An Exploration of Cognitive Diagnosis in Medical Education: Constructing Comprehensive Feedback for Enhanced Student Learning.

Feedback stands as a cornerstone in facilitating knowledge and skill acquisition, particularly in the realm of self-directed learning. Drawing from Vygotskian theory, which posits learning as an apprenticeship process within the zone of proximal development (ZPD), effective feedback becomes a crucial scaffold for students navigating their educational journey. This article delves into the significance of feedback, guided by Hattie and Timperley's three pivotal questions.

Evaluation and refinement of Self-Directed Learning Readiness Scale for medical students.

Purpose: This study evaluated the underlying subdomain structure of the Self-Directed Learning Readiness Scale (SDLRS) for medical students and refined the instrument to measure the subdomains to provide evidence for construct validity. Developing self-directed learners is a well-recognized goal amongst medical educators. The SDLRS has been frequently used, however, lack of construct validity makes it difficult to interpret results.

The Impact of Changing Step 1 to Pass/Fail Reporting on Anxiety, Learning Approaches, and Curiosity.

Purpose: Given the significance of the US Medical Licensing Exam (USMLE) Step 1 score moving from a 3-digit value to pass/fail, the authors investigated the impact of the change on students' anxiety, approach to learning, and curiosity.

Method: Two cohorts of pre-clerkship medical students at three medical schools completed a composite of four instruments: the State-Trait Anxiety Inventory, the revised two-factor Study Process Questionnaire, the Interest/Deprivation Type Epistemic Curiosity Scale, and the Short Grit Scale prior to taking the last 3-digit scored Step 1 in 2021 or taking the first pass/fail scored Step 1 in 2022. Responses of 3-digit and pass/fail exam takers were compared (Mann-Whitney ) and multiple regression path analysis was performed to determine the factors that significantly impacted learning strategies.

Real-World Analysis of Clinical and Demographic Characteristics, Treatment Patterns, and Outcomes in Predominantly Older Patients with HR+/HER2- Metastatic Breast Cancer Receiving Abemaciclib in Routine Clinical Practice.

Introduction: Hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) is the most frequently diagnosed metastatic breast cancer (mBC) subtype. Combinations of endocrine therapy (ET) with cyclin-dependent kinase 4/6 inhibitors (CDK4 & 6is) improve outcomes compared with ET alone. The efficacy and safety of abemaciclib among patients with HR+/HER2- mBC has been demonstrated in the MONARCH clinical trials; however, there is a paucity of real-world evidence, particularly in older patients.

What have we learned about constructed response short-answer questions from students and faculty? A multi-institutional study.

Purpose: The purpose of this study was to enrich understanding about the perceived benefits and drawbacks of constructed response short-answer questions (CR-SAQs) in preclerkship assessment using Norcini's criteria for good assessment as a framework.

Methods: This multi-institutional study surveyed students and faculty at three institutions. A survey using Likert scale and open-ended questions was developed to evaluate faculty and student perceptions of CR-SAQs using the criteria of good assessment to determine the benefits and drawbacks.

Real-World Biomarker Testing Patterns in Patients With Metastatic Non-Squamous Non-Small Cell Lung Cancer (NSCLC) in a US Community-Based Oncology Practice Setting.

Introduction/background: This study was designed to describe real-world changes in biomarker testing among patients with non-squamous, metastatic non-small cell lung cancer (mNSCLC) in a community oncology setting from 2015 to 2020.

Patients And Methods: This retrospective study randomly selected 500 adult patients diagnosed with nonsquamous mNSCLC to undergo chart review and data extraction. Data were extracted and validated by 2 independent abstractors.

Management of hepatocellular carcinoma from diagnosis in routine clinical practice.

Aim: To assess real-world management of patients diagnosed with hepatocellular carcinoma (HCC) within an integrated delivery network.

Materials & Methods: A retrospective cohort analysis of adults newly diagnosed with HCC from January 2014 to March 2019. Overall survival and treatment journey were assessed over the entire available follow-up period per patient.

Exploring the impact of postponing core clerkships on future performance.

Despite the many clerkship models of medical education, all can be considered a form of experiential learning. Experiential learning is a complex pedagogical approach involving the development of cognitive skills in an environment with a unique culture with multiple stakeholders, which may impact learner motivation, confidence, and other noncognitive drivers of success. Students may delay the transition to the clerkship year for myriad reasons, and the intricate nature of experiential learning suggested this may impact student performance.

A Generalizable Approach to Predicting Performance on USMLE Step 2 CK.

Introduction: The elimination of the USMLE Step 1 three-digit score has created a deficit in standardized performance metrics for undergraduate medical educators and residency program directors. It is likely that there will be greater emphasis on USMLE Step 2 CK, an exam found to be associated with later clinical performance in residents and physicians. Because many previous models relied on Step 1 scores to predict student performance on Step 2 CK, we developed a model using other metrics.

A Multi-institutional Study of the Feasibility and Reliability of the Implementation of Constructed Response Exam Questions.

Problem: Some medical schools have incorporated constructed response short answer questions (CR-SAQs) into their assessment toolkits. Although CR-SAQs carry benefits for medical students and educators, the faculty perception that the amount of time required to create and score CR-SAQs is not feasible and concerns about reliable scoring may impede the use of this assessment type in medical education.

Intervention: Three US medical schools collaborated to write and score CR-SAQs based on a single vignette.

The interplay between inflammation and thrombosis in COVID-19: Mechanisms, therapeutic strategies, and challenges.

Coronavirus disease 2019 (COVID-19), caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can cause life-threatening pathology characterized by a dysregulated immune response and coagulopathy. While respiratory failure induced by inflammation is the most common cause of death, micro-and macrovascular thrombosis leading to multiple organ failure are also causes of mortality. Dysregulation of systemic inflammation observed in severe COVID-19 patients is manifested by cytokine release syndrome (CRS) - the aberrant release of high levels of proinflammatory cytokines, such as IL-6, IL-1, TNFα, MP-1, as well as complement.

Health Care Resource Utilization and Costs for Metastatic Breast Cancer Patients Newly Treated with Human Epidermal Growth Factor Receptor 2 (HER2)-Targeted Agents.

Introduction: HER2-positive metastatic breast cancer (mBC) is an incurable disease associated with years of chronic therapy and excess cost. HER2-targeted therapies have shown survival benefit for early-stage and mBC; however, the economic impact of these therapies has not been fully assessed. We evaluated health care resource use (HCRU) and costs of mBC patients treated with HER2-targeted therapy.

Crowdsourcing biocuration: The Community Assessment of Community Annotation with Ontologies (CACAO).

Experimental data about gene functions curated from the primary literature have enormous value for research scientists in understanding biology. Using the Gene Ontology (GO), manual curation by experts has provided an important resource for studying gene function, especially within model organisms. Unprecedented expansion of the scientific literature and validation of the predicted proteins have increased both data value and the challenges of keeping pace.

Supporting Self-Directed Learning: Development of a Faculty Evaluation Scale.

We sought to assess medical education faculty members' ability to support students in the development of self-regulated learning skills. It is broadly agreed that medical students should become self-directed lifelong learners to succeed as physicians. To that end, many instruments have been developed that measure student attributes of self-directed learning (SDL).

Supporting Self-Directed Learning: A National Needs Analysis.

Introduction: It is broadly agreed that physicians must be self-directed learners, and many studies measuring medical student readiness and capacity for self-directed learning (SDL) have been reported. However, less attention has been paid to faculty tasked with guiding students to develop SDL skills. In an effort to determine whether faculty feel equipped to foster SDL, a needs assessment was developed.

Innovation in Leadership Development in Undergraduate Medical Education.

In response to the need for physician leaders, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell developed the Klar Leadership Development and Innovation Management program. This novel program leverages its partnership with a large Northeast health system to longitudinally provide students with leadership fundamentals and mentored experiences.

Changing Medical Education, Overnight: The Curricular Response to COVID-19 of Nine Medical Schools.

Calls to change medical education have been frequent, persistent, and generally limited to alterations in content or structural re-organization. Self-imposed barriers have prevented adoption of more radical pedagogical approaches, so recent predictions of the 'inevitability' of medical education transitioning to online delivery seemed unlikely. Then in March 2020 the COVID-19 pandemic forced medical schools to overcome established barriers overnight and make the most rapid curricular shift in medical education's history.

Third year medical students impersonalize and hedge when providing negative upward feedback to clinical faculty.

Medical students provide clinical teaching faculty with feedback on their skills as educators through anonymous surveys at the end of their clerkship rotation. Because faculty are in a position of power, students are hesitant to provide candid feedback. Our objective was to determine if medical students were willing to provide negative upward feedback to clinical faculty and describe how they conveyed their feedback.

Using the "Hallmarks of Cancer" as a framework for medical students and clinicians to understand oncogenesis.

Two landmark reviews in 2000 and 2011, describing the "Hallmarks of Cancer", provided a new and valuable framework for understanding the process of oncogenesis as a progressive accumulation of characteristics, each characteristic essential for a tumor to become a clinically relevant, metastatic neoplasia. The process of oncogenesis is conceptually important for physicians, both for clinical reasons, and for their engagement in oncological research. However, these reviews are written for specialists in the field, which presents barriers for novice learners.

Pandemics Past and Present: A Guided Inquiry Approach.

Background: COVID-19 exposed undergraduate medical education curricular gaps in exploring historical pandemics, how to critically consume scientific literature and square it with the lay press, and how to grapple with emerging ethical issues. In addition, as medical students were dismissed from clinical environments, their capacity to build community and promote professional identity formation was compromised.

Methods: A synchronous, online course entitled was developed using a modified guided inquiry approach.

Recent real-world treatment patterns and outcomes in US patients with relapsed/refractory multiple myeloma.

Background: In patients with relapsed/refractory multiple myeloma (RRMM) previously receiving 1-3 therapy lines, newer agents demonstrated improved outcomes versus older agents. Real-world treatment pattern data are limited. We assessed real-world treatment patterns and outcomes in patients with RRMM (≥2 prior therapy lines).

Patients don't come with multiple choice options: essay-based assessment in UME.

Curricular revision efforts have resulted in learner-centered programs that value content integration and active learning. Yet, less attention has been placed on assessment methods that are learner-centered and promote assessment for learning. The use of context rich short answer question (CR-SAQ) exams in the preclinical years of medical school was evaluated to determine if this format aligns with the criteria for assessment for learning.

Real-world treatment patterns and outcomes of patients with small cell lung cancer progressing after 2 lines of therapy.

Objectives: To evaluate treatment patterns, physician-assessed overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) among third-line (3L)-plus small cell lung cancer (SCLC) patients.

Materials And Methods: Retrospective analysis of a United States (US)-based community oncology electronic medical record (EMR) database was conducted. Target sample included SCLC patients ≥18 years of age whose disease progressed after at least 2 prior treatments.