Defining the Learning Health Care System: An International Health System Leadership Perspective.

Purpose: Over the past 2 decades, many academic health centers (AHCs) have implemented learning health systems (LHSs). However, the LHS has been defined with limited input from AHC leaders. This has implications because these individuals play a critical role in LHS implementation and sustainability.

A Chief Health Security Officer for Every Academic Health Center: Improving Readiness, Response, Recovery, and Resilience.

Academic health centers (AHCs) require expertise to ensure readiness for health security events, such as cyberattacks, natural disasters, and pandemics, as well as the ability to respond to and recover from these events. However, most AHCs lack an individual to coordinate efforts at an enterprise level across academic and operational units during an emergency; elevate the coordination of individual AHCs with local and state public health entities; and through professional organizations, coordinate the work of AHCs across national and international public health entities. Informed by AHCs' responses to the COVID-19 pandemic and a series of focused meetings in 2021 of the Association of Academic Health Centers President's Council on Health Security, the authors propose creating a new C-suite role to meet these critical needs: the chief health security officer (CHSO).

Optimizing surgical teaching through the lens of sociocultural learning theory.

Background: The objective of this study was to identify intraoperative instructional strategies that embody the ways that learning occurs in the social contexts of surgery.

Methods: We performed a qualitative review of examples of intraoperative teaching from transcripts of ten videotaped surgeries, coupled with interviews with surgical attendings and residents. We coded the examples according to the key tenets of sociocultural learning theories and used these codes to develop instructional strategies aimed at improving resident surgical autonomy.

Leaders' perspectives and actions to manage challenges in medical education presented by the COVID-19 pandemic: a nationwide survey of Japanese medical colleges.

Background: The COVID-19 pandemic has caused medical colleges worldwide to suspend in-person classes and clinical clerkships. This fluid situation urgently required educators and learners to make a paradigm shift from traditional medical education. However, descriptions of how leaders manage policy decisions, especially considering cultural contexts, are limited.

Population Health at the Academic Health Center: An Interactive, Multipart, Case-Based Session for Executives, Faculty, and Administrators.

Introduction: Academic health centers (AHCs) play critical roles in population health by providing health care, conducting population health research, and providing population health training and education. This publication describes an interactive, multipart, case-based session targeted at AHC executives, faculty, and administrators about population health initiatives at AHCs and how the AHC structure can be leveraged to promote population health.

Methods: This 90-minute virtual session was conducted during the Association of Academic Health Centers' 2020 annual meeting.

A SWOT analysis of Italian medical curricular adaptations to the COVID-19 pandemic: A nationwide survey of medical school leaders.

Background: There is a growing literature on how medical education adapts to the COVID-19 pandemic. However, there is a need to examine the facilitators and barriers of these adaptations. This study explores the strengths, weaknesses, opportunities, and threats (SWOT) of how Italian medical schools adapted their curricula to the COVID -19 pandemic.

Cybersecurity Challenges and the Academic Health Center: An Interactive Tabletop Simulation for Executives.

Problem: Academic health centers (AHCs) face cybersecurity vulnerabilities that have potential costs to an institution's finances, reputation, and ability to deliver care. Yet many AHC executives may not have sufficient knowledge of the potential impact of cyberattacks on institutional missions such as clinical care, research, and education. Improved cybersecurity awareness and education are areas of opportunity for many AHCs.

Absence or presence: Silent discourse in the operating room and impact on surgical team action.

Background: Our objective was to examine the influence of silence on team action in the operating room.

Methods: We conducted a constructed grounded theory study with semi-structured interviews with 25 interprofessional surgical team members. Using a framework of silence as communication and performance, transcripts were iteratively team-coded to develop themes and a conceptual model.

Micro-relational interdependencies are the essence of teaching and learning in the OR.

Context: In the high-stakes, time-critical environment of the operating room (OR), attendings and residents strive to complete safe, effective surgeries and ensure that learning occurs. Yet meaningful resident participation often receives less attention, and that impedes residents' ability to learn and achieve autonomous operative practice. We need a new conceptual framework for understanding progression to autonomous practice that can guide both faculty and residents.

Medical Leaders Identify Personal Characteristics and Experiences that Contribute to Leadership Success in Medicine.

This article was migrated. The article was marked as recommended. The approach of medical educators to preparing learners for leadership reflects the emphasis leadership theories once placed on experiential learning.

Preventing Error in the Operating Room: Five Teaching Strategies for High-Stakes Learning.

Background: Effective communication in the operating room between the attending and resident surgeon is necessary to prevent surgical errors. Yet, existing studies do not describe what successful intraoperative teaching looks like and how it prevents errors. Our objective was to identify strategies for successful intraoperative teaching by comparing perspectives of the learner and teacher for the same moments.

Maintaining operative efficiency while allowing sufficient time for residents to learn.

Background: Surgical residents desire independent operating experience but recognize that attendings have a responsibility to keep cases as short as possible.

Methods: We analyzed video and interviews of attending surgeons related to more than 400 moments in which the resident was the primary operator. We examined these moments for themes related to timing and pace.

Examining the readiness of best evidence in medical education guides for integration into educational practice: A meta-synthesis.

Background: To support evidence-informed education, health professions education (HPE) stakeholders encourage the creation and use of knowledge syntheses or reviews. However, it is unclear if these knowledge syntheses are ready for translation into educational practice. Without understanding the readiness, defined by three criteria-quality, accessibility and relevance-we risk translating weak evidence into practice and/or providing information that is not useful to educators.

Teaching, Learning, and Performance in the Surgical Workplace: Insights From the Examination of Intraoperative Interactions.

This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Central Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the study. These thoughts explore the value of examining intraoperative interactions among attending surgeons and residents for enhancing instructional scaffolding; entrustment decision making; and distinguishing teaching, learning, and performance in the workplace.

Medical School Factors That Prepare Students to Become Leaders in Medicine.

Purpose: To identify medical school factors graduates in major leadership positions perceive as contributing to their leadership development.

Method: Using a phenomenological, qualitative approach, in August-November 2015 the authors conducted semistructured interviews with 48 medical leaders who were 1976-1999 baccalaureate-MD graduates of the University of Missouri-Kansas City School of Medicine (UMKC). At UMKC, they participated in longitudinal learning communities, the centerpiece for learning professional values and behaviors plus clinical skills, knowledge, and judgment, but received no formal leadership instruction.

Intelligent cooperation: A framework of pedagogic practice in the operating room.

Background: Surgeons who work with trainees must address their learning needs without compromising patient safety.

Methods: We used a constructivist grounded theory approach to examine videos of five teaching surgeries. Attending surgeons were interviewed afterward while watching cued videos of their cases.

How surgical mentors teach: a classification of in vivo teaching behaviors part 2: physical teaching guidance.

Objectives: To study surgical teaching captured on film and analyze it at a fine level of detail to categorize physical teaching behaviors.

Design: We describe live, filmed, intraoperative nonverbal exchanges between surgical attending physicians and their trainees (residents and fellows). From the films, we chose key teaching moments and transcribed participants' utterances, actions, and gestures.

How surgical mentors teach: a classification of in vivo teaching behaviors part 1: verbal teaching guidance.

Objectives: To illuminate surgical teaching at a fine level of detail by filming intraoperative communication between surgical attending physicians and trainees and provide a naturalistic categorization and analysis of verbal teaching behaviors.

Design: Live, intraoperative verbal exchanges between surgical attending physicians and their trainees (residents and fellows) were filmed, and key verbal teaching moments were transcribed. In follow-up interviews, attending physicians and trainees watched video clips of their teaching case and answered open-ended questions about their surgical teaching methods.

50 years of publication in the field of medical education.

Background: The advent of new medical education (ME) journals makes evident the growth of the field of ME. However, the nature and context of growth is undefined.

Aim: To analyze the evolution of publication in ME.