Equity and justice in medical education: mapping a longitudinal curriculum across 4 years.

Background: In 2024 in the United States there is an attack on diversity, equity, and inclusion initiatives within education. Politics notwithstanding, medical school curricula that are current and structured to train the next generation of physicians to adhere to our profession's highest values of fairness, humanity, and scientific excellence are of utmost importance to health care quality and innovation worldwide. Whereas the number of anti-racism, diversity, equity, and inclusion (ARDEI) curricular innovations have increased, there is a dearth of published longitudinal health equity curriculum models.

Statement of Partnership and Humility: A Structural Intervention to Improve Equity and Justice in Medical Education.

Problem: Due to generational exposure to the Black Lives Matter movement, other antibias social movements, and diverse peer advocacy groups, health professions students are often more knowledgeable than their teachers about ways in which systemic racism and bias have led to scientific inaccuracies that contribute to health inequities. However, traditional hierarchies and concerns about retaliation may limit educational communities from benefiting maximally from students' contributions.

Approach: In spring 2021, faculty and students at the Vagelos College of Physicians and Surgeons, Columbia University, designed a structural innovation to engage faculty and students in partnership toward decreasing bias in medical education.

The Promise and Perils of Artificial Intelligence in Health Professions Education Practice and Scholarship.

Artificial intelligence (AI) methods, especially machine learning and natural language processing, are increasingly affecting health professions education (HPE), including the medical school application and selection processes, assessment, and scholarship production. The rise of large language models over the past 18 months, such as ChatGPT, has raised questions about how best to incorporate these methods into HPE. The lack of training in AI among most HPE faculty and scholars poses an important challenge in facilitating such discussions.

Practical, Privacy and Ethical, and Philosophical Considerations for Using Big Data in Medical Education.

In this issue of Academic Medicine , Thelen and colleagues present a thoughtful perspective on the emerging opportunity to use longitudinal educational data to improve graduate medical education and optimize the education of individual residents, and call for the accelerated development of large interinstitutional data sets for this purpose. Such applications of big data to medical education hold great promise in terms of informing the teaching of individuals, enhancing transitions between phases of training and between institutions, and permitting better longitudinal education research. At the same time, there is a tension between whose data they are and consequently how they ought to be used.

Entrustable professional activities as a training and assessment framework in undergraduate medical education: A case study of a multi-institutional pilot.

In 2014, the Association of American Medical Colleges (AAMC) published 13 Core Entrustable Professional Activities (EPAs) that graduating students should be able to perform with indirect supervision when entering residency. A ten-school multi-year pilot was commissioned to test feasibility of implementing training and assessment of the AAMC's 13 Core EPAs. In 2020-21, a case study was employed to describe pilot schools' implementation experiences.

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.

Core Entrustable Professional Activities for Entering Residency: A National Survey of Graduating Medical Students' Self-Assessed Skills by Specialty.

Background: The Association of American Medical Colleges described 13 Core Entrustable Professional Activities (EPAs) that graduating students should be prepared to perform under indirect supervision on day one of residency. Surgery program directors recently recommended entrustability in these Core EPAs for incoming surgery interns. We sought to determine if graduating students intending to enter surgery agreed they had the skills to perform these Core EPAs.

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.

Strategies From 11 U.S. Medical Schools for Integrating Basic Science Into Core Clerkships.

Calls for curricular reform in medical schools and enhanced integration of basic and clinical science have resulted in a shift toward preclerkship curricula that enhance the clinical relevance of foundational science instruction and provide students with earlier immersion in the clinical environment. These reforms have resulted in shortened preclerkship curricula, yet the promise of integrated basic science education into clerkships has not been sufficiently realized because of barriers such as the nature of clinical practice, time constraints, and limited faculty knowledge. As personalized medicine requires that physicians have a more nuanced understanding of basic science, this is cause for alarm.

Columbia COVID-19 Student Service Corps: Harnessing student skills and galvanizing the power of service learning.

The COVID-19 pandemic in New York City led to the forced rapid transformation of the medical school curriculum as well as increased critical needs to the health system. In response, a group of faculty and student leaders at CUIMC developed the COVID-19 Student Service Corps (Columbia CSSC). The CSSC is an interprofessional service-learning organization that galvanizes the skills and expertise of faculty and students from over 12 schools and programs in the response to the COVID-19 pandemic, and is agile enough to shift and respond to future public health and medical emergencies.

Guiding principles for undergraduate medical education in the time of the COVID-19 pandemic.

As the early epicenter of the COVID-19 pandemic, New York City's medical schools experienced dramatic disruptions in every aspect of medical education. Remote learning was created, seemingly overnight, clerkships were disrupted, licensing examinations were cancelled, teaching faculty were redeployed, student volunteers rallied, and everyone was required to shelter at home. Seismic changes were required to adapt the authors' educational programs to a constantly evolving, unpredictable, and ever-worsening public health crisis.

Toward a Bias-Free and Inclusive Medical Curriculum: Development and Implementation of Student-Initiated Guidelines and Monitoring Mechanisms at One Institution.

As research and attention on implicit bias and inclusiveness in medical school is expanding, institutions need mechanisms for recognizing, reporting, and addressing instances of implicit bias and lack of inclusiveness in medical school curricular structures. These instances can come as a result of a lack of both awareness and communication around these sensitive issues. To identify and address cases of implicit bias in the medical school curriculum, a student-led initiative at Columbia University Vagelos College of Physicians and Surgeons (VP&S) developed guidelines and a bias-reporting process for educators and students.

Mobilization of health professions students during the COVID-19 pandemic.

The COVID-19 pandemic has posed challenges for medical education and patient care, which were felt acutely in obstetrics due to the essential nature of pregnancy care. The mobilization of health professions students to participate in obstetric service-learning projects has allowed for continued learning and professional identify formation while also providing a motivated, available, and skilled volunteer cohort to staff important projects for obstetric patients.

Machine learning to extract communication and history-taking skills in OSCE transcripts.

Objectives: Observed Structured Clinical Exams (OSCEs) allow assessment of, and provide feedback to, medical students. Clinical examiners and standardised patients (SP) typically complete itemised checklists and global scoring scales, which have known shortcomings. In this study, we applied machine learning (ML) to label some communication skills and interview content information in OSCE transcripts and to compare several ML methodologies by performance and transferability.

Twelve tips for embedding assessment and learning practices in a programmatic assessment system.

Programmatic assessment supports the evolution from assessment learning to fostering assessment learning and learning practices. A well-designed programmatic assessment system aligns educational objectives, learning opportunities, and assessments with the goals of supporting student learning, making decisions about student competence and promotion decisions, and supporting curriculum evaluation. We present evidence-based guidance for implementing assessment and learning practices in the pre-clinical knowledge assessment system to help students learn, synthesize, master and retain content for the long-term so that they can apply knowledge to patient care.

Development of an online public health curriculum for medical students: the public health commute.

Background: As public health becomes increasingly central to the practice of medicine, educational efforts are necessary to prepare medical students to apply public health concepts in their care of patients. There are few accessible and informative tools to prepare students to engage with population health challenges.

Methods: We distributed an online questionnaire to clinical students, querying gaps in their education on public health topics.

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.

Implementing an Entrustable Professional Activities Framework in Undergraduate Medical Education: Early Lessons From the AAMC Core Entrustable Professional Activities for Entering Residency Pilot.

In 2014, the Association of American Medical Colleges (AAMC) published a list of 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs) that medical school graduates might be expected to perform, without direct supervision, on the first day of residency. Soon after, the AAMC commissioned a five-year pilot with 10 medical schools across the United States, seeking to implement the Core EPA framework to improve the transition from undergraduate to graduate medical education.In this article, the pilot team presents the organizational structure and early results of collaborative efforts to provide guidance to other institutions planning to implement the Core EPA framework.

Writing competitive research conference abstracts: AMEE Guide no. 108.

The ability to write a competitive research conference abstract is an important skill for medical educators. A compelling and concise abstract can convince peer reviewers, conference selection committee members, and conference attendees that the research described therein is worthy for inclusion in the conference program and/or for their attendance in the meeting. This AMEE Guide is designed to help medical educators write research conference abstracts that can achieve these outcomes.

Implementation of a weight loss program for Latino outpatients with severe mental illness.

To determine feasibility of implementation of a weight loss program for overweight Latinos with severe mental illness. In this quasi-experimental study, a 14-week behavioral weight loss course (extended) was implemented at one clinic. A one-time nutrition class (brief) was given at a sister clinic.

The medical home model: new opportunities for psychiatric services in the United States.

Purpose Of Review: The Patient-Centered Medical Home (PCMH) model is an approach to providing integrated healthcare through one main point of access. As the PCMH model gains increasing adoption in large health systems, its implications for psychiatric services are becoming increasingly important. This review highlights the development of the medical home model and a number of ways in which it has been adopted in psychiatric delivery systems.