Funding Opportunities Designed to Promote Antiracist Change Across a Health Sciences University.

Importance: As health professionals acknowledge the historic and current influences racism has on patient care and health outcomes, leaders must develop antiracist activities to disrupt current narratives. Objective: To examine the outcomes of antiracism funding opportunities for development, implementation, and evaluation of initiatives across a multi-health professions academic university. Design, Setting, and Participants: This mixed-methods cohort study involved the evaluation of 17 antiracism projects conducted at a midsize single academic university in the Pacific Northwest with schools of dentistry, medicine, nursing, pharmacy, and public health. Projects were designed by students, faculty, staff, and community members, many of whom were from diverse backgrounds. Data collection and analyses were conducted between January and December 2022. Main Outcomes and Measures: Influence and reach of institutionally funded antiracist projects and best practices for funding them. Key metrics included project types, allocation of funds, level of community engagement, number of individuals engaged, demographic characteristics of project leaders, and project facilitators and barriers. Results: Forty-two proposals were submitted, and 17 were selected for funding, representing 3 of 5 health profession schools. Study teams included women (15 of 19 [79%]), gender queer (1 [5%]), Asian American (5 [26%]), Black or African American (2 [11%]), Hispanic or Latinx (1 [5%]), Middle Eastern, North African, or biracial (4 [21%]) and White (7 [37%]) individuals. Four of 17 teams (24%) returned funds because their proposed projects exceeded their workload. Eight projects (47%) were fully implemented, most in the School of Medicine. Community engagement surveys were completed by 10 projects (59%), and 1741 participants engaged in 1 or more funded events. Two focus groups were attended by 7 of 17 projects (41%), which reflected diversity among grantees. Participants noted that facilitators of antiracist activities included strong community engagement, improved well-being, and sense of support by both the community and the institution. Barriers to advancing antiracist initiatives included restrictive timelines, being unprepared for the time needed for their efforts, distrust from community members due to previous experiences with diversity and inclusion projects, and difficulties navigating complex institutional systems and processes. Conclusions and Relevance: The findings of this study suggest that efforts needed to implement antiracist change should not be underestimated. Engagement should be inclusive across academic health centers and communities. Future efforts need to support innovator full-time equivalent support, individual mentorship, and institutional sponsorship.

Research Methodologies in Health Professions Education Publications: Breadth and Rigor.

PURPOSE: Research methodologies represent assumptions about knowledge and ways of knowing. Diverse research methodologies and methodological standards for rigor are essential in shaping the collective set of knowledge in health professions education (HPE). Given this relationship between methodologies and knowledge, it is important to understand the breadth of research methodologies and their rigor in HPE research publications. However, there are limited studies examining these questions. This study synthesized current trends in methodologies and rigor in HPE papers to inform how evidence is gathered and collectively shapes knowledge in HPE. METHOD: This descriptive quantitative study used stepwise stratified cluster random sampling to analyze 90 papers from 15 HPE journals published in 2018 and 2019. Using a research design codebook, the authors conducted group coding processes for fidelity, response process validity, and rater agreement; an index quantifying methodological rigor was developed and applied for each paper. RESULTS: Over half of research methodologies were quantitative (51%), followed by qualitative (28%), and mixed methods (20%). No quantitative and mixed methods papers reported an epistemological approach. All qualitative papers that reported an epistemological approach (48%) used social constructivism. Most papers included participants from North America (49%) and Europe (20%). The majority of papers did not specify participant sampling strategies (56%) or a rationale for sample size (80%). Among those reported, most studies (81%) collected data within 1 year.The average rigor score of the papers was 56% (SD = 17). Rigor scores varied by journal categories and research methodologies. Rigor scores differed between general HPE journals and discipline-specific journals. Qualitative papers had significantly higher rigor scores than quantitative and mixed methods papers. CONCLUSIONS: This review of methodological breadth and rigor in HPE papers raises awareness in addressing methodological gaps and calls for future research on how the authors shape the nature of knowledge in HPE.

12 Tips to Guarantee a Fragmented (Absolutely Terrible) Curriculum in a Time of Crisis.

This article was migrated. The article was marked as recommended. Medical education scholarship is filled with articles focused on rigorous curriculum design and innovation. In the midst of a public health crisis, the authors aim to provide a reflective guide to curriculum development focused on curriculum gone wrong. The authors propose twelve recommendations that will bring all educators closer to curricular failure.

How are clinician-educators evaluated for educational excellence? A survey of promotion and tenure committee members in the United States.

Background: In recent years, educational leaders have proposed domains of educational excellence and corresponding metrics to objectively measure contributions of clinician-educators for promotion and tenure (P&T). The purpose of this study was to explore whether P&T committees in United States (US) have incorporated these recommendations into practice. Method: The authors conducted a survey of P&T leaders across institutions in US. Items included questions related to institutional tracks for P&T, domains included in promotional packets, metrics for their measurement, and use of an Educator's Portfolio (EP). Results: Respondents from 55 institutions completed the survey. The presence of a teaching academy/society was associated with the presence of a promotion track for clinician-educators (p = 0.04). Only teaching activities (91%), assessment of learners (55%), and educational scholarship (51%) were required by a majority of institutions. Few institutions used objective methods for measuring impact and less than half (47%) required an EP. Discussion: These results highlight both progress in the recognition of clinician-educators while also suggesting discordance in the perspective of educational leaders and the practice of P&T committees. The authors advocate for establishing a national community of expert medical educators who may assist P&T committees in adopting consensus-based criteria and metrics to evaluate clinician-educators' contributions.

Teachers as Learners: Developing Professionalism Feedback Skills via Observed Structured Teaching Encounters.

This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Southern Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of 4 experts who shared their thoughts stimulated by the study. These thoughts explore the value of the Observed Structured Teaching Encounter in providing structured opportunities for medical students to engage with the complexities of providing peer feedback on professionalism.

If medical education was a discipline, she would have five core competencies.

To date, many medical schools define medical educators by who they teach rather than the quality of their engagement with learners. In addition, evidence suggests that a traditional terminal degree may not satisfy the developmental needs of educators engaged in competency based medical education. Perhaps, medical educators require additional competencies. This personal view introduces five competencies that enliven the way in which medical educators engage in career paths, recruitment, performance assessment, compensation, and professional development.

Speaking up: using OSTEs to understand how medical students address professionalism lapses.

BACKGROUND: Objective-structured teaching encounters (OSTEs) are used across many disciplines to assess teaching ability. The OSTE detailed in this paper assesses 191 fourth-year medical students' (M4) ability to identify and address lapses in professionalism based on Association of American Medical Colleges' professionalism competencies. The research questions addressed are How frequently do M4s address professionalism lapses observed during an OSTE? What factors influence whether M4s provide feedback when they observe professionalism lapses in an OSTE? METHODS: Standardized patients (SPs) and standardized learners (SLs) were recruited and trained to participate in a standardized encounter with specific cognitive, social, and behavioral errors, including professionalism lapses. M4s viewed this encounter and then offered feedback to the SL, while remotely observed by faculty. Post-encounter, the SL and faculty completed identical checklists to assess both teaching readiness and ability to address professionalism concerns. RESULTS: An analysis of frequencies showed that six of the Association of American Medical Colleges' nine professional competencies were addressed in the checklist and/or discussed in the focus group. Analysis of transcribed debriefing sessions confirmed that M4s did not consistently address professionalism lapses by their peers. CONCLUSIONS: In focus groups, M4s indicated that, while they noticed professionalism issues, they were uncomfortable discussing them with the SLs. Findings of the current study suggest how medical educators might support learners' ability to address lapses in professionalism as well as topics for future research.