Where Do We Go From Here? An Inventory of Publicly Available Data About Educator Academies, Medical Education Departments, and Offices of Medical Education.

ABSTRACT: With the recent widespread growth and interest among medical educators, analysis of how departments of medical education are structured and their intersection with existing structures within the same institution, such as an office of medical education and/or academy of educators, is warranted. Based on a review of the literature, the authors determined there was a need for an inventory of what medical schools have to offer their faculty, whether it be an office, an academy, or a department. This project sought to inventory the current structures of medical education departments, offices, and academies at U.S. medical schools to explore reporting structure, functions, and characteristics of these entities. Data were extracted from the A Snapshot of Medical Student Education in the United States and Canada: Reports From 145 Schools, published in 2020 in the journal Academic Medicine, for each reporting institution. This led to exploration of medical school websites to catalog institutional structures. Data collected in this inventory demonstrate the range of structures used by medical schools to offer faculty support for their work as teachers and educational researchers. The hypothesis was that departments of medical education would be the least prevalent structures identified in U.S. medical schools, which was indeed a finding. Although the search yielded considerable data for the inventory, there is a dearth of published literature describing current models and characteristics of these different entities. Significant difficulties were encountered locating information clearly delineating roles and responsibilities of each entity on many medical schools' public-facing web pages. Findings are significant because they underscore the challenges medical education leaders have in obtaining information to research, compare, select, and design the administrative model(s) best suited to support faculty educators at their institution. Future work should include creating a detailed catalogue with descriptive information supplied by schools.

Personality Compatibility Within Faculty Mentoring Dyads and Perceived Mentoring Outcomes: Survey Results of Academic Medicine Institutions in the USA.

Mentorship is recognized as a critical approach to support successful careers in academic medicine. Obstacles to successful mentoring relationships include difficulty finding appropriate mentors and poor alignment of mentee/mentor interests and goals. We set out to investigate if concordance or discordance in personality traits of mentees and mentors impacts perceived success of mentoring relationships. Our findings indicated that concordance and discordance on one personality trait, neuroticism, seemed to significantly impact the perceived mentoring relationship success related to career progression. Further work to refine criteria for matching mentees and mentors considering personality traits may impact the effectiveness of mentoring relationships.

Academies in Health Professions Education: A Scoping Review.

PURPOSE: Thirty years ago, academies were conceived as a sociocultural approach to revitalize the teaching mission of medical schools and to promote educators' career advancement. The academy movement has grown rapidly and now reaches a broad range of health professions education organizations. The authors conducted a scoping review to map the literature and describe the evidence that guides the formation of new academies and justifies the continuation of existing ones. METHOD: The authors searched MEDLINE (via Ovid), Embase (via Elsevier and Ovid), CINAHL (via EBSCOhost), and Web of Science (via Clarivate Analytics) from inception through March 6, 2020, for publications regarding academy-like organizations. They mapped the relevant literature using logic modeling as an organizing framework and included the mission, resources, activities, output, outcomes, and impact of the included academies. RESULTS: Of the 513 publications identified, 43 met the inclusion criteria, the oldest of which was published in 2000. Most publications were either case reports or perspective/opinion pieces (26, 57.8%), while studies presenting empirical findings were less common (11, 24.4%). Publications showed that academies were diversifying and increasingly were part of a broad range of organizations, including departments, hospitals, health science campuses, and national organizations. The mission, resources, and activities were similar across academies. Evaluation studies were largely limited to process measures, and rigorous studies examining outcomes (i.e., changes in academy participants) and impact on the organization at large were rare. CONCLUSIONS: The increase in the number of academy-related publications parallels the accelerating speed of the academy movement. To sustain this movement, rigorous studies must provide evidence that academies contribute to the revitalization of organizations' teaching mission and bring about an academic culture where educators thrive and where education is a legitimate career path.

Changing Medical Education, Overnight: The Curricular Response to COVID-19 of Nine Medical Schools.

Issue: Calls to change medical education have been frequent, persistent, and generally limited to alterations in content or structural re-organization. Self-imposed barriers have prevented adoption of more radical pedagogical approaches, so recent predictions of the 'inevitability' of medical education transitioning to online delivery seemed unlikely. Then in March 2020 the COVID-19 pandemic forced medical schools to overcome established barriers overnight and make the most rapid curricular shift in medical education's history. We share the collated reports of nine medical schools and postulate how recent responses may influence future medical education. Evidence: While extraneous pandemic-related factors make it impossible to scientifically distinguish the impact of the curricular changes, some themes emerged. The rapid transition to online delivery was made possible by all schools having learning management systems and key electronic resources already blended into their curricula; we were closer to online delivery than anticipated. Student engagement with online delivery varied with different pedagogies used and the importance of social learning and interaction along with autonomy in learning were apparent. These are factors known to enhance online learning, and the student-centered modalities (e.g. problem-based learning) that included them appeared to be more engaging. Assumptions that the new online environment would be easily adopted and embraced by 'technophilic' students did not always hold true. Achieving true distance medical education will take longer than this 'overnight' response, but adhering to best practices for online education may open a new realm of possibilities. Implications: While this experience did not confirm that online medical education is really 'inevitable,' it revealed that it is possible. Thoughtfully blending more online components into a medical curriculum will allow us to take advantage of this environment's strengths such as efficiency and the ability to support asynchronous and autonomous learning that engage and foster intrinsic learning in our students. While maintaining aspects of social interaction, online learning could enhance pre-clinical medical education by allowing integration and collaboration among classes of medical students, other health professionals, and even between medical schools. What remains to be seen is whether COVID-19 provided the experience, vision and courage for medical education to change, or whether the old barriers will rise again when the pandemic is over.

A Perfect Match? A Scoping Review of the Influence of Personality Matching on Adult Mentoring Relationships-Implications for Academic Medicine.

INTRODUCTION: Mentoring is a widely regarded faculty development strategy in academic medicine. However, the lack of understanding about mentoring relationship dynamics limits effective recruitment, implementation, and evaluation. Despite decades of publications describing adult mentoring initiatives, few studies examine personality influence in mentoring relationships. This scoping review examined the extent, range, and nature of the research on personality matching in mentoring relationships, and identified research gaps in the literature. METHODS: Scoping review methodology guided a search of six databases representing higher education, health sciences education, and professional contexts where mentoring is used. Consistent with the inclusive approach of a scoping review, authors included academic papers and other article types. RESULTS: The scoping review yielded 39 articles. Literature mostly originated in the United States, publication sources represented multiple disciplines, and the context for the majority of articles was the workplace. The most common publication type was a research report. Although all articles addressed personality or mentoring, only three articles examined personality matching and its contribution to the mentoring relationship. Finally, although the Big Five personality traits were cited in multiple studies, other personality frameworks were used. DISCUSSION: Academic medicine expends resources developing and supporting mentoring programs but there remains limited understanding of how best to identify and match mentors and protégés. Further understanding of the role of joint and unique personality traits in academic medicine mentoring relationships seems necessary, if the field continues to invest, time, money, and resources for mentoring programs.

Universal Design for TBL®: Promoting Inclusion and Access for All Learners.

Our institution introduced team-based learning (TBL®) in 2015. Students shared concerns that the interactivity and loud volume of TBL might disadvantage students uncomfortable with group work, with auditory processing disorders, or who need testing accommodations. We share our efforts to ensure all students can benefit from TBL.

The influence of medical school on career choice: A longitudinal study of students' attitudes toward a career in general surgery.

BACKGROUND: Less than 80% of general surgery (GS) residency positions are filled by graduates from allopathic, U.S. medical schools. The aim of this study was to gauge students' interest in pursuing GS throughout their medical school matriculation and explore students' changing perceptions of the specialty. METHODS: Students at two medical schools were surveyed annually for 4 years. Survey responses regarding interest were compared to actual NRMP match results. RESULTS: Interest in a GS career was highest at the outset of medical school and declined steadily during the program, which was similar at both schools, including a positive effect on interest from the surgical clerkship. CONCLUSIONS: Our findings suggest that experiences during medical school impact students' perceptions of GS; specifically, lifestyle, work environment, and the length of training discouraged pursuit of GS. Perception of a GS's lifestyle and the educational environment are both highly modifiable factors that could increase interest in general surgery amongst graduates.

Teaching Medical Students to Help Patients Quit Smoking: Outcomes of a 10-School Randomized Controlled Trial.

BACKGROUND: Early in medical education, physicians must develop competencies needed for tobacco dependence treatment. OBJECTIVE: To assess the effect of a multi-modal tobacco dependence treatment curriculum on medical students' counseling skills. DESIGN: A group-randomized controlled trial (2010-2014) included ten U.S. medical schools that were randomized to receive either multi-modal tobacco treatment education (MME) or traditional tobacco treatment education (TE). SETTING/PARTICIPANTS: Students from the classes of 2012 and 2014 at ten medical schools participated. Students from the class of 2012 (N = 1345) completed objective structured clinical examinations (OSCEs), and 50 % (N = 660) were randomly selected for pre-intervention evaluation. A total of 72.9 % of eligible students (N = 1096) from the class of 2014 completed an OSCE and 69.7 % (N = 1047) completed pre and post surveys. INTERVENTIONS: The MME included a Web-based course, a role-play classroom demonstration, and a clerkship booster session. Clerkship preceptors in MME schools participated in an academic detailing module and were encouraged to be role models for third-year students. MEASUREMENTS: The primary outcome was student tobacco treatment skills using the 5As measured by an objective structured clinical examination (OSCE) scored on a 33-item behavior checklist. Secondary outcomes were student self-reported skills for performing 5As and pharmacotherapy counseling. RESULTS: Although the difference was not statistically significant, MME students completed more tobacco counseling behaviors on the OSCE checklist (mean 8.7 [SE 0.6] vs. mean 8.0 [SE 0.6], p = 0.52) than TE students. Several of the individual Assist and Arrange items were significantly more likely to have been completed by MME students, including suggesting behavioral strategies (11.8 % vs. 4.5 %, p < 0.001) and providing information regarding quitline (21.0 % vs. 3.8 %, p < 0.001). MME students reported higher self-efficacy for Assist, Arrange, and Pharmacotherapy counseling items (ps ≤0.05). LIMITATIONS: Inclusion of only ten schools limits generalizability. CONCLUSIONS: Subsequent interventions should incorporate lessons learned from this first randomized controlled trial of a multi-modal longitudinal tobacco treatment curriculum in multiple U.S. medical schools. NIH Trial Registry Number: NCT01905618.

Tobacco counseling experience prior to starting medical school, tobacco treatment self-efficacy and knowledge among first-year medical students in the United States.

OBJECTIVE: To explore students' tobacco dependence counseling experiences prior to medical school and their associations with tobacco counseling self-efficacy, and familiarity with and perceived effectiveness of tobacco dependence treatment among first-year medical students in the United States. METHOD: In 2010, 1266 first-year medical students from 10 US medical schools completed a survey reporting their clinical experiences with specific tobacco counseling skills (e.g., 5As) prior to medical school. The survey also included questions on tobacco counseling self-efficacy, perceived physician impact on smokers, and familiarity and effectiveness of tobacco-related treatments. RESULTS: Half (50.4%) reported some tobacco counseling experiences prior to medical school (i.e. at least one 5A). Students with prior counseling experiences were more likely to have higher tobacco counseling self-efficacy, and greater familiarity with medication treatment, nicotine replacement treatment, and behavioral counseling for smoking cessation, compared to those with no prior experiences. Perceived physician impact on patient smoking outcomes did not differ by prior tobacco counseling experiences. CONCLUSIONS: Many first-year medical students may already be primed to learn tobacco dependence counseling skills. Enhancing early exposure to learning these skills in medical school is likely to be beneficial to the skillset of our future physicians.

Reflections from an interprofessional education experience: evidence for the core competencies for interprofessional collaborative practice.

The Core Competencies for Collaborative Practice identify the skills needed by every health care provider to be successful in implementing interprofessional practice. Health professions students need to build skills for interprofessional practice as emerging professionals. Reflection is a core skill needed for successful interprofessional practices. This study identifies themes from an interprofessional education research project and discusses their congruency with the Competencies.

The design and utility of institutional teaching awards: a literature review.

BACKGROUND: Institutional teaching awards have been used widely in higher education since the 1970s. Nevertheless, a comprehensive review of the literature on such awards has not been published since 1997. AIM: We conducted a literature review to learn as much as possible about the design (e.g., formats, selection processes) and utility (e.g., impact on individuals and institutions) of teaching awards in order to provide information for use in designing, implementing, or evaluating award programs. METHODS: We searched electronic databases for English-language publications on awards for exemplary teaching. Targeted publications included descriptions and/or investigations of award programs, their impact, and theoretical or conceptual models for awards programs. Screening was conducted by dual review; a third reviewer was assigned for disagreements. Data were analyzed qualitatively. Results were summarized descriptively. RESULTS: We identified 1302 publications for initial relevancy screening by title and abstract. We identified an additional 23 publications in a follow-up search. The full text of 126 publications was reviewed for further relevance. A total of 62 publications were identified as relevant, and of these 43 met our criteria for inclusion. Of the 43, 19 described the design features of 24 awards; 20 reports discussed award utility. Nomination and selection processes and benefits (e.g., plaques) varied as did perceived impact on individuals and institutions. CONCLUSION: Limited evidence exists regarding design and utility of teaching awards. Awards are perceived as having potential for positive impact, including promotions, but may also have unintended negative consequences. Future research should investigate the impact of awards on personal and professional development, and how promotion and tenure committees perceive awards.

Substance use and dependence education in predoctoral dental curricula: results of a survey of U.S. and Canadian dental schools.

The purpose of this study was to obtain information about education in substance use and dependence that appears in the predoctoral curricula of U.S. and Canadian dental schools. Sixty-eight deans were sent a twenty-item survey requesting information about when in the curriculum these subjects were taught, what instructional methods were used, and whether behavior change instruction was included to address these issues in clinical interactions. The survey had an 81 percent response rate. The topics of alcohol use and dependence, tobacco use and dependence, and prescription drug misuse and abuse were reported in over 90 percent (N=55) of responding schools' predoctoral curricula. The topic of other substance use and dependence was reported in only 72.7 percent (N=40) of these schools. The primary instructional method reported was the use of lecture. Less frequently used methods included small-group instruction, instruction in school-based clinic, community-based extramural settings, and independent study. As future health professionals, dental students are an important source for patients concerning substance use, abuse, and treatment. Our investigation confirmed that alcohol, tobacco, and prescription drug abuse is addressed widely in predoctoral dental curricula, but other substance use and dependence are less frequently addressed.

Twelve tips for conducting collaborative research in medical education.

BACKGROUND: Developing and ensuring successful collaborative research in medical education is no small task, but the rewards to researchers can be great. Collaborative research in medical education offers significant opportunities for investigators who wish to pool limited resources and expand professional networks. Despite this, collaboration often occurs without advance planning for the logistical aspects of collaborative work. AIMS AND METHODS: These 12 tips, derived from developing and presenting a session on strategies for effective collaboration conducted at a national meeting, will assist readers who are planning to collaborate or are already engaged in collaborative scholarship. The tips are organized into items to consider in three phases of collaboration: planning, implementation, and dissemination of outcomes. RESULTS AND CONCLUSIONS: From selecting a topic to recognizing when the collaboration should end, the tips underscore the importance of good communication, and clear expectations for participants.

A regional perspective on the attitudes of fourth-year medical students toward the field of general surgery.

BACKGROUND: Despite the stabilization of match rates, negative perceptions toward general surgery are still rife among medical students. The aim of this study was to describe the attitudes of fourth-year medical students towards general surgery at a regional level. METHOD: All fourth-year medical students in the state of Nebraska were invited to complete an online survey about their perceptions of the field of general surgery and the factors that influenced their residency choice. RESULTS: Of the 145 respondents, 10% were interested in general surgery; this result is slightly higher than the national average. The main reasons cited by those who are choosing general surgery were personal factors; the perceived adverse external factors did not influence their career choice. In contrast, students who chose nonsurgical careers did so because of external factors, such as poor lifestyle and perceptions of an unfriendly environment. CONCLUSIONS: The results of this study suggested regional variations in the level of interest toward general surgery and that interest in the field among medical students in Nebraska may be higher than what has been reported nationally. Students who chose general surgery did so for personal reasons, which were independent of external factors. Recruitment efforts into the field should be focused on those students who choose non-general surgery careers and on rectifying the negative influences that steered them away from the field.

An acculturization curriculum: orienting international medical graduates to an internal medicine residency program.

BACKGROUND: The number of International Medical Graduate (IMG) applicants to residency programs has increased steadily over the past decade. Despite high motivation and significant medical knowledge, differences in training and cultural expectations can create knowledge gaps and influence how IMGs relate to patients and staff. This contributes to increased opportunities for medical errors, patient dissatisfaction, and frustration among colleagues. DESCRIPTION: To improve this transition we introduced a required, 2-week precourse for IMGs entering our program. The curriculum focused around the Accreditation Council for Graduate Medical Education core competencies. EVALUATION: Participants reported knowledge gains and rated favorably didactic sessions and small-group activities. Program directors and other key stakeholders reported positive experiences with the precourse, especially the reduction in transition stress and missed work time in July. CONCLUSION: An intensive precourse for IMGs can attenuate transition stress and increase knowledge of core medical skills and competencies.