Medical Education Faculty Research Articles

Racism and persistent disparities: Difficult conversations on the road to equity.

The convergence of the major social events of the COVID 19 epidemic and the racial protests around the George Floyd killing spurred many conversations and calls to action for racial justice. The Behavioral Science Forum of 2020 invited a plenary presentation to discuss guidelines for medical education institutions to improve their anti-racism curricula. The plenary aimed to put forward the personal experiences of family medicine faculty contributing to dismantling racism in their institutions. Presenters provided (1) a breakdown of the step by step process of addressing these issues with faculty, residents, and staff, (2) guidelines for improving recruitment and retention of diverse student populations, and (3) small group breakouts and a subsequent discussion forum for participants to bring their experiences into the conversation and develop their personal call to action. The wrap-up discussion and "Zoom chat" yielded emotional responses and specific ideas for participants and other faculty in medical education to do their part in developing anti-racism curricula.

Immersive psychiatry simulation: a novel course for medical student training

AimsOver the last decade, there have been significant developments in the use of simulation for undergraduate medical education. Despite simulation's diverse applications across the medical school curriculum, it has thus far been underutilised within psychiatry teaching. Psychiatric simulation can support students to develop strategies to elicit psychopathology, de-escalate an aggressive patient or perform a risk assessment. Such experiences can be difficult to encounter during clinical placements and may expose a student or patient to an unacceptable level of risk. We have therefore developed an immersive simulation course that aims to enhance undergraduate psychiatry training.MethodOur course was developed by medical education faculty and psychiatry staff. The course handbook includes storyboards, patient scripts and debrief guidelines. Clinical scenarios are mapped to university intended learning outcomes and include; conducting a risk assessment for a patient with emotionally unstable personality disorder and comorbid depression, managing a manic patient in the Emergency Department and assessing a patient with obsessive-compulsive disorder who has developed skin damage due to hand washing.The one-day course is delivered to groups of 4-8 students from the Universities of Glasgow and Edinburgh during their placements in NHS Lanarkshire. The course takes place in a simulation suite and is facilitated by psychiatrists and medical education faculty. Students each take the lead role during a clinical scenario in which they will encounter a simulated patient. Live video from the simulation is broadcast to other candidates. Scenarios last 10-15 minutes with a 20-30 minute group debrief immediately afterwards. The debrief utilises the PEARLS framework (Promoting Excellence and Reflective Learning in Simulation) and provides the opportunity for peer and facilitator feedback, as well as discussions regarding mental state examination, diagnosis and management.ResultQualitative and quantitative feedback has been collected via an anonymous electronic post-course questionnaire. To date, the course has received universally positive feedback. 93% of candidates rated the overall quality of the course as a learning experience as ‘excellent’. Students reported that the course helped them develop communication skills which they could apply to future clinical situations. In addition, candidates felt participation had increased their confidence in taking a psychiatric history and performing a risk assessment.ConclusionImmersive simulation is an underutilised tool in psychiatry education. Our course complements the existing educational programme of lectures and ward-based teaching and has been positively received. It provides the opportunity for students to develop interview techniques and communication skills in a safe, controlled environment.

812 Competency Based Goals for Sleep Medicine Curriculum in Undergraduate Medical Education in India: A Survey

Abstract Introduction Sleep is recognized the world over as very important in health and disease. But there is no articulated curriculum in undergraduate (UG) medical education in India. Whence incorporated, these learning objectives serve as an important bridge across multiple medical faculties like pulmonary medicine, neurology, ENT, psychiatry, and basic sciences. Methods After obtaining informed consent, a questionnaire-based electronic survey was circulated to clinical/non-clinical teaching medical faculties in December 2020. They were asked to prioritize the objectives of the sleep medicine curriculum for the UG medical education program. The objectives were listed under knowledge and skill-based competencies each having 9 and 10 questions respectively, scale rated 1–5. Objectives were enlisted from the previous studies, consensus statements and modified according to the local needs after face to face meetings with faculties involved in UG curriculum development. Results Out of 400 faculty members from different medical schools all over India, 127 had responded. None of the Indian institutions had sleep medicine in their UG curriculum. 112 (88%) members showed their interest to begin a UG program. The suggested sleep medicine curriculum proposes a vertical integration of competency-based goals into the core curriculum with a clinical angle which will require skill and knowledge-oriented modules. Amongst the knowledge-based competency, sleep loss and its health effects (77%) was more preferred than distinguishing sleep in newborns and adults (36%). Whereas in the skill-based competency providing advice on sleep hygiene (71%) was more preferred than sleep disturbances during pregnancy and menopause (33%). When our curriculum gets implemented, it is possible to provide exposure to sleep-related disorders early on for the UG’s. This will invoke their interest and thus serve to bridge the lacunae caused by the shortage of trained sleep specialists in India. Conclusion From our study, the learning objectives of the sleep medicine curriculum have been prioritized and are ready for implementation. The survey has also created awareness and interest amongst the Indian medical teaching faculty. Support (if any):

Exploring medical educators' readiness and the priority of their educational needs for online teaching.

PurposeThis study investigated medical educators’ readiness for online teaching by exploring their perceived ability and importance of online teaching competencies and identified the highest priority of their educational needs.MethodsIn this study, 144 medical education faculty members from a university were invited to participate. The faculty online teaching readiness scale was virtually distributed at the end of the spring semester of 2020 and 38 faculty members responded for 2 weeks. The collected data were analyzed with descriptive statistics, paired t-tests, Borich Needs Assessment, and the Locus for Focus model.ResultsThe overall average perceived ability was 2.76, while the overall average perceived importance was 3.36. The course design and the technical competency categories showed the highest and lowest educational needs, respectively. Five competencies were given the highest priority of educational needs.ConclusionThe results revealed that the medical educators are not ready for online teaching; thus, urgent educational needs for online teaching competencies exist.

The Impact of Graduate Medical Education on Scholarly Activity at a Military Medical Treatment Facility.

Graduate medical education (GME) faculty and trainees have required scholarly activities to meet accreditation requirements. The impact of this contribution to the Military Health System, especially regarding innovations in military medicine, has not been previously examined. This study measured the contribution of GME in published manuscripts from a tertiary military medical center. Utilizing the Scopus database, published manuscripts from the primary military GME institutions for the San Antonio Uniformed Services Health Education Consortium were identified from 2008 to 2018. Manuscripts were sorted based on the number of citations in Scopus and analyzed for their overall impact in medicine to include military unique topics. A total of 3,700 manuscripts were identified through Scopus and based on a 10 citation minimum, 1,365 manuscripts were further analyzed; 1,152 (84.4%) included authors with GME affiliation and 554 (40.6%) had direct applicability to unique aspects of military medicine. The mean number of citations per manuscript was 39.2 ± 63.6; Mean Cite Score was 2.97 ± 2.14 and Field Weighted Citation Index of 2.22 ± 3.27. Analysis of number of citations (10-19; 20-39; or >40) did not show any significant differences in Cite Score or military relevance, whereas the percentage of military relevant articles remained consistent yearly. These findings highlight the importance of military medical research and addressing specific medical needs of the warfighter. Graduate medical education in a tertiary Military Health System facility has enormous impact in scholarly activity, in particular the importance related to military medicine topics that emphasize combat casualty care and military readiness.

A Call for Curriculum and Faculty Developers to Attend to Ambitious Teaching in Experiential Curriculum.

To realize the goals of an experiential curriculum, medical educators need support to enact a different kind of teaching: ambitious teaching. Ambitious teaching promotes curricular aims and fosters responsive, interactive environments to elicit student thinking and facilitate student-to-student discussion of clinical concepts and reasoning. The purpose of this article is to provide a framework for ambitious teaching that can be used to meet the complex challenges of experiential learning. Specifically, we describe the ways in which medical education curriculum and faculty developers can support ambitious teaching and, ultimately, enhance curricular outcomes.

Focus on medical education research in primary care: an undergraduate medical education faculty’s journey

ABSTRACT This paper provides a viewpoint on medical education research in primary care from undergraduate medical educators, discussing the issues and questions shared with other institutions, the role of medical education research in raising the profile of academic general practice, the challenges and opportunities faced and how education-based research can form an evidence-based approach to teaching.

Family Medicine Faculty Time Allocation and Burnout: A Residency Research Network of Texas Study

Burnout among graduate medical education (GME) faculty is a well-documented phenomenon, but few studies have explored the relationship between faculty time allocation and burnout. Our objectives were to (1) characterize time allocation of academic family physicians, (2) measure the difference between actual versus preferred time spent on various tasks, and (3) examine this difference in relation to burnout. From January to March 2017, family medicine GME faculty across Texas completed anonymous online surveys for burnout (Maslach Burnout Inventory) and occupational stress (Primary Care Provider Stress Checklist). They also reported the percentage of time they actually versus prefer to allocate across 5 categories of tasks: direct patient care, nondirect clinical duties, teaching, administration, and research. Difference scores between actual and preferred time allocation were calculated and correlated with burnout and stress scores. Of the faculty physicians surveyed, 53% provided complete responses (103 of 195). On average they engaged in their preferred amount of time on direct patient care (30% of their time) and administrative duties (15%). Meanwhile, faculty preferred to increase time spent teaching (37% to 41%, P = .002) and conducting research (4% to 7%, P ≤ .001), while reducing time spent on nondirect clinical duties (14% to 7%, P < .001). Those with higher misalignment in their weekly schedules reported higher levels of professional burnout and occupational stress. Many family medicine GME faculty spent 20% or more of their time in a manner incongruent with their preferences, which may place them at higher risk for burnout and occupational stress.

Albert Einstein College of Medicine.

Albert Einstein College of Medicine.

Understanding teaching and learning conceptions among clinical faculty as a means to improve postgraduate training.

ObjectivesThis study aimed to determine the conceptions of teaching and learning of postgraduate medical teachers.MethodsWe invited postgraduate clinical teachers to fill out COLT (Conceptions on Learning and Teaching) questionnaire, an 18-item instrument designed to measure the conceptions of faculty in undergraduate medical education, and did a confirmatory factor analysis (CFA) to test if it was valid to be used in a postgraduate situation. Cluster analysis was done to determine different teacher profiles. We subsequently did a qualitative study among 12 clinical teachers to further explore issues related to conceptions of teaching. We used a semi-structured interview guide with vignettes summarizing five perspectives of teaching. ResultsFour criteria of goodness of fit indices were met, although six items had to be removed from the original COLT items. Three clusters were identified, and 51% of participants favored a transmission teaching-style perspective. For the qualitative part, three themes were identified. Majority of the teachers preferred apprenticeship and nurturing teaching-style perspective, even if they were educated through a transmission teaching-style perspective. ConclusionsOur study has shown that the COLT, although initially designed for undergraduate medical setting in the Netherlands was a valid tool in a different setting and population, with some modifications. Both the survey and the interview studies showed that the majority of the faculty chose the transmission perspective initially, but when introduced to the other perspectives, preferred apprenticeship and nurturing. The faculty readily embraced other perspectives of teaching that they believe to take into consideration the well-being of the trainees.

Human anatomical dissection takes a compulsory break during Covid-19 pandemic

The outbreak of the coronavirus effects on people’s daily lives. Like nothing most people have experienced before, one of the many affected sectors is education. In response to Covid-19 pandemic, medical education faculty have quickly transitioned the curriculum to online formats. But no matter the quality of the online resource, do not provide the same level of understanding of complex anatomical relationships as studying human bodies. Under restriction of social isolation because of Covid-19 pandemic, human anatomical dissection takes a compulsory break. Afterward students will come back to their essential training in dissection room

Medical Education in the United States and Canada, 2020.

For the third time this century, the Association of American Medical Colleges has coordinated a collection of reports from their member medical schools that collectively reflect the state of medical education in the United States and Canada. This introduction to the September 2020 supplement to Academic Medicine provides an overview of the collection, with 145 out of 171 eligible medical schools participating in the project. The authors observe trends and similarities across the reports from participating schools, structuring the introduction to mirror the main questions posed to the schools: highlights of each school's medical education program, curriculum description, curricular governance, education staff, faculty development and support in medical education, regional medical campuses, and initiatives in progress. Key findings from the authors include expansion of student enrichment tracks, early clinical encounters, focus on wellness, expansion in competency-based medical education, and continued evolution of approaches to assessment. The authors note that this supplement was produced before COVID-19, and although it robustly chronicles the prepandemic state of medical education, medical education has already evolved and will continue to do so. This view offers important opportunities to observe and study changes in the curricula.

Peer Coaching as a Faculty Development Tool: A Mixed Methods Evaluation.

BackgroundIn the era of competency-based assessment, medical education faculty are frequently challenged to develop unique teaching approaches. One method to address faculty development needs in a real-time clinical learning environment is peer coaching.ObjectiveWe implemented and evaluated a faculty development program involving peer observation and feedback for attending physicians.MethodsHospital internal medicine faculty assigned to a teaching service were recruited for the study. Participants voluntarily agreed to observe and be observed by a peer attending physician during a 2-week block of teaching rounds. When serving in the coaching role, faculty were asked to observe 4 separate occasions using an observation tool based on the Stanford Faculty Development Program framework to guide feedback. An outside consultant facilitated a focus group and completed a qualitative content analysis to categorize all participants' experiences during the faculty development activity.ResultsOf the 22 eligible faculty, 14 (64%) agreed to participate by committing to 6 to 8 hours observing another faculty member during rounds, 2 feedback sessions, and 90 minutes to provide program feedback during a focus group. The analysis of the focus group revealed favorable reactions to the faculty development program, including (1) observed attending awareness of unrecognized habits; (2) personalized teaching tips for the observed attending to improve teaching quality based on individual style/preferences; and (3) exposure to new teaching techniques.ConclusionsAn inpatient-based peer-coaching faculty development program was acceptable and feasible for a majority of faculty and may improve individual teaching effectiveness among conventionally trained physicians.

Medical education leadership: from diversity to inclusivity.

Both in Canada and globally, medical schools are prioritizing diversity in medical education. The ensuing development of innovative approaches to augmenting the representation, comfort, and success of students from under-represented groups has been increasing. Curricula have also expanded to better prepare graduates for the realities of effectively meeting the needs of a diverse patient population. Leadership has however, not kept up with this progress. Evidence shows that diverse leadership teams develop innovative solutions to complex problems, recruit and retain the best talent, and remain relevant to the communities they serve. Our international conference workshop included a literature review on the current state of diversity in medical education and in leadership for medical educators, and case-based models of lived experiences to initiate conversations in three different facets of diversity to stimulate reflection, engagement and discussion. The oft-forgotten side of the conversation in conference offerings, the audience’s perspective, was purposefully included in planning the workshop and presenters adhered to this principle throughout the session. Participants recognized the importance of addressing diversity with leadership in medical education. Themes included the need for communication training, cultural education, sharing these data more broadly with faculty in medical education and continuing these conversations. A final theme “we will never represent all minorities”, led us to a conclusion that a culture of inclusivity and not diversity would be required to successfully meet this challenge.

A Systematic Approach to Working With Medical Learners in Difficulty: A Faculty Development Workshop.

For medical educators, applying a systematic approach to working with struggling learners (learners in difficulty) can improve faculty success and satisfaction with the remediation process. Use of the familiar SOAP diagnostic framework can ensure that faculty develop a thorough differential diagnosis and target their interventions to address underlying issues affecting learner success. We developed a workshop to teach medical education faculty essential skills for supporting learners in difficulty. Teaching methods included didactic presentation, large-group discussion, and small-group work with role-plays. Over three 2-hour sessions, participants learned to assess a learner in difficulty, develop an initial remediation plan, and evaluate their learning system with the goal of improving support to learners in difficulty. Evaluation included pre- and postsession assessment of learner self-perceived confidence and skill with working with struggling learners, as well as brief postsession evaluation. Ninety-nine faculty participated in the Learners in Difficulty workshop over 7 years. Participants' overall rating of the workshop was 4.9 (1 = poor, 5 = outstanding). Pre- and postworkshop evaluation showed a statistically significant increase in perceived self-confidence to "Meet the needs of a struggling learner," from an average of 4.4 to 7.6 on a 10-point scale (mean Δ = 3.2; 95% confidence interval, 2.6-3.8; p < .001). This workshop provides a stepwise approach to working with learners in difficulty and assessing participants' educational systems to identify strengths and weaknesses. Evaluations indicated participants felt more confident in their ability to engage in this topic following completion of the workshop.

Hubungan Tingkat Stres dengan Gejala Vaginitis pada Mahasiswi Program Studi Kedokteran FK UNAND 2019

Objective: determine the relationship between stress levels with symptoms of vaginitis in medical students at the Faculty of Medicine, Andalas University batch 2019.Method: was observational analytic with cross-sectional approach. Sampling was conducted by non-probability sampling. The sample was 140 by conducting a guided interview on 140 female students of the Medical Education Faculty of Andalas University batch 2019. The stress level of the female students was measured by a stress questionnaire from the Depression Anxiety Stress Scale (DASS 42) and vaginitis symptoms questionnaire. Data analysis used Chi-Square test.Result: more than half of respondents which is 71 respondents (50,6%) has stress. Then, moderate stress levels is the largest percentage, that is 31 respondents (43,6%). Most respondents, 121 respondents (86.4%) have experienced symptoms of vaginitis. The statistical test results obtained p-value = 0.943.Conclusion: more than half of repondents has stress and most respondents have experienced symptoms of vaginitis. The p-value showed that there is no significant relationship between stress levels and symptoms of vaginitis.Keywords: Stress, vaginitis, adolescent

Hubungan Tingkat Stres dengan Gejala Vaginitis pada Mahasiswi Program Studi Kedokteran FK UNAND 2019

Objective : determine the relationship between stress levels with symptoms of vaginitis in medical students at the Faculty of Medicine, Andalas University batch 2019. Method : was observational analytic with cross-sectional approach. Sampling was conducted by non-probability sampling. The sample was 140 by conducting a guided interview on 140 female students of the Medical Education Faculty of Andalas University batch 2019. The stress level of the female students was measured by a stress questionnaire from the Depression Anxiety Stress Scale (DASS 42) and vaginitis symptoms questionnaire. Data analysis used Chi-Square test. Result : more than half of respondents which is 71 respondents (50,6%) has stress. Then, moderate stress levels is the largest percentage, that is 31 respondents (43,6%). Most respondents, 121 respondents (86.4%) have experienced symptoms of vaginitis. The statistical test results obtained p-value = 0.943. Conclusion : more than half of repondents has stress and most respondents have experienced symptoms of vaginitis. The p-value showed that there is no significant relationship between stress levels and symptoms of vaginitis. Keywords: Stress, vaginitis, adolescent

Prevalence and curriculum of sexual and gender minority education in Japanese medical school and future direction

ABSTRACT Background: In Japan, sexual and gender minorities (SGM) remain stigmatized, provoking hospital access barriers and health disparities from judgmental care. Japan’s Western-influenced introduction of SGM course content into medical education for future physicians addresses these disparities, although often perfunctorily and inconsistently. Objective: To examine the prevalence and characteristics of medical education curriculum with respect to SGM patients, we surveyed medical schools. Methods: A medical education faculty member from each of 80 Japanese medical schools received double postcards to identify relevant SGM coursework. Upon acknowledgement, 43 schools received seven-item anonymous questionnaires in March 2018. Survey results were analyzed from the perspective of three of the qualities and abilities required of a physician – Patient Care, Knowledge for Practice, and Professionalism from Japan’s Medical Core Curriculum – to develop recommendations for outcomes-based SGM curriculum through the lens of Van Melle’s medical education framework. Results: The response rate was 46%, with 22 schools providing SGM lectures mostly to first- and third-year students. Obstetrics and Gynecology, Neuropsychiatry, and Introduction to Medicine lectures were the top three subjects offering SGM lectures, primarily consisting of basic knowledge of SGM and Differences in Sex Development. Several lectures addressed the health challenges of SGM. Primary reasons for not offering SGM lectures were lack of suitable instructors or no school policies. Conclusions: Students can best experience the humanity of SGM patients and employ more appropriate diagnostic practices and modes of treatment with targeted curriculum to address SGM health disparities and inclusion of SGM patients in clinical practice training. To disseminate SGM education in Japanese medical schools, development of qualified instructors and policies is essential, employing currently active experts. The Van Melle reforms framework can guide in the development of recommended tailored learning experiences and lectures for improved and expanded SGM education, integrating appropriate coursework within current medical core curriculum structure.

Teachers’ Content Knowledge, Beliefs, and Practice after a Project-Based Professional Development Program with Ultrasound Scanning

ABSTRACTThis research investigated 20 middle and high school teachers’ use of project-based learning curriculum after engaging in a 115-hour professional development program that was developed collaboratively with medical school and education faculty. The project-based learning (PBL) unit centered on the case of Marcus Brown (a pseudonym), a high school football player, who collapsed suddenly while playing football. The teachers engaged in scientific investigations, including ultrasound investigations of standard patients’ internal anatomy, and research into various inherited cardiovascular diseases to determine a final diagnosis for Marcus. The teachers, using this PBL as a model, developed and taught their own project-based learning unit to their students during the following year. Through pre and post-program interviews, classroom observations, and content assessments, our results show that the teachers improved their content knowledge and quality of inquiry-based instruction over the program. The teachers also modified their instructional beliefs to align with more reform-based beliefs about student learning and teaching. Our analysis of teacher interviews provides insights into the elements of PBL instruction that teachers struggle with implementing. This study also provides insight into the value of using ultrasound scanning technology with K-12 teachers and students. These findings can improve professional development targeting the integration of NGSS scientific and engineering practices and disciplinary core ideas (content).

The Power of Peers: Faculty Development for Medical Educators of the Future.

The Power of Peers: Faculty Development for Medical Educators of the Future.