A decade of faculty development for health professions educators: lessons learned from the Macy Faculty Scholars Program.

Faculty development (FD) programs are critical for providing the knowledge and skills necessary to drive positive change in health professions education, but they take many forms to attain the program goals. The Macy Faculty Scholars Program (MFSP), created by the Josiah Macy Jr. Foundation (JMJF) in 2010, intends to develop participants as leaders, scholars, teachers, and mentors. After a decade of implementation, an external review committee conducted a program evaluation to determine how well the program met its intended goals and defined options for ongoing improvement.The committee selected Stufflebeam's CIPP (context, input, process, products) framework to guide the program evaluation. Context and input components were derived from the MFSP description and demographic data, respectively. Process and product components were obtained through a mixed-methods approach, utilizing both quantitative and qualitative data obtained from participant survey responses, and curriculum vitae (CV).The evaluation found participants responded favorably to the program and demonstrated an overall increase in academic productivity, most pronounced during the two years of the program. Mentorship, community of practice, and protected time were cited as major strengths. Areas for improvement included: enhancing the diversity of program participants, program leaders and mentors across multiple sociodemographic domains; leveraging technology to strengthen the MFSP community of practice; and improving flexibility of the program.The program evaluation results provide evidence supporting ongoing investment in faculty educators and summarizes key strengths and areas for improvement to inform future FD efforts for both the MFSP and other FD programs.

Medical School Rankings-Bad for the Health of the Profession and the Public.

This Viewpoint discusses the limitations of medical school ranking in attracting a diverse student population and urges administrators to holistically communicate their mission, goals, and learning environment as an alternative strategy.

Prioritizing Asian Americans, Native Hawaiians, and Pacific Islanders in the U.S. Health Equity Agenda.

Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations are growing rapidly in the United States, yet AANHPIs remain understudied, overlooked, and misunderstood. During the COVID-19 pandemic, themes from the tragic history of anti-Asian bias and marginalization have resurfaced in a surge of renewed bigotry and xenophobic violence against AANHPIs. In this commentary, the authors discuss the role of medical schools in combating anti-Asian sentiment as an important step toward achieving health equity. Based on their collective expertise in health disparities research, medical education, and policy, they offer suggestions about how to disrupt the pattern of invisibility and exclusion faced by AANHPI populations. They consider ways that representative data, leadership in medical education, research funding, national policies, and broad partnerships can help address AANHPI health disparities.

Alpha Omega Alpha in the 21st Century: One School's Approach.

Recent data suggest that students from population groups that have been underrepresented in medicine are disproportionately excluded from admission into the national medical honor society, Alpha Omega Alpha (AΩA). This finding, in combination with increasing concerns about bias in medical student assessment, has led some medical schools to reexamine their AΩA selection process and/or their relationship with the organization. The Pritzker School of Medicine at the University of Chicago formed a task force to study the schools process of choosing students for recognition and to make recommendations regarding this issue.

Supporting Inclusive Learning Environments and Professional Development in Medical Education Through an Identity and Inclusion Initiative.

In 2015, the Pritzker School of Medicine experienced increasing student interest in the changing sociopolitical landscape of the United States and the interaction of these events with student and patient identity. To address this interest, an Identity and Inclusion Steering Committee was formed and formally charged with "providing ongoing direction for programs and/or curricula at Pritzker that support an inclusive learning environment and promote respectful and effective communication with diverse patients and colleagues around issues of identity." The authors describe this committee's structure and steps taken by the committee to create an inclusive community of students at Pritzker characterized by learning through civil discourse. Initiatives were guided by a strategy of continuous quality improvement consisting of regular iterative evaluation, ongoing school-wide engagement, and responsiveness to issues and concerns as they emerged. Data collected over the committee's 4-year existence demonstrate significant improvement in students' sense of inclusion and respect for different perspectives on issues related to identity, such as access to health care, racialized medicine, safe spaces, and nursing labor strikes. The authors discuss several principles that support the development of an inclusive community of students as well as challenges to the implementation of such programming. They conclude that a strategy of continuous quality improvement guided by values of social justice, tolerance, and civil discourse can build community inclusion and enhance medical training for the care of diverse patient populations.

Building Equity, Inclusion, and Diversity Into the Fabric of a New Medical School: Early Experiences of the Kaiser Permanente Bernard J. Tyson School of Medicine.

In July 2020, the Kaiser Permanente Bernard J. Tyson School of Medicine opened in Pasadena, California, with an inaugural class of 50 students. The school endeavors to address systemic barriers that have contributed to health care and educational disparities in the United States. To realize its vision for change, equity, inclusion, and diversity (EID) have been woven throughout the school. Board members were chosen in part based on their commitment to the core values of EID. The board developed mission, vision, and values statements that explicitly avow a commitment to EID and recruited a dean (and the dean recruited leaders) who espoused and evinced these values. Leaders, faculty, and staff received training to foster an inclusive environment and ensure accountability. The school developed a curriculum that has been thoroughly evaluated for its representative and inclusive content by a team drawn from all departments. The diverse first class, selected through a holistic admissions approach, has access to student support systems that emphasize an appreciation of the distinct experiences and context of each student. The school plans a rigorous evaluation program to assess its performance in EID. Although the school may well fall short of achieving all of its EID objectives, by learning from its experiences and from evidence of others in academic medicine, the school recognizes its opportunity to continue to come closer to achieving its goals and to help shape and contribute to the national and international discourse on EID.

Impact of a Video-Based Interactive Workshop on Unprofessional Behaviors Among Internal Medicine Residents.

BACKGROUND: Unprofessional behaviors undermine the hospital learning environment and the quality of patient care. OBJECTIVE: To assess the impact of an interactive workshop on the perceptions of and self-reported participation in unprofessional behaviors. METHODS: We conducted a pre-post survey study at 3 internal medicine residency programs. For the workshop we identified unprofessional behaviors related to on-call etiquette: "blocking" an admission, disparaging a colleague, and misrepresenting a test as urgent. Formal debriefing tools were utilized to guide the discussion. We fielded an internally developed 20-item survey on perception and participation in unprofessional behaviors prior to the workshop. An online "booster" quiz was delivered at 4 months postworkshop, and the 20-item survey was repeated at 9 months postworkshop. Results were compared to a previously published control from the same institutions, which showed that perceptions of unprofessional behavior did not change and participation in the behaviors worsened over the internship. RESULTS: Of 237 eligible residents, 181 (76%) completed both pre- and postsurvey. Residents perceived blocking an admission and the misrepresentation of a test as urgent to be more unprofessional at a 9-month follow-up (2.0 versus 1.74 and 2.63 versus 2.28, respectively; P < .05), with no change in perception for disparaging a colleague. Participation in unprofessional behaviors did not decrease after the workshop, with the exception of misrepresenting a test as urgent (61% versus 50%, P = .019). CONCLUSIONS: The results of this multi-site study indicate that an interactive workshop can change perception and may lower participation in some unprofessional behaviors.

SEALS: an Innovative Pipeline Program Targeting Obstacles to Diversity in the Physician Workforce.

OBJECTIVE: Medical schools may find implementing pipeline programs for minority pre-medical students prohibitive due to a number of factors including the lack of well-described programs in the literature, the limited evidence for program development, and institutional financial barriers. Our goals were to (1) design a pipeline program based on educational theory; (2) deliver the program in a low cost, sustainable manner; and (3) evaluate intermediate outcomes of the program. METHODS: SEALS is a 6-week program based on an asset bundles model designed to promote: (1) socialization and professionalism, (2) education in science learning tools, (3) acquisition of finance literacy, (4) the leveraging of mentorship and networks, and (5) social expectations and resilience, among minority pre-medical students. This is a prospective mixed methods study. Students completed survey instruments pre-program, post-program, and 6 months post-program, establishing intermediate outcome measures. RESULTS: Thirteen students matriculated to SEALS. The SEALS cohort rated themselves as improved or significantly improved when asked to rate their familiarity with MCAT components (p < 0.01), ability to ask for a letter of recommendation (p = 0.04), and importance of interview skills (p = 0.04) compared with before the program. Over 90 % of students referenced the health disparities lecture series as an inspiration to advocate for minority health. Six-month surveys suggested that SEALS students acquired and applied four of the five assets at their college campuses. CONCLUSIONS: This low-cost, high-quality, program can be undertaken by medical schools interested in promoting a diverse workforce that may ultimately begin to address and reduce health care disparities.

Continuous quality improvement in an accreditation system for undergraduate medical education: Benefits and challenges.

BACKGROUND: Accreditation reviews of medical schools typically occur at fixed intervals and result in a summative judgment about compliance with predefined process and outcome standards. However, reviews that only occur periodically may not be optimal for ensuring prompt identification of and remediation of problem areas. AIMS: To identify the factors that affect the ability to implement a continuous quality improvement (CQI) process for the interval review of accreditation standards. METHODS: Case examples from the United States, Canada, the Republic of Korea and Taiwan, were collected and analyzed to determine the strengths and challenges of the CQI processes implemented by a national association of medical schools and several medical school accrediting bodies. The CQI process at a single medical school also was reviewed. RESULTS: A functional CQI process should be focused directly on accreditation standards so as to result in the improvement of educational quality and outcomes, be feasible to implement, avoid duplication of effort and have both commitment and resource support from the sponsoring entity and the individual medical schools. CONCLUSIONS: CQI can enhance educational program quality and outcomes, if the process is designed to collect relevant information and the results are used for program improvement.

No time for teaching? Inpatient attending physicians' workload and teaching before and after the implementation of the 2003 duty hours regulations.

PURPOSE: Understanding the association between attending physicians' workload and teaching is critical to preserving residents' learning experience. The authors tested the association between attending physicians' self-reported workload and perceptions of time for teaching before and after the 2003 resident duty hours regulations. METHOD: From 2001 to 2008, the authors surveyed all inpatient general medicine attending physicians at a teaching hospital. To measure workload, they used a conceptual framework to create a composite score from six domains (mental demand, physical demand, temporal demand, effort, performance, frustration). They measured time for teaching using (1) open-ended responses to hours per week spent doing didactic teaching and (2) responses (agree, strongly agree) to the statement "I had enough time for teaching." They conducted multivariate logistic regression analyses, controlling for month, year, and clustering by attending physicians, to test the association between workload scores and time for teaching. RESULTS: Of 738 eligible attending physicians, 482 (65%) completed surveys. Respondents spent a median of three hours per week dedicated to teaching. Less than half (198; 43%) reporting enough time for teaching. The composite workload scores were normally distributed (median score of 15) and demonstrated a weak positive correlation with actual patient volume (r = 0.25). The odds of an attending physician reporting enough time for teaching declined by 21% for each point increase in composite workload score (odds ratio = 0.79 [95% confidence interval 0.69-0.91]; P = .001). CONCLUSIONS: The authors found that attending physicians' greater self-perceived workload was associated with decreased time for teaching.

Assessing competencies during education in psychiatry.

The utilization of competencies in medical education is relatively recent. In 1999 the United States Accreditation Council for Graduate Medical Education (ACGME) established six main competencies. Since then, the American Board of Psychiatry and Neurology have approved a specific list of competencies for their specialities in each of the ACGME's core competency areas. Assessment of competencies in both medical students and residents can be achieved through such methods as structured case discussion, direct observation, simulation, standardized patients, and 360-degree assessments, etc. Each assessment methodology has specific applications in the discipline of psychiatry. This paper reviews the different methods for assessing competencies with specific examples in psychiatric education. It is not intended as a comprehensive review of all assessment methods, but to provide examples and strategies to guide psychiatric educators in their practice. Students and residents were intentionally separated because there are differences in the teaching goals and objectives, and thus in the assessment purposes and design. Students are general, undifferentiated physicians-in-training who need to learn about psychiatric nosology, examinations, and treatment. Residents are mental health professionals who need more in-depth supervision in order to hone skills in all the specialized areas that arise in psychiatric practices, making supervision a vital part of residency programs.