Ensuring Equitable Application of Interventions to Vulnerable Subpopulations in the Kentucky Consortium for Accountable Health Communities (KC-AHC).

Introduction: The Centers for Medicare and Medicaid Services (CMS) has funded the Accountable Health Communities (AHC) model to test whether systematically identifying and addressing the health-related social needs (HRSNs) of individuals would impact healthcare utilization and total cost of care for Medicare and Medicaid beneficiaries. Toward this effort, AHCs implement screening, referral, and community navigation services in their local areas. There are 28 CMS-funded AHCs nationwide, including the Kentucky Consortium for Accountable Health Communities (KC-AHC).

Sex differences and psychological stress: responses to the COVID-19 pandemic in China.

Background: About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals' "normal" daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored - in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors.

Lack of Diversity in Simulation Technology: An Educational Limitation?

Despite increased attention on diversity in medicine and healthcare, heterogeneity in simulation technology has been slow to follow suit. In a nonsystematic review of simulation technology available in 2018 with respect to skin tone, age and sex, we found limited diversity in these offerings, suggesting limitations to educators' abilities to represent the full array of patients, conditions, and scenarios encountered in medicine and training. We highlight these limitations and propose basic strategies by which educators can increase awareness of and incorporate diversity into the simulation arena.

Legitimizing Continuous Quality Improvement (CQI): Navigating Rationality in Undergraduate Medical Education.

In July of 2015, the Liaison Committee on Medical Education (LCME)-the primary accrediting body for North American allopathic medical schools-formally advanced a model of "formative accreditation" by requiring that medical schools engage in "ongoing planning and continuous quality improvement processes that establish short and long-term programmatic goals, result in the achievement of measurable outcomes that are used to improve programmatic quality, and ensure effective monitoring of the medical education program's compliance with accreditation standards."As these and parallel forces redefine undergraduate medical education (UME) in increasingly rationalistic (i.e.

Inspiring the next generation of academic physicians: the academic health careers program.

There is growing evidence in the medical education literature for the aggressive need to recruit and retain the next generation of academic physicians. In 2008, the University of Kentucky College of Medicine (UK COM) developed an academic health careers (AHCs) program for preclinical medical students as an introduction into the practice of academic medicine. The goals of this elective experience included (1) highly customized training and mentorship experiences in research, teaching, and other aspects of academic medicine; (2) information and perspectives to assist students in making informed career choices, including options for academic careers; (3) access to academic career mentors and role models related to individual faculty research interests and teaching responsibilities; and (4) opportunities to network with UK COM administrators.

Sources of medical student stress.

Background: Key elements in the clinical practice of prevention, health and wellness are best cultivated in medical professionals during undergraduate medical training. This study explores students' self-assessed stress relative to gender, academic expectations, and level of medical training to guide development of targeted wellness interventions.

Methods: In early 2012, undergraduate (M1-M4) students in four Southeastern U.

Discerning applicants' interests in rural medicine: a textual analysis of admission essays.

Background: Despite efforts to construct targeted medical school admission processes using applicant-level correlates of future practice location, accurately gauging applicants' interests in rural medicine remains an imperfect science. This study explores the usefulness of textual analysis to identify rural-oriented themes and values underlying applicants' open-ended responses to admission essays.

Methods: The study population consisted of 75 applicants to the Rural Physician Leadership Program (RPLP) at the University of Kentucky College of Medicine.

End-of-life and palliative care curricula in internal medicine clerkships: a report on the presence, value, and design of curricula as rated by clerkship directors.

Purpose: End-of-life and palliative care (EOL/PC) education is a necessary component of undergraduate medical education. The extent of EOL/PC education in internal medicine (IM) clerkships is unknown. The purpose of this national study was to investigate the presence of formal EOL/PC curricula within IM clerkships; the value placed by IM clerkship directors on this type of curricula; curricular design and implementation strategies; and related barriers and resources.

A holistic review of the medical school admission process: examining correlates of academic underperformance.

Background: Despite medical school admission committees' best efforts, a handful of seemingly capable students invariably struggle during their first year of study. Yet, even as entrance criteria continue to broaden beyond cognitive qualifications, attention inevitably reverts back to such factors when seeking to understand these phenomena. Using a host of applicant, admission, and post-admission variables, the purpose of this inductive study, then, was to identify a constellation of student characteristics that, taken collectively, would be predictive of students at-risk of underperforming during the first year of medical school.

Medical student interest in academic medical careers: a multi-institutional study.

Little is known about how medical students view academic medicine. This multi-institutional study explored student perceptions of this career path. During 2009-2010, third- and fourth-year students at three United States medical schools completed a 30-item online survey.

Does gender moderate medical students' assessments of unprofessional behavior?

Background: Despite widespread acceptance of professionalism as a clinical competency, the role of certain contextual factors in assessing certain behaviors remains unknown.

Objective: To examine the potential moderating role of gender in assessing unprofessional behaviors during undergraduate medical training.

Design: Randomized, anonymous, self-administered questionnaire.

Should Histologic Grade Be Incorporated into the TNM Classification System for Small (T1, T2) Node-Negative Breast Adenocarcinomas?

Prognosis of invasive ductal carcinoma (IDC) strongly correlates with tumor grade as determined by Nottingham combined histologic grade. While reporting grade as low grade/favorable (G1), intermediate grade/moderately favorable (G2), and high grade/unfavorable (G3) is recommended by American Joint Committee on Cancer (AJCC) staging system, existing TNM (Primary Tumor/Regional Lymph Nodes/Distant Metastasis) classification does not directly incorporate these data. For large tumors (T3, T4), significance of histologic grade may be clinically moot as those are nearly always candidates for adjuvant therapy.

Assessing the quality of clinical teaching: a preliminary study.

Objectives: Evaluations in the clinical arena are fraught with problems. Current assessments of clinical teaching typically measure attributes of clinical teachers in overly broad terms, are often subjective and often succumb to the halo effect. This is in contradistinction to measurements of lectures, workshops or online educational content, which can more readily be assessed using objective criteria.

Emotional intelligence and medical specialty choice: findings from three empirical studies.

Context: Despite only modest evidence linking personality-type variables to medical specialty choice, stereotypes involving empathy and 'emotional connectedness' persist, especially between primary care providers and surgeons or subspecialists. This paper examines emotional intelligence (EI) and specialty choice among students at three US medical schools.

Methods: Results from three independent studies are presented.

Impact of two types of Internet-based information on medical students' performance in an Objective Structured Clinical Exam (OSCE).

Objectives: Internet-based information has potential to impact physician-patient relationships. This study examined medical students' interpretation and response to such information presented during an objective clinical examination.

Method: Ninety-three medical students who had received training for a patient centered response to inquiries about alternative treatments completed a comprehensive examination in their third year.

Changes in medical students' emotional intelligence: an exploratory study.

Background: The ability to recognize and adapt to affective states in one's self and others, emotional intelligence is thought to connote effective, compassionate doctor-patient communication. Unfortunately, medical training has been shown to erode some of the very attributes it purports to instill in students.

Purpose: The objective is to examine changes in students' emotional intelligence and empathy across an undergraduate medical curriculum.

Toward a sociological understanding of complementary and alternative medicine use.

Background And Objectives: The wide array of treatments and modalities comprising complementary and alternative medicine (CAM) represent a growing option for many individuals. Seeking to better understand this, much research has centered on identifying sociodemographic (e.g.

Evaluating CAM education in health professions programs.

As medical, nursing, and allied health programs integrate complementary and alternative medicine (CAM) content into existing curricula, they face many of the same challenges to assessment and evaluation as do more traditional aspects of health professions education, namely, (1) specifying measurable objectives, (2) identifying valid indicators, and (3) evaluating the attainment of desired outcomes. Based on the experiences of 14 National Center for Complementary and Alternative Medicine (NCCAM) education grant recipients funded between 2000 and 2003, the authors cite selected examples to illustrate strengths and deficits to "mainstreaming" CAM content into established health professions curricula, including subjecting it to rigorous, systematic evaluation. In addition to offering recommendations for more strenuously evaluating key CAM-related educational outcomes, the authors discuss related attitudes, knowledge, and skills and how these, like other aspects of health professions training, may result in enhanced patient care through modifications in clinical (provider) behaviors.

Lessons from industry: one school's transformation toward "lean" curricular governance.

As medical education grapples with organizational calls for centralized curricular oversight, programs may be compelled to respond by establishing highly vertical, stacked governance structures. Although these models offer discrete advantages over the horizontal, compartmentalized structures they are designed to replace, they pose new challenges to ensuring curricular quality and the educational innovations that drive the curricula. The authors describe a hybrid quality-assurance (QA) governance structure introduced in 2003 at the University of Kentucky College of Medicine (UKCOM) that ensures centralized curricular oversight of the educational product while allowing individualized creative control over the educational process.

Stories from the field: students' descriptions of gender discrimination and sexual harassment during medical school.

Purpose: Previous studies have documented the prevalence of gender discrimination and sexual harassment during medical training, but very few have examined the behaviors that students perceive as discriminatory or harassing. The authors addressed this lack of information by examining graduating medical students' written descriptions of personal experiences with such behaviors during medical school.

Method: The authors reviewed the responses of graduating seniors at 12 U.

The Kentucky medical curriculum: continuing innovations in educating physicians.

The University of Kentucky College of Medicine (UKCOM) retains a long history of educational commitment, quality, and innovation. Since undergoing a major curricular revision in the early 1990s, the evolving UKCOM curriculum has continued to incorporate advances in biomedical knowledge and pedagogy while meeting changing societal needs and expectations for physicians in practice. Building upon its established record of excellence in medical education, a curricular quality assurance (QA) program has been initiated to more efficiently guide improvement and innovation by providing faculty with key resources to identify and disseminate local best practices in teaching, learning, and evaluation.

Medical School Performance, Alumni Membership, and Giving: How Do Scholarship Recipients and Non-Recipients Differ?

Purpose: This study examines student recipients of merit, need-based, service, or minority scholarships, their performance in medical school, and the relationship to future alumni association membership and financial giving.

Method: Retrospective data on grade-point average attained across the four-year curriculum and extracurricular activities reported at graduation were collected on students at the University of Kentucky College of Medicine from 1981-1991. Comparisons of academic performance and participation in institutional activities were made across scholarship recipients and non-recipients.