Changing the Clock in Medical Education: Addressing Physician Shortages and Patient Outcomes.

Despite the shortage of physicians in the United States, there is no consensus among medical educators as to how to address the nation's unmet needs. A growing but unfulfilled argument is to revisit the configuration of medical education and the time required to complete medical training. Pilot programs, such as shortened programs or advancement-in-place structures to accelerate the practice capability of trainees, have been attempted. This manuscript addresses underlying economic and human considerations that medical educators must reconcile, drawing on lessons from international educational structures, as we advance toward a system that supports the needs of the communities that our graduates will serve.

Multisystem Inflammatory Syndrome in Children: Two Years' Worth of Learning.

Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening sequela of SARS-CoV-2 infection. Limited data are available regarding risk-stratification or long-term outcomes in MIS-C. This study sought to determine associations between serologic markers and severity of illness and understand long-term cardiac outcomes. This series includes 46 cases (mean age 8.1 years; 63.0% male) of MIS-C. Pearson's chi-squared analysis showed an erythrocyte sedimentation rate (ESR) greater than 30 mm/h and 50 mm/h were disproportionately associated with pediatric intensive care unit (PICU) admission (χ2 = 4.44, P = .04) and use of vasopressors (χ2 = 6.06, P = .01), respectively. Ferritin less than 175.6 ng/mL was associated with use of vasopressors (χ2 = 5.28, P = .02). There was a negative correlation between ESR and ejection fraction (EF) (r = -0.39, P = .009). Most patients with abnormal echocardiograms had resolution of abnormalities within 30 days. Therefore, inflammatory markers may be helpful in predicting which patients may require specific interventions or experience cardiac dysfunction, but MIS-C does not appear to be associated with complications at 1 year.

What Makes a Near-Peer Learning and Tutoring Program Effective in Undergraduate Medical Education: a Qualitative Analysis.

Peer tutoring can benefit both learners and peer teachers that are distinct from the learning that occurs in expert-guided learning environments. This study sought to evaluate the peer tutoring program at a large public medical school to determine the strengths and weaknesses of a near-peer tutoring program and its benefits beyond students' typical classroom-based learning. This was a survey-based study of learners and tutors participating in the peer tutoring program. Fifty-six learners and 20 tutors participated in the survey; most learners received tutoring in the preclinical phase of the curriculum. Narrative responses were thematically analyzed to identify themes for both groups. Learners' responses about the benefit of the near-peer tutoring program were in three primary categories: creating a safe learning environment, direct coaching skills, and pitfalls around the need for individualized direction. Tutors' responses about what made a successful tutoring relationship centered around crucial activities used to engage with learners, beneficial intrinsic qualities of learners such as motivation, and qualifications of tutors that were most helpful such as knowledge base. Peer tutoring programs should emphasize individualized feedback for learners that focuses on metacognitive, content-based, and socio-emotional support. In doing so, such programs can provide a well-structured approach to improve learner success. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01680-0.