Faculty Bibliography

RATIONAL AND OBJECTIVE/OBJECTIVE:Formative feedback is an important strategy to improve resident learning. The purpose of our study is to evaluate the impact on frequency, quality and perceptions of resident formative feedback after implementation of a diagnostic breast imaging specific entrustable professional activity based mid-rotation checklist. MATERIAL AND METHODS/METHODS:In this IRB-approved multicenter study, a six-step methodology was used to develop the validated EPA based checklist, participant pre- and post-implementation surveys, and analyze the collected data. RESULTS:26 out of 32 (81%) residents and 7 out of 9 (78%) teaching attendings found the structured feedback checklist helpful in evaluating residents' performance on the diagnostic breast imaging rotation. 9 of 9 (100%) attending stated it improved their ability to give specific, timely, actionable and thoughtful feedback and 6 of 9 (67%) agreed that their feedback was more structured. 27 of 32 (84%) residents found that the feedback they received allowed them to tailor their studying to areas that needed improvement during the remainder of their rotation. CONCLUSION/CONCLUSIONS:Mid-rotation feedback using a structured EPA-based checklist improves the frequency and quality of resident formative feedback from both a residents' and attendings' perspective.

INTRODUCTION/UNASSIGNED:Medical students' accounts of gender bias in their patient care learning experiences remain limited. This study examines students' responses to gender bias and their consideration for how to prepare for gender bias in their futures. METHODS/UNASSIGNED:We analyzed reflective writings of third-year clinical students. Within a phenomenology framework, conventional content analysis was used to inductively analyze all essays, using HyperResearch software. We coded in teams and reconciled disagreements, then combined codes in categories to identify themes. RESULTS/UNASSIGNED:Sixty-seven students (39 females; 28 males) wrote about gender bias in patient encounters. We identified five themes: bias, context, students' responses to patients' bias, patient-centered approach, and preparation for future encounters. Observations of bias addressed gender and structural bias, sexism, and racism. Students reflected on how context framed their experiences. Students aimed for patient-centered care, while simultaneously feeling ambivalence regarding patients' expressed bias. Students described their need to prepare for future experiences of gender bias and their plans to use specific strategies to cope with this bias. DISCUSSION/UNASSIGNED:Our study offers the voices of medical students regarding gender bias in their clinical learning, presenting an important perspective, given an often-hierarchical system of medical education. This examination, which includes recommendations for curricula and policies, informs education leaders of the need to incorporate preparation for dealing with gender bias and to help students personally as they face challenging encounters with patients and medical teams. Enlightened by critical theories, these findings should also motivate resident and faculty development and promote critical inquiry for institutional changes.

JBJS convened a symposium to discuss the reporting of sex and gender in research studies as an imperative to improve research methods and results to benefit all patients. Barriers to improved reporting include a lack of societal and cultural acceptance of its need; a lack of education regarding appropriate terminology and appropriate statistical methods and efficient study designs; a need for increased research funding to support larger group sizes; unknown concordance of cell and animal models with humans to reflect biologic variables such as sex; and a lack of understanding of key considerations of gender, race, and other social determinants of health and how these factors intersect. Attention to developing and disseminating best-practice statistical methods and to educating investigators (at all career levels), reviewers, funders, editors, and staff in their proper implementation will aid reporting. Concomitantly, well-designed studies with sufficient rigor and adequate resources are essential to enable meaningful and reproducible research. Existing recommendations, such as the Sex and Gender Equity in Research (SAGER) guidelines, provide valuable guidance that can be applied across the research ecosystem. Academic institutions and private foundations are likely groups to assist in scientific and institutional review board guidance and study recruitment and pilot funding to generate meaningful power estimates, and to serve as sources for additional funding and presentation of workshops, educational events, and seminars. All of this needs to be conducted on an ongoing basis to ensure that sex and gender are considered in scientific analyses, where relevant.

Sex and gender impact all areas of health. However, they are not consistently considered in research design. The lack of a sufficient research base regarding the impacts of sex or gender affects the ability to develop health-care professional curricula that include this content for learners across the spectrum of experience. Teaching the importance of sex and gender is critical in training the next generations of health-care professionals and researchers. In addition to improving the current research base, there is a need to raise awareness of this topic among faculty and a need for additional faculty development materials. Learners, clinical faculty, researchers, journal reviewers, and journal leadership all play a role in improving the knowledge base regarding sex and gender and subsequently incorporating this information into curricula.

OBJECTIVE:To perform a qualitative content analysis of learning and assessment strategies that pediatric subinterns describe in Individualized Learning Plans (ILPs) and to explore barriers and facilitators to their learning. METHODS:We analyzed ILPs from medical students enrolled in pediatric subinternships at 10 US medical schools that utilized a standardized curriculum and were recruited to reflect diversity in geographic location, funding, and enrollment. Students used an ILP to record 3 or more selected learning objectives, rationale for selection, and reflection on learning and assessment strategies. Investigators used the constant comparative method to perform a content analysis of the ILPs, grouping codes into themes, and verifying relationships between codes within themes. RESULTS:Two hundred and four ILPs that included student reflections on 850 learning objectives were analyzed. Content was analyzed in 5 categories: rationale for selecting objectives, learning strategies, assessment strategies, challenges to learning, and facilitators of learning. Students showed strong commitment to individualized, self-directed learning, developed a wide range of creative learning strategies, and relied heavily on self-reflection to assess their progress. The learning environment both helped and hindered students' ability to make and assess progress on their selected learning objectives. CONCLUSIONS:Through ILP-guided reflection and a formal curriculum, students can choose well-justified learning objectives and demonstrate resourcefulness and independence in developing self-directed learning and assessment strategies. The strategies that students identified in this study provide a menu of learning and assessment options for subinterns. Identified challenges and facilitators of learning provide guidance for educators who seek to enhance the clinical learning environment.

INTRODUCTION/UNASSIGNED:Trainees and faculty in academic medicine often struggle with self-promotion. Barriers may be more formidable for women and other groups underrepresented in medicine. Experience-based stories illustrating personal strengths are preferable when engaging in self-promotion activities. METHODS/UNASSIGNED:) and free-response evaluations, which we analyzed for workshop strengths and areas for improvement. RESULTS/UNASSIGNED:= 4.7). Strengths included the PAR format, interactivity, journaling, opportunity for reflection, and tips for interviewing and writing. Areas to improve included offering the workshop earlier in the academic year and providing more written examples of PAR stories. DISCUSSION/UNASSIGNED:This workshop used strategies of personal reflection, journaling, and peer feedback to help participants understand behavior-based recruiting practices and the PAR framework as a strategy for successful self-promotion. Learners can use these strategies to develop greater confidence and efficacy and to address barriers to effective self-promotion they encounter.

OBJECTIVE:In 2006 the Association of American Medical Colleges recommended standardization of documentation of the contributions of medical educators and guidelines for their academic promotion. The authors characterized current United States (US) medical school promotion guidelines for medical educators. METHODS:Authors collected publicly available data from medical school promotion websites from March through July 2022 after determining categories by traditional-set domains as well as peer-reviewed standards. Extracted data were analyzed using descriptive and inferential statistics, and frequencies were calculated for nominal and categorical data. RESULTS:Of 155 medical schools identified, promotion criteria were publicly available for 143 (92%) schools. Ninety-one (64%) schools identified a distinct educator track. Of those with a defined educator track, 44 (48%) schools consider workshops or other media when evaluating candidates for promotion, and only 52 (57%) of schools with a specified educational track require additional documentation of teaching or education as part of their promotion process. Notably, 34 (37%) of the 91 schools with an educator track specifically require an Educational Portfolio, compared to 27 (52%) of the 52 schools that do not have a specific educator track for promotion. CONCLUSION/CONCLUSIONS:This study describes the current lack of clarity and consistency of the promotion criteria for medical educators and indicates that the guidelines proposed by the Association of American Medical Colleges over 15 years ago have not been widely adopted. These data amplify previous calls for a more objective set of criteria for evaluating and recognizing the contributions of medical educators.

RATIONALE AND OBJECTIVES/OBJECTIVE:While the ACGME requires Resident as Teacher (RAT) training, curricula in radiology remain limited. Our study was performed to examine radiology residents (RR) and teaching faculty (TF) perceptions about RAT training. MATERIALS AND METHODS/METHODS:In 2021, anonymous online surveys were administered to all RR (53-item) and to all TF (24-item) of a radiology residency program. Content domains included attitudes about RAT training and learning topics. RESULTS:Response rates were 97% (38/39) for RR and 54% (58/107) for TF. Most RR desired training to become better educators to medical students (MS) (81%) and other residents (83%). Seventy-seven percent of RR reported the importance regarding how to give feedback to other learners, while 94% desired formal training on delivering case presentations. While 94% of RR reported that resident feedback was valuable, only 6% reported always giving feedback to MS. Seventy-two percent of RR did not apply at least some best-practices in their reading room teaching. Fifty-nine percent of RR wanted TF to observe their own teaching skills and provide feedback although 70% reported rarely or never receiving TF feedback. Ninety-three percent of TF reported RR should receive RAT training, while 88% reported that feedback of RR to MS was important. CONCLUSION/CONCLUSIONS:RR and TF strongly endorsed the need for RAT training. RR anticipate teaching to be an important part of their careers. We identified learning topics and possible gaps regarding how TF are meeting RR needs, which could inform the development of RAT curricula.

Introduction: Increases in vaccine hesitancy continue to threaten the landscape of public health. Literature provides recommendations for vaccine communication and highlights the importance of patient trust, yet few studies have examined medical student perspectives on vaccine hesitancy in clinical settings. Therefore, we aimed to explore medical student experiences encountering vaccine hesitancy, mistrust, and personal biases, with the goal of informing medical student education. Methods: A health disparities course including simulated clinical scenarios required students to complete a written reflection. We sorted reflections written in 2014-2016 to identify common topics and used inductive thematic analysis to identify themes relevant to vaccine hesitancy by group consensus. Results: Our sample included 84 de-identified essays sorted into three non-exclusive topics: vaccine hesitancy (n=42), mistrust (n=34), and personal bias (n=39). We identified four themes within medical students"™ reflections: 1) Building a Relationship, including emphasis on patient-centred approaches; 2) Preparedness and Need to Prepare for Future Encounters, including highlighting gaps in medical education; 3) Reactions to Encountering Hesitant Patients, including frustration; 4) Insights for Providing Information and Developing a Plan with Hesitant Patients, including approaches to presenting knowledge. Conclusion: Reflections in the context of simulated encounters and discussion are useful in students identifying their preparedness for vaccine discussion with patients. Student reflections can assist educators in identifying missing educational frameworks for particular scenarios such as vaccine hesitancy. Without a structured framework regarding addressing vaccine hesitancy, students draw upon other skills that may contradict recommended practices.