Clinical Faculty Research Articles

A qualitative assessment of medical students’ readiness for virtual clerkships at a Qatari university during the COVID-19 pandemic

BackgroundThis study aims to qualitatively examine the readiness of medical students to change to virtual clerkship (VC) during the pandemic, from both the faculty and students’ perspectives.MethodsA qualitative study was conducted based on the framework of readiness to change. Focus group discussions with students, and semi-structured interviews with clinical faculty members were done using appropriate online platforms. Transcripts were then analyzed using inductive-deductive approach.ResultsTwelve themes emerged which are (1) Perceptions about the university’s decision and its communication to students, (2) A Perceived lack of clinical experience, (3) Students’ role as members of the medical team facing the pandemic, (4) Student safety, (5) Quality and design of VC and the skills it offered, (6) Belief in own ability to succeed in the VC, (7) Confidence that VC would reach its goals, (8) New enhanced learning approaches, (9) Preparing students for new types of practice in the future (10) Acquired skills, 11) Academic support and communication with faculty and college, and 12) Psychological support. Medical students showed limited readiness to undertake a virtual clerkship and not play their role as healthcare professionals during the pandemic. They perceived a huge gap in gaining clinical skills virtually and asked for a quick return to training sites.ConclusionMedical students were not ready for virtual clerkships. There will be a need to integrate novel learning modalities such as patient simulations and case-based learning in order to meet future demands of the medical profession and enhance the efficiency of virtual clerkships.

Academic Pharmacy Fellowship Programs are an Innovative Solution to Improve the Faculty Pipeline

Academic pharmacy fellowship programs can offer an innovative training solution to help prepare pharmacists for successful careers as clinical faculty members. However, there is no well-defined program blueprint or recommendations for what a successful program should include. This commentary describes the program overview for the academic pharmacy fellowship at the University of Houston College of Pharmacy and discusses the implications of incorporating a similar program at a college of pharmacy. The purpose of the fellowship program is to prepare pharmacists for a career in pharmacy education through training in teaching, curriculum development, college service, mentoring, scholarship, and clinical practice. A structured program with monthly rotations in key academic areas, teaching experience and mentorship (didactics and skills labs), committee service, and leading a research project make up the core structure of the program. These experiences, coupled with significant student interaction, can prepare fellowship graduates to transition effectively into clinical faculty roles.

Can veterinary medicine improve diversity in post-graduate training programs? Current state of academic veterinary medicine and recommendations on best practices.

The American Association of Veterinary Clinicians (AAVC) convened a Diversity, Equity, and Inclusivity working group in March 2021 to address the limited diversity (including but not limited to ethnic, racial, and cultural diversity) in clinical post-DVM graduate training programs and academic faculty. Concurrent with a working group formation, the AAVC developed a strategic plan. The central mission of the AAVC is to develop, support, and connect academic leaders to fuel the future of the veterinary medical profession. House officers and their training programs are central to all goals outlined in the strategic plan. Amongst other strategic goals, the working group identified best practices for intern and resident recruitment and selection. We report herein from the current health profession literature ways to identify and recruit talented, diverse candidates especially those with non-traditional (atypical) preparation and experience. We also provide recommendations on best practices for intern and resident selection. This document highlights holistic approaches, some of which are incrementally being incorporated into the Veterinary Intern Resident Matching Program application, that emphasize diversity as a selection criteria for intern and resident selection an important step towards building a more resilient and inclusive workforce. These include expanding candidate assessment beyond grades and class rank into a more standardized method for screening candidates that includes consideration of life experiences and talents outside of veterinary medicine.

A Critical Review from the Perspective of 2 Years Thereafter of the Effectiveness of Revolutionary Changes in a Gastroenterology Division at a Medical School Teaching Hospital due to the Coronavirus Disease-2019 Pandemic: Gastrointestinal Physician Clinical Practice and Emotional Stresses, Gastrointestinal Graduate Medical Education, Gastrointestinal Professional Societies, and Pandemic Control.

Critically review approximately 2 years afterward the effectiveness of revolutionary changes at an academic gastroenterology division from coronavirus disease-2019 (COVID-19) pandemic surge at the metropolitan Detroit epicenter from 0 infected patients on March 9, 2020, to>300 infected patients (one-quarter of) in-hospital census in April 2020 and>200 infected patients in April 2021. GI Division, William Beaumont Hospital which had 36 GI clinical faculty who used to perform>23,000 endoscopies annually with a massive plunge in endoscopy volume during the past 2 years; fully accredited GI fellowship since 1973; employs>400 house staff annually since 1995; predominantly voluntary attendings; and primary teaching hospital, Oakland-University-Medical-School. Expert opinion, based on: Hospital GI chief>14years until September 2019; GI fellowship program director, at several hospitals for>20years; author of 320 publications in peer-reviewed GI journals; and committee-member Food-and-Drug-Administration-GI-Advisory Committee for>5years. Original study exempted by Hospital Institutional Review Board (IRB), April 14, 2020. IRB approval is not required for the present study because this opinion is based on previously published data. Advantageous changes: Division reorganized patient care to add clinical capacity and minimize risks to staff of contracting COVID-19. Affiliated medical school changes included: changing "live" to virtual lectures, meetings, and conferences. Initially, virtual meetings usually used telephone conferencing which proved cumbersome until meetings were changed to completely computerized virtual meetings using Microsoft Teams or Google Zoom, which performed superbly. Some clinical electives were canceled for medical students and residents because of the need to prioritize car for COVID-19 infection during the pandemic, and medical students graduated on time despite partly missing electives. Division reorganized by changing "live" GI lectures to virtual lectures; by four GI fellows temporarily reassigned as medical attendings supervising COVID-19-infected patients; postponing elective GI endoscopies; and drastically reducing an average number of endoscopies from 100/weekday to a small fraction long-term! GI clinic visits were reduced by half by postponing nonurgent visits, and physical visits were replaced by virtual visits. Economic pandemic impact included a temporary, hospital deficit initially relieved by federal grants and hospital employee terminations. GI program director contacted GI fellows twice weekly to monitor pandemic-induced stress. Applicants for GI fellowship were interviewed virtually. Graduate medical education changes included weekly committee meetings to monitor pandemic-induced changes; program managers working from home; canceling annual ACGME fellowship survey, ACGME site visits, and national GI conventions changed from physical to virtual. Dubious changes: Temporarily mandated intubation of COVID-19-infected patients for EGD; temporarily exempted GI fellows from endoscopy duties during surge; fired highly respected anesthesiology group employed for 20years during pandemic leading to anesthesiology shortages, and abruptly firing without warning or cause numerous senior respected faculty who greatly contributed to research, academics, and reputation. Profound and pervasive GI divisional changes maximized clinical resources devoted to COVID-19-infected patients and minimized risks of transmitting infection. Academic changes were degraded by massive cost-cutting while offering institutions to about 100 hospital systems and eventually "selling" institutions to Spectrum Health, without faculty input.

Embracing lifelong learning as a novice nurse educator.

Abilene Smith is a clinical assistant professor of nursing and the lead clinical faculty for the Direct Entry Program in Nursing at the University of Vermont. Her clinical area of expertise is case management and neurology including stroke care, brain injury rehabilitation, and movement disorders. The author has disclosed no financial relationships related to this article.

Dismantling White Supremacy and Promoting Antiracism in Social Work: Tensions, Paradoxes, and a Collective Response

The social work profession in the United States is striving to advance antiracism amidst increasing threats of white supremacist violence. However, tensions and paradoxes in the contexts of academic research and knowledge development, education and teaching, and service undermine the profession’s efforts. Structural or institutional processes—in higher education broadly and in schools of social work specifically—shape who publishes research, educates, and serves, and how labor is evaluated and rewarded. We identify practical recommendations to advance antiracism while cautioning against overemphasizing the responsibility of individual actors. Recommendations include prioritizing and generously funding scholarship on white supremacy and antiracism, providing clinical and adjunct faculty with sufficient remuneration and supports to excel in teaching, joining with students in protest against oppressive conditions in higher education, and equalizing rewards for service in accordance with those for research. Social workers must work proactively across multiple contexts to realize our professional commitment to dismantling white supremacy and advancing antiracism.

Tips and Tricks: Starting Your Own Continuing Medical Education Course

Tips and Tricks: Starting Your Own Continuing Medical Education Course

Big ideas

The Big Ideas Soapbox at Family Medicine Forum (FMF) showcases concepts that could make a difference to clinical practice, faculty development, postgraduate or undergraduate education, patient care and outcomes, or health policy. This session offers a platform for innovators to share fresh ideas,

Differential Grading of Reflective Writing Between Clinical Instructors and Faculty Type

It is important for instructors to give equivalent grades for comparable student performances on an assignment. Students complain of differential grading, especially when multiple instructors grade a course assignment. This descriptive comparative study examined clinical instructor-assigned grades for reflective thinking and writing components. Grades for 480 critical reflective papers by 80 undergraduate nursing students were assessed for differences between clinical group instructors and part-time versus full-time instructors. Despite evidence of comparable student performance on the assignment across both groups, grades differed among the 10 instructors on both components. Grades differed between part-time and full-time faculty on reflective thinking but not writing, with part-time faculty grading reflective thinking higher than full-time faculty. Differential grading was identified between clinical instructors and type of faculty. The merit of multiple instructors grading a single course assignment warrants reconsideration. Enhanced grading training is recommended for part-time instructors who are expected to grade written assignments. [J Nurs Educ. 2023;62(2):101-104.].

Clinical Faculty Perceptions of Online Learning in Health Professions Education.

The purpose of this study was to investigate clinical faculty perceptions of online learning in health professions education. Clinical faculty members from various health professions programs in New York were surveyed to determine whether there was a relationship between clinical faculty members' attitudes toward online learning competencies and their ability to teach online. Additionally, this study explored what type of impact years of teaching experience and online training had on clinical faculty perceptions of online learning. The study received 60 responses from clinical faculty, most of whom were teaching on Long Island, New York. Although the findings were not significant for most variables, a t -test demonstrated a significant statistical difference between online training and faculty perceptions of online learning. When clinical faculty completed online training, they had a more positive attitude toward online learning. The study also found that clinical faculty members' attitudes toward technology in online learning positively influenced their ability to troubleshoot technical issues in online environments. Years of online teaching experience did not affect how clinical faculty perceived online learning; however, clinical faculty with 1-5 years and 6-10 years of teaching experience rated their attitudes and abilities the lowest out of all the groups. While there appears to be a correlation between faculty perceptions of online learning and online training, more research is needed to objectively determine which specific trainings would be most advantageous.

Mediating effects of ageism and knowledge on the relationship between contact with older adults and attitudes toward older adults' sexuality among nursing students

BackgroundHealthcare professionals often ignore sexuality in aging and avoid discussing related topics, especially in China. Nursing students, as future professionals, can address the sexuality of older adults encountered in clinical practice by establishing positive attitudes toward aging sexuality. Previous studies have demonstrated that contact has positive impacts on nursing students' attitudes toward aging sexuality. However, little is known about the mechanism underlying this relationship between contact and attitudes. ObjectivesTo explore the mediating effects of ageism and knowledge on the relationship between contact and nursing students' attitudes toward aging sexuality. DesignThis was a cross-sectional study. SettingsThe study was conducted at a nursing school in Hefei city, China. Participants and methods614 nursing students completed online-administered questionnaires measuring the level of contact with older adults, ageism, knowledge, and attitudes toward aging sexuality. Data were analyzed using SPSS and AMOS. ResultsThe mean scores for knowledge and attitudes toward aging sexuality were 85.70 (SD = 16.39) and 104.91 (SD = 14.88), respectively. Overall, our findings confirmed that these hypotheses were accepted. Ageism (β = −0.079, P = 0.007) and knowledge (β = −0.070, P < 0.001) mediated the relationship between contact and attitude. ConclusionGiven the mediating role of ageism and knowledge in the relationship between contact and attitude, reducing ageism and enhancing knowledge are vital to changing students' attitudes, including integrating ageism and aging sexuality knowledge learning into the nursing curriculum and creating opportunities for contact with older adults. The frequency and quality of contact between nursing students and older adults can be improved by rationalizing the internship duration, tasks, and assessment objectives of placements on geriatric wards and by the role of clinical faculty role models in cultivating positive attitudes toward aging sexuality.

Clinical Teacher Evaluation Methods in Medical Education: A Systematic Review

Context: Evaluating systems is one of the essential items affecting faculty member performance. Using an appropriate evaluating system is essential for performing different proper roles for faculty members. Objective: This study aimed to systematically review the models, tools, and challenges of evaluating the performance of clinical faculty members. Methods: This systematic review investigated eight international and four national electronic databases in 2019. Descriptive and thematic analyses were done to extract the most relevant information about the models, tools, and challenges of evaluating the performance of clinical faculty members. Results: In total, 15163 articles were identified, of which 25 met the inclusion criteria. The findings were demonstrated in four main categories of the model of evaluating the performance of clinical faculty members, education, data gathering tools, and challenges of evaluating the performance of clinical faculty members. The main subthemes for evaluating the performance of the clinical faculty member model were systems, structure, indicators, and process. Conclusions: This study recommends policymakers and educational managers to design an appropriate evaluating tool. Further research should be conducted to develop a practical system for solving the mentioned challenges.

Use of short videos and case studies to enhance student confidence in biochemistry knowledge and application in a large lecture biochemistry course in first year veterinary curriculum.

Large lecture courses are an efficient way to convey material to many students but have potential limitations, most notably the tendency for them to promote passive learning opportunities rather than active pedagogies. The curriculum at Cummings School of Veterinary Medicine at Tufts University, like many veterinary schools, contains many large lecture courses in the pre-clinical curriculum. This objective of this study was to use two active pedagogical interventions in a first-year lecture course named Veterinary Biochemistry and Metabolism that drew connections between basic science and several veterinary diseases. The first intervention targeted increasing students' intrinsic motivation and their confidence with understanding biochemistry concepts using videos created via collaborations between students, staff, and clinical and basic science faculty. The second intervention targeted active and collaborative learning via the implementation of clinical case studies completed in groups to relate lecture content to clinical scenarios with the aim of further enhancing student confidence in their knowledge of the material. To assess the effectiveness of these two interventions, pre-and post-course surveys using Likert style questions were administered to evaluate student confidence in the targeted concepts. The post-survey included open-ended responses on students' perspectives on their most important takeaways from the activities and their suggestions for improvements. The data showed a positive impact of these interventions on student motivation and confidence in their knowledge. This study provides support that targeted interventions to increase active learning strategies increase student engagement and may improve learning efficacy in large lecture courses.

Nursing Journal Club as a Tool to Facilitate Evidence-Based Practice: Participant’s Feedback

"Background and aim: Nursing journal clubs have a proven value in nursing education and continuing education, which has expanded widely in the promotion of evidence-based clinical care in recent years. This study aimed to evaluate the clinical nursing journal clubs from the viewpoints of nurses. Methods: This descriptive study was conducted from July 2019- October 2020. This study was conducted in two phases, consisting of designing the format and flowchart and implementing nursing journal clubs and the second phase was evaluation. Results: Format and executive flowchart prepared by the research team and reviewed and approved in the group. In terms of evaluation, minimum (33) and maximum (165) scores with a mean± SD total score of 123.49 ± 19.91 calculated for nursing journal clubs indicate an optimum quality. Conclusions: The qualities of nursing journal clubs were evaluated to be favorable. Accordingly, authorities and planners should consider appropriate actions to facilitate Nursing journal clubs, such as credit points in rank promotion for faculty members, and inclusive in continuing education privileges for nurses, to adapt these activities to the roles of the clinical faculty and the benefits of this educational method in nursing. "

Recruitment of women in neurosurgery: a 7-year quantitative analysis.

The authors aimed to characterize which US medical schools have the most female neurosurgery residents and to identify potential associations between medical school characteristics and successful recruitment of women pursuing a neurosurgery career. The authors evaluated a total of 1572 residents in US neurosurgery programs accredited by the Accreditation Council for Graduate Medical Education as of February 2021, representing match cohorts from 2014 to 2020. The authors extracted US medical school characteristics and ranked schools based on the percentages of women graduates entering neurosurgery. They additionally studied yearly trends of the percentage of women constituting incoming neurosurgery resident cohorts as well as associations between female recruitment percentage and medical school characteristics using univariable and stepwise multivariable linear regression (including significant univariable factors). The cohort consisted of 1255 male and 317 (20%) female residents. Yearly trends indicated a significant drop in incoming female residents in 2016, followed by significant increases in 2017 and 2019. On multivariable analysis, the following factors were associated with a higher average percentage of female graduates entering neurosurgery: total affiliated neurosurgery clinical faculty (β = 0.006, 95% CI 0.001-0.011, p = 0.01), allopathic versus osteopathic schools (β = 0.231, 95% CI 0.053-0.409, p = 0.01), and top 10 U.S. News & World Report ranking (β = 0.380, 95% CI 0.129-0.589, p < 0.01). When the number of female clinical faculty was added to the model, the variable was not statistically significant. Multivariable bibliometric analyses indicated a higher mean preresidency H-index for men, with an even greater gender difference identified in the 2021 H-index. This study characterizes which medical schools are most successful at recruiting female students who constituted the total neurosurgery resident workforce of the 2020-2021 academic year. The overall number of clinical neurosurgery faculty rather than faculty gender was independently associated with female recruitment. Gender differences in research productivity persisted with control for confounders and increased between preresidency and 2021 time points. Such understanding of factors that influence the recruitment of women can help improve female representation in neurosurgery residency training moving forward.

Comparative and quantitative study of three premier medical institutes in India so as to suggest baseline of key performance indicators for medical colleges

Introduction: There has been substantial increase in the number of medical colleges along with student enrollment necessitate a need for improving the quality of medical education in India. This led to the development of accreditation and ranking system for medical institutions. Key performance indicators (KPIs) for medical institutions can be determined by parameters considered for accreditation and ranking of medical institutes. KPIs for medical institutions are set of quantifiable measurements used to analyze long-term performance and progress of the medical institutions. KPIs provide a focus for strategic and operational improvement, create an analytical basis for decision-making, and help focus attention on parameters that matter most in improving the quality of teaching and learning resources and patient care services provided by the medical institutes.Methodology: A descriptive and quantitative study was conducted to compare secondary data of three premier medical institutions of India, namely, All India Institute of Medical Sciences, New Delhi; Post Graduate Institute of Medical Education and Research, Chandigarh; and Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow. Baseline for KPIs was designed based on the parameters included in external accreditation and ranking, namely, National Accreditation and Assessment Council Accreditation, National Institutional Ranking Framework Ranking, National Accreditation Board for Hospitals and Healthcare Providers Accreditation, and National Accreditation Board for Testing and Calibration Laboratories Accreditation.Observations and Results: Teaching and training identify four KPIs, annual intake of undergraduate students per hospital beds, annul intake of postgraduate students (DM/MCh/MD/MS degree, DNB, Diploma, Certificate programs, Fellowships, PhD) per hospital beds, annual intake of nursing students expressed as ratio of available hospital beds, and annual intake of paramedical and allied students (diploma, degree, pharmacy, etc.) expressed as ratio of available hospital beds. Patient care includes annual outpatient department consultations including casualty (old + new) expressed as ratio of available clinical faculty, annual In-Patient Department (IPD) admission expressed as ratio of available hospital beds, and annual surgeries conducted (operations and procedures) expressed as ratio of available surgeons. Research and publications include total number of extramural projects currently running expressed as ratio of faculty, total amount of extramural grant expressed as ratio of faculty, and total number of indexed research publications per faculty.Conclusion: The KPIs are absolute necessity due to increase in number of medical colleges across the country. KPIs provide a focus for strategic and operational improvement, create an analytical basis for decision-making, and help focus attention on what matters most to enhance the quality and performance of the medical institutes and subsequently uplift the quality of health-care services across the country.

A Study on Awareness of POCSO Act &amp; Sec 375 I.P.C Amongst the Medical Professionals at Puducherry – A Cross Sectional Study

Child sexual abuse, the most under reported crime, has gained public attention in the past years. The Protection of Children from Sexual Offences Act 2012 (POCSO) is a gender neutral friendly act to protect children from sexual related offences. Rape (Sec 375 IPC) law is amended with a sole agenda of safeguarding women and to ensure justice delivery with emphasis on physical and mental health care during judicial proceedings. The aim is to study the awareness of POCSO Act 2012 &amp; Sec 375 IPC (Indian Penal Code) amongst the medical professionals in the state of Puducherry. It's a cross sectional study, conducted among the pre, para and clinical faculties &amp; nurses. The total sample size was 305 and the sampling procedure used was convenience sampling. The study participants were consenting medical professionals. Out of nine questions on general information of child sexual abuse, only four questions were answered correctly by more than 50% of the participants. Out of thirteen questions asked on POCSO Act, only five questions were answered correctly by more than 50% of the participants. Out of eleven questions asked about the Sec 375 IPC (Rape), only one question was answered correctly by more than 50% of the participants. On analysing the outcome of the study, it is very much evident that medical professionals are not up to date regarding the recent amendments in the law related to medical field. It is mandatory to create awareness of POCSO act &amp; Rape laws in the society. This lack of knowledge, may subject many children &amp; women to repeated victimization.

Implementing Interprofessional Education Into Clinical Experiences: Athletic Training Faculty Perceptions

Context Health care students must be prepared to engage in collaborative practice with one another. Because athletic training programs are preparing students to enter this collaborative world, interprofessional education (IPE) must be integrated into the curriculum. One aspect for consideration is clinical experiences, but little is known about how athletic training programs are implementing IPE during clinical education experiences. Objective To explore how professional, postbaccalaureate athletic training programs are integrating IPE from a clinical education perspective. Design Consensual qualitative research. Setting Phone interviews. Patients or Other Participants Coordinators of clinical education and program faculty who have a role in IPE implementation. A total of 17 faculty engaged in an interview regarding implementing IPE in their respective athletic training programs. Data Collection and Analysis Participants engaged in 30- to 45-minute phone interviews that were audio recorded for accuracy and transcribed verbatim. We used a consensual qualitative research approach to data analysis and developed a codebook collaboratively and continued to code using updated codebooks to ensure codes were accurate. We used member checking, internal auditing, and external auditing to ensure trustworthiness. Results Two main themes emerged from the data, with resulting subthemes for each. The theme of clinical experiences comprised four subthemes including intentional placement, assessment, linking to courses, and organic IPE. The theme of preceptor involvement includes the need for preceptor development, clear objectives, and active facilitation. We also used a frequency count to determine how many faculty indicated that IPE was currently occurring during clinical education in their programs. Conclusions As IPE continues to grow in necessity, athletic training educators should seek opportunities to allow athletic training students to learn about, from, and with other professions. Faculty will need to be intentional about these opportunities and will need to ensure preceptors are trained to integrate IPE and have clear objectives for IPE.

Assessing academic productivity of U.S. otolaryngology departments using the h(5) index.

We aim to examine the h(5) index of U.S. otolaryngology programs to help assess current academic productivity. A total of 116 otolaryngology departments with residency programs were included. Our primary outcome was the h(5) index, calculated cumulatively for faculty MDs, DOs, and PhDs within the department. Audiologists and clinical adjunct faculty were excluded. This was calculated over a 5-year period (2015-2019) using Elsevier's database SCOPUS. Faculty affiliation within SCOPUS was confirmed by cross-referencing department websites. The h(5) indices were calculated and then correlated with other publication metrics, including total publications by department and publications in major otolaryngology journals. The h(5) index was highly correlated positively with other metrics of academic productivity, including total publications and publications in top 10 otolaryngology journals. Greater variability in data was noted as the h(5) index increased. Similar trends were observed when the h(5) was compared to the number of residents accepted per year. Rankings of departments by Doximity and US News and World Report were positively correlated with h(5) though they remained weaker when compared to other correlations. h(5) indices are a valuable tool to objectively assess academic productivity for otolaryngology residency departments. They are a better indicator of academic productivity than national rankings.

Well-being grants in an academic medical center: A case example.

Academic medical centers (AMCs) rely on engaged and motivated faculty for their success. Significant burnout among clinical and research faculty has resulted in career disengagement and turnover. As such, AMCs must be vested in cultivating faculty engagement and well-being through novel initiatives that support faculty. The Well-Being Education Grants program was established by the Office for Well-Being within the Center for Faculty Development at Massachusetts General Hospital to provide the impetus many faculty needed to dedicate time to their well-being, demonstrating that investments in multi-component interventions around faculty well-being require resources and funding.