods: Descriptive statistics were used to examine inter/intradepartmental relationships and affiliations of included clinical faculty and departmental leadership based on current employment and medical training sites. A "prior affiliation ratio" was calculated to assess the degree of self-hiring and account for multiple possible prior affiliations (medical school, residency, and fellowship) by dividing all prior self-hired affiliations of faculty by the total number of faculty at each department. Results: A total of 1344 clinical faculty were identified, and 596 (44.35%) had at least 1 prior affiliation with their department. The overall prior affiliation ratio was 0.6, and 7 departments had a value >0.8, with the highest being 1.27 (>1.0 indicating multiple prior affiliations per individual such as both residency and fellowship). A network map of departments #1-10 showed heavy intradepartmental faculty recruitment with 24% of faculty having completed a #1-10 residency, 24% a #11-20 residency, 13% a #21-30 residency, and 11% a #31-40 residency. Totaling this data, 76% of faculty at departments ranked #1-10 had completed training at a program ranked #1-40. Furthermore, our data shows high rates of self-hiring among departmental leadership, (40% of Departmental Chairs and 62.5% of Program Directors) though rates are not significantly higher than self-hiring among faculty overall. Conclusion: The top 40 ranked O-HNS departments have high rates of self-hiring, relying on prestige of training programs and prior affiliation in hiring decisions. The effect on departmental productivity and training is unclear.

Validation of a Clinical Teaching Competency Framework for Physical Therapists: A Mixed-Methods Approach.

A competency framework for clinical teaching in physical therapy was established in a recent study. Validation of competency frameworks requires multiple steps, including consideration of end-user perceptions of value and utility. The purpose of this study was to further validate the clinical teaching competency framework by gathering input specifically from clinical education faculty. This study used an explanatory sequential mixed methods approach to seek input from clinical instructors (CI) and site coordinators of clinical education (SCCE) from diverse practice areas and geographic regions. A survey invited participation from active clinical education faculty, and survey respondents were invited to participate in a focus group. Two focus groups were held via Zoom. Survey responses from those holding roles of CI (59.3%), SCCE (11.3%), and CI/SCCE (29.4%) indicated support for the competency framework, including perceived value to their role (93.1%) and enhancement of quality of clinical education (94.1%). Concern regarding ease of utilization of the framework was indicated by 24% of respondents. There were no statistically significant differences in responses based on role or credentials. The focus groups resulted in an overarching theme of Collective Impact, with 4 subthemes: Assessment, CI development, Implementation, and Guidelines. Clinical education faculty perceive value and utility in the Clinical Teaching Competency Framework. Implementation of the framework into practice should be collaborative and consistent across academic and clinical education programs. This study moves the profession one step closer to use of a competency framework specifically targeted at clinical teaching in physical therapy. Clinical education faculty will be primary users of a competency framework and buy-in from this user group is key to implementation. Continued efforts to validate this framework contribute to addressing the need for CI development and support in delivering excellence in clinical education.

Promoting Collaborative Scholarship During the COVID-19 Pandemic Through an Innovative COVID-19 Data Explorer and Repository at Yale School of Medicine: Development and Usability Study.

The COVID-19 pandemic sparked a surge of research publications spanning epidemiology, basic science, and clinical science. Thanks to the digital revolution, large data sets are now accessible, which also enables real-time epidemic tracking. However, despite this, academic faculty and their trainees have been struggling to access comprehensive clinical data. To tackle this issue, we have devised a clinical data repository that streamlines research processes and promotes interdisciplinary collaboration. This study aimed to present an easily accessible up-to-date database that promotes access to local COVID-19 clinical data, thereby increasing efficiency, streamlining, and democratizing the research enterprise. By providing a robust database, a broad range of researchers (faculty and trainees) and clinicians from different areas of medicine are encouraged to explore and collaborate on novel clinically relevant research questions. A research platform, called the Yale Department of Medicine COVID-19 Explorer and Repository (DOM-CovX), was constructed to house cleaned, highly granular, deidentified, and continually updated data from over 18,000 patients hospitalized with COVID-19 from January 2020 to January 2023, across the Yale New Haven Health System. Data across several key domains were extracted including demographics, past medical history, laboratory values during hospitalization, vital signs, medications, imaging, procedures, and outcomes. Given the time-varying nature of several data domains, summary statistics were constructed to limit the computational size of the database and provide a reasonable data file that the broader research community could use for basic statistical analyses. The initiative also included a front-end user interface, the DOM-CovX Explorer, for simple data visualization of aggregate data. The detailed clinical data sets were made available for researchers after a review board process. As of January 2023, the DOM-CovX Explorer has received 38 requests from different groups of scientists at Yale and the repository has expanded research capability to a diverse group of stakeholders including clinical and research-based faculty and trainees within 15 different surgical and nonsurgical specialties. A dedicated DOM-CovX team guides access and use of the database, which has enhanced interdepartmental collaborations, resulting in the publication of 16 peer-reviewed papers, 2 projects available in preprint servers, and 8 presentations in scientific conferences. Currently, the DOM-CovX Explorer continues to expand and improve its interface. The repository includes up to 3997 variables across 7 different clinical domains, with continued growth in response to researchers' requests and data availability. The DOM-CovX Data Explorer and Repository is a user-friendly tool for analyzing data and accessing a consistently updated, standardized, and large-scale database. Its innovative approach fosters collaboration, diversity of scholarly pursuits, and expands medical education. In addition, it can be applied to other diseases beyond COVID-19.