Not a Benign (Mis)Label: Penicillin Allergy Education for the Nonallergist.

Introduction: Up to 20% of the US population carries a penicillin allergy label; however, over 95% of those patients can safely tolerate penicillin. This discrepancy has important personal and public health consequences. There is no published curriculum for medical trainees that covers penicillin allergy history taking, risk assessment, and antibiotic prescribing.

Developing an educational "hub": impact of a distance-learning curriculum in a multinational cohort.

Purpose: To address a gap in radiation oncology education in low- and middle-income countries (LMICs), we sought to evaluate the effectiveness and generalizability of a refined curriculum on intensity modulated radiotherapy (IMRT) offered to existing radiation therapy (RT) clinics across Africa and Latin America (LATAM) at no cost.

Methods: A curriculum was created based on prior needs assessments and adapted for participating medical physicists, radiation oncologists, radiation therapists, and trainees in LMICs. English-speaking and Spanish-speaking teams of volunteer educators delivered 27 hour-long sessions 1-2 times weekly for 4 months using video conferencing to African and LATAM cohorts, respectively.

How well do workplace-based assessments support summative entrustment decisions? A multi-institutional generalisability study.

Background: Assessment of the Core Entrustable Professional Activities for Entering Residency requires direct observation through workplace-based assessments (WBAs). Single-institution studies have demonstrated mixed findings regarding the reliability of WBAs developed to measure student progression towards entrustment. Factors such as faculty development, rater engagement and scale selection have been suggested to improve reliability.

Competency-Based Medical Education in a Norm-Referenced World: A Root Cause Analysis of Challenges to the Competency-Based Paradigm in Medical School.

Competency-based medical education (CBME) requires a criterion-referenced approach to assessment. However, despite best efforts to advance CBME, there remains an implicit, and at times, explicit, demand for norm-referencing, particularly at the junction of undergraduate medical education (UME) and graduate medical education (GME). In this manuscript, the authors perform a root cause analysis to determine the underlying reasons for continued norm-referencing in the context of the movement toward CBME.

Master clinical teachers and personalised learning.

Clinical history taking and physical examination are two of the most important competencies of physicians. In addition to informing diagnoses, these activities build rapport and establish relationships between caregivers and patients. Despite this, emphasis on the assessment of bedside clinical skills is declining.

Educating for adaptive expertise: case examples along the medical education continuum.

Adaptive expertise represents the combination of both efficient problem-solving for clinical encounters with known solutions, as well as the ability to learn and innovate when faced with a novel challenge. Fostering adaptive expertise requires careful approaches to instructional design to emphasize deeper, more effortful learning. These teaching strategies are time-intensive, effortful, and challenging to implement in health professions education curricula.

Comparing Entrustment Decision-Making Outcomes of the Core Entrustable Professional Activities Pilot, 2019-2020.

Importance: Gaps in readiness for indirect supervision have been identified for essential responsibilities encountered early in residency, presenting risks to patient safety. Core Entrustable Professional Activities (EPAs) for entering residency have been proposed as a framework to address these gaps and strengthen the transition from medical school to residency.

Objective: To assess progress in developing an entrustment process in the Core EPAs framework.

Measuring the Master Adaptive Learner: Development and Internal Structure Validity Evidence for a New Instrument.

Background: The master adaptive learner (MAL) uses self-regulated learning skills to develop adaptive, efficient, and accurate skills in practice. Given rapid changes in healthcare, it is essential that medical students develop into MALs. There is a need for an instrument that can capture MAL behaviors and characteristics.

Precision Cancer Medicine: Dynamic Learning of Cancer Biology in a Clinically Meaningful Context.

Purpose: Precision medicine is revolutionizing healthcare practices, most notably in oncology. With cancer being the second leading cause of death in the USA, it is important to integrate precision oncology content in undergraduate medical education.

Methods: In 2015, we launched a Integrated Science Course (ISC) for post-clerkship medical students at Vanderbilt University School of Medicine (VUSM).

Exploiting the power of information in medical education.

The explosion of medical information demands a thorough reconsideration of medical education, including what we teach and assess, how we educate, and whom we educate. Physicians of the future will need to be self-aware, self-directed, resource-effective team players who can synthesize and apply summarized information and communicate clearly. Training in metacognition, data science, informatics, and artificial intelligence is needed.

Entrustment Decision Making in the Core Entrustable Professional Activities: Results of a Multi-Institutional Study.

Purpose: In 2014, the Association of American Medical Colleges defined 13 Core Entrustable Professional Activities (EPAs) that all graduating students should be ready to do with indirect supervision upon entering residency and commissioned a 10-school, 5-year pilot to test implementing the Core EPAs framework. In 2019, pilot schools convened trained entrustment groups (TEGs) to review assessment data and render theoretical summative entrustment decisions for class of 2019 graduates. Results were examined to determine the extent to which entrustment decisions could be made and the nature of these decisions.

Revisiting the Core Entrustable Professional Activities for Entering Residency.

The Core EPAs for Entering Residency Pilot project aimed to test the feasibility of implementing 13 entrustable professional activities (EPAs) at 10 U.S. medical schools and to gauge whether the use of the Core EPAs could improve graduates' performance early in residency.

The educators' experience: Learning environments that support the master adaptive learner.

Background: The Master Adaptive Learner (MAL) theoretical framework describes an integrated approach to learning that combines features of educational theory on self-regulated learning and aspects of quality improvement. In order to develop MAL students, it is important to pay attention to the learning environment.

Purpose: To describe educators' perspectives about the needed to promote the development of master adaptive learners.

Embedding Ethics Education in Clinical Clerkships by Identifying Clinical Ethics Competencies: The Vanderbilt Experience.

The clinical clerkships in medical school are the first formal opportunity for trainees to apply bioethics concepts to clinical encounters. These clerkships are also typically trainees' first sustained exposure to the "reality" of working in clinical teams and the full force of the challenges and ethical tensions of clinical care. We have developed a specialized, embedded ethics curriculum for Vanderbilt University medical students during their second (clerkship) year to address the unique experience of trainees' first exposure to clinical care.

Assessing medical student performance of Entrustable Professional Activities: A mixed methods comparison of Co-Activity and Supervisory Scales.

Observations of medical student participation in entrustable professional activities (EPAs) provide insight into the student's ability to synthesize competencies across domains and effectively function in different clinical scenarios. Both Supervisory and Co-Activity Assessment Scales have been recommended for use with medical students. Students were assessed on EPAs during Acting Internships in Medicine and Pediatrics.

Too Many Hats? Conflicts of Interest in Learning Community Faculty Roles.

Purpose: Many US medical schools have adopted learning communities to provide a framework for advising and teaching functions. Faculty who participate in learning communities often have additional educator roles. Defining potential conflicts of interest (COIs) among these roles is an important consideration for schools with existing learning communities and those looking to develop them, both for transparency with students and also to comply with regulatory requirements.

Learning to balance efficiency and innovation for optimal adaptive expertise.

It is critical for health professionals to continue to learn and this must be supported by health professions education (HPE). Adaptive expert clinicians are not only expert in their work but have the additional capacity to learn and improve in their practices. The authors review a selective aspect of learning to become an adaptive expert: the capacity to optimally balance routine approaches that maximize efficiency with innovative ones where energy and resources are used to customize actions for novel or difficult situations.

Exploring the characteristics and context that allow Master Adaptive Learners to thrive.

Because change is ubiquitous in healthcare, clinicians must constantly make adaptations to their practice to provide the highest quality care to patients. In a previous article, Cutrer et al. described a metacognitive approach to learning based on self-regulation, which facilitates the development of the Master Adaptive Learner (MAL).

Framing Medicine as a Moral Practice: An Introductory Medical School Course.

Problem: The transition into medical school represents a time of profound professional development for medical students. Many medical schools manage this transition with brief orientations followed by abrupt moves into the anatomy laboratory. Recognizing that early introduction of key humanistic concepts could have a lasting impact on students' attitudes, faculty at the Vanderbilt University School of Medicine created the Foundations of the Profession (FoP) course to frame medicine as a moral practice.

Faculty Development Revisited: A Systems-Based View of Stakeholder Development to Meet the Demands of Entrustable Professional Activity Implementation.

In 2015, the Association of American Medical Colleges implemented an interinstitutional pilot of 13 core entrustable professional activities (EPAs) for entering residency, activities that entering residents should be expected to perform with indirect supervision. The pilot included a concept group on faculty development; this group previously offered a shared mental model focused on the development of faculty who devote their efforts to clinical teaching and assessment for learning and entrustment decision making. In this article, the authors draw from the literature of competency-based education to propose what is needed in overall approaches to faculty development to prepare institutions for undergraduate EPA implementation.

Integrating Foundational Sciences in a Clinical Context in the Post-Clerkship Curriculum.

Purpose: To design, implement, and launch courses that integrate foundational science learning and clinical application in a post-clerkship undergraduate medical school curriculum.

Method: In Academic Year (AY) 15-16, as part of a comprehensive curricular revision, Vanderbilt University School of Medicine (VUSM) formally implemented "Integrated Science Courses" (ISCs) that combined rigorous training in the foundational sciences with meaningful clinical experiences. These courses integrated foundational sciences that could be leveraged in the clinical environment, utilized a variety of instructional modalities, and included quantitative and qualitative (competency-based milestones) student assessments.