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.

Using a Modified Delphi Method to Reach Consensus on Best Practices for Medical Education Abstract Submissions to Multiple Conferences.

PURPOSE: Medical education researchers are often uncertain whether they should submit abstracts to certain conferences. Therefore, we aimed to elicit consensus among medical education conference organizers to answer the question: what are best practices for research abstract submissions to multiple conferences? METHODS: Using a 44-question online survey, we conducted a modified Delphi process to identify best practices for abstract submissions to medical education conferences. Consistent with the Delphi process, we identified conference representatives from non-specialty medical education conferences and across four conference types (institutional, regional, national, and international) to serve as panelists. RESULTS: Eleven expert panelists, representing all four conference types-two institutional conferences, five regional conferences, two national conferences, and two international conferences-completed three rounds of the survey. After three rounds, panelists reached consensus on 39/44 survey items-26 items in round 1, 10 items in round 2, and three items in round 3. Panelists' consensus and rationale indicated that it is most appropriate to resubmit abstracts to conferences with a larger or different audience, but not to more homogeneous audiences. Among the four conference types, abstract resubmission from institutional conferences to other conference types was the most widely accepted. Panelists agreed that abstracts using data and results submitted or accepted for publication could be submitted to any conference type. CONCLUSION: The results of this study provide best practices for presenting scholarship to medical education conferences. We recommend that guidelines for medical education conference abstract submissions provide consistent, clear instructions regarding the appropriate life cycle of an abstract.

A Snapshot of Current US Medical School Off-Ramp Programs-a Way to Leave Medical School with Another Degree.

Although most students finish medical school, those who do not frequently have no obvious programmatic alternatives. In recent years, a growing number of medical schools have been developing "off-ramp" programs to help such learners. We surveyed 12 medical schools with off-ramp programs to understand their characteristics and challenges. Differences existed between programs but most were deemed helpful to the students and institutions they served. Advantages included the opportunity to acknowledge the students' hard work, increase career opportunities, and reduce debt. Understanding and promoting such programs will assist students for whom medical school does not represent the optimal career path.

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.

Planning for Happenstance: Helping Students Optimize Unexpected Career Developments.

Introduction: Planning for and responding to happenstance is an important but rarely discussed part of the professional development of medical students. We noted this gap while conducting a study of career inflection points of 24 physicians who frequently mentioned how luck had shaped their unfolding careers. A review of the career counseling literature led us to a body of work known as Planned Happenstance Learning Theory (PHLT). PHLT focuses on the attitudes and skills to make happenstance a positive force in one's life. We found no reference to this work in the medical education literature and resolved to address this gap. Methods: We created resources for an interactive, 90-minute faculty development workshop. In the workshop, the facilitator used a PowerPoint presentation, vignettes of happenstance, a student testimonial, and a reflection worksheet. We presented and formally evaluated the workshop at three national meetings for health science educators. Results: Workshop participants, mostly faculty (N = 45), consistently expressed positive regard for the workshop content, organization, and instructional methods, especially the opportunity for guided reflection. A retrospective pre/postevaluation revealed a meaningful increase in knowledge about PHLT attitudes and skills, as well as a commitment to use these skills in promoting professional development. Discussion: The skills and attitudes of PHLT are relevant to students' career development. A workshop designed to introduce PHLT skills and attitudes to faculty advisors and mentors can help prepare faculty to promote students' awareness and use of these attitudes and skills.

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.

"Virtual Radiology Workstation": Improving Medical Students' Radiology Rotation.

BACKGROUND: Radiology education in clinical clerkship is increasingly important. There is an acute need for active engagement and self-directed learning by medical students rotating in radiology compared with mainly observational current learning practice involving shadowing in the reading room. ACTIVITY: "Virtual Radiology Workstations" supplemented by PowerPoint presentation of normal radiologic anatomy were introduced for fourth-year medical student radiology electives. RESULTS AND DISCUSSION: All 18 students were satisfied with this new teaching model and agreed their understanding of imaging procedures, and recognition of basic anatomic structures improved. It also resulted in efficient utilization of both the teachers' and the students' time.

A Longitudinal Assessment of Professional Identity, Wellness, Imposter Phenomenon, and Calling to Medicine Among Medical Students.

OBJECTIVE: This study assessed changes in professional identity, wellness, imposter phenomenon, and calling to medicine over time in medical school. METHODS: Medical students from the first through third years anonymously completed four validated measures: Perceived Wellness Survey (PWS), Brief Calling Scale (BCS), Physician In-group Identification Scale (PID), and Clance's Imposter Phenomenon Scale (CIP). Survey completion implied informed consent. The study was exempted by the university IRB. RESULTS: All class of 2018 students (n = 110) returned surveys at the beginning of year 1; 58 completed surveys at the end of the preclinical years (post year 2, n = 44) and/or end of the third-year clerkship (post year 3, n = 35) and were analyzed. From pre to post preclinical years, there was a significant decrease in the PID. There were no statistically significant changes in the PWS, BCS, and CIP. From pre year 1 to post third-year clerkships, the PWS and PID decreased, the CIP increased, and the BCS did not change. Only 19% of students participated in all three survey administrations and this group was excluded from the analysis due to the low response rate. CONCLUSION: Student wellness and sense of professional identity (in-group identity) dropped over 3 years of medical education, while imposter phenomenon increased. The BCS did not change over time. The decrease in identity as part of the physician community is concerning; future curriculum initiatives should focus on integration of professional identity into students' individual identities and on initiatives to improve student well-being.

High-Stakes Collaborative Testing: Why Not?

Phenomenon: Studies of high-stakes collaborative testing remain sparse, especially in medical education. We explored high-stakes collaborative testing in medical education, looking specifically at the experiences of students in established and newly formed teams. APPROACH: Third-year psychiatry students at 5 medical schools across 6 sites participated, with 4 participating as established team sites and 2 as comparison team sites. For the collaborative test, we used the National Board of Medical Examiners Psychiatry subject test, administering it via a 2-stage process. Students at all sites were randomly selected to participate in a focus group, with 8-10 students per site (N = 49). We also examined quantitative data for additional triangulation. FINDINGS: Students described a range of heightened emotions around the collaborative test yet perceived it as valuable regardless if they were in established or newly formed teams. Students described learning about the subject matter, themselves, others, and interpersonal dynamics during collaborative testing. Triangulation of these results via quantitative data supported these themes. Insights: Despite student concerns, high-stakes collaborative tests may be both valuable and feasible. The data suggest that high-stakes tests (tests of learning or summative evaluation) could also become tests for learning or formative evaluation. The paucity of research into this methodology in medical education suggests more research is needed.

Multiple Mini Interview Performance and Career Maturity related to Medicine.

This article was migrated. The article was marked as recommended. Introduction: Multiple Mini Interview (MMI) is used to determine the most suitable candidates for the medical profession. It is also important to ensure students have the career maturity necessary to cope with the developmental tasks associated with medical training. This study explored if students stronger in their career decision of medicine perform better on the MMI. Methods: 119 students (72% response rate) completed a career maturity measure. Student MMI scores were matched to career maturity responses. Results: A significant positive correlation (p <.05) existed between MMI score and specify physician as a career preference (r =.177, N =112, p <.031). There was no significant correlation with the MMI score and crystalize a career preference (r =.046, N =119, p =.31) or implement physician as career choice (r =.039, N =114, p =.34). Mean scores for both crystalize career preference ( M = 18.91) and implement physician as career choice ( M = 17.46) indicate that students performing lower on the MMI continue coping with those tasks as compared to specify (M=20.65). Conclusion: Findings suggest a relation between medical student's career maturity and interview performance as measured using the MMI, with students in the intermediate stages of career development having higher MMI scores.

The Educational Climate Inventory: Measuring Students' Perceptions of the Preclerkship and Clerkship Settings.

PURPOSE: To develop an instrument to assess educational climate, a critical aspect of the medical school learning environment that previous tools have not explored in depth. METHOD: Fifty items were written, capturing aspects of Dweck's performance-learning distinction, to distinguish students' perceptions of the educational climate as learning/mastery oriented (where the goal is growth and development) versus performance oriented (where the goal is appearance of competence). These items were included in a 2014 survey of first-, second-, and third-year students at six diverse medical schools. Students rated their preclerkship or clerkship experiences and provided demographic and other data. The final Educational Climate Inventory (ECI) was determined via exploratory and confirmatory factor analysis. Relationships between scale scores and other variables were calculated. RESULTS: Responses were received from 1,441/2,590 students (56%). The 20-item ECI resulted, with three factors: centrality of learning and mutual respect; competitiveness and stress; and passive learning and memorization. Clerkship students' ratings of their learning climate were more performance oriented than preclerkship students' ratings (P < .001). Among preclerkship students, ECI scores were more performance oriented in schools with grading versus pass-fail systems (P < .04). Students who viewed their climate as more performance oriented were less satisfied with their medical school (P < .001) and choice of medicine as a career (P < .001). CONCLUSIONS: The ECI allows educators to assess students' perceptions of the learning climate. It has potential as an evaluation instrument to determine the efficacy of attempts to move health professions education toward learning and mastery.

A typology of teaching roles and relationships for medical education.

BACKGROUND: Educational programs involve interactions between the instructors and the learners. In these interactions, instructors may play various roles. However, a nomenclature for relationships with learners appropriate to those roles has not been developed for medical education. AIMS: This article presents a typology of instructor's roles to facilitate the connection of outcomes with instructional methods and to inform training sessions for instructors. METHOD: Published articles in general education and medical education were searched for examples of terms used for instructor's roles in developmental interactions. Examples were grouped and classified to develop a two-dimensional typology. RESULTS: The typology has eight categories on two dimensions. One dimension is the purpose for interaction: (1) knowledge transmission, (2) professional identity formation, (3) negotiating the institutional milieu, and (4) relationship building. The other dimension is dichotomous on whether the instructor is a member of the profession to which the learners aspire. Twelve terms were categorized: Advisor, Advocate, Buddy, Coach, Counselor, Facilitator, Guru, Master, Mentor, Role model, Teacher and Tutor. CONCLUSIONS: Faculty instructors in medical education are often pressed for time, so clarifying role expectations is a low-cost scheme to enhance results. Using the typology can align instructor behavior with the desired learner outcomes and enhance efficient use of instructional time.

Pre-clinical versus clinical medical students' attitudes towards the poor in the United States.

This study assessed the poverty-related attitudes of pre-clinical medical students (first and second years) versus clinical medical students (third and fourth years). First through fourth year medical students voluntarily completed the Attitude Towards Poverty scale. First and second year students were classified together in the preclinical group and third and fourth year students together in the clinical group. A total of 297 students participated (67% response rate). Statistically significant differences were noted between pre-clinical and clinical students for scores on the subscales personal deficiency (P<0.001), stigma (P=0.023), and for total scores (P=0.016). Scores across these subscales and for total scores were all higher in the clinical group. The only subscale which did not show statistical significance between pre-clinical and clinical students was the structural perspective. Medical students in their clinical training have a less favorable attitude towards the poor than their preclinical counterparts.

Assessment of medical students' proficiency in dermatology: Are medical students adequately prepared to diagnose and treat common dermatologic conditions in the United States?

This study assessed whether a current medical school curriculum is adequately preparing medical students to diagnose and treat common dermatologic conditions. A 15-item anonymous multiple choice quiz covering fifteen diseases was developed to test students' ability to diagnose and treat common dermatologic conditions. The quiz also contained five items that assessed students' confidence in their ability to diagnose common dermatologic conditions, their perception of whether they were receiving adequate training in dermatology, and their preferences for additional training in dermatology. The survey was performed in 2014, and was completed by 85 students (79.4%). Many students (87.6%) felt that they received inadequate training in dermatology during medical school. On average, students scored 46.6% on the 15-item quiz. Proficiency at the medical school where the study was performed is considered an overall score of greater than or equal to 70.0%. Students received an average score of 49.9% on the diagnostic items and an average score of 43.2% on the treatment items. The findings of this study suggest that United States medical schools should consider testing their students and assessing whether they are being adequately trained in dermatology. Then schools can decide if they need to re-evaluate the timing and delivery of their current dermatology curriculum, or whether additional curriculum hours or clinical rotations should be assigned for dermatologic training.

Team cohesiveness, team size and team performance in team-based learning teams.

OBJECTIVES: The purpose of this study was to explore the relationships among variables associated with teams in team-based learning (TBL) settings and team outcomes. METHODS: We administered the National Board of Medical Examiners (NBME) Psychiatry Subject Test first to individuals and then to teams of Year three students at four medical schools that used TBL in their psychiatry core clerkships. Team cohesion was analysed using the Team Performance Scale (TPS). Bivariate correlation and linear regression analysis were used to analyse the relationships among team-level variables (mean individual TPS scores for each team, mean individual NBME scores of teams, team size, rotation and gender make-up) and team NBME test scores. A hierarchical linear model was used to test the effects of individual TPS and individual NBME test scores within each team, as well as the effects of the team-level variables of team size, team rotation and gender on team NBME test scores. Individual NBME test and TPS scores were nested within teams and treated as subsampling units. RESULTS: Individual NBME test scores and individual TPS scores were positively and statistically significantly (p < 0.01) associated with team NBME test scores, when team rotation, team size and gender make-up were controlled for. Higher team NBME test scores were associated with teams rotating later in the year and larger teams (p < 0.01). Gender make-up was not significantly associated. CONCLUSIONS: The results of an NBME Psychiatry Subject Test administered to TBL teams at four medical schools suggest that larger teams on later rotations score higher on a team NBME test. Individual NBME test scores and team cohesion were positively and significantly associated with team NBME test scores. These results suggest the need for additional studies focusing on team outcomes, team cohesion, team size, rotation and other factors as they relate to the effective and efficient performance of TBL teams in health science education.

Team Emotional Intelligence, Team Interactions, and Gender in Medical Students During a Psychiatry Clerkship.

OBJECTIVE: This study examined the relationship between team emotional intelligence, quality of team interactions, and gender. METHODS: Psychiatry clerkship students participating in Team-Based Learning (TBL, n = 484) or no TBL (control, n = 265) completed the Workgroup Emotional Intelligence Profile (WEIP-S) and the Team Performance Scale (TPS). RESULTS: Significant correlations (p < 0.01) existed between quality of team interactions (i.e., TPS) and team emotional intelligence (i.e., WEIP-S) subscales, but not gender. Control and TBL groups experienced significant increases in WEIP-S subscales pre to post (p < 0.01, η (2) = .08), with the TBL group experiencing significantly higher gains in three of four subscales. Control group scored higher on TPS. CONCLUSIONS: A significant relationship exists between team emotional intelligence and quality of team interactions. Gender was unrelated to TPS or WEIP-S subscales. TBL group experienced higher gains in WEIP-S subscales while the control group experienced slightly higher TPS scores. Results suggest implications for medical educators who use TBL.

Well-being in first year medical students.

OBJECTIVE: This study explored the well-being, attitudes toward counseling, willingness to seek counseling, and coping strategies of first year medical students. Gender differences in attitudes toward and willingness to seek counseling were also explored. METHODS: One hundred five first year medical students (98 % response rate) were administered a 59-item questionnaire about well-being, attitudes toward counseling, willingness to seek counseling, and coping strategies during the first week of medical school. The data were analyzed with hierarchical regression and multivariate analysis of covariance (MANCOVA). RESULTS: Female medical students were less willing to seek counseling and had more negative attitudes toward counseling compared to male medical students. Most students indicated that they chose not to seek counseling because they did not feel a need for it. Three students reported that stigma prevented them from seeking counseling. Unhealthy coping strategies (denial, self-blame, and substance use) were negatively associated with well-being while healthy coping strategies (active coping, emotional support, and instrumental support) did not correlate with well-being. CONCLUSIONS: Medical schools should continue efforts to make counseling accessible. Conversations about counseling may help address the more negative attitudes of female students toward counseling, a finding which merits further investigation given that women typically have more positive attitudes toward counseling than men. Use of unhealthy coping strategies can be addressed in classes, clubs, and by advisors and mentors. Limitations of this study include that only first year medical students were surveyed and that it was a cross sectional study.

How prepared are medical students to diagnose and manage common ocular conditions.

It is essential that primary care physicians have a solid fund of knowledge of the diagnosis and management of common eye conditions as well as ocular emergencies, as management of these diseases commonly involves appropriate referral to an ophthalmologist. Thus, it is crucial to receive comprehensive clinical knowledge of ophthalmic disease in the primary care setting during medical school. This study investigated how well prepared medical students are to diagnose and manage common ocular conditions. The study used scores from a standardized 12-question quiz administered to fourth-year medical students (N = 97; 88% response rate) and second-year medical students (N = 97; 97% response rate). The quiz comprising diagnosis and referral management questions covered the most frequently tested ophthalmology topics on board exams and assessed students' ability to recognize when referral to an ophthalmologist is appropriate. Fourth-year medical students had quiz scores ranging from 0%-94.5% with an average score of 68.7%. Second-year students had quiz scores ranging from 27.2%-86.4%, with an average score of 63.8%. Passing rate was 70%. Student's t-test showed fourth-year students had a significantly higher quiz average (P = 0.003). In general, both classes performed better on diagnostic questions (fourth-year, 73.7%; second year, 65.8%) rather than on management questions (fourth-year, 64.8%; second year, 61.8%). Both second-year and fourth-year students on average fell short on passing the ophthalmology proficiency quiz, and in general students were more adept at diagnosing rather than managing ocular conditions and emergencies.