Development and Implementation of a Climate Change and Health Curriculum Into Pediatric Residency Education.

There is an increasing body of evidence demonstrating the impacts of climate change on health. Physicians recognize the significance but feel unprepared to address it. Despite a call to action from prominent medical organizations, climate change and health (CCH) education has remained sparse.

A Rapid-Response Curricular Approach to Teaching Politically Charged Topics.

Residency education in the United States faces challenges from evolving external influence on evidence-based reproductive and gender-affirming health care (R/GAHC). Curricula must incorporate information and resources to assist residents in navigating changes. To illustrate a process for expeditiously adapting curriculum in response to changing laws affecting R/GAHC.

Comorbid Diabetes Is Associated With Dyspnea Severity and Cardiometabolic Biomarkers in Black Adults With Heart Failure.

Background: Comorbidities such as Type 2 diabetes mellitus significantly and adversely influence heart failure outcomes, especially in Black adult populations. Likewise, heart failure has a negative effect on diabetes and cardiometabolic outcomes. Dyspnea, a common symptom of heart failure, often correlates with disease severity and prognosis.

Nonhealing Surgical Wounds in a Patient with Plasminogen Deficiency Type 1 Successfully Treated with Intravenous Plasminogen: A Case Report.

Intravenous plasminogen replacement therapy for patients with plasminogen deficiency type 1 (hypoplasminogenemia) was recently approved for marketing in the US. In this case report, the authors describe a 33-year-old man with hypoplasminogenemia who developed nonhealing postsurgical wounds following trauma to his right hand despite receiving standard treatment for 4 months. The patient was enrolled in a compassionate-use protocol with intravenous plasminogen replacement therapy and experienced prompt resolution of surgical wounds.

Time and Note Characteristic Effects of an Electronic Health Record Template for Internal Medicine Resident Notes.

Inpatient internal medicine (IM) residents spend most of their time on indirect patient care activities such as clinical documentation. We developed optimized electronic health record (EHR) templates for IM resident admission and progress notes, with the objective to reduce note-writing time, shorten note length, and decrease the percentage of progress note text that was copy-forwarded from prior notes. In 2022, a multidisciplinary team created, over an 8-month period, optimized EHR templates for IM resident admission and progress notes.

The Virtual Visit: A Telehealth Curriculum for Internal Medicine Residents Featuring a Virtual Physical Examination.

Background: During the COVID-19 pandemic, medical professionals were obligated to adapt to virtual care. Most resident physicians had no formal telehealth training. The virtual physical examination remained underutilized.

Near-Peer Supervision in Primary Care: Bringing Teaching Teams From the Wards to the Clinic.

Background: Teaching near-peers yields numerous benefits to residents. Opportunities for near-peer teaching are typically restricted to hospital settings. Little is known about the educational potential of outpatient near-peer teaching.

A Graduate Medical Orientation Intervention Focused on Local Health Inequities.

Background: Residents must understand the social drivers of health in the communities they serve to deliver quality care. While resident orientation provides an opportunity to introduce residents to social and structural drivers of health, inequity, and care delivery relevant to the patient population in their new communities, many graduate medical education orientation curricula do not include this content.

Objective: To report the development and implementation of a novel, patient-centered health equity orientation curriculum, including initial feasibility and acceptability data as well as preliminary self-reported outcomes.

U.S. Department of Justice Investigation of a State Psychiatric Hospital.

The Department of Justice investigation of state psychiatric hospitals is nothing like investigation by more familiar regulatory agencies such as The Joint Commission or Centers for Medicare and Medicaid Services (CMS). For one, it comes with the threat of serious legal consequences for both the state psychiatric hospital under investigation and the state in general. Although little has been written about this topic, much of what has been written describes a negative, painful, and expansive experience affecting every aspect of the hospital system.

Presence, Resilience, and Compassion Training in Clinical Education (PRACTICE): A Follow-Up Evaluation of a Resident-Focused Wellness Program.

Background: Graduate medical education is demanding, and many residents eventually experience a reduced sense of well-being. Interventions are in development, but knowledge gaps remain in terms of time commitment and efficacy.

Objective: To evaluate a mindfulness-based wellness program for residents-PRACTICE (Presence, Resilience, and Compassion Training in Clinical Education).

Elder Financial Exploitation in the Digital Age.

Elder financial abuse violates the dignity, mental integrity, and fundamental rights of older adults. Reports of elder financial exploitation climbed during the COVID-19 pandemic, as many older adults were targeted by perpetrators seeking to take advantage of their worries about health and finances, increased isolation, and relative lack of familiarity with the digital technologies prevalent in their everyday lives. This article examines trends in usage of electronic financial technologies by older adults and describes new technology-based mechanisms of elder financial exploitation.

Late-Onset Sex Offending and the Assessment of Behavioral Variant Frontotemporal Dementia (bvFTD).

Behavioral variant frontotemporal dementia (bvFTD) is a common neuropsychiatric disorder, which is often missed or misdiagnosed by both neurologists and psychiatrists as a cause of emotional and behavioral problems. Inappropriate emotional responses and maladaptive behavior, including criminal behaviors, may be the first obvious expression of bvFTD caused by altered moral feelings, loss of empathy, disinhibition, and compulsive behavior. New onset sex offenses, including indecent exposure, sexually inappropriate comments, and unwanted sexual advances have been documented in early bvFTD.

Learner Handoffs Within Clinical Rotations: From the Resident Perspective.

Purpose: Competency-based medical education relies on repeated longitudinal assessments of learners. Frequent attending physician transitions within clinical rotations present a significant barrier to the educational continuity required in competency-based medical education. Learner handoffs (LHs), or the transfer of information regarding learners on a team among faculty supervisors, is a potential solution.

"The Feeling of Failure Is Immense": A Qualitative Analysis of the Experiences of Unmatched Residency Applicants Using Reddit.

Purpose: The increasing number of applicants who do not match to a residency program has been identified as an issue in Canada and the United States, yet the experiences of those individuals going unmatched have remained largely unexplored. By better understanding such experiences, medical schools will be better equipped to support unmatched graduates. The authors sought to understand the shared experiences of unmatched residency applicants, including those who did not match to American residency programs.

Legal Dilemmas when Victims of Sexual Assault are Voluntarily Intoxicated.

This issue of The Journal includes an article that brings to the forefront legal challenges that arise in prosecuting sexual assault cases in which the victim is voluntarily intoxicated. As we move as a society away from victim blaming and closer to an objective, nonjudgmental approach to victims of sexual assault, the law too has to evolve. In this commentary, we review how laws have generally approached intoxication in the contexts of criminal defenses, sexual consent, and other decisional capacities related to voluntary intoxication.

Maintaining Medical Student Motivation During Remote Clinical Learning.

Purpose: Remote clinical learning (RCL) may result in learner disengagement. The factors that influence medical student motivation during RCL remain poorly understood. The authors aimed to explore factors that affect medical student motivation during RCL and determine potential strategies to optimize student motivation during RCL.

Standardized Patients' Perspectives on Bias in Student Encounters.

Purpose: Standardized patient (SP) encounters are widely used in health professional education to evaluate trainees' clinical skills. Prior literature suggests that bias can influence the evaluations of student learners in SP-student encounters. Understanding how SPs perceive bias in their work and how they view their role in mitigating or perpetuating bias in simulation is an important first step in addressing bias in the SP-student encounter.

The Latino Resident Physician Shortage: A Challenge and Opportunity for Equity, Diversity, and Inclusion.

Purpose: The purpose of this study is to examine the number of Latino physicians in residency training and Latino resident physician trends in the nation's 10 largest medical specialties in the United States and in the 4 states with the largest Latino populations: California, Florida, New York, and Texas.

Method: The authors used data from the United States Census Bureau's American Community Survey to determine Latino populations and a special report from the Association of American Medical Colleges to determine rates of Latino resident physicians in the United States and in California, Florida, New York, and Texas from 2001 to 2017. Rates of Latino residents in the nation's 10 specialties with the largest number of residents were also determined.

Linking the Humanities With Clinical Reasoning: Proposing an Integrative Conceptual Model for a Graduate Medical Education Humanities Curriculum.

Discussion surrounding the role of the humanities as an important analytic epistemology within medical education is generally less robust than literature supporting its value in building empathy and promoting personal reflection and wellness. As such, the humanities have not been considered to be as relevant when teaching medical reasoning or technical skills. Yet, might the humanities offer value in emboldening the analytic thinking of medical learners? This article proposes an integrative conceptual model that links the thought process defining medicine-clinical reasoning-with humanistic analysis in an effort to advance the argument that the humanities offer a complementary and innovative platform that can be used within traditional medical education.

Expert Testimony in Sex Trafficking Cases.

In the courtroom, the credibility of sex trafficking survivors is often called into question. Particularly of interest are the survivors' complex behaviors and reactions, which may be misunderstood as being incongruent with claims that they were sex trafficked. Expert testimony may be essential to help the trier of fact understand the seemingly counterintuitive behavior of trafficking survivors.

A Call to Action From the California Consortium for the Assessment of Clinical Competence: Making the Case for Regional Collaboration.

The discontinuation of the United States Medical Licensing Examination Step 2 Clinical Skills Examination emphasizes the need for other reliable standardized assessments of medical student clinical skills. For 30 years, the California Consortium for the Assessment of Clinical Competence (CCACC) has collaborated in the development of clinical skills assessments and has become a valuable resource for clinicians, standardized patient educators, psychometricians, and medical educators. There are many merits to strong multi-institutional partnerships, including the integration of data across multiple schools to provide feedback to both students and curricula, pooled test performance statistics for analysis and quality assurance, shared best practices and resources, individual professional development, and opportunities for research and scholarship.

The Effects of Leadership Curricula With and Without Implicit Bias Training on Graduate Medical Education: A Multicenter Randomized Trial.

Purpose: To determine whether a brief leadership curriculum including high-fidelity simulation can improve leadership skills among resident physicians.

Method: This was a double-blind, randomized controlled trial among obstetrics-gynecology and emergency medicine (EM) residents across 5 academic medical centers from different geographic areas of the United States, 2015-2017. Participants were assigned to 1 of 3 study arms: the Leadership Education Advanced During Simulation (LEADS) curriculum, a shortened Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) curriculum, or as active controls (no leadership curriculum).

Latina Women in the U.S. Physician Workforce: Opportunities in the Pursuit of Health Equity.

Purpose: Some progress has been made in gender diversity in undergraduate medical education and the physician workforce, but much remains to be done to improve workforce disparities for women, particularly women from underrepresented populations, such as Latinas. This study examines the current level of representation and demographic characteristics of Latina physicians, including age, language use, nativity, and citizenship status.

Method: The authors used data from the 2014-2018 U.

Developing the Virtual Resus Room: Fidelity, Usability, Acceptability, and Applicability of a Virtual Simulation for Teaching and Learning.

Problem: Physical distancing restrictions during the COVID-19 pandemic led to the transition from in-person to online teaching for many medical educators. This report describes the Virtual Resus Room (VRR)-a free, novel, open-access resource for running collaborative online simulations.

Approach: The lead author created the VRR in May 2020 to give learners the opportunity to rehearse their crisis resource management skills by working as a team to complete virtual tasks.