The Indigenous Faculty Forum: A Longitudinal Professional Development Program to Promote the Advancement of Indigenous Faculty in Academic Medicine.

American Indian, Alaska Native (AIAN) and Native Hawaiian and other Pacific Islander (NHPI) faculty, are substantially under-represented (<1%) at US medical schools. The Oregon Health & Science University's Northwest Native American Center of Excellence and The University of Hawai'i Native Hawaiian Center of Excellence have created an Indigenous Faculty Forum (IFF), a one-day structured course with flanking social activities, specifically designed to meet the unique needs of AIAN and NHPI academic faculty. It provided: (1) Indigenous space, (2) skill building, (3) networking, and (4) ongoing mentorship, each of which were included to specifically mitigate isolation and tokenism that negatively affects promotion and advancement. Two Forums have been conducted, first in Portland, OR in 2017 and the second in Hilo, Hawai'i in 2018. Nine of eighteen AIAN faculty in the three-state region (CA, OR, WA) attended IFF Session #1, representing 50% of known AIAN faculty in this region. Thirty-four Indigenous faculty from around the world attended IFF Session #2, with twenty-nine completing program evaluations. Respondents were predominantly female (81.6%), under age 44 (52.7%), and either instructors or assistant professors (52.6%). In terms of career choice, both sessions included primary care physicians as the most represented group (55.6% at Session #1 and 62.1% at Session #2). Increasing Indigenous faculty representation in US medical schools, while simultaneously fostering their career advancement and meaning in work, is vitally important. We have begun the work needed to address this problem and look forward to conducting more efforts, including longitudinal evaluation designs to study effectiveness.

Shifting the Tide: Innovative Strategies to Develop an American Indian/Alaska Native Physician Workforce.

Despite extensive efforts to diversify the US physician workforce and increases in both the number of US medical schools and number of students enrolled, there has been no difference in the matriculation and graduation of American Indians and Alaska Natives (AI/AN). Furthermore, advancement remains elusive for AI/AN US medical school faculty, which currently constitutes approximately 0.1% of all US medical school faculty and remains disproportionately underrepresented at the Associate and Full Professor ranks. The Northwest Native American Center of Excellence (NNACoE) aims to address these worrisome trends by implementing innovative programs to support a meaningful journey toward recruiting, training, and supporting AI/AN youth, medical students and faculty. NNACoE has piloted three innovations: 1) Tribal Health Scholars, a 14-week clinical shadowing experience for AI/AN youth in their tribal clinic; 2) Wy'East Post-baccalaureate Pathway, a 9-month structured curriculum with conditional acceptance into Oregon Health & Science University School of Medicine; and 3) Indigenous Faculty Forum, a longitudinal professional development conference for AI/AN medical school faculty to foster career advancement. NNACoE piloted all three programs in 2017 and is actively expanding efforts, while systematically evaluating all programs. Pilot results demonstrate that all Tribal Health Scholars are pursuing college and health science majors, 10 AI/AN Wy'East Post-Baccalaureate Scholars are enrolled to date, and 63 Indigenous medical school faculty are participating in professional development. More systematic evaluation of AI/AN-specific programming is needed to better illuminate how to successfully recruit, train and retain AI/ANs in the US physician workforce.

Applying the institutional review board data repository approach to manage ethical considerations in evaluating and studying medical education.

ISSUE: Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. APPROACH: IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. IMPLICATIONS: Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data.

Implementation of interprofessional education (IPE) in 16 U.S. medical schools: Common practices, barriers and facilitators.

BACKGROUND: Enhanced patient outcomes and accreditation criteria have led schools to integrate interprofessional education (IPE). While several studies describe IPE curricula at individual institutions, few examine practices across multiple institutions. PURPOSE: To examine the IPE integration at different institutions and determine gaps where there is potential for improvement. METHOD: In this mixed methods study, we obtained survey results from 16 U.S. medical schools, 14 of which reported IPE activities. RESULTS: The most common collaboration was between medical and nursing schools (93%). The prevalent format was shared curriculum, often including integrated modules (57%). Small group activities represented the majority (64%) of event settings, and simulation-based learning, games and role-play (71%) were the most utilized learning methods. Thirteen schools (81.3%) reported teaching IPE competencies, but significant variation existed. Gaps and barriers in the study include limitations of using a convenience sample, limited qualitative analysis, and survey by self-report. CONCLUSIONS: Most IPE activities focused on the physician role. Implementation challenges included scheduling, logistics and financial support. A need for effective faculty development as well as measures to examine the link between IPE learning outcomes and patient outcomes were identified.