Professional development for clerkship administrators: a 16-year overview of the clerkship administrator certificate program

Background: Increasing accreditation requirements as well as transformations in medical school curricula necessitate administrative staff who are not only invested in the clerkship coordinator role but also view what they do as a career. To date, there has been a lack of professional development opportunities for clerkship administrators. Methods: In 2003, the Central Group on Educational Affairs of the Association of American Medical Colleges recognized a need for professional development for clerkship administrators. The Clerkship Administrator Certificate Program emerged from that decision and presented for the first time in 2004 in Omaha, Nebraska. This article provides an overview of the program, how it has been evaluated, and how it continues to evolve. Results: The program had two guiding principles: to offer professional development opportunities for clerkship administrators through interactive workshops and to ensure the program was feasible both in terms of completion and in cost. Over the past 16 years, the Clerkship Administrator Certificate Program workshops have been delivered to over 300 clerkship administrators. Of those, 206 have completed a project in order to receive their certificate. Projects have related to innovations in medical education (n = 41), grading (n = 26), professional development (n = 26), and patient care (n = 20) to name a few. Discussion: In order to meet the demands for presenting the workshops, a train-the-trainer model has been employed to expand the number of individuals presenting the workshops. Additional research needs to be done to determine influence of the program on future professional development endeavors

The Relationship of Emotions and Burnout to Medical Student's Academic Performance

Phenomenon: Medical school curricula challenge even the most adept learner, potentially leading to feelings of burnout. When faced with uncertainties in a new curriculum, confidence in achieving academic goals may be threatened. We previously found associations between academic performance and pride, hope, anxiety, and shame in medical students. Are these emotions still associated in the context of an evolving curriculum? Approach: All 1st- and 2nd-year medical students were invited to participate in a survey study (n = 264). Year 1 students were in the first semester of the new curriculum. The Hope, Pride, Shame, and Anxiety subscales of the Achievement Emotions Questionnaire and the Maslach Burnout Inventory (MBI) General Survey for Students were administered in fall 2017. Academic performance (semester overall percentage) was matched to participants completing all 4 questionnaires. Descriptive and inferential statistics were used to analyze the results. Findings: Response rates for those who completed every survey administered was 18.5%. Combined data from the classes revealed relationships between academic performance with MBI subscale-professional efficacy (r = .577), hope (r = .497), pride (r = .411), anxiety (r = −.307), and shame (r = −.402). Upon analyzing data from each class, professional efficacy (M1: r = .535; M2: r = .674) and pride (M1: r = .591; M2: r = .450) were correlated to academic performance. In a stepwise regression model, professional efficacy was the only predictor of academic performance (B = .560, t = 3.82, R2 = .31). Insights: When faced with challenges from medical school, positive emotions strengthen self-efficacy, allowing students to identify strategies to accomplish academic goals. Although it is important to acknowledge the emotions that students experience, our finding that professional efficacy was the most significant predictor of academic performance suggests the need for strategies to enhance self-efficacy. Use of flipped classrooms or problem-based learning offers opportunities for cognitive appraisal to foster their self-efficacy

Faculty bridging individual and organizational resilience: results of a qualitative analysis

Background: Medical student burnout and anxiety has received growing attention in the past decade. The culture of competition and assessment has resulted in increasing stress levels amongst medical students, causing a decline in their academic performance and overall mental health. The objective of this qualitative analysis was to characterize recommendations from educational experts to aid students’ academic progress. Methods: At an international meeting in 2019, worksheets were completed by medical educators during a panel discussion. Participants responded to four scenarios representing common challenges medical students face in school (eg. Postponing Step 1, failing clerkships, etc.). For each case, participants addressed what students, faculty and medical schools could do to mitigate the challenge. Inductive thematic analysis was conducted by two authors followed by deductive categorization using an individual-organizational resilience model. Results: Across the four cases, common suggestions made for students, faculty and medical schools were aligned to a resilience model representing the complex interplay between individuals and organizations and the impact on student wellbeing. Discussion: Using suggestions from medical educators from across the US, we were able to identify recommendations for students, faculty, and medical schools to help students succeed in medical school. By applying a model of resilience, faculty serve as a critical bridge to connect students to the medical school administration. Our findings also support a pass/fail curriculum to ease the competition and burden students place on themselves

Establishing Regional Medical Campuses to Ensure Comparable Experiences: Recommendations From a Narrative Review

Background: Given increasing class sizes and desires to keep costs down, many medical schools are developing regional clinical campuses. We found our regional campus system to be very successful in allowing class size expansion, inspiring a workforce for the state, and concurrently allowing our students to individualize their experience. We desire to articulate our experience, with a review of the relevant evidence, with the goal of assisting other medical schools in their efforts to develop regional medical campuses. Methods: We conducted a narrative literature review to identify considerations for developing regional campuses, taking into consideration our experiences in the process. A medical librarian undertook a literature search for the purposes of this narrative review. Results: Of the 61 articles identified, 14 were included for full-text review. Five facets on branch campus development were identified: relationships, infrastructure, curriculum, recruitment, and accreditation. Within each of these facets we provide further details based on findings from the literature complemented by our experience. Conclusions: Launching a regional campus requires building relationships with clinical partners, ensuring an infrastructure that supports student need and accreditation, comparable curriculum with the same objectives and assessment measures, and aspects of the experience that inspire a student desire to learn in that setting. We share our experience in building successful branch campuses, which have added significantly to our large public school of medicine and its service to our state

Characteristics of multi-institutional health sciences education research: a systematic review

Objectives: Multi-institutional research increases the generalizability of research findings. However, little is known about characteristics of collaborations across institutions in health sciences education research. Using a systematic review process, the authors describe characteristics of published, peer-reviewed multi-institutional health sciences education research to inform educators who are considering such projects. Methods: Two medical librarians searched MEDLINE, the Education Resources Information Center (ERIC), EMBASE, and CINAHL databases for English-language studies published between 2004 and 2013 using keyword terms related to multi-institutional systems and health sciences education. Teams of two authors reviewed each study and resolved coding discrepancies through consensus. Collected data points included funding, research network involvement, author characteristics, learner characteristics, and research methods. Data were analyzed using descriptive statistics. Results: One hundred eighteen of 310 articles met inclusion criteria. Sixty-three (53%) studies received external and/or internal financial support (87% listed external funding, 37% listed internal funding). Forty-five funded studies involved graduate medical education programs. Twenty (17%) studies involved a research or education network. Eighty-five (89%) publications listed an author with a master’s degree or doctoral degree. Ninety-two (78%) studies were descriptive, whereas 26 studies (22%) were experimental. The reported study outcomes were changes in student attitude (38%; n=44), knowledge (26%; n=31), or skill assessment (23%; n=27), as well as patient outcomes (9%; n=11). Conclusions: Multi-institutional descriptive studies reporting knowledge or attitude outcomes are highly published. Our findings indicate that funding resources are not essential to successfully undertake multi-institutional projects. Funded studies were more likely to originate from graduate medical or nursing programs

Near-Peer Teaching in Radiology Symposia: A Success Story in Residents as Teachers

INTRODUCTION Peer learning and near-peer teaching have been described in many specialties, less so in Radiology. We present near-peer teaching whereby residents present a series of didactic sessions at the course outset in the form of “symposia” and perform a scholarly activity in the form of teaching. We aim to demonstrate how near-peer teaching in symposia front-loaded within an introductory radiology course can improve medical student satisfaction. METHOD A total of 169 students were enrolled over a period of 3 years, 55 before (2017-2018) and 114 (2018-2020) after the introduction of the symposium. Anonymous course evaluations were collected from all students. In addition, 240 fourth-year medical students who also attended symposium lectures received satisfaction surveys in 2019 and 2020. RESULTS All (169/169, 100%) students taking the course evaluated it. Overall evaluation scores rose from 8.3/10 to 9.0/10 post-symposia. Among student satisfaction surveys, 89/240 (37%) specifically commented on symposia; 91% (80/89) of those found symposia very or extremely informative. 29/71 (41%) of all residents were able to participate in the symposia, 20/29 in multiple years throughout residency, allowing them to fulfill the Accreditation Council for Graduate Medical Education interpersonal and communication skills core competencies and meet scholarly activity requirements. CONCLUSION Near-peer teaching in the form of resident-taught interactive didactics grouped in symposia can have a positive outcome on medical student satisfaction

Aligning Medical Student Curriculum with Practice Quality Goals: Impacts on Quality Metrics and Practice Capacity for Students

The practice of medicine occurs primarily in the ambulatory environment where providers have many competing demands, including health record documentation and patient volume expectations. Subsequently, medical student education has not been a priority for providers, health systems, or community practices. Yet, accrediting and professional organizations, such as the Association of American Medical Colleges, American Academy of Family Physicians, Ambulatory Pediatric Association, Society of General Internal Medicine, and the Liaison Committee on Medical Education, recommend education in ambulatory settings

Rules of Engagement: Implementing Student-Centered Learning in Breast Imaging

In response to changing learner needs, our institution launched a new translational curriculum wherein basic sciences and clinical skills were integrated, longitudinal patient care experiences provided, and earlier opportunities in specialty fields introduced to better inform residency program decisions. Medical students taking the breast imaging elective were enrolled in a breast imaging immersive experience designed to meet the School of Medicine’s core competencies. In focusing the elective on a narrow range of specialized topics and skills, we labeled this experience the Breast Imaging Boot Camp. Outcome data from March 6, 2017, to April 26, 2019, have been analyzed for this report. The modifications made to the elective include: e-mailing a detailed orientation document to students prior to the start of the rotation; assigning students to diagnostic, procedural, and screening roles; the attendance of students at introductory radiology symposia; students’ weekly attendance at institutional multidisciplinary and divisional breast radiologic–pathologic correlation conferences; student self-study assignments using faculty-vetted resources; student participation in breast biopsy simulation and small parts ultrasound laboratories; the development of a student-centric radiology educational website; and student-directed publishing of digital case files. Medical student feedback and course analytics indicated superior course evaluation scores reinforced by narrative feedback. In website domain utilization data, the breast file domain is the most viewed subspecialty domain. The Breast Imaging Boot Camp is a successful curriculum. Its novelty lies in both its integrated approach to medical student core competencies and its clinician educators’ use of today’s student-favored teaching tools

Evaluating Family Medicine Resident Narrative Comments Using the RIME Scheme

Background In 2013, the Accreditation Council on Graduate Medical Education (ACGME) launched the Next Accreditation System, which required explicit documentation of trainee competence in six domains. To document narrative comments, the University of North Carolina Family Medicine Residency Program developed a mobile application to document real time observations. Objective The objective of this work was to assess if the Reporter, Interpreter, Manager, Expert (RIME) framework could be applied to the narrative comments in order to convey a degree of competency. Methods From August to December 2020, 7 individuals analyzed narrative comments of four family medicine residents. The narrative comments were collected from July to December 2019. Each individual applied the RIME framework to the comments and the team met to discuss. Comments where 5/7 individuals agreed were not further discussed. All other comments were discussed until consensus was achieved. Results 102 unique comments were assessed. Of those comments, 25 (25.5%) met threshold for assessor agreement after independent review. Group discussion about discrepancies led to consensus about the appropriate classification for 92 (90.2%). General comments on performance were difficult to fit into the RIME framework. Conclusions Application of the RIME framework to narrative comments may add insight into trainee progress. Further faculty development is needed to ensure comments have discrete elements needed to apply the RIME framework and contribute to overall evaluation of competence

Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy

Background: There is an ongoing call for leadership development in academic health care and medical students desire more training in this area. Although many schools offer combined MD/MBA programs or leadership training in targeted areas, these programs do not often align with medical school leadership competencies and are limited in reaching a large number of students.Methods:The Leadership Initiative (LI) was a program created by a partnership between a School of Medicine (SOM) and Business School with a learning model that emphasized the progression from principles to practice, and the competencies of self-awareness, communication, and collaboration/teamwork. Through offerings across a medical school curriculum, the LI introduced leadership principles and provided an opportunity to apply them in an interactive activity or simulation. We utilized the existing SOM evaluation platform to collect data on program outcomes that included satisfaction, fidelity to the learning model, and impact.Results:From 2017 to 2020, over 70% of first-year medical students participated in LI course offerings while a smaller percentage of fourth-year students engaged in the curriculum. Most students had no prior awareness of LI course material and were equivocal about their ability to apply lessons learned to their medical school experience. Students reported that the LI offerings provided opportunities to practice the skills and competencies of self-awareness, communication, and collaboration/teamwork.Discussion: Adding new activities to an already crowded medical curriculum was the greatest logistical challenge. The LI was successful in introducing leadership principles but faced obstacles in having participants apply and practice these principles. Most students reported that the LI offerings were aligned with the foundational competencies