Faculty Bibliography

The authors created Geriatrics Connect (GeriConnect), a program for first-year medical students at NYU Grossman School of Medicine to learn about healthy aging by developing a 7-month long telephonic relationship with an older adult living in the community. Background and Objectives: Early exposure to geriatrics and older adults is instrumental to preparing future physicians to care for the aging population. The objective of this study was to evaluate how the GeriConnect program affected students' attitudes on aging and ageism. Design: Paired students conducted monthly telephone or video calls with a geriatric patient recruited from the NYU Internal Medicine outpatient practice and wrote required reflections on ageism. Participants: 99 first-year medical students at NYU Grossman School of Medicine. Measurements: Student reflection essays were descriptively coded by five independent reviewers. Results: Thematic analysis revealed that many students had limited exposure to older adults prior to starting medical school, and suggested that the longitudinal relationships developed in the program improved students' understanding of aging and ageism. Conclusion: Establishing longitudinal telephonic relationships with older adults may be an effective method of enhancing student exposure to geriatrics and fostering more positive attitudes toward older adults.

This report describes a delayed recognition of mpox in a patient admitted to an inpatient psychiatry unit, resulting in potential exposures to staff and patients. We detail the investigation and risk mitigation efforts and emphasize the importance of prompt identification and isolation in congregate healthcare settings to prevent transmission.

INTRODUCTION/UNASSIGNED:In response to accreditation bodies requiring health disparities curricula, medical educators are tasked with incorporating structural competency, the understanding of how social and structural barriers like structural racism impact health, into their teaching. Most have not received training in this area, yet there remains a scarcity of faculty development curricula to address this gap. We describe the creation, implementation, and evaluation of a faculty development workshop series rooted in the framework of structural competency. METHODS/UNASSIGNED:test. RESULTS/UNASSIGNED:< .001) incorporating structural competency. DISCUSSION/UNASSIGNED:Our application of structural competency to faculty workshops and teaching tools feasibly engages faculty in instruction to incorporate concepts of structural racism and the downstream effects of social determinants of health into clinical teaching. It represents an innovative tool as we seek to enhance clinical teaching to improve care for racially and ethnically minoritized communities.

Access to an academic clinical research center (CRC) in health professional shortage areas (HPSA) can help address healthcare disparities and increase research accessibility and enrollment. Here we describe the development of a community-centered CRC in the underserved area of Sunset Park, Brooklyn, New York, centered within a larger academic health network and the evaluation of its outcomes within the first two years. In addition to resources and space, establishment of the CRC required a culturally competent and multilingual team of healthcare professionals and researchers and buy-in from the community. Between 1/2022 and 12/2023, the CRC opened 21 new trials (10 interventional and 11 noninterventional) with greater than 500 participant visits that reflect the racial and ethnic diversity of the community. These participants represent 110 distinct zip codes; 76% of these zip codes are underserved and designated HPSA. 60% self-identified as non-White and 20% identified as Hispanic, with 12 other distinct ethnicities represented. 28% of participants speak 11 languages other than English. Community-based CRCs can be created with sustainable growth to align with the mission of the National Institutes of Health and U.S. Food and Drug Administration to meet the ever-growing clinical, social, and research needs of the communities they serve.

In this introduction, the guest editors of the "Next Era in Assessment" special collection frame the invited papers by envisioning a next era in assessment of medical education, based on ideas developed during a summit that convened professional and educational leaders and scholars. The authors posit that the next era of assessment will focus unambiguously on serving patients and the health of society, reflect its sociocultural context, and support learners' longitudinal growth and development. As such, assessment will be characterized as transformational, development-oriented and socially accountable. The authors introduce the papers in this special collection, which represent elements of a roadmap towards the next era in assessment by exploring several foundational considerations that will make the next era successful. These include the equally important issues of (1) focusing on accountability, trust and power in assessment, (2) addressing implementation and contextualization of assessment systems, (3) optimizing the use of technology in assessment, (4) establishing infrastructure for data sharing and data storage, (5) developing a vocabulary around emerging sources of assessment data, and (6) reconceptualizing validity around patient care and learner equity. Attending to these priority areas will help leaders create authentic assessment systems that are responsive to learners' and society's needs, while reaping the full promise of competency-based medical education (CBME) as well as emerging data science and artificial intelligence technologies.

INTRODUCTION/UNASSIGNED:Over the past decade, the growth of accelerated three-year MD (3YMD) programs has flourished. In 2015, with support from the Josiah Macy Jr. Foundation, the Consortium of Medical Pathway Programs (CAMPP) started with eight North American medical schools. The objective of this paper is to evaluate the current state of the 3YMD programs. MATERIAL AND METHODS/UNASSIGNED:Since 2015, the CAMPP has tracked new and prospective 3YMD programs. An electronic survey collecting curricular and programmatic information about the programs was disseminated to all members of the CAMPP in August 2023. The survey included elements related to year of initiation, number of graduates, and curricular elements. RESULTS/UNASSIGNED:Of the schools with known established three-year MD programs, 29 of 32 programs responded (response rate 90%). There is growth of Accelerated Medical Pathway Programs over time with almost 20% of United States Allopathic Medical Schools having or developing an accelerated program. There have been 817 graduates from these programs from 2013-2023. Most schools include an opportunity for a 'directed pathway' experience for students. A directed pathway is where a student completes the MD degree in three-years and then has a direct placement into an affiliated residency program, provided they meet the goals and objectives of the curriculum. Most of the schools report a mission to reduce medical student debt and build a workforce for a specialty, for a population of patients, or geographical distribution. CONCLUSIONS/UNASSIGNED:Accelerated three-year medical pathway programs have grown significantly over the last decade, consistent with an overall effort to redesign medical curricula, reduce debt and contribute to the workforce.

INTRODUCTION/UNASSIGNED:Addressing systemic bias in medical school assessment is an urgent task for medical education. This paper outlines recommendations on topic areas for further research on systemic bias, developed from a workshop discussion at the 2023 annual meeting of the Society of Directors of Research in Medical Education. MATERIALS AND METHODS/UNASSIGNED:During the workshop, directors engaged in small-group discussions on guidelines to address bias in assessment practices following a proposed categorization of 'Do's,' 'Don'ts,' and 'Don't knows' and listed their insights using anonymous sticky notes, which were shared and discussed with the larger group of participants. The authors performed a content analysis of the notes through deductive and inductive coding. We reviewed and discussed our analysis to reach consensus. RESULTS/UNASSIGNED:The workshop included 31 participants from 28 institutions across the US and Canada, generating 51 unique notes. Participants identified 23 research areas in need of further study. The inductive analysis of proposed research areas revealed four main topics: 1) The role of interventions, including pre-medical academic interventions, medical-education interventions, assessment approaches, and wellness interventions; 2) Professional development, including the definition and assessment of professionalism and professional identity formation; 3) Context, including patient care and systemic influences; and 4) Research approaches. DISCUSSION/UNASSIGNED:While limited to data from a single workshop, the results offered perspectives about areas for further research shared by a group of directors of medical education research units from diverse backgrounds. The workshop produced valuable insights into the need for more evidence-based interventions that promote more equitable assessment practices grounded in real-world situations and that attenuate the effects of bias.

CONTEXT/BACKGROUND:Over 200 000 people seeking asylum have arrived in New York City from 2022 to 2024. PROGRAM/METHODS:As the safety net hospital system for our city, New York City (NYC) Health + Hospitals (H + H) has taken the lead in caring for newly arrived asylum seekers. We used electronic medical record data to gain early insights into utilization and needs among these patients. IMPLEMENTATION/METHODS:We developed a hybrid definition to identify patients who are asylum seekers and examined their demographics, insurance, utilization, primary billing diagnoses, and immunizations from the Epic EMR. We included data on other patients as a point of comparison and analyzed data separately for adult and pediatric patients. EVALUATION/RESULTS:In 2023, 15 233 or 1.4% of H + H patients were asylum seekers. Asylum seekers had fewer visits than other patients in 2023, and utilization was particularly driven by pregnancy and childbirth. Children seeking asylum were engaged in primary care at high rates. Documented childhood vaccinations were higher among asylum-seeking children engaged in primary care compared to those who were not. The majority of adults and children were insured. Adult primary care engagement was low, as were visits for those seeking care for behavioral health issues. DISCUSSION/CONCLUSIONS:For adult asylum seekers, pregnancy and childbirth are key needs for adults. Increasing vaccination rates among children is critical and promoting engagement in primary care is a promising way to do so. Coordinated efforts are required to meet the varied needs of migrant arrivals, and safety net hospitals can play a key role in addressing their health care needs.

BACKGROUND:Structured faculty development programs focused on integrating health equity into medical education curricula remain limited. AIM/OBJECTIVE:To describe an interdisciplinary faculty development program grounded in adult learning theory and to assess its impact on participants' professional growth. SETTING AND PARTICIPANTS/METHODS:Twenty-one faculty members across six academic-affiliated health systems. PROGRAM DESCRIPTION/METHODS:Fourteen 2-h monthly sessions were delivered over one full year. Course topics included health equity, adult learning theory, curriculum development, implicit bias, social determinants of health, racism, oppression, and collaborating with community partners. Educational strategies included reflections, small group discussions, logic models, and capstone development. PROGRAM EVALUATION/RESULTS:Using a Likert-type scale, participants rated all aspects of the program highly favorably, with median ratings ranging from 4 (agree) to 5 (strongly agree). Focus group results demonstrated that faculty experienced well-needed personal empowerment and professional growth in unexpected ways and identified several opportunities for programmatic growth. DISCUSSION/CONCLUSIONS:Program strengths included its interdisciplinary nature, creating a space to address isolation experienced by faculty working to advance health equity within their departments, advancement of skills to integrate health equity into their teaching contexts, and the opportunity for participants to envision their scholarship as part of a more extensive approach within the social determinants of health, health equity, and community health framework.