Next Generation Of Physicians Research Articles

Physician educators' perceptions of experiences contributing to teaching.

Physician educators are essential in training the next generation of physicians. However, physician educators' perspectives about what experiences they find beneficial to their teaching and the prevalence of these experiences remain unknown. Guided by social cognitive career theory (SCCT) and communities of practice (CoP), we explored what experiences physician educators perceive as beneficial in preparing them to teach. In 2019, the Uniformed Services University School of Medicine in the United States surveyed its physician alumni to understand their education experiences during medical school, their current career path and what has contributed to their teaching role. Content analysis was applied to extract themes across the text response. Chi-square analysis was applied to examine if perceived contributing factors vary based on physician educators' gender, specialty and academic ranks. The five most prevalent contributing factors participants (n = 781) identified are (1) experiences gained during residency and fellowship (29.8%), (2) teaching as faculty member (28.9%) and (3) class experiences and peer interaction during medical school (26%). We organised three themes that reflected major avenues of how physician educators acquire teaching skills: reflection about quality teaching, journey as learners and learning by doing. Gender and clinical specialty were differentially associated with contributing factors such as faculty development and meta-reflection. The results are in line with theories of SCCT and CoP, in which we identified self-directed learning and regulation in shaping physician educators' teaching. The findings also revealed gaps and potential contexts for more formalised teaching practices to develop physician educators.

Social Determinants of Health in Family Medicine Residency: A National Survey of Program Directors.

Social factors account for most health outcomes, underscoring the need to address social determinants of health (SDH) to eliminate health disparities. Our objectives are (1) to describe the scope of formal SDH curricula in family medicine residency, (2) to identify residency program characteristics associated with integrated core curriculum components to teach SDH, and (3) to identify barriers to addressing SDH in residency. We distributed a cross-sectional survey to all family medicine residency program directors (PDs) accredited by the Accreditation Council for Graduate Medical Education as identified by the Association of Family Medicine Residency Directors. Of 624 eligible program directors, 279 completed the survey (45% response rate). Overall, 41.2% of respondents reported significant formal SDH training in their program. Though a majority (93.9%) agreed that screening for social needs should be a standard of care, most (58.9%) did not use standardized screening tools. The most common barriers to addressing SDH were lack of clinical resources (eg, social workers, legal advocates), lack of community resources (eg, food banks, substance use disorder treatment), and inadequate screening instruments or integration into the electronic medical record system. Availability of referral resources was associated with PDs' increased perception of resident SDH competency. Nearly all respondents agreed that screening for social needs should be a standard part of care; however, this vision is not yet realized. To better train the next generation of physicians to identify and meaningfully address social needs, additional research is needed. This research might include mixed-methods approaches that incorporate qualitative assessments to define best practices and patient-centered outcomes related to identifying and responding to SDH.

Comparison of medical students' considerations in choosing a specialty: 2020 vs. 2009/10

BackgroundWorkforce shortage in healthcare and particularly in physicians poses a threat to healthcare delivery and its quality. In comparison to other OECD countries, Israel currently has a small number of medical graduates relative to its number of physicians, naturally emphasizing the importance of ensuring that this population chooses to remain in medicine. Understanding what is most important to medical students can help improve working conditions in residency. Such information is particularly needed to facilitate policy planning that will encourage the next generation of physicians to specialize in medical fields that are experiencing shortages. We hypothesized that between 2009/2010 and 2020, there were significant changes in medical students' preferences regarding their considerations for choosing a medical specialty.MethodsWe compared cross-sectional data from questionnaire-based surveys of 5th year medical students performed in 2009–2010 and 2020 at two Israeli universities.ResultsOf the 335 medical students who responded (237 and 98 in 2009/2010 and 2020, respectively) those in 2020 were 2.26 less likely vs. those in 2009/2010, to choose a residency for its high-paying potential (P < 0.05), and had significantly more interest in residencies with greater teaching opportunity (98.8% vs 82.9%, P < 0.05), increased responsibility and chances to make clinical decisions on their own (67.9% vs 51.6%, P < 0.05). Criteria important to both the 2009/2010 and 2020 students were choosing a bedside specialty (70.2%vs 67.9%, NS), and an interesting and challenging specialty (95.2%v s 91.3%, NS).ConclusionsThese results partially supported our hypothesis that medical students' preferences have changed over the years, though there are fundamental factors that apparently reflect medical students’ nature that do not change over time.

Leveraging telemedicine in gastroenterology and hepatology: a narrative review.

Over the years, telemedicine has played a prominent role in delivering healthcare to patients. Due to its flexibility and many benefits, telemedicine confers physicians the ability to guide and promote medical care remotely. The advent of the coronavirus disease 2019 (COVID-19) pandemic has changed the landscape of medicine and has accelerated the usage of digital and remote healthcare systems for clinical care. Herein, we provide an overview of telemedicine, its applications in managing inflammatory bowel disease (IBD), celiac disease (CD), and liver diseases, its advantages and limitations, and its use in educating the next generation of gastroenterologists. We conducted a review of scientific articles published in PubMed and Google Scholar. Articles were selected based on the search terms included in the search strategy summary. The language of the articles was restricted to English only. We report that telemedicine has the potential to streamline and improve patient care in gastroenterology (GI) and hepatology while also limiting health care expenses. Additionally, we noted the importance of tele-education for training the next generation of physicians who intend on practicing in rural settings. Furthermore, we identified barriers to telemedicine care that exacerbate health inequities and potential solutions to achieving digital health equity. Lastly, we briefly discuss the role of artificial intelligence (AI) in remote patient monitoring. Although telemedicine has existed for many decades, over the past decade there have been many advancements in telemedicine applications in GI and hepatology. Despite its broad benefits, further research needs to be done to alleviate barriers to telemedicine care.

A Survey Evaluating Extent of Undergraduate Medical Education Regarding Sex-Based Differences in Pathophysiology

Introduction A historical gap in research on sex differences in health outcomes has led to a lack of education on sex-based differences in pathophysiology. The primary objective of this research study was to survey pathophysiology professors of medical schools in the United States (US) to understand the current extent to which the impact of sex on disease is included in the pre-clinical curricula of undergraduate medical institutions in the US. Methods A survey tool was created via literature review to assess the extent of education on sex-based differences in pathophysiology. This survey was distributed using the Qualtrics electronic platform to the head professor of pathophysiology at each of the 141 Liaison Committee on Medical Education (LCME) accredited medical schools in the United States. Results The survey response rate was 14.9%. The most taught topics were epidemiology of most common cancers affecting each sex and risk factors for development of osteoporosis between different sexes. Sex-based differences in zolpidem dosing, smoking cessation, and the physiologic mechanism of narcotic addiction had the least curricular coverage. 28.57% of faculty and 38.10% of faculty agree and somewhat agree, respectively, their institution provides faculty development for teaching about topics relating to sex differences in pathophysiology. Medical students are primarily evaluated on their knowledge of sex pathophysiology in the form of written examination, followed by evaluation by standardized patients, and lastly faculty observed patient interactions. Discussion Curricular topics relating to sex-based differences in pathophysiology are taught to varying degrees in medical school preclinical curricula. Improved efforts can be made to increase instruction on specific topics and to support faculty development in teaching about sex-based differences in disease evaluation and management, enhancing the education of the next generation of physicians and facilitating better care for patients.

Kolb Meets Quality: Applying Learning Theory to a Process Improvement and Safety Curriculum.

The healthcare landscape is changing, and the Accreditation Council for Graduate Medical Education has recognized the importance of training our physician workforce to demonstrate competency in quality, safety, and process improvement. In the renewal of our quality improvement and patient safety curriculum, we set out to create an impactful and relevant course of study using adult learning theories as a scaffold to design the curriculum and inform our teaching methods. In this Perspective, we describe a few key learning theories and demonstrate how we have used them in the teaching of quality improvement and patient safety concepts. Our intent was to create a curriculum that could equip the next generation of physicians with the knowledge, skills, and attitudes they will need to adapt to the changes they face in practice and improve their work environments.

Emotional intelligence among medical students in Sweden – a questionnaire study

BackgroundEmotional intelligence (EI), the ability to understand and regulate one’s and other’s emotions, has been linked to academic and clinical performance and stress management, making it an essential skill to develop during medical school. Nevertheless, uncertainty remains about the impact of medical education on EI, its association with sociodemographic factors, and the potential moderating role of gender. Therefore, this study aimed to explore levels of global EI among Swedish medical students based on their completed semesters while analyzing the potential moderator role of gender and identifying potential EI differences associated with age, gender, prior education, work experience, and previous experience working in a leadership position.MethodsThe participants were medical students in semesters 1, 3, 5, 7, 9, and 11 at a Swedish University. Participants answered the self-report Trait Emotional Intelligence Questionnaire - Short Form (TEIQue-SF) and demographic questions. For each participant, the mean global trait EI was calculated (range 1–7), and differences were compared based on semesters and sociodemographic factors. In addition, we investigated the relationship between semester and EI scores with gender as a moderator.ResultsOf the 663 invited medical students, 429 (65%) responded, including 269 women (62.7%), 157 men (36.6%), and 3 identifying as others (0.7%). The participants had a mean global trait EI score of 5.33. Final-year students demonstrated significantly higher global trait EI scores than first-year students, and gender did not have a moderating effect across semesters. Furthermore, students in the age group 25–29 years showed higher EI scores compared to those in the age group 21–24 years, while there were no significant differences in EI scores for older students (≥ 30 years) compared to other age groups. Higher EI scores were also positively associated with previous work-and leadership experiences. Gender and previous education did not significantly impact EI scores.ConclusionsOur findings suggest that higher EI scores are associated with semesters of medical education, age, and previous work and leadership experience. Future longitudinal studies are needed to identify factors that could improve EI among medical students to design curricular activities aimed at supporting the EI of the next generation of physicians.

Teaching medicine web-based with the help of interactive audience response systems.

The COVID-19 pandemic confronted the medical community worldwide with numerous challenges, not only with respect to medical care, but also for teaching the next generation of physicians. To minimize the risk of infections patient-unrelated classes can be held digitally. Here we present a student initiated, web-based teaching approach, called "From symptom to diagnosis". In this seminar case reports of rare diseases were presented to the audience in a symptom-focused manner. The patients´ most significant symptoms were presented, followed by an in-depth discussion about differential diagnosis. First glance diagnosis pictures were shown to improve students´ ability to identify important clinical scenarios. We used chat functions as well as an audience response system to make the seminar more interactive. By this we attracted between 71 and 147 participants per session. The online seminar was very well perceived and 97% of the students saw an improvement of their diagnostic skills. In summary, we successfully established an interactive, web-based teaching format for medical students.

The need for digital health education among next-generation health workers in China: a cross-sectional survey on digital health education

BackgroundDigital health is important for sustainable health systems and universal health coverage. Since the outbreak of COVID-19, many countries, including China, have promoted the introduction of digital health in their medical services. Developing the next generation of physicians with digital health knowledge and skills is a prerequisite for maximizing the potential of digital health.ObjectiveWe aimed to understand the perception of digital health among Chinese medical students, the current implementation of digital health education in China, and the urgent need of medical students.MethodsOur cross-sectional survey was conducted online and anonymously among current medical students in China. We used descriptive statistical analysis to examine participant demographic characteristics and the demand for digital health education. Additional analysis was conducted by grouping responses by current participation in a digital health course.ResultsA total of 2122 valid responses were received from 467 medical schools. Most medical students had positive expectations that digital health will change the future of medicine. Compared with wearable devices (85.53%), telemedicine (84.16%), and medical big data (86.38%), fewer respondents believed in the benefits of clinical decision support systems (CDSS) (63.81%). Most respondents said they urgently needed digital health knowledge and skills, and the teaching method of practical training and internship (78.02%) was more popular than the traditional lecture (10.54%). However, only 41.45% wanted to learn about the ethical and legal issues surrounding digital health.ConclusionsOur study shows that the current needs of Chinese medical students for digital health education remain unmet. A national initiative on digital health education, is necessary and attention should be paid to digital health equity and education globally, focusing on CDSS and artificial intelligence. Ethics knowledge must also be included in medical curriculum. Students as Partners (SAP) is a promising approach for designing digital health courses.

Enhancing Curricula About Diversity, Equity, Inclusion, and Justice in Undergraduate Medical Education

Curricula in medical education continue to evolve as societal demographics shift and medical innovation transforms the practice of medicine. The next generation of physicians must be well trained, prepared, and adept to provide health care to diverse patient populations. The last few years have witnessed increased awareness about racial and social injustice, with medical institutions acting swiftly to create and implement or enhance curricula about diversity, equity, inclusion, and justice (DEIJ) including topics such as antiracism, bias, cultural humility and sensitivity, and health care disparities and inequities. In this review article, we highlight the incorporation of DEIJ into undergraduate medical education with a focus on the standards provided by the Liaison Committee on Medical Education. We draw on examples of enacted and revised DEIJ curricula in medical education including student activism, clinical electives at pediatric residency programs targeting historically underrepresented in medicine (UIM) students, and community building for UIM students through participation in professional affinity organizations. The article also addresses current state legislation that could affect medical student learning about DEIJ and patient care. [ Pediatr Ann . 2023;52(7):e249–e255.]

Visual Learning Equity: A Course Auditing System of Skin Color in Preclinical Medical Education.

Visual learning equity is a health justice effort in response to the lack of representation of brown and black skin images in medical education. This paucity creates a knowledge gap and decreases providers' competence in managing skin disease in minoritized populations. Herein, we aimed to create a standardized course auditing system to assess the use of brown and black skin images in medical education. We performed a cross-sectional analysis of the 2020-2021 preclinical curriculum at one US medical school. All human images in the learning material were analyzed. Skin color was categorized as light/white, medium/brown, and dark/black using the Massey-Martin New Immigrant Survey Skin Color Scale. We included 1,660 unique images in our analysis; 71.3%, (n=1,183) were light/white, 16.1% (n=267) were medium/brown and 12.7% (n=210) were dark/black. Dermatologic images of skin, hair, nails, or mucosal disease made up 62.1% (n=1,031) of the images and 68.1% (n=702) were light/white. The pulmonary course presented the highest proportion of light/white skin (88.0%, n=44/50) and the dermatology course presented the lowest proportion of light/white skin (59.0%, n=301/510). Images of infectious diseases were more frequently presented in darker skin colors (χ2 [2]=15.46, P&lt;.001). Light/white skin was the standard used for visual learning images in the medical school curriculum at this institution. The authors outline steps to perform a curriculum audit and diversify medical curricula to ensure the next generation of physicians are educated to care for all patients.

Digital health competencies for the next generation of physicians.

As health care continues to change and evolve in a digital society, there is an escalating need for physicians who are skilled and enabled to deliver care using digital health technologies, while remaining able to successfully broker the triadic relationship among patients, computers and themselves. The focus needs to remain firmly on how technology can be leveraged and used to support good medical practice and quality health care, particularly around resolution of longstanding challenges in health care delivery, including equitable access in rural and remote areas, closing the gap on health outcomes and experiences for First Nations peoples and better support in aged care and those living with chronic disease and disability. We propose a set of requisite digital health competencies and recommend that the acquisition and evaluation of these competencies become embedded in physician training curricula and continuing professional development programmes.

Estamos preparando os futuros médicos para atendimentos de situações de violência com enfoque em gênero e em sexualidades não heterossexuais? Relato de uma “experiência” educacional diagnóstica

Abstract Medical schools must incorporate the teaching of professionalism into the curriculum to ensure that the next generations of physicians are prepared for a compassionate, humane, and ethical professional practice, suitable to the interests of society in a world with ever-increasing and ever-changing demands. This study’s greatest contribution is to highlight the interns’ poor performance in the legal and support aspects of the situations addressed. The data speak in favor of an institutionalized training policy as the first step toward getting the healthcare sector to prioritize competence in healthcare for victims of violence related to gender and non-heterosexual sexuality.

The Gendered Work/Role of Program Directors in International Graduate Medical Education.

Healthcare organizations offer numerous clinical and academic leadership pathways for physicians, among which the position of program director (PD) is considered to be a prominent educational leadership role. As PDs are instrumental in the recruitment and training of the next generations of physicians, PD gender distribution can affect the present and future of a medical specialty. This study offers a dialectical perspective in understanding how international PDs negotiate gendered understanding of their work/role by using the framework of Relational Dialectics Theory 2.0. Thirty-three interviews of PDs from Qatar, Singapore, and the United Arab Emirates were conducted and, using contrapuntal analysis, the competing discourses of meanings of gender in the PD work/role were examined. Competing discourses where structural, cultural, and professional meanings of gender were interrogated revealed inherent multiple meanings of how gender is understood in PD work/roles. In making sense of these meanings of gender, PDs express dilemmas of traditional gender binaries of masculine/feminine work/role meanings to explain the term in different ways in their everyday organizational and cultural struggles. The findings have implications for PD recruitment and retention in teaching hospitals.

How the Quadruple Aim Widens the Lens on the Transition to Residency.

Medical education is interconnected with the health of the population. In recent years, reforms in undergraduate medical education (UME) and graduate medical education (GME) have attempted to align physician training outcomes with complexities in medical practice. Concerningly, UME and GME have not always worked in concert toward this aim. Various stages of medical education and practice remain siloed, and health outcomes in the United States lag behind other developed nations.1The Quadruple Aim, a framework highlighting the goals of lower costs, improved patient outcomes, improved care team experiences, and improved patient experiences, is accepted as a compass to optimize health system performance.2 Systems improvement goals in medical education should align with goals for health care, such as those in the Quadruple Aim.The Coalition for Physician Accountability recently convened the UME-GME Review Committee (UGRC) to address challenges in the UME-GME transition—including complexity, negative impact on well-being, costs, and inequities—and to make recommendations to improve the transition. In addition to individual members representing diverse perspectives, 10 organizations associated with medical education provided representatives. Among the guiding principles for the work were optimizing fit between applicants and programs to ensure the highest quality health care for patients and communities, and increasing trust between medical schools and residency programs. The work resulted in 34 recommendations across 9 themes.3When one considers the Quadruple Aim, it becomes clear that the UGRC recommendations, if implemented, have potential for direct and indirect positive impacts on patients, with indirect impacts being mediated through improved experiences and well-being of learners transitioning into residency (applicants) as well as residency program staff and faculty. Residency program directors are in the unique position of training the next generation of physicians and advancing the health of the public through the development of a sustainable, diverse, and competent workforce. Reviewing the UGRC recommendations through the lens of the Quadruple Aim demonstrates the importance of optimizing the UME-GME transition and emphasizes each medical educator's obligation to continuously improve this complex process to positively affect patients and all involved stakeholders. The Box provides guiding principles of the UGRC, and the Table provides themes, selected recommendations, and suggested actions program directors and others may take to improve the UME-GME transition. The online supplementary data provides additional detail about the UGRC's recommendations.The current transition places significant financial burdens on debt-laden applicants and overstretched residency program staff. Graduates from Liaison Committee on Medical Education–accredited schools have median educational debt from $200,000 to $215,000.4 Electronic Residency Application Service fees are substantial based on average numbers of applications submitted. Registration for the National Resident Matching Program and costs for interviewing and away rotations add to expenses. Applicants commit time reviewing suboptimal advising resources, preparing applications, and interviewing, all of which detracts time from their final year of medical school. Yet the stakes of not matching far outweigh monetary and opportunity costs, and applicant behavior has reflected this with year-over-year increases in applications submitted and programs ranked.5 In parallel, residency programs are overwhelmed by the volume of applications. The cost of recruitment and selection, measured in faculty time as well as financial expenditures, pulls resources from education and patient care.The UGRC recommendations address these problems. Recommendations for continued virtual interviews during the COVID-19 pandemic, and for ongoing studies on the benefits and disadvantages of in-person interviews and away rotations, are directed at controlling costs. Recommendations centered on providing low-cost, trustworthy program information in an easily accessible database will allow applicants to create a feasible application plan. If pilot programs that are aimed at helping students identify goals and reducing application numbers continue to gain support, costs may further be reduced for applicants and residency programs.Data suggest that physician racial and gender concordance is associated with better patient outcomes.6,7 Unfortunately, many aspects of the current UME-GME transition perpetuate inequities among applicants and disadvantage underrepresented in medicine (UIM) applicants applying for residency positions. UGRC recommendations aimed at decreasing the overemphasis on grades or examination scores can help mitigate the influence of minimal differences in group performance on residency selection.8 Recommendations focused on equity are aimed at mitigating structural biases toward UIM applicants as well as international and osteopathic applicants, many of whom struggle with belonging.9The UGRC recommendations also call for faculty development in anti-racism, avoiding bias, and ensuring equity.Residents serve critical roles in the delivery of care, and their ability to do so is affected by their clinical readiness and personal well-being.10 Ensuring applicant-program compatibility is critical to optimizing training. Many of the UGRC recommendations aimed at matching applicants and programs with corresponding mutual interests have the capacity to improve the experience of all members of the care team. In addition, UGRC recommendations focused on the availability of inclusive and trustworthy advising materials can help applicants find programs that fit their goals and needs. Recommendations aimed at improving resident onboarding and coaching can optimize both trainee well-being and, by extension, patients' experiences of care. For residency program faculty and newly matched learners, improved transparency of assessments, including a post-match summary assessment, can help foster the development of incoming residents' self-directed learning, which has the potential to improve patient care.Optimal patient experiences depend on more than the medical knowledge of a health care professional. Recommendations focused on creating consensus assessment frameworks have the capacity to create competency standards that more directly relate to improved patient experiences. Students and residents afforded clinical learning environments that support growth mindsets and positive identity formation may have the skills necessary for lifelong learning and should therefore be able to deliver optimal care. Recommendations focused on specialty-specific preparation and orientation to local learning environments can translate to residents who are more aware of expectations and are better able to provide high-quality patient care.11Nundy et al recently proposed the Quintuple Aim to emphasize the importance of achieving health equity.12 This newly proposed aim also aligns with the UGRC recommendations, specifically those related to diversity, equity, and inclusion; holistic review of applicants; and training and competency expectations in all areas of medicine, including health equity and anti-racism.The UME-GME transition is viewed as a transactional process that occurs over a limited time frame. In reality it is a complex system that, if not reformed, will be driven by self-interest over the public good. Throughout the work of the UGRC, clarity developed on the interconnectedness of the transition, the broader health care system, and our goals for health care improvement. The UGRC recommendations are not mandates but are suggestions for broad improvements to a decentralized process. As a result, the UGRC's recommendations may suffer from a condition of everyone being accountable; therefore, no one being accountable. Leaders in medical education should be compelled to implement the recommendations through individual and local action, organizational and professional societal initiatives, as well as advocacy for systems-wide changes. Adopting the UGRC's recommendations not only has the capacity to improve experiences and outcomes for applicants and residency program faculty and staff, but also holds the promise of contributing to positive patient outcomes.

Leveraging Resident-As-Teacher Training for Health Equity Education: A Transformative Approach

Issue : Resident teachers play an essential role in medical education and can support broader efforts to advance anti-racism and health equity in medicine. The Accreditation Council for Graduate Medical Education requires programs to provide education about health care disparities so residents can contribute to and lead work in this area. However, the literature includes few examples, frameworks, or strategies for preparing residents to develop the knowledge and skills needed to promote health equity, including in their role as clinical teachers. Evidence : In this article, the authors propose leveraging Resident-as-Teacher training to support residents in learning and teaching for health equity. Gorski’s conceptualization of equity literacy provides an evidence-based framework for four main abilities (recognizing, responding, redressing, and cultivating/sustaining) residents and medical students can develop through co-learning about health equity in the clinical learning environment. The authors discuss preconditions, example activities, and assessments strategies for effective health equity education. Based on the principles of social learning theory, the authors recommend that Resident-as-Teacher training be part of an institutional strategy to cultivate a community of practice for health equity education. Implications : Incorporating health equity education into Resident-as-Teacher curriculum offers a potentially transformative part of the broader strategy needed to prepare the next generation of physicians to enact anti-racism and advance health equity.

EDITORIAL COMMENT

In this article, “Urology Boot Camp: A Pilot Medical Student Curriculum For Common Bedside Urologic Procedures,” the authors developed a novel, urology-specific (catheter placement and irrigation) "boot camp" for third year medical students. The boot camp was very thoughtfully designed to minimize in-person instruction time, and included an online module that students needed to view ahead of time, followed by a single hands-on session. The intervention was incredibly well-received by students, who said they would recommend repeating it for others and reported increased comfort with Foley catheter placement and irrigation. As urologists we have a vested interest in exposing medical students to the most basic and fundamental urologic procedures for multiple reasons; not only can this early exposure pique interest in our fantastic field, but knowledge of basic bladder management can be utilized in every field of medicine. The intervention reported on in this article is simple and reproducible. The logical next step is how it can be scaled to reach more students. There are 192 medical schools in the US (MD and DO), and rather than every institution re-inventing the wheel to develop their own curriculum, this is an opportunity ripe for standardization and facilitation of such skill and educational sessions. The American Urological Association has been, and should continue to be, a driver in these efforts to standardize educational sessions and afford their broad availability. Simulation allows for exposure and repetition of skills in a low-stress and low-risk environment. If cost prohibits model-based simulation of the skills discussed in this article, consideration can be given to low-fidelity simulation of the same skills, as a rudimentary lower urinary tract can certainly be simulated without a costly human model. We applaud the authors for addressing an unmet need in medical education and are encouraged by the interest in empowering the next generation of physicians to gain confidence and competence in basic urologic skills.

Using a Nationwide Virtual Radiology Student Interest Group to Expand Medical Students’ General Awareness, Drive Greater Interest, and Achieve Uniform National Messaging in the Field of Radiology

Many medical schools offer minimal exposure to radiology, leading to a decreased understanding of the field and negative perceptions among medical students. The purpose of this study was to examine the effects of a radiology intensive series piloted by a novel virtual radiology interest group. Specifically, we were interested in how radiologists and medical educators can expand students' general awareness, drive greater interest in the field, and achieve more uniform national messaging across all trainees. We launched a national/international interest group called Radiology Student Interest Group (RadSIG) and piloted the RadSIG Intensive, a series of five events aimed at increasing awareness and dispelling misconceptions among preclinical medical students. Validated pre-intensive and post-intensive surveys were used to ascertain the students' baseline and changed perspectives, respectively. A separate faculty survey was also distributed to understand how they perceived our events. Statistical analysis was carried out on the collected data to identify trends and assess the utility of our programming. 205 students completed the pre-intensive survey, and 61 students completed the post-intensive survey. Of the pre-intensive survey respondents, 51.7% (106/205) indicated that they had a limited understanding of what a career in radiology entails. Of those who completed the entire RadSIG Intensive, average 5-point Likert scale scores for understanding of a radiology career rose from 3.30 to 4.38 respectively pre- to post-completion. A Wilcoxon signed-rank test revealed that this difference was statistically significant (Z=-5.95, p<0.001), and that the RadSIG Intensive significantly improved perceptions of radiologists across every single question measured, except for perception of long hours worked (Z=-0.20, p=0.841). The results also showed increased student comfort in reaching out to radiology attendings (Z=-4.30, p<0.001) and residents (Z=-5.12, p<0.001). Faculty survey results indicated positive perceptions of the series. Our results show that the RadSIG Intensive was effective in increasing students' understanding of radiology as a field and a potential career. Online outreach can also lower the resistance and improve student comfort in reaching out for mentorship, which may provide a new pathway to reach underserved students with a unifying message. By furthering a platform based on voluntary and supplemental resources, we see a far greater potential of impacting the perception and known role of the imager in patient care among our next generation of physicians.

COVID19 Limits on Physician Shadowing Harm Undergraduate Students’ Futures

Shadowing is constantly praised as an essential component of an undergraduate student's pre-medical journey, at times even described as “ubiquitous.” Whether a student decides to pursue a career as a physician or a different pathway, students report shadowing as a key deciding factor. For students considering a career in medicine, shadowing is a unique opportunity to understand physician-patient interactions. Shadowing is crucial for students to make professional connections and find physician mentors. In particular, shadowing unlocks opportunities for underrepresented groups, underprivileged students, and women, as shadowing may be their only opportunity to see what a physician does on a day to day basis.The coronavirus (COVID-19) has caused rapidly changing rules. Formal shadowing programs have been suspended and informal shadowing has been prohibited for over two years, and there's no end in sight. We cannot continue on this way. To mitigate this dire situation, we propose the following four specific recommendations.First, allow in-person, undergraduate student shadowing while ensuring safety. Undergraduate students need shadowing experiences, and it is essential that shadowing programs are conducted with proper risk mitigation protocols.Second, enhance and maximize virtual shadowing. True virtual shadowing is technically feasible and could be made available with physicians who are seeing patients via telemedicine. By enabling three-way video calling, students could observe the patient-provider interaction in the virtual setting.Third, fill clinical, front-line hospital roles with student volunteers and/or workers. Students could gain practical frontline, clinical exposure and real-world experiences supporting the medical system during a pandemic.Fourth, recognize the student experiences. College advisors, medical school admissions officers, and medical school faculty need to understand the drastically decreased in-hospital time that current students have had, and all the obstacles that will impede shadowing opportunities for years to come.We owe it to students, current and future physicians, the entire medical community, and society at large to reinvigorate opportunities for shadowing. The pipeline and the next generation of physicians depends on it.

Mentoring for diversity and inclusion in pediatric radiology: nurturing the next generation of physicians from underrepresented minorities.

The increasing recognition of the need for a diverse workforce as a tool for excellence in medicine has fortified the efforts toward recruitment, retention and development of faculty from racial and ethnic minorities. Despite these efforts, individuals of Black, Hispanic, American Indian and Alaska Native, Native Hawaiian and other Pacific Islander backgrounds remain vastly underrepresented in the radiology workforce. The main impediments to increasing their representation are an insufficient pipeline and the long time required to train a pediatric radiologist. A greater representation of minorities can only be achieved through the enduring nurturing of future pediatric radiologists along every step in the professional life cycle of a physician, from high school through fellowship completion. Restructuring of faculty recruitment and faculty development policies is also required. A key component of faculty development and overall wellness is mentorship. Junior faculty, particularly those from racial and ethnic minorities, benefit from the experience, advice and support of more experienced radiologists. Successful mentorship is key to ensuring that staff from underrepresented backgrounds thrive within their institutions and in turn become successful mentors to younger individuals, thus completing a virtuous cycle of minority mentorship.