Variation in Case Exposure During Internal Medicine Residency.

Importance: Variation in residency case exposure affects resident learning and readiness for future practice. Accurate reporting of case exposure for internal medicine (IM) residents is challenging because feasible and reliable methods for linking patient care to residents are lacking.

Objective: To develop an integrated education-clinical database to characterize and measure case exposure variability among IM residents.

A Rollercoaster of Grades Versus Growth in the Clerkship Year: A Phenomenological Study of Medical Student Experience with Competency Development.

Purpose: As competency-based medical education (CBME) continues to advance in undergraduate medical education, students are expected to simultaneously pursue their competency development while also discriminating themselves for residency selection. During the foundational clerkship year, it is important to understand how these seemingly competing goals are navigated.

Methods: In this phenomenological qualitative study, the authors describe the experience of 15 clerkship students taking part in a pilot pathway seeking to implement CBME principles.

Public Board Score Reporting Undermines Holistic Review for Residency Selection.

Holistic review has become the gold standard for residency selection. As a result, many programs are de-emphasizing standardized exam scores and other normative metrics. However, if standardized exam scores predict passing of an initial certifying exam, this may lead to an increase in board failure rates within specific residency training programs who do not emphasize test scores on entry.

Legitimation Without Argumentation: An Empirical Discourse Analysis of 'Validity as an Argument' in Assessment.

Introduction: Validity is frequently conceptualized in health professions education (HPE) assessment as an argument that supports the interpretation and uses of data. However, previous work has shown that many validity scholars believe argument and argumentation are relatively lacking in HPE. To better understand HPE's discourse around argument and argumentation with regard to assessment validity, the authors explored the discourses present in published HPE manuscripts.

Validity in the Next Era of Assessment: Consequences, Social Impact, and Equity.

Validity has long held a venerated place in education, leading some authors to refer to it as the "sine qua non" or "cardinal virtue" of assessment. And yet, validity has not held a fixed meaning; rather it has shifted in its definition and scope over time. In this Eye Opener, the authors explore if and how current conceptualizations of validity fit a next era of assessment that prioritizes patient care and learner equity.

A realist evaluation of prospective entrustment decisions in paediatric residency clinical competency committees.

Purpose: Making entrustment decisions (granting more responsibility, advancement and graduation) are important actions in medical training that pose risks to trainees and patients if not done well. A previous realist synthesis of the existing literature revealed that clinical competency committees (CCCs) do not typically make deliberate entrustment decisions, instead defaulting to the promotion and graduation of trainees in the absence of red flags. This study sought further understanding of these areas through empirical data.

Competency-based medical education: Connecting training outcomes to patient care.

Competency-based medical education (CBME) is a patient-centered and learner-focused approach to education where curricula are delivered in a manner tailored to the individuals' learning needs, and assessment focuses on ensuring trainees achieve requisite and clearly specified learning outcomes. Despite calls to focus assessment on what matters for patients. In this article, the authors explore one aspect of this next era: the use of electronic health record clinical performance indicators, such as Resident-Sensitive Quality Measures (RSQMs) and TRainee Attributable and Automatable Care Evaluations in Real-time (TRACERs), for learner assessment.

How do validity experts conceptualise argumentation? It's a rhetorical question.

Introduction: Health professions education (HPE) has adopted the conceptualization of validity as an argument. However, the theoretical and practical aspects of how validity arguments should be developed, used and evaluated in HPE have not been deeply explored. Articulating the argumentation theory undergirding validity and validation can help HPE better operationalise validity as an argument.

Ambulatory Long Block: A Model of Precision Education and Assessment for Internal Medicine Residents.

High-quality precision education (PE) aims to enhance outcomes for learners and society by incorporating longitudinal data and analytics to shape personalized learning strategies. However, existing educational data collection methods often suffer from fragmentation, leading to gaps in understanding learner and program performance. In this article, the authors present a novel approach to PE at the University of Cincinnati, focusing on the Ambulatory Long Block, a year-long continuous ambulatory group-practice experience.

AI-Enabled Medical Education: Threads of Change, Promising Futures, and Risky Realities Across Four Potential Future Worlds.

Background: The rapid trajectory of artificial intelligence (AI) development and advancement is quickly outpacing society's ability to determine its future role. As AI continues to transform various aspects of our lives, one critical question arises for medical education: what will be the nature of education, teaching, and learning in a future world where the acquisition, retention, and application of knowledge in the traditional sense are fundamentally altered by AI?

Objective: The purpose of this perspective is to plan for the intersection of health care and medical education in the future.

Methods: We used GPT-4 and scenario-based strategic planning techniques to craft 4 hypothetical future worlds influenced by AI's integration into health care and medical education.

User-Centered Evaluation and Design Recommendations for an Internal Medicine Resident Competency Assessment Dashboard.

Objectives: Clinical Competency Committee (CCC) members employ varied approaches to the review process. This makes the design of a competency assessment dashboard that fits the needs of all members difficult. This work details a user-centered evaluation of a dashboard currently utilized by the Internal Medicine Clinical Competency Committee (IM CCC) at the University of Cincinnati College of Medicine and generated design recommendations.

Finding Medicine's Moneyball: How Lessons From Major League Baseball Can Advance Assessment in Precision Education.

Precision education (PE) leverages longitudinal data and analytics to tailor educational interventions to improve patient, learner, and system-level outcomes. At present, few programs in medical education can accomplish this goal as they must develop new data streams transformed by analytics to drive trainee learning and program improvement. Other professions, such as Major League Baseball (MLB), have already developed extremely sophisticated approaches to gathering large volumes of precise data points to inform assessment of individual performance.

The Next Era of Assessment: Can Ensuring High-Quality, Equitable Patient Care Be the Defining Characteristic?

Previous eras of assessment in medical education have been defined by how assessment is done, from knowledge exams popularized in the 1960s to the emergence of work-based assessment in the 1990s to current efforts to integrate multiple types and sources of performance data through programmatic assessment. Each of these eras was a response to why assessment was performed (e.g.

A realist synthesis of prospective entrustment decision making by entrustment or clinical competency committees.

Introduction: The real-world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthesis of the published literature to address the following research question: In E/CCC efforts to make defensible prospective entrustment decisions (PEDs), what works, for whom, under what circumstances and why?

Methods: Realist work seeks to understand the contexts (C), mechanisms (M) and outcomes (O) that explain how and why things work (or do not). In the authors' study, contexts included individual E/CCC members, E/CCC structures and processes, and training programmes.

Lessons From Organic Chemistry: The Case for Considering Both High Standards and Equity in Assessment.

In this commentary, the authors explore the tension of balancing high performance standards in medical education with the acceptability of those standards to stakeholders (e.g., learners and patients).

Using Theory-Informed Group Processes to Make TIMELESS Promotion Decisions.

Competency-based medical education (CBME) depends on effective programs of assessment to achieve the desired outcomes and goals of training. Residency programs must be able to defend clinical competency committee (CCC) group decisions about learner readiness for practice, including decisions about time-variable resident promotion and graduation. In this article, the authors describe why CCC group decision-making processes should be supported by theory and review 3 theories they used in designing their group processes: social decision scheme theory, functional theory, and wisdom of crowds.