Building on Strengths: An Affirmational and Systems-Level Approach to Revisiting Character in Medicine.

Although U.S. medical education has continued to place increased emphasis on defining competency standards and ensuring accountability to the public, health care inequities have persisted, several basic health outcomes have worsened, public trust in the health care system has eroded, and moral distress, burnout, and attrition among practicing physicians have escalated.

Discovering social learning ecosystems during clinical clerkship from United States medical students’ feedback encounters: a content analysis.

Purpose: We examined United States medical students’ self-reported feedback encounters during clerkship training to better understand in situ feedback practices. Specifically, we asked: Who do students receive feedback from, about what, when, where, and how do they use it? We explored whether curricular expectations for preceptors’ written commentary aligned with feedback as it occurs naturalistically in the workplace.

Methods: This study occurred from July 2021 to February 2022 at Southern Illinois University School of Medicine.

On pandemics and pivots: a COVID-19 reflection on envisioning the future of medical education.

The required adjustments precipitated by the coronavirus disease 2019 crisis have been challenging, but also represent a critical opportunity for the evolution and potential disruptive and constructive change of medical education. Given that the format of medical education is not fixed, but malleable and in fact must be adaptable to societal needs through ongoing reflexivity, we find ourselves in a potentially transformative learning phase for the field. An Association for Medical Education in Europe ASPIRE Academy group of 18 medical educators from seven countries was formed to consider this opportunity, and identified critical questions for collective reflection on current medical education practices and assumptions, with the attendant challenge to envision the future of medical education.

A Proposed Blueprint for Operative Performance Training, Assessment, and Certification.

Objective: The aim of this study was to propose an evidence-based blueprint for training, assessment, and certification of operative performance for surgical trainees.

Summary Background Data: Operative skill is a critical aspect of surgical performance. High-quality assessment of operative skill therefore has profound implications for training, accreditation, certification, and the public trust of the profession.

Medical Students' Progress in Detecting and Interpreting Visual and Auditory Clinical Findings.

Detection of visual and auditory clinical findings is part of medical students' core clinical performance abilities that a medical education curriculum should teach, assess, and remediate. However, there is a limited understanding of how students develop these skills. While training physical exam technical skills has received significant attention and emphasis, teaching and assessing medical students' ability to detect and interpret visual and auditory clinical findings skills has been less systematic.

The journeys of three ASPIRE winning medical schools toward excellence in student assessment.

ASPIRE Excellence Awards in Student Assessment are offered to medical schools with innovative and comprehensive assessment programmes adjudged by international experts, using evidence-based criteria. The journeys of three ASPIRE-winning medical schools toward "assessment excellence" are presented. These schools include Aga Khan University Medical College (AKU-MC), Pakistan, Southern Illinois University School of Medicine (SIUSOM), USA, and University of Leeds School of Medicine, UK.

Getting Real: Aligning the Learning Needs of Clerkship Students With the Current Clinical Environment.

The authors present follow-up to a prior publication, which proposed a new model for third-year clerkships. The new model was created to address deficiencies in the clinical year and to rectify a recognized mismatch between students' learning needs and the realities of today's clinical settings. The new curricular model was implemented at Southern Illinois University School of Medicine in academic year 2016-2017.

Twelve tips for enhancing student engagement.

Student engagement refers to a broad range of activities where students participate in management, education, research, and community activities within their institutions. It is a mutually beneficial collaborative approach between students and their institutions. This article provides practical advice for the implementation or further development of student engagement at medical, dental, and veterinary schools.

The ASPIRE-to-Excellence Program: A Global Effort to Improve the Quality of Medical Education.

Publications and organizations ranking medical schools rely heavily on schools' research-oriented and grant-success data because those are the publicly available data. To address the vacuum of evidence for medical education quality, in 2012 the Association for Medical Education in Europe (AMEE) introduced an initiative entitled A Schools Programme for International Recognition of Excellence in Education (ASPIRE) awards. ASPIRE panels of international experts in specific areas of medical education have developed internationally peer-based criteria to benchmark excellence in social accountability, student engagement, student assessment, faculty development, and simulation; they plan to publish criteria on curriculum design and development in 2018.

ASPIRE-ing to Excellence at SIUSOM.

This article was migrated. The article was marked as recommended. This Personal View article describes the experience of Southern Illinois University School of Medicine (SIUSOM) with the AMEE School Programme for International Recognition of Excellence in Education (ASPIRE) awards program.

Competencies, milestones, and EPAs - Are those who ignore the past condemned to repeat it?

Background: The idea of competency-based education sounds great on paper. Who wouldn't argue for a standardized set of performance-based assessments to assure competency in graduating students and residents? Even so, conceptual concerns have already been raised about this new system and there is yet no evidence to refute their veracity.

Aims: We argue that practical concerns deserve equal consideration, and present evidence strongly suggesting these concerns should be taken seriously.

Twenty Questions game performance on medical school entrance predicts clinical performance.

Context: This study is based on the premise that the game of 'Twenty Questions' (TQ) tests the knowledge people acquire through their lives and how well they organise and store it so that they can effectively retrieve, combine and use it to address new life challenges. Therefore, performance on TQ may predict how effectively medical school applicants will organise and store knowledge they acquire during medical training to support their work as doctors.

Objectives: This study was designed to determine whether TQ game performance on medical school entrance predicts performance on a clinical performance examination near graduation.

Placing constraints on the use of the ACGME milestones: a commentary on the limitations of global performance ratings.

As part of the outcomes-based accreditation process, the Accreditation Council for Graduate Medical Education (ACGME) now requires that medical specialties formulate and use educational milestones to assess residents' performance. These milestones are specialty-specific achievements that residents are expected to demonstrate at established intervals in their training. In this Commentary, the authors argue that the pressure to efficiently use program directors' and faculty members' time, particularly in the increasingly clinical-revenue-dependent model of the academic medical center, will lead program directors to meet these new accreditation expectations solely by adding items that assess these competencies to global end-of-rotation rating forms.

Variations in senior medical student diagnostic justification ability.

Purpose: To determine the diagnostic justification proficiency of senior medical students across a broad spectrum of cases with common chief complaints and diagnoses.

Method: The authors gathered diagnostic justification exercise data from the Senior Clinical Comprehensive Examination taken by Southern Illinois University School of Medicine's students from the classes of 2011 (n = 67), 2012 (n = 66), and 2013 (n = 79). After interviewing and examining standardized patients, students listed their key findings and diagnostic possibilities considered, and provided a written explanation of how they used key findings to move from their initial differential diagnoses to their final diagnosis.

Patient safety education: what was, what is, and what will be?

Patient safety is an important topic that has been receiving more attention in the current health care climate. Patient safety as a curriculum topic in medical schools has only become apparent in the late 1990 s, and much more needs to be done. This article summarizes patient safety curricular content as it occurred (or did not occur) in medical education circles in the past (pre-1990 s), and present.

Biomedical knowledge, clinical cognition and diagnostic justification: a structural equation model.

Context: The process whereby medical students employ integrated analytic and non-analytic diagnostic strategies is not fully understood. Analysing academic performance data could provide a perspective complementary to that of laboratory experiments when investigating the nature of diagnostic strategy. This study examined the performance data of medical students in an integrated curriculum to determine the relative contributions of biomedical knowledge and clinical pattern recognition to diagnostic strategy.

The case of the entitled resident: a composite case study of a resident performance problem syndrome with interdisciplinary commentary.

Background: Residents with performance problems create substantial burden on programs and institutions. Understanding the nature and quality of performance problems can help in learning to address performance problems.

Aim: We sought to illuminate the effects of resident performance problems and the potential solutions for those problems from the perspectives of people with various roles in health care.

Pursuing professional accountability: an evidence-based approach to addressing residents with behavioral problems.

Objective: To develop an evidence-based approach to the identification, prevention, and management of surgical residents with behavioral problems.

Design: The American College of Surgeons and Southern Illinois University Department of Surgery hosted a 1-day think tank to develop strategies for early identification of problem residents and appropriate interventions. Participants read a selection of relevant literature before the meeting and reviewed case reports.

Examining the diagnostic justification abilities of fourth-year medical students.

Purpose: Fostering ability to organize and use medical knowledge to guide data collection, make diagnostic decisions, and defend those decisions is at the heart of medical training. However, these abilities are not systematically examined prior to graduation. This study examined diagnostic justification (DXJ) ability of medical students shortly before graduation.

Tracking development of clinical reasoning ability across five medical schools using a progress test.

Purpose: Little is known about the acquisition of clinical reasoning skills in medical school, the development of clinical reasoning over the medical curriculum as a whole, and the impact of various curricular methodologies on these skills. This study investigated (1) whether there are differences in clinical reasoning skills between learners at different years of medical school, and (2) whether there are differences in performance between students at schools with various curricular methodologies.

Method: Students (n = 2,394) who had completed zero to three years of medical school at five U.

Can students' scores on preclerkship clinical performance examinations predict that they will fail a senior clinical performance examination?

Purpose: This study was designed to determine whether preclerkship performance examinations could accurately identify medical students at risk for failing a senior clinical performance examination (CPE).

Method: This study used a retrospective case-control, multiyear design, with contingency table analyses, to examine the performance of 412 students in the classes of 2005 to 2010 at a midwestern medical school. During their second year, these students took four CPEs that each used three standardized patient (SP) cases, for a total of 12 cases.

The efficacy of a targeted remediation process for students who fail standardized patient examinations.

Background: Current remediation strategies for students failing standardized patient examinations represent poorly targeted approaches since the specific nature of clinical performance weaknesses has not been defined.

Purpose: The purpose is to determine the impact of a specifically targeted clinical performance course required of students who failed a clinical performance examination.

Methods: A month-long clinical performance course, targeted to treat specific types of clinical performance deficiencies, was designed to remediate students failing standardized patient examinations in 2007 (n=8) and 2008 (n=5).