Faculty Development Resources Research Articles

Pediatric Anesthesiology Milestones 2.0: An Update, Rationale, and Plan Forward.

Formal training in the subspecialty of pediatric anesthesiology began >60 years ago. Over the years, the duration and clinical work has varied, but what has stayed constant is a mission to develop clinically competent and professionally responsible pediatric anesthesiologists. Since accreditation in 1997, there has been additional guidance by the Accreditation Council on Graduate Medical Education (ACGME) and greater accountability to the public that we, indeed, are producing competent and professional pediatric anesthesiologists. This has been influenced by the slow evolution from time-based educational curriculum to a competency-based paradigm. As with all ACGME-accredited specialties, education leaders in pediatric anesthesiology first convened in 2014 to design specialty-specific developmental trajectories within the framework of the 6 core competencies, known as milestones, on which fellows were to be tracked during the 1-year fellowship. With 5 years of implementation, and substantial data and feedback, it has become clear that an iterative improvement was necessary to mirror the evolution of the profession. It was evident that the community required brevity and clarity in the next version of the milestones and required additional resources for assessment and faculty development. We describe here the methodology and considerations of our working group, guided by ACGME, in the rewriting of the milestones. We also provide suggestions for implementation and collaboration to support the education and assessment of pediatric anesthesiology fellows across the country.

An Exploration of Support for Clinical Education Partners.

Effective academic-clinical partnerships require a greater understanding of how academic programs can best support clinical education (CE) faculty. This study aimed to determine resources and support that clinical partners need. As the number of physical therapist (PT) programs, cohort sizes, and CE weeks have risen, so has demand for CE sites. Conversely, staffing reductions, increased administrative duties, and rising productivity expectations have decreased the time available for clinical instruction. To promote a successful CE experience, there must be a renewed understanding of CE faculty needs. Clinical education faculty affiliated with any of the 8 contributing programs from the Ohio-Kentucky Consortium participated in survey research (n = 24) and subsequent interview (n = 4) and focus group (n = 6) research. Constructivist grounded theory design was used to explore the needs of CE faculty. Academic and clinical partners developed the initial survey and used survey results to establish interview questions. The investigators iteratively assessed data saturation and clarity of results of coded survey, interview, and focus group data to determine whether the study's aims of identifying CE faculty needs had been met. The aggregated results yielded 5 main themes of Director of Clinical Education support for CE faculty needs: student readiness for CE experience; effective academic-clinical partner communication; collaborative management of exceptional students; judicious standardization of CE processes; and provision of CE faculty development resources. Clinical education faculty have noted challenges that affect their ability to mentor students. They want academic programs to be more collaborative and proactive with communication, resources, and support. Future research should address aids and barriers to proactive communication, resource provision, and academic-clinical partner collaboration.

Faculty Need Assessment For Online Teaching Skill in Local Medical And Dental Institutes

Objective: This study sought to evaluate the expertise of educators at Rashid Latif Medical and Dental College in an effort to maximize the potential of online learning and aimed to identify the gaps, highlighting areas that needed improvement and open the door for specialized training and support with an emphasis on teaching, learning, and evaluation apps. Materials and Methods: The study was conducted in the Rashid Latif Medical and Dental College faculty members were gathered using a cross-sectional quantitative approach and circulating e questionnaire to gather information on demographics, proficiency with educational apps, and satisfaction with IT department services. The gathered data was examined using descriptive statistics, such as, frequency, percentages, means, and standard deviation. Results: The response rate from faculty members was 63%, with a total of 79 participants included in the study. The results indicated variations in techsavviness among participants, with some apps being less familiar to faculty members. Google Forms emerged as the most widely app. Gender and age-related differences were observed in techsavviness levels, with women generally exhibiting better levels of tech expertise. Faculty felt the need to improve IT related services and organizing tech workshops relevant to teaching. Conclusion: This study unlocks valuable insights into faculty members' proficiency in using online teaching, learning, and assessment apps in education. The results emphasize the need for targeted training to enhance faculty members' online teaching skills. Institutions can utilize these findings to allocate resources for faculty development to improve medical education

Abstract A031: Leveraging the Meharry-Vanderbilt alliance to develop a faculty affiliate program to expand cross-collaborative research

Abstract Background: Academic institutions struggle to break down research silos and boost interdisciplinary collaboration. The challenge is magnified when multiple partners seek to build research collaboratives. The Meharry-Vanderbilt-Tennessee State Cancer Partnership (MVTCP) is one of the longest-standing Comprehensive Partnerships to Advance Cancer Health Equity (U54 CPACHE) in the nation and includes faculty from 4 partner institutions, including 2 historically black institutions: Meharry Medical College (MMC), Vanderbilt University Medical Center (VUMC), Vanderbilt University, and Tennessee State University. While this partnership has been extremely productive, a 2022 MVTCP strategic planning session indicated opportunities for deeper scientific discovery and community engagement. The Meharry-Vanderbilt Alliance (MVA) is a 20+year collaboration between MMC and VUMC explicitly designed to advance clinical, translational and basic research focused on ending health disparities by developing and supporting mutually beneficial partnerships between academic centers and the community. A mixed-methods approach was employed to ascertain how the MVA could leverage its resources to further enhance the mission of the MVTCP. Methods: Semi-structured interviews were conducted with 10 MVA stakeholders (2 MMC; 5 VUMC, 3 community partners) to identify opportunities to grow cross-institutional collaborations. Emerging themes were used to develop exploratory questions for faculty-centric focus groups. Focus groups with MMC and VUMC faculty were held to elicit barriers to collaboration and explore possible solutions. A faculty survey was designed and deployed among faculty from all 4 MVTCP institutions from April to December 2022. Results: Themes from semi-structured interviews included limited networking opportunities between institutions, need for greater community engagement, and lack of awareness of faculty development resources, scholarly opportunities, and research funding. Focus group participants (6 MMC; 7 VUMC) recommended solutions that included hosting networking events, newsletters to highlight research and community partners, and developing a resource repository. Faculty respondents to the survey (n=52) indicated their willingness to support cross-institutional capacity building by mentoring students (86.5%), connecting research and clinical colleagues (63.5%), and peer mentorship (57.7%). Faculty requested connections to resources and community organizations (82.7%), support for research and grant development (63.5%), and career development opportunities (50%). Conclusion: This project informed the MVA to actualize the Faculty Affiliate Program (FAP). FAP membership is open to faculty across all MVTCP institutions and has grown to over 75 members. This centralized resource hub facilitates collaborative research and fosters cross-institutional engagement. It is hoped that with support from the FAP, the MVTCP will continue to develop more robust cross-institutional collaborations and community partnerships designed to eliminate cancer disparities. Citation Format: Karen M. Winkfield, Jessica L. Jones, Virginia Fuqua-Meadows, Freneka F. Minter, Calandra G. Whitted, Alecia M. Fair. Leveraging the Meharry-Vanderbilt alliance to develop a faculty affiliate program to expand cross-collaborative research [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A031.

US medical school curriculum on opioid use disorder—a topic review of current curricular research and evaluation of winning student-designed opioid curricula for the 2021 Coalition on Physician Education in Substance Use Disorders curricular competition

The opioid crisis in the US severely affected and continues to affect population's health. The opioid crisis was in part fueled by inadequate pain management, which is in part due to the inadequate education in both pain and opioid use disorder (OUD) for health care professionals. In 2021, the Coalition on Physician Education in Substance Use Disorders (COPE) organized a curricular competition soliciting US medical students-designed OUD-related curricula. Twelve winning curricula were identified. Here, we first conducted a topic review regarding current US medical school OUD curricula. Then we evaluated the COPE winning curricula and compared them to the curricula identified in the topic review. For the topic review, ten relevant databases were searched up to December 31, 2021 using a combination of pre-determined keywords. Total of 25 peer-reviewed articles were selected based on the pre-determined criteria, which included 5 articles describing opioid curricular development at the state level (AZ, CA, MA, PA, and RI), 17 research articles evaluating a curriculum developed in a single institution, 2 literature reviews, and 1 article detailing curricular development and validation processes in a single institution. Although vary in organizations and formats, state-level curricula were comprehensive and could be adopted by other states or institutions with necessary local issue-based modifications. Faculty development and critical resources were major challenges for curricular implementation. The 17 research articles exhibited good scientific quality (Medical Education Research Study Quality Instrument (MERSQI) score = 11.94 ± 2.33 (maximal score = 18)). All research articles reported to some extent, the success of respective curriculum, in improving students' knowledge in and/or attitude towards OUD, based on primarily pre- and post- comparisons. Compared to these published curricula, winning students-designed curricula had more specific focuses, diverse learning activities, and varieties in assessment methods. For all curricula, long-term evaluations were lacking. Except for the state level curricula, majority of the other curricula did not emphasize specifically on chronic pain education or the biopsychosocial approach. Interprofessional education approach was also lacking. Our topic review and curricular evaluation highlighted the needs for integrating OUD and chronic pain medical curricula, developing long-term assessment tools, and more OUD curriculum research overall.

From provider to professor: Supporting nurse practitioner faculty through NONPF's Faculty Institute.

Over the past 15 years, the number of practicing nurse practitioners (NPs) has increased exponentially. This growth has been sustained by an increase in the number of schools offering NP preparation. Experienced NPs have assumed faculty positions in these schools. Although educational curricula prepare NPs to deliver high-quality patient care, it does not prepare graduates for academic roles in teaching, dissemination of scholarship, or service leadership to advance the profession. To address these gaps in NP faculty preparation, faculty development resources specific to NP education are needed. The National Organization of Nurse Practitioner Faculties (NONPF) has stepped forward to fill this gap. The NONPF Faculty Institute was created in 2017, and it includes the annual Fall Conference, the Faculty Leadership Mentoring Program, the Webinar Series, and, most recently, the joint NPACE/NONPF New Faculty Development Program. This comprehensive focus on faculty development aligns with NONPF's mission to promote excellence in NP education and advance the NP role in health care. Programs in the NONPF Faculty Institute are specifically designed to address the distinct learning needs of NP faculty. They use "just in time" presentations and active learning strategies to provide NP faculty with easily accessible and targeted content and opportunities for direct application of new skills. The Institute's goal is to provide NP faculty opportunities to prepare themselves to meet the teaching, scholarship and service leadership expectations of academia, the learning needs of students, and advance the impact of NP practice on patient and health care system outcomes.

Telehealth Policy, Practice, and Education: a Position Statement of the Society of General Internal Medicine.

Telehealth services, specifically telemedicine audio-video and audio-only patient encounters, expanded dramatically during the COVID-19 pandemic through temporary waivers and flexibilities tied to the public health emergency. Early studies demonstrate significant potential to advance the quintuple aim (patient experience, health outcomes, cost, clinician well-being, and equity). Supported well, telemedicine can particularly improve patient satisfaction, health outcomes, and equity. Implemented poorly, telemedicine can facilitate unsafe care, worsen disparities, and waste resources. Without further action from lawmakers and agencies, payment will end for many telemedicine services currently used by millions of Americans at the end of 2024. Policymakers, health systems, clinicians, and educators must decide how to support, implement, and sustain telemedicine, and long-term studies and clinical practice guidelines are emerging to provide direction. In this position statement, we use clinical vignettes to review relevant literature and highlight where key actions are needed. These include areas where telemedicine must be expanded (e.g., to support chronic disease management) and where guidelines are needed (e.g., to prevent inequitable offering of telemedicine services and prevent unsafe or low-value care). We provide policy, clinical practice, and education recommendations for telemedicine on behalf of the Society of General Internal Medicine. Policy recommendations include ending geographic and site restrictions, expanding the definition of telemedicine to include audio-only services, establishing appropriate telemedicine service codes, and expanding broadband access to all Americans. Clinical practice recommendations include ensuring appropriate telemedicine use (for limited acute care situations or in conjunction with in-person services to extend longitudinal care relationships), that the choice of modality be done through patient-clinician shared decision-making, and that health systems design telemedicine services through community partnerships to ensure equitable implementation. Education recommendations include developing telemedicine-specific educational strategies for trainees that align with accreditation body competencies and providing educators with protected time and faculty development resources.

SIM-STEPS: a structured trainee educator programme in simulation – an innovative, blended learning approach for simulation faculty development

At present there are limited resources for simulation faculty development and educators are unable to access face-to-face courses uniformly across the region. Currently available online resources lack interactive reflective activity and recorded faculty videos which leads to a less engaging and effective learner experience. We aimed to create a structured and accredited simulation faculty development course on the Bridge online platform for educators who are novice in simulation-based education using a blended learning approach by incorporating recorded faculty videos and current available resources on eLearning For Healthcare (eLFH), Scottish Simulation framework and provide a platform with links to online resources. A scoping review was conducted to review current available online resources and face to face courses across the East of England region. Faculty across the region were contacted to understand the learning objectives, outcomes, and content of their courses. A survey was sent out to Bridge users across the region to determine how best to deliver the simulation faculty development course and whether they would find a Bridge course useful. We received 158 responses of which 94% respondents were keen to develop their simulation education skills, 74% had not received any formal training, and nearly 90% wanted a blended learning course. SIMSTEPS has been developed following a detailed gap analysis and scoping review. The course has been designed incorporating the eLFH learning modules, the Scottish framework for Simulation Faculty development. It does not replace face to face teaching but gives a starting point to develop the learners’ knowledge and skills about simulation-based education which can be enhanced further in face-to-face courses or workshops. Modules have been developed on key topics relevant to simulation-based education [1] with links to videos, recorded Faculty sessions, and online educational resources. Learners are encouraged for continuing reflective practice [2] and prompted to reflect after modules. The course would be accessible to all Bridge users (Interprofessional educators) in the East of England at no cost and can be completed by them at their own pace and time. We planned meticulously to ensure the course content meets learning objectives and ensured quality assurance by independent review of the course by established and experienced faculty. Post-course evaluation by learners will be done on course completion. A blended learning course like SIM-STEPS can potentially provide an effective resource on Simulation faculty development and improve learner experience and engagement. 1. Motola I, Devine LA, Chung HS, Sullivan JE, Issenberg SB. Simulation in healthcare education: a best evidence practical guide. AMEE Guide No. 82. Medical teacher. 2013;35(10):e1511–1530. 2. Brydges R, Manzone J, Shanks D, Hatala R, Hamstra SJ, Zendejas B, Cook DA. Self‐regulated learning in simulation‐based training: a systematic review and meta‐analysis. Medical education. 2015;49(4):368–378.

Online versus face‐to‐face cheating: The prevalence of cheating behaviours during the pandemic compared to the pre‐pandemic among Turkish University students

AbstractBackgroundDuring the COVID‐19 period, academics and higher education institutions have shown deep concern about academic integrity related to measurement and evaluation issues that have arisen in online education.ObjectivesTo address this concern, this paper examined the prevalence of cheating behaviour among university students before and during the pandemic by comparing self‐reported cheating behaviours of students and academics' perceived levels of cheating behaviours of their students.MethodsA correlational design was employed aligned with study objectives.Results and ConclusionsThe results indicate that although both groups reported a significant increase in cheating incidents in online education, instructors' perceived frequency of student cheating is remarkably greater than students' self‐report cheating incidents. Contrary to the perceptions of instructors and stakeholders in education, students did not report a very drastic cheating increase in online education during the pandemic. The strongest predictive power for online cheating behaviours was the cheating behaviours in face‐to‐face education. Whereas the sensitivity of institutions and course instructors toward cheating behaviour was negatively associated with cheating behaviours in face‐to‐face education, this situational factor did not show a significant effect in distance education. Regarding individual factors, we found a significant relationship between cheating behaviours and gender, discipline, whereas no significant relationship was found in terms of student GPA. Consequently, in order to minimize the threats to the validity of scores associated with cheating, faculty should be supported through faculty development programs and resources so that they can develop authentic assessment strategies for measuring higher‐order thinking skills.

Reimagining Faculty Development Deployment: A Multipronged, Pragmatic Approach to Improve Engagement.

Faculty at academic health centers have many competing demands on their time, leading to high work stress, burnout, and limited capacity to meaningfully improve their teaching, evaluation, feedback, and other education-related skills. Faculty development provides a useful mechanism to assist faculty in enhancing their knowledge and skills in these areas, but engaging faculty can be a challenge. To promote engagement, the authors developed a multipronged, pragmatic approach to faculty development. They created: (1) brief videos leveraging micro-learning strategies; (2) prepackaged workshops for use during existing faculty meetings; (3) a newsletter to raise awareness of faculty development opportunities; (4) a searchable, web-based catalog to facilitate rapid retrieval of faculty development content; and (5) an academy to acknowledge engagement of individual faculty members, provide certificates, and promote a culture that prioritizes our education mission. Since they launched the new approach in 2017, they have developed 41 microlearning videos, 15 prepackaged workshops, and 24 issues of the newsletter. Between January 2017 and May 2021, the videos generated more than 150,055 views; the workshops were downloaded 2,850 times; and the issues of the newsletter, emailed bimonthly to 3,500 members of the faculty, had an open rate that increased from 30% in 2017 to 70% in 2021. The Academy of Educational Excellence, which was launched in 2018, grew to more than 490 members. Preliminary feedback suggests faculty and education leaders are highly satisfied with the faculty development resources and approaches to engagement. Next steps include obtaining more user satisfaction data and evaluating whether education-related knowledge and skills have improved among faculty participants.

Faculty Development for Christian Mission: The State of the Field

Scholars studying Christian higher education frequently suggest that faculty are the campus constituents with the most influence over the future of an institution’s Christian mission. Thus, both faculty hiring and development are important elements for maintaining and strengthening the Christian identity of a university over time. Despite this importance, we do not know of a study that has surveyed the missional faculty-development processes of Christian colleges and universities. We utilized a survey research design to determine how Christian institutions educate faculty to integrate their Christian mission into their teaching, scholarship, and institutional service. We found that institutions tended to offer introductory trainings and workshops early in the career of faculty. After these early programs, the most effective faculty development resources identified were the conversations facilitated through discipline-specific academic journals and professional organizations. Moving forward, the institutions from which we heard hoped for increased resources and institutional prioritization for these conversations, especially at the advanced and senior faculty level. In conclusion, we suggest four opportunities for practical innovation to ensure future growth and engagement of faculty development for Christian mission: include a proactive approach to hiring practices, place a renewed emphasis on Christ-animated scholarship, continue to expand the conversation beyond the humanities, and introduce programming and incentives aimed at engaging senior faculty.

The Propagation of Race and Racial Differences as Biological in Preclinical Education.

Modern scientific research has demonstrated that race is a social construct rather than a biological construct. Yet, medical education research suggests that medical faculty still sometimes characterize race and racial differences as biological during lectures. To explore this dynamic, we reviewed (1) how race is presented in the preclinical curriculum of an undergraduate medical institution and (2) how preclinical faculty both define race and attribute disparate health outcomes to race. In part 1 of the study, the authors conducted a retrospective summative content analysis of all first-year preclinical lectures during the 2018-2019 academic year. In part 2, the authors administered a survey to preclinical faculty on the understanding of race, and responses were assessed through conventional content analysis. A number of faculty suggested a biological basis for racial differences during lectures, though survey results suggested that the majority characterize race as a social construct. Faculty knowledge of race and racial differences as a social construct was not reflected in the majority of the curricular analysis. Instead, the lectures showed that faculty predominantly discussed race without context (e.g., as a standalone epidemiological statistic or an unexplained factor of risk, diagnosis, prognosis, or treatment), or with a biological context. We conclude that there is a discrepancy between preclinical faculty knowledge of race and the presentation of race and racial differences in lectures. This discrepancy has implications on medical education. We offer possible explanations for this discrepancy as well as resources for preclinical faculty development to bridge this gap.

The impact of interprofessional faculty development on scholarly activity

Health professions faculty face intense pressure to advance through tenure and promotion while learning and applying educational theory. The transition to competency-based medical education (CBME) and curricular emphasis on interprofessional and collaborative practice (IPECP) has created additional faculty development needs. Identifying a connection between faculty scholarship and the promotion of IPECP could create an efficient synergy. The objective of this work is to determine whether interprofessional faculty development programs result in discovery and/or integration scholarship as defined by Boyer's model of scholarship. A literature (narrative) review identified interprofessional faculty development resources in PubMed, Eric, CINAHL, and APA Psych Info. Articles were screened for relevance and included if the faculty development program described was interprofessional and reported scholarly activity stratified as discovery, integration, teaching and/or application. Seventeen articles were included for review. Among them, 6 were related to discovery and integration, 16 to teaching, and 8 to application, with 10 programs describing mixed outcomes. Programs intentionally including writing better aligned with discovery and integration scholarship. IP faculty development initiatives result in a variety of scholarly activities. Inclusion of writing plans in IP faculty development programs is more likely to culminate in discovery or integration scholarship.

84. CAN FACULTY DEVELOPMENT BE EFFICIENT AND EFFECTIVE IN OUR OVER-SCHEDULED WORLD?

Background Faculty are responsible for teaching medical learners, yet most have little training on how to be effective educators. The ACGME common program requirements mandate that all physicians supervising trainees receive faculty development on an annual basis, but time and resources for educational faculty development are scarce. We led brief faculty development sessions at division meetings. Feedback was chosen as the first topic based on a faculty needs assessment and resident ACGME survey results. Purpose: To evaluate 1. Feasibility of visiting all departmental divisions to conduct brief educational faculty development sessions 2. Effectiveness of a faculty development session on knowledge of specific feedback. Methods Baseline quantity of specific feedback reported by residents and faculty was obtained by survey. Our session on specific feedback consisted of power point slides and video clips. It was delivered during regularly scheduled division meetings. A knowledge quiz was given before and after each session. Results 62 Faculty from 15 divisions completed the sessions over a 7-week period. 22/62 (35%) faculty answered all pre-test questions correctly. This increased to 48/62 (77%) post intervention. Post-session, faculty self-reported a positive trend in the specificity of their feedback. Survey comments also indicate the session was well-received. Discussion As 14 sessions were completed by two presenters during a short time period and with limited resources, this approach to educational faculty development seems feasible. Each session was completed in under 20 minutes, making it efficient. Improved post-test results indicate effectiveness. Next steps include utilizing the knowledge quiz and quantitative survey 3 months after the initial intervention to evaluate for lasting effects. Similar sessions could cover additional faculty development topics in the future, both within our department and in other departments at our institution. This would address weaknesses of the pilot study, which include a small study size and assessing for generalizability of the approach.

Late-Career Faculty: A Survey of Faculty Affairs and Faculty Development Leaders of U.S. Medical Schools.

Individuals 55 or older constitute 28.5% of the U.S. population but 32% of full-time faculty at U.S. medical schools accredited by the Liaison Committee on Medical Education (LCME). The academic medicine community knows little about the policies, programs, and resources for faculty in pre- and post-retirement stages. The authors sought to inventory the range of institutional resources for late-career faculty development and retirement planning in U.S. LCME-accredited medical schools. The authors surveyed 138 medical school faculty affairs deans and leaders in May 2017 to ascertain (1) priorities around retirement, succession planning, and workforce development/support; (2) retirement policies; (3) late-career and retirement resources; and (4) perceived factors impacting faculty retirement. Of those invited, 84 (60.9%) responded to the survey, and of these, 44 (52.4%) disagreed or strongly disagreed that retirement planning and support was a top priority in their offices. Less than half (n = 35 [41.7%]) reported that their institution had a retirement policy. The 5 most common late-career and retirement-related resources offered were emeriti or honorific appointments, academic benefits for retirees, phased retirement, retirement counseling, and financial planning. More than half the respondents noted that the following factors impact faculty retirements: physician burnout (43/75 respondents [57.3%]), decreased grant funding (42/75 [56.0%]), and changes in productivity requirements (38/75 [50.7%]). These data highlight a distinct, startling gap between the needs of a fast-growing population of late-career faculty and the priorities of their institutions. Faculty affairs/faculty development offices must meet these growing needs.

Leading Change in Academic Pharmacy: Report of the 2018-2019 AACP Academic Affairs Committee

EXECUTIVE SUMMARYThe Committee was charged with the responsibility for examining the need for change in pharmacy education and the models of leadership that would enable that change to occur across the academy. They also examined the question of faculty wellbeing in a time of change and made several recommendations and suggestions regarding both charges. Building upon the work of the previous Academic Affairs Committee, the 2018-19 AAC encourages the academy to implement new curricular models supporting personalized learning that creates engaged and lifelong learners. This will require transformational leadership and substantial investments in faculty development and new assessment strategies and resources. Recognizing that the magnitude of the recommended change will produce new stress on faculty, the committee identified the need for much additional work on student, faculty and leaders' wellbeing, noting the limited amount of empirical evidence on pharmacy related to stress and resilience. That said, if faculty and administrators are not able to address personal and community wellbeing, their ability to support their students' wellbeing will be compromised.

Rising to the Challenge: Residency Programs' Experience With Implementing Milestones-Based Assessment.

Changes to assessment efforts following the shift to milestones-based assessment in the ACGME Next Accreditation System have not been fully characterized. This study describes themes in initial milestones-based assessment practices with the goal of informing continued implementation and optimization of milestones-based assessment. Semistructured interviews were conducted with 15 residency program leaders in 6 specialties at 8 academic medical centers between August and December 2016. We explored what was retained, what was added, and what was changed from pre-milestones assessment efforts. We also examined the perceived impact of the shift to milestones-based assessment on the programs. Thematic analysis began after the first 5 interviews and ended once thematic sufficiency was reached. Two additional authors reviewed the codes, offered critical input, and informed the formation and naming of the final themes. Three themes were identified: (1) program leaders faced challenges to effective implementation; (2) program leaders focused on adaptability and making milestones work in what felt like a less than ideal situation for them; and (3) despite challenges, program leaders see value and utility in their efforts to move to milestones-based assessment. We describe a number of strategies that worked for programs during the transition, with perceived benefits acknowledged. While adaptation to milestones has occurred and benefits are noted, negative impacts and challenges (eg, perceived lack of implementation guidance and faculty development resources) persist. There are important lessons learned (eg, utilizing implementation experiences formatively to improve curricula and assessment) in the transition to milestones-based assessment.

Transferability of faculty development resources.

Adapting existing training resources for clinical teachers is more efficient than creating resources de novo. There is limited evidence on how to effectively use and ensure the relevance of training materials originally developed for different contexts and audiences. We tested in Sri Lanka and Malaysia the transferability of scenario-based training videos and session plans developed for Australian medical schools, to identify those aspects which need adaptation, and make recommendations to enhance transferability. Staff involved in student support from three medical schools were invited to participate in five workshops facilitated by an Australian educator. Video discussion triggers of students presenting with concerns were used in workshop activities, including written exercises, group discussions and reflection. The quantitative and qualitative data collected included categorical and free-text participant responses to questionnaires and structured field notes from local faculty developers using peer observation. Academic and clinician-teacher participants predominated in the workshops. Of 66 participant questionnaires (92% response rate), over 90% agreed that the workshop was relevant, and over 95% agreed that the videos facilitated discussion and the sharing of experiences. Field notes confirmed that participants were engaged by the videos, but identified that one student scenario and the approaches for seeking support in others were not immediately transferable to local contexts. The adaptation of facilitation techniques used in Australian workshops was needed to address audience responses. Our findings confirm faculty development principles of content relevancy and incorporation of reflection. To enhance transferability, we recommend co-facilitation with local faculty members, the explicit signposting of topics and re-contextualising key concepts through reflective discussion.

Clinical Reasoning as a Core Competency.

Diagnostic error is a challenging problem; addressing it effectively will require innovation across multiple domains of health care, including medical education. Diagnostic errors often relate to problems with clinical reasoning, which involves the cognitive and relational steps up to and including establishing a diagnostic and therapeutic plan with a patient. However, despite a call from the National Academies of Sciences for medical educators to improve the teaching and assessment of clinical reasoning, the creation of explicit, theory-informed clinical reasoning curricula, faculty development resources, and assessment tools has proceeded slowly in both undergraduate and graduate medical education. To accelerate the development of this critical element of health professions education and to promote needed research and innovation in clinical reasoning education, the Accreditation Council for Graduate Medical Education (ACGME) should revise its core competencies to include clinical reasoning. The core competencies have proven to be an effective means of expanding educational innovation across the United States and ensuring buy-in across a diverse array of institutions and disciplines. Reformulating the ACGME core competencies to include clinical reasoning would spark much-needed educational innovation and scholarship in graduate medical education, as well as collaboration across institutions in this vital aspect of physicianship, and ultimately, could contribute to a reduction of patient suffering by better preparing trainees to build individual, team-based, and system-based tools to monitor for and avoid diagnostic error.

Incorporating Sex and Gender into Culturally Competent Simulation in Medical Education.

Background and Objectives: Simulation provides a vehicle to introduce sex and gender competent training into the education of medical trainees. Materials and Methods: Using the previously validated Texas Tech University Health Sciences Center Sex and Gender Specific Health PubMed Advanced Search Tool, we reviewed the existing sex- and gender-based medical simulation education literature. A single article specifically addressed the incorporation of sex- and gender-based medicine in the development of simulation-based training. The Society for Academic Emergency Medicine Sex and Gender Interest Group then collaboratively developed recommendations for the incorporation of these concepts into simulation training. Results: Collaboratively developed recommendations were as follows. Knowledge-based competency in sex- and gender-based medicine involves understanding the relevant key terminology. Attitude-based competencies include an understanding of tendencies toward bias in patient assessment and care, which can be addressed in the self-reflection component of a simulation debrief. Skill-based competencies include communication skills, assessing the social context in which a patient is pursuing medical care, and recognition of gender-based cultural models of health and disease. Successful implementation includes specific faculty development, administrative and financial resources, gender-specific simulation equipment and selection of standardized patients, and scenarios that address sex- and gender-based medical care. Conclusion: The adoption of sex and gender competent simulation has the potential to significantly impact medical training and the provision of empathetic and humanistic care while reducing sex- and gender-based health care disparities.