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Hirsh DA, Crampton PES, Osman NY. Applying self-determination theory to stem medical schools' clinical teacher sustainability crisis. MEDICAL EDUCATION 2024; 58:118-128. [PMID: 37593835 DOI: 10.1111/medu.15181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/19/2023]
Abstract
THE PROBLEM Medical schools require highly skilled and committed clinical faculty to teach, assess, supervise and mentor students' clinical care. Medical education is facing a crisis in recruiting and sustaining these clinical teachers. Faced with multiple demands and responsibilities in fast-paced clinical environments, teachers may not have the time, resources or stamina to sustain these critical roles. Medical school leaders must commit to and provide structures and processes to attract, sustain and retain clinical teachers. CONCEPTUAL FRAMEWORK The authors use the lens of self-determination theory to frame approaches to support teacher sustainability. Self-determination theory describes sources of human motivation. The theory and its evidence base characterise three human psychological needs: autonomy, competence, and relatedness. This theory can bridge individual psychological and institutional leadership perspectives to help medical school leaders anticipate and respond to their clinical teachers' needs. The authors propose three practical steps: practices to advance employee-centredness, processes to align individual and institutional values, and restructuring education to support clinical teachers' needs alongside student and patient needs. The authors describe limitations to this relational approach that focuses on leadership actions and consider individual agency as another key factor for sustainability. DISCUSSION Medical school leaders can develop and apply theory-driven approaches to advance sustainability. Sustainability now and in the future requires careful attention to the needs of clinical teachers and to their relationships with and within medical schools.
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Affiliation(s)
- David A Hirsh
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts, USA
| | - Paul E S Crampton
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK
| | - Nora Y Osman
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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West K, Oyoun Alsoud L, Andolsek K, Sorrell S, Al Hageh C, Ibrahim H. Diversity in Mission Statements and Among Students at US Medical Schools Accredited Since 2000. JAMA Netw Open 2023; 6:e2346916. [PMID: 38095898 PMCID: PMC10722335 DOI: 10.1001/jamanetworkopen.2023.46916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/26/2023] [Indexed: 12/17/2023] Open
Abstract
Importance Diversity in the physician workforce improves patient care and decreases health disparities. Recent calls for social justice have highlighted the importance of medical school commitment to diversity and social justice, and newly established medical schools are uniquely positioned to actively fulfill the social mission of medicine. Objective To identify diversity language in the mission statements of all medical schools accredited since 2000 and to determine whether the presence of diversity language was associated with increased diversity in the student body. Design, Setting, and Participants Cross-sectional study of public websites conducted between January 6, 2023, and March 31, 2023. Qualitative content analysis of mission statements was conducted using a deductive approach. Eligible schools were identified from the 2021-2022 Medical School Admission Requirements and American Medical Colleges and American Association of Colleges of Osteopathic Medicine websites. Each school's publicly available website was also reviewed for its mission and student body demographics. All United States allopathic and osteopathic medical schools that have been accredited and have enrolled students since 2000. Exposure Content analysis of medical school mission statements. Main Outcomes and Measures Prevalence of diversity language in medical school mission statements and its association with student body racial diversity. Data were analyzed in 5-year groupings: 2001 to 2005, 2006 to 2010, 2011 to 2015, and 2016 to 2020). Results Among the 60 new medical schools (33 [55%] allopathic and 27 [45%] osteopathic; 6927 total students), 33 (55%) incorporated diversity language into their mission statements. In 2022, American Indian or Alaska Native individuals accounted for 0.26% of students (n = 18), Black or African American students constituted 5% (n = 368), and Hispanic or Latinx individuals made up 12% (n = 840). The percentage of schools with diversity language in their mission statements did not change significantly in schools accredited across time frames (60% in 2001: mean [SE], 0.60 [0.24] vs 50% in 2020: mean [SE], 0.50 [0.11]). The percentage of White students decreased significantly over the time period (26% vs 15% students in 2001-2005 and 2016-2020, respectively; P < .001). No significant differences were observed in student body racial or ethnic composition between schools with mission statements that included diversity language and those without. Conclusions and Relevance In this cross-sectional study of US medical schools accredited since 2000, diversity language was present in approximately half of the schools' mission statements and was not associated with student body diversity. Future studies are needed to identify the barriers to increasing diversity in all medical schools.
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Affiliation(s)
- Kelsey West
- Indiana University School of Medicine, Indianapolis
| | - Leen Oyoun Alsoud
- Department of Medicine, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Kathryn Andolsek
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Sara Sorrell
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
| | - Cynthia Al Hageh
- Department of Medicine, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Halah Ibrahim
- Department of Medicine, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
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Adams ZM, Mekbib K, Encandela J, Reisman A. Variation in medical humanities program mission statements in United States and Canadian Medical Schools. MEDICAL TEACHER 2023; 45:615-622. [PMID: 36448773 DOI: 10.1080/0142159x.2022.2151886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
PURPOSE In 2019, the American Association of Medical Colleges (AAMC) identified the discipline of medical humanities as a priority in medical education. Although medical humanities programs have existed in medical and osteopathic schools in the U.S. and Canada since the late 1960's, this interdisciplinary field remains difficult to define. We studied the mission statements of medical humanities programs to identify core themes and priorities. MATERIALS AND METHODS We conducted a content analysis of U.S. and Canada medical humanities MD and DO mission statements and associated descriptions (n = 56). We compared themes across programs whose directors had a clinical degree versus a terminal research degree, conducted comparisons between medical humanities programs housed in medical schools ranked in Top 20 U.S. News and World Report for Research or Primary Care, and conducted a word frequency analysis. RESULTS Content analysis revealed five themes: improving patient care, improving the provider experience, generating scholarship, cultivating community relationships, and promoting diversity/sociocultural awareness. 70% of programs emphasized patient care and provider experience. Only 34% included the promotion of diversity/sociocultural awareness as a theme. Word frequency analysis corroborated our findings. CONCLUSIONS U.S. and Canada medical humanities programs focus primarily on improving patient care and provider wellness.
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Affiliation(s)
- Zoe M Adams
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Kedous Mekbib
- Medical Student, Yale School of Medicine, New Haven, CT, USA
| | - John Encandela
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Anna Reisman
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Wu H, Zhong Y, Zheng B, Liu Y. Mapping themes, trends, and knowledge structure of Behcet syndrome: a bibliometric analysis from 2010 to 2021. Biotechnol Genet Eng Rev 2023:1-23. [PMID: 37144667 DOI: 10.1080/02648725.2023.2208452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This study employed bibliometric analysis to examine the current literature on Behcet Syndrome, an autoimmune disorder with complex pathophysiology and inadequate therapeutic options. The researchers collected 3,462 publications related to Behcet Syndrome from 2010 to 2021 via PubMed and conducted co-word and social network analyses to identify research hotspots and potential future directions. The co-word analysis produced a bibliographic data matrix, which revealed 72 high-frequency medical topic title (MeSH) terms. Using repeated dichotomy in the gCLUTO software, the researchers created a visualization matrix that classified the hot topics into six categories over the 12-year study period. The first quadrant contained six mature and well-developed research topics, including biological therapy, immunosuppressive agents, clinical manifestations, complications of Behcet Syndrome, Behcet Syndrome diagnosis, and aneurysm etiology and therapy. The third quadrant comprised four research topics with potential for growth, including Behcet Syndrome genetics and polymorphism, immunosuppressive agents, biological therapy and heart diseases, and thrombosis etiology. The fourth quadrant encompassed the pathophysiology of and quality of life in Behcet Syndrome as well as psychology. In the social network analysis, the researchers identified potential hotspots based on subject keywords close to the network's edge. These included genetic association studies, antibodies, genetic predisposition to disease/genetics, and monoclonal and humanized therapeutic use. Overall, this study's bibliometric analysis of Behcet Syndrome literature from the past 12 years identified unexplored subjects and developing hot spots that could lead to potential research directions for Behcet Syndrome.
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Affiliation(s)
- Haopeng Wu
- School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yuan Zhong
- School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Bowen Zheng
- School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yi Liu
- School and Hospital of Stomatology, China Medical University, Shenyang, China
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Kraus MB, Hasan SH, Buckner-Petty SA, Files JA, Hayes SN, Habermann EB, LeMond LM. Out-of-State Students at State Medical Schools and Increasing Medical Education Debt. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:595-605. [PMID: 36512837 DOI: 10.1097/acm.0000000000005079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
PURPOSE Medical school tuition has increased at alarming rates ahead of inflation over the past 20 years. The authors investigated whether state-funded medical schools have had an increased number of out-of-state matriculants, which may create a diaspora of displaced in-state medical students matriculating to out-of-state programs and incurring substantial debt. METHOD Publicly available data from the Association of American Medical Colleges (AAMC) were accessed from 2004 through 2019 for applicants and matriculants at U.S. state-funded schools. Schools listed as public that reported tuition charges in the AAMC Tuition and Student Fees reports were included in this study. The numbers and trends of medical school applications and trends in tuition costs and average indebtedness were summarized for in-state and out-of-state matriculants. Values were analyzed by group as median and interquartile range (IQR). Group differences were assessed via t tests. P values less than .05 were considered statistically significant. RESULTS From 2004 through 2019, the annual number of out-of-state matriculants in state-funded schools increased 7% (16%-23% [7,195-11,144]). Among 74 schools with data in 2004, the median percentage of out-of-state applications increased from 60% (IQR, 31%-74%) to 80% (IQR, 57%-85%; P < .001), and the median percentage of out-of-state matriculants increased from 13% (IQR, 5%-23%) to 17% (IQR, 11%-33%; P < .001). In 2004, the mean (standard error) debt upon completion of medical school (inflation adjusted to 2018 dollars) was $144,100 ($10,950); by 2016, the mean debt had increased to $251,600 ($32,040), a 75% increase over 12 years. CONCLUSIONS Since 2004, substantial increases have occurred in out-of-state matriculants at state-funded medical schools. This may displace residents from attending their in-state schools, causing them to attend out-of-state or private medical schools, where tuition is typically much higher.
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Affiliation(s)
- Molly B Kraus
- M.B. Kraus is anesthesiologist and associate professor, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona
| | - Shaina H Hasan
- S.H. Hasan is a resident physician, Department of Internal Medicine, University of Virginia, Charlottesville, Virginia
| | - Skye A Buckner-Petty
- S.A. Buckner-Petty is a senior biostatistician, Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona
| | - Julia A Files
- J.A. Files is an internist, Division of Women's Health Internal Medicine, and professor of medicine, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona
| | - Sharonne N Hayes
- S.N. Hayes is cardiologist and professor of medicine, Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Elizabeth B Habermann
- E.B. Habermann is professor of health services research, Division of Surgery Research, and associate scientific director, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - Lisa M LeMond
- L.M. LeMond is cardiologist and assistant professor, Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Scottsdale, Arizona
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Squirrell K, Deivanayagam S, Niles K, Wang J, Kopar PC. A Gap in Mission: The Disparate Missions of Medical Schools and Teaching Hospitals. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231211081. [PMID: 37928890 PMCID: PMC10621289 DOI: 10.1177/23821205231211081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
Objective The social contract mandates that in return for the government-funded labor of residents and fellows, the medical profession trains, to the best of its ability, the physicians of our future. This contract obligates graduate medical education (GME) to utilize all available information to create an optimal learning environment for its trainees. Business research has determined that a clearly defined mission statement is associated with improved employee engagement, retention, and wellness. Given that GME trainees are situated at the intersection of at least two institutions, each with its own separate mission, trainees could potentially be hindered by incongruent missions in the learning environment. The literature on mission statements has analyzed medical schools and hospitals separately; however, investigations comparing the statements of these affiliated institutions have not been conducted. Therefore, we plan to compare the content and assess the consistency of mission statements from affiliated medical schools and hospitals to determine if incongruencies exist. Methods In 2023, the mission statements from the Association of American Medical Colleges (AAMC) medical schools and affiliated teaching hospitals (n = 163) were aggregated from their public websites. The content of each mission statement was thematically analyzed to assess variation. Results According to content analysis of the mission statements from 163 AAMC medical school members and affiliated teaching hospitals, less than half of their top priorities are shared by their affiliated hospitals (45%). Additionally, themes of diversity, religion, and global care were found to be contrasting priorities between affiliated institutions. Conclusion Given the precedence within the business and the observed discrepancies in mission, further research is needed to determine whether collaborating medical schools and hospitals could provide a more favorable graduate training environment by uniting their priorities and identifying shared goals.
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Affiliation(s)
- Kyler Squirrell
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
| | - Shanthi Deivanayagam
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
| | - Katharine Niles
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
| | - John Wang
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
| | - Piroska Cornell Kopar
- The Center for Humanism and Ethics in Surgical Specialties, Washington University, Saint Louis, MO, USA
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Michael SH, Rougas S, Zhang XC, Clyne B. A Content Analysis of the ACGME Specialty Milestones to Identify Performance Indicators Pertaining to the Development of Residents as Educators. TEACHING AND LEARNING IN MEDICINE 2019; 31:424-433. [PMID: 30669871 DOI: 10.1080/10401334.2018.1560298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Construct: For curriculum development purposes, this study examined how the development of residents as educators is reflected in the Accreditation Council for Graduate Medical Education (ACGME) Milestones. Background: Residents teach patients, families, medical students, physicians, and other health professionals during and beyond their training. Despite this expectation, it is unclear how the development of residents as educators is reflected in the specialty-specific Milestones. Approach: We performed a textual content analysis of 25 specialty Milestone documents available as downloads from the ACGME website in December 2015. Syntactical units of interest included developmental progressions that describe the development of educators over the course of residency training and 16 key terms identified during the analysis. We then categorized the terms by associated Milestone level, ACGME core competency, and targeted learner(s). Results: We identified 10 developmental progressions and 546 instances of the 16 key terms that describe the development of physician educators. The frequency of terms among specialties was quite variable (5-46 terms per specialty, Mdn = 21). The majority of education-related terms appeared at advanced Milestone levels; there were 139 (26%) such instances in Level 4 and 296 (54%) in Level 5. Education-related terms were identified in all six ACGME core competencies, with greatest frequency in Patient Care (157, 29%). Other residents were the learners most frequently targeted by education-related Milestones (211, 40%). Conclusions: The current ACGME Milestones largely imply that resident teaching is a high-level or aspirational goal, achieved without a clear or consistently assessed developmental progression. These findings run counter to the theoretical basis that underlies the development of the Milestones. Wide variation among specialties indicates lack of consensus around the ideal skill set of the resident educator and limits the utility of these documents for curriculum development in this domain.
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Affiliation(s)
- Sarah H Michael
- a Department of Emergency Medicine, University of Colorado Denver , Aurora , Colorado , USA
| | - Steven Rougas
- b Department of Emergency Medicine, Brown University , Providence , Rhode Island , USA
| | - Xiao C Zhang
- c Department of Emergency Medicine, Thomas Jefferson University , Philadelphia , Pennsylvania , USA
| | - Brian Clyne
- b Department of Emergency Medicine, Brown University , Providence , Rhode Island , USA
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Hafferty FW, Grbic D, Hafferty PK. Mapping the Mission Statements of U.S. LCME-Accredited Medical Schools: An Exploration of Organizational Communalities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:723-730. [PMID: 30720524 DOI: 10.1097/acm.0000000000002626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Mission statements (MSs) express an organization's purpose and reflect the broader social environment in which they function. The authors analyze MS text to explore how medical schools can be relationally viewed and how particular thematic narratives within MSs can be deployed to associate schools in hithertofore unexplored ways. METHOD The authors analyzed the MSs (as of 1/1/2017) of 144 U.S. Liaison Committee on Medical Education-accredited schools. Using schools as their unit of analysis, they coded MSs using 44 themes. They employed content analysis to identify themes within MSs, factor analysis to identify core thematic dimensions embedded in MSs, and network analysis to examine relationships among schools based on these thematic dimensions. The authors used four standard school characteristics to examine the validity of their results. RESULTS Content analysis revealed 20 core themes. Factor analysis identified four thematic dimensions: Primary Care/Diversity; Future Learning-External; Traditional; and Learning Environment-Internal. Based on the 20 core themes and using the MSs of 125 schools with nonextreme MS code counts, the authors found that schools form a complete network, and that schools form distinctive network-based clusters based on the identified factors. The four thematic dimensions were significantly differentiated across the four standard school characteristics. CONCLUSIONS The authors found distinctive patterns of MS linkages among schools along with thematic linkages within MS themes, supporting the contentions that medical schools can be both differentiated and connected based on their MSs and that understanding MS content must move beyond simple frequency counts of MS attributes.
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Affiliation(s)
- Frederic W Hafferty
- F.W. Hafferty is professor of medical education, Division of General Internal Medicine, Program in Professionalism and Values, and College of Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0002-5604-7268. D. Grbic is lead research analyst for medical education, Association of American Medical Colleges, Washington, DC. P.K. Hafferty is gallery assistant and administrator, Koichi Yanagi Oriental Fine Arts, New York, New York
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Kreiter C, O’Shea M, Bruen C, Murphy P, Pawlikowska T. A meta-analytic perspective on the valid use of subjective human judgement to make medical school admission decisions. MEDICAL EDUCATION ONLINE 2018; 23:1522225. [PMID: 30286694 PMCID: PMC6179055 DOI: 10.1080/10872981.2018.1522225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/06/2018] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
While medical educators appear to believe that admission to the medical school should be governed, at least in part, by human judgement, there has been no systematic presentation of evidence suggesting it improves selection. From a fair testing perspective, legal, ethical, and psychometric considerations, all dictate that the scientific evidence regarding human judgement in selection should be given consideration. To investigate the validity of using human judgements in admissions, multi-disciplinary meta-analytic research evidence from the wider literature is combined with studies from within medical education to provide evidence regarding the fairness and validity of using interviews and holistic review in medical school admissions. Fourteen studies, 6 of which are meta-analytic studies that summarized 292 individual studies, were included in the final review. Within these studies, a total of 33 studies evaluated the reliability of the traditional interview. These studies reveal that the interview has low to moderate reliability (~.42) which significantly limits its validity. This is confirmed by over 100 studies examining interview validity which collectively show interview scores to be moderately correlated with important outcome variables (corrected value ~.29). Meta-analyses of over 150 studies demonstrate that mechanical/formula-based selection decisions produce better results than decisions made with holistic/clinical methods (human judgement). Three conclusions regarding the use of interviews and holistic review are provided by these meta-analyses. First, it is clear that the traditional interview has low reliability and that this significantly limits its validity. Second, the reliable variance from interview scores appears moderately predictive of outcomes that are relevant to consider in medical school admission. And third, the use of holistic review as a method of incorporating human judgement is not a valid alternative to mechanical/statistical approaches as the evidence clearly indicates that mechanistic methods are more predictive, reliable, cost efficient, and transparent.
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Affiliation(s)
- Clare Kreiter
- Department of Family Medicine, Office of Consultation and Research in Medical Education, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Marie O’Shea
- Health Professions Education Center, Royal College of Surgeons, Dublin, Ireland
| | - Catherine Bruen
- Technology Enhanced Learning Manager, Royal College of Surgeons, Dublin, Ireland
| | - Paul Murphy
- Information Specialist, Royal College of Surgeons, Dublin, Ireland
| | - Teresa Pawlikowska
- Director of Health Professions Education Centre, Royal College of Surgeons, Dublin, Ireland
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Orcutt VL, James K, Bradley-Guidry C, Jones PE. Similarities and Differences Between Physician Assistant Program and Medical School Mission Statement Themes. J Physician Assist Educ 2018; 29:7-11. [PMID: 29461451 DOI: 10.1097/jpa.0000000000000178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study was to examine the concordance of US physician assistant (PA) program mission statements with those of US public- and private-sponsored medical schools. With the exception of a broader medical school focus on research, the authors hypothesized that little difference in mission statement congruence would be found in a comparison of medical schools and PA programs. METHODS Mission statements of 209 of the 210 accredited US PA programs as of May 2016 were obtained and analyzed. Keywords and phrases were identified, coded, and analyzed using NVivo. Themes that previously reported medical school mission statement analyses (including education, research, service, primary care, diversity, prevention, provider distribution, and cost control) were examined. Additional themes of evidence-based medicine (EBM), interprofessional care, patient safety, and quality improvement were included in the analyses. RESULTS Analyses revealed similar emphasis in both PA programs and medical schools on themes of education, prevention, and cost control, with dissimilar emphases on themes of research, service, primary care, diversity, and provider distribution. Physician assistant programs were more likely to emphasize interprofessional care than EBM, patient safety, or quality improvement. CONCLUSIONS In the comparison of mission statements of medical schools and PA programs, much less congruence was found than had been hypothesized. Although this study examined the similarities and differences between the mission statements of US medical schools and PA programs, it did not examine the extent to which programs succeeded in meeting the stated missions. Additional research is necessary to understand the factors that determine whether mission statements are actualized in measurable deliverables.
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Affiliation(s)
- Venetia L Orcutt
- Venetia L. Orcutt, PhD, is an associate professor for the Department of Physician Assistant Studies at the University of Texas Southwestern Medical Center, Dallas, Texas. Kassidy James, MHS, is an assistant professor and associate academic coordinator for the Department of Physician Assistant Studies at the University of Texas Southwestern Medical Center, Dallas, Texas. Carolyn Bradley-Guidry, MPAS, PA-C, is a clinical assistant professor for the Department of Physician Assistant Studies at the University of Texas Southwestern Medical, Center, Dallas, Texas. P. Eugene Jones, PhD, PA-C, is a professor emeritus, Department of Physician Assistant Studies at the University of Texas Southwestern Medical Center, Dallas, Texas
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Moxham BJ, Pais D. A critique of utilitarian and instrumentalist concepts for the teaching of gross anatomy to medical and dental students: Provoking debate. Clin Anat 2017; 30:912-921. [DOI: 10.1002/ca.22953] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/12/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Bernard J. Moxham
- Cardiff School of Biosciences, Cardiff University, Cardiff; CF10 3AX Wales United Kingdom
- Anatomical Sciences, St George's University; Grenada West Indies
| | - Diogo Pais
- NOVA Medical School NOVA University of Lisbon; 1169-056 Lisboa Portugal
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12
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Kim DH, Hwang J, Lee S, Shin JS. Institutional factors affecting participation in national faculty development programs: a nation-wide investigation of medical schools. BMC MEDICAL EDUCATION 2017; 17:48. [PMID: 28245868 PMCID: PMC5331658 DOI: 10.1186/s12909-017-0888-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/20/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Medical schools have used faculty development programs as an essential means to improve the instruction of faculty members. Thus far, however, participating in such programs has been largely voluntary for individuals even though a certain degree of participation is required to achieve practical effectiveness. In addition, the learning behaviors of faculty members are known to be influenced by organizational contexts such as a hidden curriculum. Therefore, this study explored the organizational characteristics of medical schools affecting attendance at faculty development programs. METHODS Forty medical schools in South Korea were included in this study. In total, 1,667 faculty members attended the faculty development programs at the National Teacher Training Center for Health Personnel between 2007 and 2015. For independent variables, information on the basic characteristics and the educational states was collected from all the medical schools. Themes were identified from their educational goals and objectives by inductive content analysis. RESULTS The number of nine-year cumulative attendees from medical schools ranged from 8 to 104. The basic characteristics of the medical schools had little influence on faculty development program attendance, while several themes in the educational goals and objectives, including "cooperation", "serving various societies", and "dealing with a changing future" showed a significant difference in participation. The number of full-time faculty showed a significant positive correlation when it was smaller than the median, and the proportion of alumni faculty showed a significant negative correlation when it was higher than 50%. CONCLUSIONS This study adds to existing knowledge on factors affecting attendance at faculty development programs by identifying related institutional factors that influence attendance. While the variations depending on the basic characteristics were minimal, the organizational environment surrounding medical education significantly contributed to attendance. Addressing institutional as well as individual factors could contribute to improving participation by faculty members in faculty development programs.
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Affiliation(s)
- Do-Hwan Kim
- Department of Medical Education, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080 Republic of Korea
| | - Jinyoung Hwang
- Department of Educational Psychology, The University of Texas at Austin, 1 University Station, MS/D5800, Austin, TX 78712 USA
| | - Seunghee Lee
- Department of Medical Education, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080 Republic of Korea
| | - Jwa-Seop Shin
- Department of Medical Education, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080 Republic of Korea
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Hong S, Cagle JG, Plant AJ, Culler KL, Carrion IV, Van Dussen DJ. Quality of death among hospice decedents: Proxy observations from a survey of community-dwelling adults in the contiguous United States. DEATH STUDIES 2016; 40:529-537. [PMID: 27260970 DOI: 10.1080/07481187.2016.1188867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study examines hospice service experience and quality of death. A survey of 123 community-dwelling adults in the United States found that physical comfort, pain-free, and spiritual peace were more important to respondents reporting a personal experience with hospice. A "good death" was associated with older patients who died at home, and respondent satisfaction with hospice service. A "good death" was mapped as 29 nodes and 79 links using semantic network analysis. Three subjects (patient, family, hospice), three timeframes (end-of-life, moment of dying, death), and four central causes (home, peaceful, pain-free, and expected) were identified.
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Affiliation(s)
- Seokho Hong
- a School of Social Work , University of Maryland-Baltimore , Baltimore , Maryland , USA
| | - John G Cagle
- a School of Social Work , University of Maryland-Baltimore , Baltimore , Maryland , USA
| | - Amy J Plant
- b Department of Gerontology , Youngstown State University , Youngstown , Ohio , USA
| | - Krystal L Culler
- c College of Health Solutions, Doctor of Behavioral Health Program , Arizona State University , Phoenix , Arizona , USA
| | - Iraida V Carrion
- d School of Social Work , University of South Florida , Tampa , Florida , USA
| | - Daniel J Van Dussen
- b Department of Gerontology , Youngstown State University , Youngstown , Ohio , USA
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14
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Dupper M, Millard H, Lyons P. Shifting concepts, changing contexts: the new schools' drive for change. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2016; 21:131-139. [PMID: 26164284 DOI: 10.1007/s10459-015-9619-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 06/19/2015] [Indexed: 06/04/2023]
Abstract
Seventeen new medical schools were founded in the US and Canada in the decade prior to 2014. These new medical schools continue the tradition of utilizing mission statements (MSs) to convey goals and ideals. The authors aimed to compare these 17 new medical schools' MSs with MSs of previously established medical schools in the US and Canada. The MSs of the 17 newest medical schools were processed and analyzed utilizing network text analysis software that assessed centrality of concepts within new medical schools' MSs. This semantic network data was then compared to existing similar analysis by Grbic et al. (Acad Med 88(6):852-860, 2013. doi: 10.1097/ACM.0b013e31828f603d ). Four concepts were found to be more central in new medical schools' MSs as compared to established medical schools' MSs: "physicians," "improve," "diversity," and "innovation." Grbic et al. found four concepts to be central to all 132 medical schools "health" or "health_care," "research," "education," and "premier" which are shared top themes of the new medical schools' MSs. The author's analysis has demonstrated that new medical schools, as compared to previously established subsets of medical schools, developed both shared and unique language within their MSs. This unique vocabulary reflected a response to a dynamic healthcare environment during the decade of new medical school development. New medical schools may have responded to environmental challenges including a physician shortage while also recognizing the need for a diverse physician workforce prepared to apply innovative strategies to healthcare.
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Affiliation(s)
- Maegen Dupper
- University of California, Riverside School of Medicine, Riverside, CA, USA.
| | - Heidi Millard
- University of California, Riverside School of Medicine, Riverside, CA, USA.
| | - Paul Lyons
- University of California, Riverside School of Medicine, Riverside, CA, USA.
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15
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Ineichen C, Christen M. Analyzing 7000 texts on deep brain stimulation: what do they tell us? Front Integr Neurosci 2015; 9:52. [PMID: 26578908 PMCID: PMC4620160 DOI: 10.3389/fnint.2015.00052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 09/27/2015] [Indexed: 01/15/2023] Open
Abstract
The enormous increase in numbers of scientific publications in the last decades requires quantitative methods for obtaining a better understanding of topics and developments in various fields. In this exploratory study, we investigate the emergence, trends, and connections of topics within the whole text corpus of the deep brain stimulation (DBS) literature based on more than 7000 papers (title and abstracts) published between 1991 to 2014 using a network approach. Taking the co-occurrence of basic terms that represent important topics within DBS as starting point, we outline the statistics of interconnections between DBS indications, anatomical targets, positive, and negative effects, as well as methodological, technological, and economic issues. This quantitative approach confirms known trends within the literature (e.g., regarding the emergence of psychiatric indications). The data also reflect an increased discussion about complex issues such as personality connected tightly to the ethical context, as well as an apparent focus on depression as important DBS indication, where the co-occurrence of terms related to negative effects is low both for the indication as well as the related anatomical targets. We also discuss consequences of the analysis from a bioethical perspective, i.e., how such a quantitative analysis could uncover hidden subject matters that have ethical relevance. For example, we find that hardware-related issues in DBS are far more robustly connected to an ethical context compared to impulsivity, concrete side-effects or death/suicide. Our contribution also outlines the methodology of quantitative text analysis that combines statistical approaches with expert knowledge. It thus serves as an example how innovative quantitative tools can be made useful for gaining a better understanding in the field of DBS.
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Affiliation(s)
- Christian Ineichen
- Institute of Biomedical Ethics and History of Medicine, University of Zurich Zurich, Switzerland ; Preclinical Laboratory for Translational Research into Affective Disorders, Clinic for Affective Disorders and General Psychiatry, Psychiatric University Hospital Zurich Zurich, Switzerland
| | - Markus Christen
- Institute of Biomedical Ethics and History of Medicine, University of Zurich Zurich, Switzerland ; University Research Priority Program Ethics, University of Zurich Zurich, Switzerland
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16
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Drake RL, McBride JM, Pawlina W. An update on the status of anatomical sciences education in United States medical schools. ANATOMICAL SCIENCES EDUCATION 2014; 7:321-5. [PMID: 24895314 DOI: 10.1002/ase.1468] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/06/2014] [Accepted: 05/22/2014] [Indexed: 05/28/2023]
Abstract
Curricular changes continue at United States medical schools and directors of gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses continue to adjust and modify their offerings. Developing and supplying data related to current trends in anatomical sciences education is important if informed decisions are going to be made in a time of curricular and course revision. Thus, a survey was sent to course directors during the 2012-2013 academic years to gather information on total course hours, lecture and laboratory hours, the type of laboratory experiences, testing and competency evaluation, and the type of curricular approach used at their institution. The data gathered were compared to information obtained from previous surveys and conclusions reached were that only small or no change was observed in total course, lecture and laboratory hours in all four courses; more gross anatomy courses were part of an integrated curriculum since the previous survey; virtual microscopy with and without microscopes was the primary laboratory activity in microscopic anatomy courses; and neuroscience/neuroanatomy and embryology courses were unchanged.
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Affiliation(s)
- Richard L Drake
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio
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