Forming Physicians: Evaluating the Opportunities and Benefits of Structured Integration of Humanities and Ethics into Medical Education.

This paper offers a novel, qualitative approach to evaluating the outcomes of integrating humanities and ethics into a newly revised pre-clerkship medical education curriculum. The authors set out to evaluate medical students' perceptions, learning outcomes, and growth in identity development. Led by a team of interdisciplinary scholars, this qualitative project examines multiple sources of student experience and perception data, including student essays, end-of-year surveys, and semi-structured interviews with students. Data were analyzed using deductive and inductive processes to identify key categories and recurring themes. Results suggest that students not only engaged with the curricular content and met the stated learning objectives but also acknowledged their experience in the humanities and ethics curriculum as an opportunity to reflect, expand their perceptions of medicine (and what it means to be "in" medicine), connect with their classmates, and further cultivate their personal and professional identities. Results of this qualitative study show how and in what ways the ethics and humanities curriculum motivates students past surface-level memorization of factual knowledge and encourages thoughtful analysis and evaluation about how the course material relates to and influences their thinking and how they see themselves as future doctors. The comprehensive qualitative approach reflects a holistic model for evaluating the integration of humanities and ethics into the pre-clerkship medical education curriculum. Future research should examine if this approach provides a protective factor against the demonstrated ethical erosion and empathy decrease during clinical training.

Learning How to Learn: An Innovative Medical School Orientation Activity.

PROBLEM: In 2018, Creighton University School of Medicine initiated a multiyear strategy to redesign the pedagogic approach of its educational program, transitioning from large-group, lecture-based experiences to small-group, active learning experiences using case-based learning (CBL) as required prework for team-based learning (TBL). In July 2019, the authors introduced their first-year medical students to the pedagogic and empiric underpinnings of the new curriculum they would experience. Initially, and ironically, this introduction was presented as a 30-minute didactic lecture, and students' ability to assimilate this information in any meaningful way was challenged. In addition, students required several sessions of the CBL-TBL activities during the official curriculum before they were able to effectively function as a team of learners. The authors created a novel introduction to their educational program that was active, meaningful, and efficient. APPROACH: In 2022, the authors created a 2-hour, small-group CBL activity using a fictional narrative of a medical student encountering their curriculum. During development, the authors recognized that the narrative was conducive to introduction of affective responses to medical education stressors, such as imposter phenomenon and Stanford duck syndrome. The CBL activity was given 4 hours during the formal 2022 orientation; 230 students participated. The CBL activity occurred on the second day of orientation and the TBL activity on the third (final) day of orientation. OUTCOMES: The results of the TBL activity indicate that students acquired a fundamental understanding of the attributes of active learning, features of imposter syndrome, substance abuse associated with Stanford duck syndrome, and peer evaluation. NEXT STEPS: This CBL-TBL activity will become a permanent part of orientation. The authors hope to evaluate the qualitative outcomes of this innovation on students' professional identity formation, institutional affiliation, and motivation. The authors will assess for any negative impact of this experience and the overall orientation.

Teaching Medical Students to Help Patients Manage Their Weight: Outcomes of an Eight-School Randomized Controlled Trial.

BACKGROUND: Given the rising rates of obesity there is a pressing need for medical schools to better prepare students for intervening with patients who have overweight or obesity and for prevention efforts. OBJECTIVE: To assess the effect of a multi-modal weight management curriculum on counseling skills for health behavior change. DESIGN: A pair-matched, group-randomized controlled trial (2015-2020) included students enrolled in eight U.S. medical schools randomized to receive either multi-modal weight management education (MME) or traditional weight management education (TE). SETTING/PARTICIPANTS: Students from the class of 2020 (N=1305) were asked to participate in an objective structured clinical examination (OSCE) focused on weight management counseling and complete pre and post surveys. A total of 70.1% of eligible students (N=915) completed the OSCE and 69.3% (N=904) completed both surveys. INTERVENTIONS: The MME implemented over three years included a web-based course, a role-play classroom exercise, a web-patient encounter with feedback, and an enhanced clerkship experience with preceptors trained in weight management counseling (WMC). Counseling focused on the 5As (Ask, Advise, Assess, Assist, Arrange) and patient-centeredness. MEASUREMENTS: The outcome was student 5As WMC skills assessed using an objective measure, an OSCE, scored using a behavior checklist, and a subjective measure, student self-reported skills for performing the 5As. RESULTS: Among MME students who completed two of three WMC components compared to those who completed none, exposure was significantly associated with higher OSCE scores and self-reported 5A skills. LIMITATIONS: Variability in medical schools requiring participation in the WMC curriculum. CONCLUSIONS: This trial revealed that medical students struggle with delivering weight management counseling to their patients who have overweight or obesity. Medical schools, though restrained in adding curricula, should incorporate should incorporate multiple WMC curricula components early in medical student education to provide knowledge and build confidence for supporting patients in developing individualized plans for weight management. NIH TRIAL REGISTRY NUMBER: R01-194787.

Exposure to Weight Management Counseling Among Students at 8 U.S. Medical Schools.

INTRODUCTION: Clinical guidelines support physician intervention consistent with the Ask, Advise, Assess, Assist, Arrange framework for adults who have obesity. However, weight management counseling curricula vary across medical schools. It is unknown how frequently students receive experiences in weight management counseling, such as instruction, observation, and direct experience. METHODS: A cross-sectional survey, conducted in 2017, of 730 third-year medical students in 8 U.S. medical schools assessed the frequency of direct patient, observational, and instructional weight management counseling experiences that were reported as summed scores with a range of 0‒18. Analysis was completed in 2017. RESULTS: Students reported the least experience with receiving instruction (6.5, SD=3.9), followed by direct patient experience (8.6, SD=4.8) and observational experiences (10.3, SD=5.0). During the preclinical years, 79% of students reported a total of ≤3 hours of combined weight management counseling instruction in the classroom, clinic, doctor's office, or hospital. The majority of the students (59%-76%) reported never receiving skills-based instruction for weight management counseling. Of the Ask, Advise, Assess, Assist, Arrange framework, scores were lowest for assisting the patient to achieve their agreed-upon goals (31%) and arranging follow-up contact (22%). CONCLUSIONS: Overall exposure to weight management counseling was less than optimal. Medical school educators can work toward developing a more coordinated approach to weight management counseling.

Deferred Personal Life Decisions of Women Physicians.

OBJECTIVE: Inadequate work-life balance can have significant implications regarding individual performance, retention, and on the future of the workforce in medicine. The purpose of this study was to determine whether women physicians defer personal life decisions in pursuit of their medical career. MATERIALS AND METHODS: We conducted a survey study of women physicians ages 20-80 from various medical specialties using a combination of social media platforms and women physicians' professional listservs with 801 survey responses collected from May through November 2015. The primary endpoint was whether women physicians deferred personal life decisions in pursuit of their medical career. Secondary outcomes include types of decisions deferred and correlations with age, hours worked per week, specialty, number of children, and career satisfaction. RESULTS: Respondents were categorized into deferred and nondeferred groups. Personal decision deferments were reported by 64% of respondents. Of these, 86% reported waiting to have children and 22% reported waiting to get married. Finally, while 85% of women in the nondeferment group would choose medicine again as a career, only 71% of women in the deferment group would do so (p < 0.0001). Physicians who would choose medicine again cited reasons such as career satisfaction, positive patient interactions, and intellectual stimulation, whereas those who would not choose medicine again reported poor work-life balance, decreasing job satisfaction, and insurance/administrative burden. CONCLUSIONS: The results of this survey have significant implications on the future of the workforce in medicine. Overall, our analysis shows that 64% of women physicians defer important life decisions in pursuit of their medical career. With an increase in the number of women physicians entering the workforce, lack of support and deferred personal decisions have a potential negative impact on individual performance and retention. Employers must consider the economic impact and potential workforce shortages that may develop if these issues are not addressed.

The complex interplay between semantics and grammar in impression formation.

We sought to bridge findings showing that (a) describing a person's behavior with the perfective verb aspect (did), compared to the imperfective aspect (was doing), increases processing of semantic knowledge unrelated to the target's action such as stereotypes and (b) an increased recognition of stereotypical thoughts often promotes a judgment correction for the stereotypes. We hypothesized an interplay between grammar (verb conjugation) and semantic information (gender) in impression-formation. Participants read a resume, attributed to a male or female, for a traditionally masculine job. When the resume was written in the imperfective, people rated a male (vs. female) more positively. When the resume was in the perfective, this pattern reversed. Only these latter effects of gender were influenced by cognitive load. Further, people more quickly indicated the applicant's gender in the perfective condition, suggesting an enhanced focus on gender during processing.

The prevalence and prevention of crosstalk: a multi-institutional study.

It is a common problem in psychology subject pools for past study participants to inform future participants of key experimental details (also known as crosstalk). Previous research (Edlund, Sagarin, Skowronski, Johnson, & Kutter, 2009) demonstrated that a combined classroom and laboratory treatment could significantly reduce crosstalk. The present investigation tested a laboratory-only treatment for the prevention of crosstalk at five universities, along with institutional-level moderators of crosstalk. Results indicated the presence of crosstalk at all universities and that the laboratory-based treatment was effective in reducing crosstalk. Importantly, crosstalk rates were higher (but successfully neutralized) in research pools with higher research credit requirements. Therefore, this research provides valuable guidance regarding crosstalk prevalence and its minimization by researchers.

Missed Programs (You Can't TiVo This One): Why Psychologists Should Study Media.

Media psychology involves the scientific examination of the cognitive processes and behavior involved in the selection, use, interpretation, and effects of communication across a variety of media (e.g., via the Internet, television, telephone, film). Media are central to people's lives, with projections indicating that an average person spent over 3,515 hours using media in 2012. New technologies are increasing the importance of media. Data from two content analyses demonstrate the underrepresentation of media psychology in mainstream psychological literature and in undergraduate and graduate psychology course offerings. We argue for the importance of a psychological approach to the study of media because of its presence in people's lives and because psychologists use it in their research and their choices may affect the external validity of their findings. We provide a useful framework from which psychologists can approach the study of media, and we conclude with recommendations for further areas of scientific inquiry relevant to psychological science.

Warmth and competence on the witness stand: implications for the credibility of male and female expert witnesses.

In this study, we examined how manipulations of likeability and knowledge affected mock jurors' perceptions of female and male expert witness credibility (n = 290). Our findings extend the person-perception literature by demonstrating how warmth and competence overlap with existing conceptions of likeability and knowledge in the psycholegal domain. We found that experts high in likeability, knowledge, or both were perceived equally positively, regardless of gender, in a death penalty sentencing context. Gender differences emerged when the expert was low in likeability or knowledge. In these conditions the male expert was perceived more positively than the comparable female expert. Although intermediate judgments (e.g., perceptions of credibility) were affected by our manipulations, ultimate decisions (e.g., sentencing) were not. Implications for theory and practice are discussed.

Effect of playing violent video games cooperatively or competitively on subsequent cooperative behavior.

Research on video games has yielded consistent findings that violent video games increase aggression and decrease prosocial behavior. However, these studies typically examined single-player games. Of interest is the effect of cooperative play in a violent video game on subsequent cooperative or competitive behavior. Participants played Halo II (a first-person shooter game) cooperatively or competitively and then completed a modified prisoner's dilemma task to assess competitive and cooperative behavior. Compared with the competitive play conditions, players in the cooperative condition engaged in more tit-for-tat behaviors-a pattern of behavior that typically precedes cooperative behavior. The social context of game play influenced subsequent behavior more than the content of the game that was played.

The content of cigarette counter-advertising: are perceived functions of smoking addressed?

Media campaigns can be an effective tool in reducing adolescent smoking. To better understand the types of ads that have been used in campaigns in the United States, a content analysis was conducted of ads available at the U.S. Centers for Disease Control and Prevention (CDC) Media Campaign Resource Center (MCRC; Waves 1 through 7). A total of 487 ads were coded. Ads were coded for target audience, primary theme present in the ad, and sensation value-production techniques that have been demonstrated to attract attention and increase arousal. Primary themes extended earlier studies by focusing on the perceived functions of smoking (weight lose, stress management, controlling negative affect) as well as the traditional themes of industry attack, the health consequences of smoking, secondhand smoke, quitting, and the social image of smokers. A majority of ads were rated as having moderate sensation value, and ads targeted at teens and children were, on the average, higher in sensation value than those targeting general audiences. Changes across time suggest that campaigns are focusing more on adolescent smoking and relying more on attacking the tobacco industry. Research indicates that the functions of stress relief, mood regulation, and weight loss are strong reasons for initiating and continuing to smoke cigarettes; however, none of the 487 ads addressed these functional themes. Implications for developing campaigns that more closely relate to the functions of smoking are discussed.