Context: A career in medicine is a journey of countless opportunities, challenges and choices. Determining the "right" decision for any given career choice ultimately must come from within; thus, a clear understanding of a physician's core professional identity is critical. Existing conceptualizations of professional identity within medicine focus primarily on medical training; however, it is clear that professional identity evolves throughout one's career.
View Article and Find Full Text PDFJ Am Coll Emerg Physicians Open
October 2024
Objective: The objectives of the study were to assess emergency medicine (EM) physician perceptions of the EM job market 2 years after "The Emergency Medicine Physician Workforce: Projections for 2030" was published in and to examine how the workforce report may have influenced perceptions about job prospects.
Methods: A cross-sectional survey was conducted in 2022 of EM residents, fellows, and attendings at 21 practice sites. Main outcomes were perceptions of the likelihood of currently finding any job, currently finding a desirable job, and confidence in the future EM job market.
Objectives: The Master Adaptive Learner (MAL) model postulates that learners develop adaptive expertise through cycles of self-regulated learning. Despite a robust theoretical basis, the actual observable behaviors of MALs are not well characterized. We sought to define behaviors that characterize MALs within emergency medicine (EM) training.
View Article and Find Full Text PDFBackground: Routine expertise is the efficient use of mastered skills at a high level of competency in familiar situations.
Problem: Novel case variation and continuous scientific advances preclude reliance on routine expertise alone.
Solution: Medical training programs must prepare learners to solve unfamiliar problems by cultivating adaptive expertise.
Residency and fellowship program directors profoundly impact trainees, institutions, and patient safety. Yet, there is concern for rapid attrition in the role. The average program director tenure is only 4-7 years, and that timeline is likely a result of burnout or opportunities for career advancement.
View Article and Find Full Text PDFPurpose: Annual increases in the number of residency applications burden students and challenge programs. Several reforms to the application process have been proposed; however, stakeholder input is often overlooked. The authors examined key stakeholders' opinions about several proposed reforms to the residency application process and identified important factors to guide future reforms.
View Article and Find Full Text PDFAdv Health Sci Educ Theory Pract
December 2022
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.
View Article and Find Full Text PDFBackground: A lack of educational continuity creates disorienting friction at the onset of residency. Few programs have harnessed the benefits of coaching, which can facilitate self-directed learning, competency development, and professional identity formation, to help ease this transition.
Objective: To describe the process of training faculty Bridge Coaches for the Transition to Residency Advantage (TRA) program for interns.
Purpose: Adaptive expertise (AE) has been identified as a critical trait to cultivate in future physicians. The 4-phase master adaptive learner (MAL) conceptual model describes the learning skills and behaviors necessary to develop AE. Though prior work has elucidated skills and behaviors used by MALs in the initial planning phase of learning, most resident learners are not thought to be MALs.
View Article and Find Full Text PDFBackground: Adaptive expertise is an important physician skill, and the Master Adaptive Learner (MAL) conceptual model describes learner skills and behaviors integral to the acquisition of adaptive expertise. The learning environment is postulated to significantly impact how MALs learn, but it is unclear how these successful learners experience and interact with it. This study sought to understand the authentic experience of MALs within the learning environment and translate those experiences into practical recommendations to improve the learning environment for all trainees.
View Article and Find Full Text PDFObjectives: Women are underrepresented in emergency medicine (EM) leadership. Some evidence suggests that geographic mobility improves career advancement. We compared movement between medical school and residency by gender.
View Article and Find Full Text PDFBackground: The number of residency applications submitted by medical students rises annually, resulting in increased work and costs for residency programs and applicants, particularly in emergency medicine. We propose a solution to this problem: an optional, two-stage Match with a "summer match" stage, in which applicants can submit a limited number of applications early. This would be conducted similarly to the early decision process for college admissions.
View Article and Find Full Text PDFJ Educ Teach Emerg Med
April 2021
Audience And Type Of Curriculum: This curriculum, designed and implemented at the Ronald O. Perelman Department of Emergency Medicine at NYU Langone Health, primarily targets third- and fourth-year emergency medicine (EM) residents, and is an immersive observation medicine rotation that can be integrated into existing emergency medicine residency training.
Length Of Curriculum: The curriculum is designed for a dedicated rotation of two weeks for senior residents and can be expanded to 4 weeks.
The development of lifelong learners is among the most challenging goals for medical educators. The authors identify two important scholarly works that profoundly altered their understanding and approach to lifelong learning and curriculum design: L. Dee Fink's and Cutrer et al.
View Article and Find Full Text PDFBackground: The Accreditation Council for Graduate Medical Education Common Program Requirements effective 2017 state that programs and sponsoring institutions have the same responsibility to address well-being as they do other aspects of resident competence.
Objectives: The authors sought to determine if the implementation of a multifaceted wellness curriculum improved resident burnout as measured by the Maslach Burnout Inventory (MBI).
Methods: We performed a multicenter educational interventional trial at 10 emergency medicine (EM) residencies.
Objectives: Despite increasing prevalence in emergency medicine (EM), the vice chair of education (VCE) role remains ambiguous with regard to associated responsibilities and expectations. This study aimed to identify training experiences of current VCEs, clarify responsibilities, review career paths, and gather data to inform a unified job description.
Methods: A 40-item, anonymous survey was electronically sent to EM VCEs.
Purpose: To compare the performance characteristics of the electronic Standardized Letter of Evaluation (eSLOE), a widely used structured assessment of emergency medicine (EM) residency applicants, and the Association of American Medical Colleges (AAMC) Standardized Video Interview (SVI), a new tool designed by the AAMC to assess interpersonal and communication skills and professionalism knowledge.
Method: The authors matched EM residency applicants with valid SVI total scores and completed eSLOEs in the 2018 Match application cycle. They examined correlations and group differences for both tools, United States Medical Licensing Examination (USMLE) Step exam scores, and honor society memberships.
The ability to adapt expertise to both routine and uncommon situations, termed , has been suggested as a necessary skill for physicians. The Master Adaptive Learner (MAL) framework proposes four phases necessary to develop adaptive expertise. The first phase, "planning" for learning, includes three stages: identification of gaps, prioritization of gaps, and identification of learning resources.
View Article and Find Full Text PDF: Competency-Based Medical Education (CBME) focuses on demonstrable outcomes, as well as upholding medical education's accountability to society. Despite calls for a robust, multifaceted approach to competency-based assessment (CBA), lingering critiques exist. These critiques include reductionism, reinforcement of an external locus of control within learners, an loss of focus on learner development.
View Article and Find Full Text PDFBackground: Assessment of trainees' competency is challenging; the predictive power of traditional evaluations is debatable especially in regard to noncognitive traits. New assessments need to be sought to better understand affective areas like personality. Grit, defined as "perseverance and passion for long-term goals," can assess aspects of personality.
View Article and Find Full Text PDF