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n broader diversity and inclusion efforts.
Weave is a customizable online mentorship platform that fosters empowered vulnerability and increases dialogue between medical students and faculty based on professional and personal interests and identities. Weave may be expanded to other mentoring contexts and adapted for implementation at other institutions to help cultivate an institutional culture that values mentoring and to strengthen broader diversity and inclusion efforts.
Learning is markedly improved with high-quality feedback, yet assuring the quality of feedback is difficult to achieve at scale. Natural language processing (NLP) algorithms may be useful in this context as they can automatically classify large volumes of narrative data. However, it is unknown if NLP models can accurately evaluate surgical trainee feedback. This study evaluated which NLP techniques best classify the quality of surgical trainee formative feedback recorded as part of a workplace assessment.
During the 2016-2017 academic year, the SIMPL (Society for Improving Medical Professional Learning) app was used to record operative performance narrative feedback for residents at 3 university-based general surgery residency training programs. Feedback comments were collected for a sample of residents representing all 5 postgraduate year levels and coded for quality. In May 2019, the coded comments were then used to train NLP models to automatically classify the quality of feedback across 4 categories (e use of NLP for classifying feedback quality. SVM NLP models demonstrated the ability to automatically classify the quality of surgical trainee evaluations. Larger training data sets would likely further increase accuracy.
Accurate self-assessment is a critical skill for residents to develop to become safe, adaptive clinicians upon graduation. Physicians need to be able to identify and fill in knowledge and skill gaps to deal with rapid expansion of medical knowledge and unpredicted novel emerging medical issues. Residency training to date has not consistently focused on building these overarching skills, nor have the burgeoning assessment data that competency-based medical education (CBME) affords been used beyond their initial intent to inform summative assessment decisions. Both are important missed opportunities.
The Queen's University family medicine program adopted CBME in 2010. In 2011 it added the capacity for residents to electronically self-assess their daily performance, with preceptors reviewing and modifying as needed before submitting. In 2018 it designed software to report discordance between residents' self-assessment and preceptors' assessment of performance.
From 2011-2019, 56,585 field notes were submit fostering improved self-assessment of performance.
Inaccurate self-assessment (both overcalling and undercalling performance) has negative consequences. Awareness is a first step in addressing this. Discrepancy reports will now be used during regular academic reviews with residents to discuss the nature, degree, and frequency of discrepancies, with the intent of fostering improved self-assessment of performance.
Reflecting on and using feedback is important for physicians' continuous professional development (CPD). A common format is the discussion of multisource feedback (MSF) in a one-on-one session with a trusted peer or coach. A new approach is to discuss MSF during a peer group session moderated by a professional facilitator. This qualitative study explored how physicians experience participation in these peer group sessions in the context of their CPD.
Between March and July 2018, 26 physicians were interviewed about their experiences in a peer group session. These physicians represented 13 monospecialty physician groups from 5 general hospitals in the Netherlands. Interviews were transcribed verbatim and analyzed iteratively, following the interpretative phenomenological approach.
Participation was experienced as a process of disclosing and sharing personal reflections with others while striking a balance between interpersonal proximity to and distance from peers. Sharing reflections with others rendered action and monitoring the follow-up process.
Peer group sessions offered interactivity and established a clear link between individual physicians and their work environments. Sharing reflections on MSF in a peer group setting provided physicians with nuanced insight into their professional performance and fostered a community spirit that supported the implementation of intended changes. Future research should focus on the role of group dynamics and communication strategies and the application of coaching principles, such as drawing up a detailed plan of action and monitoring the follow-up process.The term "health systems science" (HSS) has recently emerged as a unifying label for competencies in health care delivery and in population and community health. Despite strong evidence that HSS competencies are needed in the current and future health care workforce, heretofore the integration of HSS into medical education has been slow or fragmented-due, in part, to a lack of evidence that these curricula improve education or population outcomes. The recent COVID-19 pandemic and the national reckoning with racial inequities in the United States further highlight the time-sensitive imperative to integrate HSS content across the medical education continuum. While acknowledging challenges, the authors highlight the unique opportunities inherent in an HSS curriculum and present an elaborated curricular framework for incorporating health care delivery and population health into undergraduate medical education. This framework includes competencies previously left out of medical education, increases the scope of faculty development, and allows for evidence of effectiveness beyond traditional learner-centric metrics. The authors apply a widely adopted six-step approach to curriculum development to address the unique challenges of incorporating HSS. Two examples-of a module on quality improvement (health care delivery) and of an introductory course on health equity (population and community health)-illustrate how the six-step approach can be used to build HSS curricula. The Supplemental Digital Appendix (at http//links.lww.com/ACADMED/B106) outlines this approach and provides specific examples and resources. Adapting these resources within local environments to build HSS curricula will allow medical educators to ensure future graduates have the expertise and commitment necessary to effect health systems change and to advocate for their communities, while also building the much-needed evidence for such curricula.
Competency-based education relies on the validity and reliability of assessment scores. Generalizability (G) theory is well suited to explore the reliability of assessment tools in medical education but has only been applied to a limited extent. This study aimed to systematically review the literature using G-theory to explore the reliability of structured assessment of medical and surgical technical skills and to assess the relative contributions of different factors to variance.
In June 2020, 11 databases, including PubMed, were searched from inception through May 31, 2020. Eligible studies included the use of G-theory to explore reliability in the context of assessment of medical and surgical technical skills. Descriptive information on study, assessment context, assessment protocol, participants being assessed, and G-analyses were extracted. Data were used to map G-theory and explore variance components analyses. A meta-analyses was conducted to synthesize the extracted data on the sources of variancehould be a best practice when developing assessment of technical skills.
G-theory is increasingly being used to examine reliability of technical skills assessment in medical education but more rigor in reporting is warranted. Contextual factors can potentially affect variance components and thereby reliability estimates and should be considered, especially in high-stakes assessment. Reliability analysis should be a best practice when developing assessment of technical skills.
During the COVID-19 pandemic, medical schools have offered a virtual application process. Minimal literature is available to guide best practices.
The Icahn School of Medicine at Mount Sinai (ISMMS) implemented a completely virtual interview (VI) process in April/May 2020. Large-group sessions for applicants, interviews with applicants, and ISMMS Admission Committee meetings occurred via Zoom (Zoom Video Communications, Inc., San Jose, California). Large-group sessions and committee meetings occurred via communal conference calls, while one-on-one, semi-structured interviews occurred in individual breakout rooms. ISMMS offered live, virtual question-and-answer sessions with students and faculty, plus digital resources describing program features. After the interview day, applicants and interviewers were invited to complete anonymous surveys regarding their experiences with and perspectives of VI.
Of 125 applicants and 20 interviewers, 99 (79%) and 18 (90%), respectively, completed at least part of the scation process for all.
VI, likely to be a temporary-but-universal fixture of upcoming application cycles, may benefit applicants and interviewers alike by saving resources and diversifying those involved. Next steps are developing programming that will permit applicants to virtually explore the institution and connect more with current students. Future research should evaluate potential bias in VI to ensure an equitable application process for all.In response to the COVID-19 pandemic, many medical schools suspended clinical clerkships and implemented newly adapted curricula to facilitate continued educational progress. While the implementation of these new curricula has been described, an understanding of the impact on student learning outcomes is lacking. In 2020, the authors followed Kern's 6-step approach to curricular development to create and evaluate a novel COVID-19 curriculum for medical students at the University of California San Francisco School of Medicine and evaluate its learning outcomes. The primary goal of the curriculum was to provide third- and fourth-year medical students an opportunity for workplace learning in the absence of clinical clerkships, specifically for students to develop clerkship-level milestones in the competency domains of practice-based learning and improvement, professionalism, and systems-based practice. The curriculum was designed to match students with faculty-mentored projects occurring primarily in virtual forogy in medicine, and quality improvement were developed through the curriculum more readily than in traditional clerkships, and could be considered as integral learning objectives in future curricular design.
The aim of this study was to investigate the efficacy of endoscopic selective vidian neurectomy in the treatment of severe persistent allergic rhinitis (AR) combined with chronic rhinosinusitis (CRS) with nasal polyps (ARwCRSwNP).
One hundred thirty patients with moderate to severe persistent ARwCRSwNP were enrolled at Xuanwu Hospital, Capital Medical University, from September 2015 to September 2017. Patients were divided into 2 groups. Sixty-one patients (the control group) underwent conventional surgical treatment for CRS with nasal polyps and received conservative treatment for AR. Sixty-nine patients (the experimental group) received conventional surgical treatment for CRS with nasal polyps plus endoscopic selective vidian neurectomy with amputation of the posterior nasal nerve and pharyngeal branch of the vidian nerve. Curzerene order Clinical parameters, including visual analog scale (VAS) score, Lund-Kennedy endoscopic mucosal morphology score, and Lund-Mackay sinus computed tomography (CT) scan lesion range score, were used to analyze and evaluate the preoperative and postoperative data.
