Professional Identity Formation of Basic Science Medical Educators: A Qualitative Study of Identity Supports and Threats.

PURPOSE: Basic science medical educators (BSME) play a vital role in the training of medical students, yet little is known about the factors that shape their professional identities. This multi-institutional qualitative study investigated factors that support and threaten the professional identity formation (PIF) of these medical educators. METHOD: A qualitative descriptive study was conducted with a purposive sample of 58 BSME from 7 allopathic medical schools in the U.S. In-depth semi-structured interviews of individual BSME were conducted between December 2020 and February 2021 to explore the facilitators and barriers shaping the PIF of BSME. Thematic analysis was conducted. RESULTS: Factors shaping PIF were grouped into 3 broad domains: personal, social, and structural. Interrelated themes described a combination of factors that pushed BSME into teaching (early or positive teaching experiences) and kept them there (satisfaction and rewards of teaching, communities of like-minded people), as well as factors that challenged their PIF (misunderstanding from medical students, clinical, and research faculty, lack of formal training programs, and lack of tenure-track educator positions). The structural environment was reported to be crucial for PIF and determined whether BSME felt that they belonged and were valued. CONCLUSIONS: This study shows that although most BSME derive a sense of fulfillment and meaning from their role as medical educators, they face considerable obstacles during their PIF. Structural change and support are needed to increase recognition, value, promotion, and belonging for BSME to improve the satisfaction and retention of this important group of faculty.

Information overdose: Student performance and perceptions of pharmacology resources on exams.

Physicians of the future will be expected to synthesize new knowledge and appropriately apply it in patient care. Here, we report on the effects of and student attitudes towards resource-enhanced exams by comparing student performance on closed-book exams with or without access to pharmacology flashcards. Setting: the University of California, San Francisco (UCSF) School of Medicine (SOM), class of 2021 (N = 149), followed over 4 years. We provided pharmacology flashcards for studying purposes in all blocks; flashcards were only accessible during closed-book exams in 2 of 5 blocks. We collected pharmacology open-ended question (OEQ) scores and analyzed results using repeated measures ANOVA (SPSS). We collected MS4 survey data using Qualtrics and conducted a thematic content analysis. Performance on pharmacology questions on exams was not higher with access to pharmacology flashcards during exams. The number of students who passed pharmacology questions without flashcards on exams was as follows: 137 ± 3.7, 132 ± 5.0, and 134 ± 7.9 (average ± SEM). The number of students who passed pharmacology questions with flashcards on exams was as follows: 132 ± 6.6 and 120 ± 7.5. Survey comments revealed several themes. Access to pharmacology flashcards during exams allowed learners to focus on understanding the bigger picture and reduced stress. A subset of students reported having access to flashcards on pre-clerkship exams hurt their preparation for clerkships. Flashcards as exam resources were received well by approximately half the class, who reported benefits including more time to focus on understanding bigger picture concepts and reduced stress.

Implementation and Evaluation of a 10-Week Health Equity Curriculum for Pharmacy Students.

Objective To describe a health equity curriculum created for pharmacy students and evaluate students' perceptions and structural competency after completion of the curriculum.Methods A health equity curriculum based on transformative learning and structural competency frameworks was implemented as a 10-week mandatory component of the pass-no pass neuropsychiatric theme for second year pharmacy students. Each week, students reviewed materials around a neuropsychiatric-related health equity topic and responded to discussion prompts through asynchronous forums or synchronous online video discussions. The effectiveness of the health equity curriculum was evaluated through assessment of structural competency through a validated instrument, an objective structured clinical examination (OSCE), and a questionnaire.Results All enrolled second year pharmacy students (n=124) participated in the health equity curriculum. Of the 75 students who completed the structural competency instrument, 46 (61%) were able to identify structural determinants of health, explain how structures contribute to health disparities, or design structural interventions. Ninety-six of the 124 students (77%) were able to address their OSCE standardized patient's mistrust in the health care system. Thematic analysis of student comments elucidated three themes: allyship, peer connection, and self-awareness. Students rated asynchronous discussion forums as significantly less effective than online video discussions and patient cases for achieving curricular objectives.Conclusion A mandatory curriculum delivered remotely throughout the didactic pharmacy curriculum using a blended learning approach was an effective way to incorporate health equity content and conversations into existing courses. Implementation of this or similar curriculums could be an important step in training pharmacy students to be advocates for social justice.