What Are Doctors For? A Call for Compassion-Based Metrics as a Measure of Physician Value.

Modern measures of physician value are couched in terms of productivity, volume, finance, outcomes, cure rates, and acquisition of an increasingly vast knowledge base. This inherently feeds burnout and imposter syndrome as physicians experience an inability to measure up to unrealistic standards set externally and perceived internally. Ancient and modern wisdom suggests that where populations fail to flourish, at root is a failure to grasp a vision or true purpose.

Evaluation of a Pilot Wellness Elective for Master of Public Health Students during the COVID-19 Pandemic.

Background: Graduate student wellbeing is a public health issue in the United States. The COVID-19 outbreak exacerbated the mental health burden on graduate students worldwide. Culture of Wellness (PH 104) is a 2-week wellbeing elective course that teaches evidence-based wellbeing strategies for graduate students at a university in the United States.

A Curriculum to Promote a Culture of Wellness Among Medical Students and Faculty.

Introduction: Self-care has not been traditionally taught in medical education, but the epidemic of burnout among health professionals necessitates a change in culture, and consequently a change in curriculum. Burnout begins early in training and negatively impacts health professionals, patients, and institutions. Interventions that prevent and avert burnout are necessary at all stages of a doctor's career to assure well-being over a lifetime.

Economic impact of a primary care career: a harsh reality for medical students and the nation.

Purpose: The ranks of U.S. medical students choosing careers in primary care (PC) are declining even as the demand for new PC physicians is increasing.

Self-directed community health assessment projects in a required family medicine clerkship: an effective way to teach community-oriented primary care.

Background And Objectives: Community-oriented primary care (COPC) is a key teaching objective of many medical school family medicine clerkships. Though many programs are in place, little is published evaluating the effectiveness of curricula.

Methods: Within the family medicine clerkship at Dartmouth Medical School, students complete community health assessments.

A web-based system for students to document their experiences within six core competency domains during all clinical clerkships.

The authors describe the design and implementation of a new Web-based system that allows students to record important features of their clinical encounters during all 10 required clinical clerkships, document their learning experiences in six major competency domains, and generate detailed real-time reports for themselves and their clerkship directors. A new Web-based system, DMEDS (Dartmouth Medical Encounter Documentation System), accepts input from computers and PDAs. Its design permits students to describe their patients, learning sites, interactions with preceptors, and important aspects of their clinical encounters in all of our medical school's competency domains.

Preclinical preceptorships in medical school: can curricular objectives be met in diverse teaching settings?

Background: Although preclinical preceptorships for medical students during the first 2 years are now common, little is known about how well the curricular objectives can be met in clinical training sites.

Purpose: To evaluate whether a clinical encounter system can help align preclinical preceptorship experiences with the core curriculum.

Methods: Using a PDA documentation system, 27 students collected student-preceptor-patient encounter information on all patients (N = 2,953) during a 2-year clinical training course.

Educational epidemiology: applying population-based design and analytic approaches to study medical education.

Conducting educational research in medical schools is challenging partly because interventional controlled research designs are difficult to apply. In addition, strict accreditation requirements and student/faculty concerns about educational inequality reduce the flexibility needed to plan and execute educational experiments. Consequently, there is a paucity of rigorous and generalizable educational research to provide an evidence-guided foundation to support educational effectiveness.

Teaching the testicular exam: a model curriculum from "A" to "Zack".

Background And Objectives: The testicular exam was not explicitly taught at our medical schools before 2002. In this article, we explore different phases of curriculum development, implementation, and evaluation of a method for teaching the testicular exam.

Methods: Medical students participated in surveys and focus groups, and male patients participated in focus groups.

Collaborating to integrate curriculum in primary care medical education: successes and challenges from three US medical schools.

Background And Objectives: Traditional medical school department-based clerkship structures can lead to redundancy and/or gaps in curriculum, inefficient administrative systems, and academic isolation for clerkship directors. This paper describes the approaches, successes, and challenges three institutions experienced when implementing an interdepartmental collaboration to create an integrated primary care clerkship experience.

Methods: Each school combined family medicine, ambulatory pediatrics, and ambulatory medicine into contiguous clerkship blocks.

Teaching of medical informatics in UME-21 medical schools: best practices and useful resources.

Objectives: Information-based decision making is important to modern medical practice. This report identifies learning objectives, teaching innovations, and student outcomes for teaching medical informatics (MI) in medical schools that participated in the Undergraduate Medical Education for the 21st Century (UME-21) curriculum project.

Methods: Project reports by the UME-21 schools were analyzed, and curricular content was classified in terms of the five categories for MI literacy adapted from the Medical School Objectives Project.

Teaching quality measurement and improvement, cost-effectiveness, and patient satisfaction in undergraduate medical education: the UME-21 experience.

Background: The health care system in the United States is changing at an ever-increasing rate. Recent reports by the Institute of Medicine raising concerns regarding rates of medical errors and suggesting the need for reengineering of the health care delivery system have focused attention on the need for quality measurement and improvement.

Methods: We abstracted data from final written reports submitted by 18 Undergraduate Medical Education for the 21st Century (UME-21) schools, as well as other materials available from participating UME-21 schools.

Ambulatory care education: how do academic medical centers, affiliated residency teaching sites, and community-based practices compare?

Purpose: Little is known about how different ambulatory sites compare as clinical educational settings. The authors used students' log data to compare the educational content and processes in academic medical center-based clinics (AMCs), affiliated residency teaching sites (ARTs), and local community-based practices (CBPs) at one medical school.

Method: Students recorded their experiences with symptoms, counseling, procedures, and common medical conditions as well as characteristics of the learning process during a required eight-week third-year ambulatory clerkship in family medicine.

An analysis of students' clinical experiences in an integrated primary care clerkship.

Purpose: Combining complementary clinical content into an integrated clerkship curriculum should enhance students' abilities to develop skills relevant to multiple disciplines, but how educational opportunities in primary care ambulatory settings complement each other is unknown. The authors conducted an observational analytic study to explore where opportunities exist to apply clinical skills during a 16-week integrated primary care clerkship (eight weeks of family medicine, four weeks of ambulatory pediatrics, and four weeks of ambulatory internal medicine).

Method: Using handheld computers, students recorded common problems, symptoms, and diagnoses they saw.

A collaborative model for supporting community-based interdisciplinary education.

Development and support of community-based, interdisciplinary ambulatory medical education has achieved high priority due to on-site capacity and the unique educational experiences community sites contribute to the educational program. The authors describe the collaborative model their school developed and implemented in 2000 to integrate institution- and community-based interdisciplinary education through a centralized office, the strengths and challenges faced in applying it, the educational outcomes that are being tracked to evaluate its effectiveness, and estimates of funds needed to ensure its success. Core funding of $180,000 is available annually for a centralized office, the keystone of the model described here.

Development of a handheld computer documentation system to enhance an integrated primary care clerkship.

Documentation systems are used by medical schools and residency programs to record the clinical experiences of their learners. The authors developed a system for their school's (Dartmouth's) multidisciplinary primary care clerkship (family medicine, internal medicine, pediatrics) that documents students' clinical and educational experiences and provides feedback designed to enhance clinical training utilizing a timely data-reporting system. The five critical components of the system are (1) a valid, reliable and feasible data-collection instrument; (2) orientation of and ongoing support for student and faculty users; (3) generation and distribution of timely feedback reports to students, preceptors, and clerkship directors; (4) adequate financial and technical support; and (5) a database design that allows for overall evaluation of educational outcomes.