Academic Medicine

PURPOSE: Clinical practice variability is characterized by 2 or more clinicians making different treatment decisions despite encountering a similar case. This study explores how medical residents and fellows experience and interpret intersupervisor clinical practice variability and how these variations influence learning. METHOD: Seventeen senior residents or fellows in internal medicine, hematology, or thrombosis medicine (postgraduate year 3 or above) participated in semistructured interviews after a clinical rotation in thrombosis medicine from December 2019 to March 2021...

PURPOSE: The notion of physician invulnerability to illness contributes to the ongoing marginalization of physicians with personal experiences of illness and complicates professional identity development in medical learners. As such, physician self-disclosure of lived experiences as patients has seen an increasing role in medical education. Existing literature, centered on mental health, has characterized the positive effect of physician discussion of experience with mental illness on medical students and residents...

No abstract text is available yet for this article.

Uganda experienced two COVID-19 waves that challenged health professional education. All health professions training institutions (HPTIs) in Uganda closed in March 2020. Cognizant of the threat to quality education and the frontline workforce, the National Council for Higher Education (NCHE) and Seed Global Health partnered to examine the risks and benefits of HPTI reopening through the Safe Schools Initiative (SSI). This article described the processes to unify stakeholders in health professions education and the outcomes from these discussions during the COVID-19 pandemic in Uganda...

PURPOSE: A substantial body of evidence describes the multidimensional relationship between the intersection of physicians' work and personal lives and health care quality and costs, workforce sustainability, and workplace safety culture. However, there is no clear consensus on the terms, definitions, or measures used in physician work-personal intersection (WPI) research. In this scoping review, the authors aimed to describe the terms and definitions used by researchers to describe physician WPI, summarize the measurement tools used, and formulate a conceptual model of WPI that can inform future research...

Performing bedside procedures requires knowledge, reasoning, physical adeptness, and self-confidence; however, no consensus on a specific, comprehensive strategy for bedside procedure training and implementation is available. Bedside procedure training and credentialing processes across large institutions may vary among departments and specialties, leading to variable standards, creating an environment that lacks consistent accountability, and making quality improvement difficult. In this Scholarly Perspective, the authors describe a standardized bedside procedure training and certification process for graduate medical education with a common, institution-wide educational framework for teaching and assessing the following 7 important bedside procedures: paracentesis, thoracentesis, central venous catheterization, arterial catheterization, bladder catheterization or Foley catheterization, lumbar puncture, and nasogastric, orogastric, and nasoenteric tube placement...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

In this commentary, the authors explore the tension of balancing high performance standards in medical education with the acceptability of those standards to stakeholders (e.g., learners and patients). The authors then offer a lens through which this tension might be considered and ways forward that focus on both patient outcomes and learner needs.In examining this phenomenon, the authors argue that high performance standards are often necessary. Societal accountability is key to medical education with the public demanding that training programs prepare physicians to provide high-quality care...

In this article, the authors explore the current state of divisiveness in U.S. society and its impact on medical schools. Higher education institutions are increasingly faced with challenges in supporting freedom of speech while respecting marginalized groups who may feel attacked by certain kinds of speech. "Cancel culture" has resulted in misunderstandings, job loss, and a growing fear of expressing ideas that may offend someone. These dynamics are particularly relevant in medicine, where issues of racial justice, reproductive health, gender identity, and end-of-life care, occurring in the context of personal and religious differences, affect patient care...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

PROBLEM: Physicians-in-training are responsible for leading clinical teams, coordinating interdisciplinary management, navigating conflict, and supervising and giving feedback to junior learners. Giving feedback and resolving conflict are key leadership skills for internal medicine (IM) residents, many of whom desire additional training. Although these skills are integral to successful clinical leadership for physicians-in-training, residents receive little explicit education and existing curricula have not established best practices for skill acquisition...

PURPOSE: Over the past 2 decades, many academic health centers (AHCs) have implemented learning health systems (LHSs). However, the LHS has been defined with limited input from AHC leaders. This has implications because these individuals play a critical role in LHS implementation and sustainability. This study aims to demonstrate how an international group of AHC leaders defines the LHS and to identify key considerations they would pose to their leadership teams to implement and sustain the LHS...

PURPOSE: To assess the impact of applicant and residency program characteristics on preference signaling outcomes in the Match during the first 2 years of implementation across 6 specialties. METHOD: Data were obtained from the Texas Seeking Transparency in Application to Residency survey for applicants applying into otolaryngology during the 2020-2021 and 2021-2022 application cycles and into dermatology, internal medicine (categorical and preliminary year), general surgery, and urology during the 2021-2022 application cycle...

PROBLEM: Reflective practice is necessary for self-regulated learning. Helping medical students develop these skills can be challenging since they are difficult to observe. One common solution is to assign students reflective self-assessments, which produce large quantities of narrative assessment data. Reflective self-assessments also provide feedback to faculty regarding students' understanding of content, reflective abilities, and areas for course improvement. To maximize student learning and feedback to faculty, reflective self-assessments must be reviewed and analyzed, activities that are often difficult for faculty due to the time-intensive and cumbersome nature of processing large quantities of narrative assessment data...

No abstract text is available yet for this article.