A Multicenter Curricular Intervention to Address Resident Knowledge and Perceptions of Personal Finance.

OBJECTIVES: We evaluated internal medicine residents' confidence and knowledge of personal finance, perceptions of burnout, and relations between these issues before and after an educational intervention. METHODS: We surveyed internal medicine residents at two university-based training programs in 2018. We developed and implemented a curriculum at both sites, covering topics of budgeting, saving for retirement, investment options, and the costs of investing. Each site used the same content but different strategies for dissemination. One used a condensed-form lecture series (two 1-hour sessions) and the other used a microlecture series (four 30-minute sessions) series. Residents were resurveyed following the intervention for comparison. RESULTS: The preintervention survey response rate was 41.2% (122/296) and the postintervention response rate was 44.3% (120/271). Postintervention mean scores for personal finance knowledge improved for basic concepts (52.6% vs 39.4%, P < 0.001), mutual fund elements (30.8% vs 19.7%, P < 0.001), investment plans (68.5% vs. 49.2%, P < 0.001), and overall knowledge (50.1% vs 36.1%, P < 0.001). A significantly smaller proportion of residents reported feelings of burnout following the intervention (23.3% vs 36.9%, P = 0.022). CONCLUSIONS: Our findings show that residents want to learn about finances. Our brief educational intervention is a practical way to improve overall knowledge. Our intervention suggests that improving knowledge of finance may be associated with decreased feelings of burnout.

Effects of Different Athletic Playing Surfaces on Jump Height, Force, and Power.

Hatfield, DL, Murphy, KM, Nicoll, JX, Sullivan, WM, and Henderson, J. Effects of different athletic playing surfaces on jump height, force, and power. J Strength Cond Res 33(4): 965-973, 2019-Artificial turfs (ATs) have become more commonplace. Some aspects of performance such as speed seem to be better on ATs, but there are few published studies on the effects of playing surfaces on performance. Furthermore, there is no research that compares performance on ATs, hard surfaces (HSs), and different composite natural surfaces. Forty-three subjects, 21 men (age: 20 ± 1.82 years; height: 177.53 ± 5.87 cm; body mass: 78.44 ± 11.59 kg; and body fat: 11.17 ± 4.45%) and 22 women (age: 25 ± 1.32 years; height: 161.37 ± 6.47 cm; body mass: 60.94 ± 10.24 kg; and body fat: 27.16 ± 7.08%) performed a single countermovement jump (SCMJ), repeated CMJs (RCMJs), and single depth jump (SDJ) on 4 different playing surfaces (peat soil composition turf [NT1], sandy loam composition turf [NT2], 1 AT, and 1 HS. Repeated-measures analysis of variance with Bonferroni post hoc was used to calculate differences in performance across playing surfaces. Statistical significance was set at p ≤ 0.05. Force and jump height were not different across different surfaces. Men had significantly higher force, power, and jump height on all surfaces. Only SCMJ power was lower on NT1 compared with all other surfaces. The difference in power between surfaces was not reproduced when RCMJ and SDJ were performed, and may be due to the increased reactiveness of the stretch-shortening cycle during those jumps. Because of marginal differences between athletic performance and playing surface type, future research comparing playing surface type and other aspects of athletic success such as rate of injury should be considered.

The MD-MEd Joint-Degree Program at Vanderbilt University: Training Future Expert Medical Educators.

PROBLEM: Some medical students are drawn to medical education as an area of academic specialization. However, few options exist for medical students who wish to build a scholarly foundation for future careers in medical education. APPROACH: In 2011, Vanderbilt University School of Medicine (VUSM) and Peabody College of Education and Human Development at Vanderbilt University partnered to establish a novel dual-degree program that, through transfer of credit, allows students to graduate with both an MD and a master of education (MEd) degree in five years. The MD-MEd joint-degree program equips students with robust knowledge and skills related to general education while providing opportunities through independent studies and capstone projects to contextualize these ideas in medical education. OUTCOMES: This innovation at Vanderbilt University demonstrates the feasibility of an MD-MEd joint-degree program. MD-MEd graduates' demonstrated commitment to medical education and credentials will allow them to take on greater educational responsibilities earlier in their careers and quickly gain experience. The three author participants feel their experiences allowed them to achieve desired competencies as educators. They have each gained early experience by chairing the Student Curriculum Committee and contributing to major curricular reform at VUSM. NEXT STEPS: The authors plan to integrate specific medical education competencies into the program, which will require MD-MEd students to develop and demonstrate proficiency in the knowledge and skills expected of dedicated medical educators. Graduates' career trajectories will be tracked to explore whether they become medical educators, conduct educational research, and assume leadership positions.

More than a list of values and desired behaviors: a foundational understanding of medical professionalism.

The term "professionalism" has been used in a variety of ways. In 2012, the American Board of Medical Specialties (ABMS) Standing Committee on Ethics and Professionalism undertook to develop an operational definition of professionalism that would speak to the variety of certification and maintenance-of-certification activities undertaken by ABMS and its 24 member boards. In the course of this work, the authors reviewed prior definitions of professions and professionalism and found them to be largely descriptive, or built around lists of proposed professional attributes, values, and behaviors. The authors argue that while making lists of desirable professional characteristics is necessary and useful for teaching and assessment, it is not, by itself, sufficient either to fully define professionalism or to capture its social functions. Thus, the authors sought to extend earlier work by articulating a definition that explains professionalism as the motivating force for an occupational group to come together and create, publicly profess, and develop reliable mechanisms to enforce shared promises-all with the purpose of ensuring that practitioners are worthy of patients' and the public's trust.Using this framework, the authors argue that medical professionalism is a normative belief system about how best to organize and deliver health care. Believing in professionalism means accepting the premise that health professionals must come together to continually define, debate, declare, distribute, and enforce the shared competency standards and ethical values that govern their work. The authors identify three key implications of this new definition for individual clinicians and their professional organizations.

Educational strategies for improving clinical reasoning.

Clinical reasoning serves as a crucial skill for all physicians regardless of their area of expertise. Helping trainees develop effective and appropriate clinical reasoning abilities is a central aim of medical education. Teaching clinical reasoning however can be a very difficult challenge for practicing physicians. Better understanding of the different cognitive processes involved in physician clinical reasoning provides a foundation from which to guide learner development of effective reasoning skills, while pairing assessment of learner reasoning abilities with understanding of different improvement strategies offers the opportunity to maximize educational efforts for learners. Clinical reasoning errors often can occur as a result of one of four problems in trainees as well as practicing physicians; inadequate knowledge, faulty data gathering, faulty data processing, or faulty metacognition. Educators are encouraged to consider at which point a given learner's reasoning is breaking down. Experimentation with different strategies for improving clinical reasoning can help address learner struggles in each of these domains. In this chapter, various strategies for improving reasoning related to knowledge acquisition, data gathering, data processing, and clinician metacognition will be discussed. Understanding and gaining experience using the different educational strategies will provide practicing physicians with a toolbox of techniques for helping learners improve their reasoning abilities.