Better Decision-Making: Shared Mental Models and the Clinical Competency Committee.

BACKGROUND: Shared mental models (SMMs) help groups make better decisions. Clinical competency committees (CCCs) can benefit from the development and use of SMMs in their decision-making as a way to optimize the quality and consistency of their decisions. OBJECTIVE: We reviewed the use of SMMs for decision making in graduate medical education, particularly their use in CCCs. METHODS: In May 2020, the authors conducted a narrative review of the literature related to SMMs. This review included the SMM related to teams, team functioning, CCCs, and graduate medical education. RESULTS: The literature identified the general use of SMMs, SMMs in graduate medical education, and strategies for building SMMs into the work of the CCC. Through the use of clear communication and guidelines, and a shared understanding of goals and expectations, CCCs can make better decisions. SMMs can be applied to Milestones, resident performance, assessment, and feedback. CONCLUSIONS: To ensure fair and robust decision-making, the CCC must develop and maintain SMMs through excellent communication and understanding of expectations among members.

Role of the clinical learning environment in preparing new clinicians to engage in quality improvement efforts to eliminate health care disparities.

PURPOSE: The National Collaborative for Improving the Clinical Learning Environment offers guidance to health care leaders for engaging new clinicians in efforts to eliminate health care disparities. SUMMARY: To address health care disparities that are pervasive across the United States, individuals at all levels of the health care system need to commit to ensuring equity in care. Engaging new clinicians is a key element of any systems-based approach, as new clinicians will shape the future of health care delivery. Clinical learning environments, or the hospitals, medical centers, and ambulatory care clinics where new clinicians train, have an important role in this process. Efforts may include training in cultural humility and cultural competency, education about the organization's vulnerable populations, and continuous interprofessional experiential learning through comprehensive, systems-based QI efforts focused on eliminating health care disparities. CONCLUSION: By preparing and supporting new clinicians to engage in systems-based QI efforts to eliminate health care disparities, clinical learning environments are instilling skills and supporting behaviors that clinicians can build throughout their careers-and helping pave the road towards equity throughout the US health care system.

Pursuing Excellence in Clinical Learning Environments.

The Accreditation Council for Graduate Medical Education (ACGME) has launched a new shared learning collaborative as part of its larger Clinical Learning Environment Review (CLER) initiative. The collaboration, called Pursuing Excellence in Clinical Learning Environments, aims to improve teaching practices and patient care in the hospitals, medical centers, and ambulatory care sites where residents and fellows pursue their formal clinical training in a specialty or subspecialty. The Pursuing Excellence Initiative (PEI) builds on the 2015 report of findings of the CLER program. These findings demonstrate variability across the nation's teaching hospitals in addressing 6 key focus areas. PEI sets up a shared system of collaborative learning among participating sites of ACGME-accredited institutions, in which early participants share advances that will be disseminated through an expanding circle of other participants. The ACGME will award funding to encourage participation in the first major component of PEI. The goal is to stimulate high-leverage changes that will broadly improve patient care and clinical learning environments across the nation.

Characteristics of simulation activities at North American medical schools and teaching hospitals: an AAMC-SSH-ASPE-AACN collaboration.

SUMMARY STATEMENT: In September 2011, the Association of American Medical Colleges released the results of a survey conducted in 2010 on simulation activities at its member medical schools and teaching hospitals. In this commentary, we offer a synthesis of data and conclude that (1) simulation is used broadly at Association of American Medical Colleges member institutions, for many types of learners, including other health care professionals; (2) it addresses core training competencies and has many educational purposes; (3) its use in learner assessment is more prevalent at medical schools but is still significant at teaching hospitals; and (4) it requires a considerable investment of money, space, personnel, and time. These data confirm general perceptions about the state of simulation in North America for physician training. Future endeavors should include a more granular examination of how simulation is integrated into curricula, a similar survey of other health care-related institutions and professions, and a periodic assessment to characterize trends over time.

Educating medical students as competent users of health information technologies: the MSOP data.

UNLABELLED: As more health information technologies become part of the health care environment, the need for physicians with medical informatics competencies is growing. In 2006, a survey was created to determine the degree to which the Association of American Medical College's Medical School Objectives Project (MSOP) medical informatics competencies had been incorporated into medical school curricula in the United States. METHODS: a web-based tool was used to create the survey; medical education deans or their designees were requested to complete the survey. Analysis focused on the clinician, researcher, and manager roles of physicians. RESULTS: Seventy usable surveys were returned. Many of the objectives were stated in the schools' respective curricula and the competencies were being evaluated. However, only a few schools taught and assessed the medical informatics objectives that required interaction with health information. CONCLUSION: To insure that physicians have the knowledge, skills, and attitudes to effectively and efficiently interact with today's health information technologies, more medical informatics concepts need to be included and assessed in all undergraduate medical education curricula in the United States.