Must Reads

What is a ‘Must Read’ for those interested in medical education?

Each month, we identify 3-4 noteworthy articles from the health professions education literature and label them as “must reads.” Selection is based on several criteria including originality and methodological rigor. Our process includes a formal search of the peer-reviewed literature, screening titles and abstracts, full text review, and an editorial meeting to achieve consensus.

Who are we and why are we doing this?

Our reviewers include individuals with expertise in teaching, educational oversight, and research as well as those who are beginning their careers as educational scholars.

The volume of health professions education articles has become overwhelming. In curating some of the best new published papers, we hope to make it easier for all of us to keep abreast of cutting edge educational scholarship and practices.

We’d welcome involvement in the selection process. Reviewers can earn CME credit and contribute to Must Reads research. If you are interested in supporting this work or have perspectives to share, please email Sean Tackett: stacket1@jhmi.edu.

You can also follow @MedEdMustReads on X (aka Twitter) to be notified when new must read articles are selected and sign up to receive an email each month.

(Current Reviewers: Kara Alcegueire, Paul Bain, Kavita Chapla, Scott Kinkade, Pranav Kotamraju, Viviane Liao, Erica Lin, Liju Mathew, Pallavi Menon, Amin Nakhostin-Ansari, Bridget O’Brien, Ashley Paul, Julianne Perretta, Katherine Senko, Julia Shalen, Sean Tackett, Scott Wright)

Featured This Month

The Gist

• Case study with interviews and focus groups including patients, educators, and students to describe patient partnerships in healthcare education.
• Described 3 themes: (1) equality is not necessary for effective partnership, (2) partnership means feeling valued, and (3) value can be shown multiple ways.

WHY THIS IS A MUST READ

Patient perspectives should be represented throughout healthcare. This study integrated multiple points of view to propose a “Wheel of Patient Partnerships” to guide patient involvement in health professions education.

The Gist

• Surveys of students and teachers combined with data from videos of bedside teaching encounters.
• Smaller groups, more time, and teacher motivation (not teacher experience) were correlated with ratings of quality by students.

WHY THIS IS A MUST READ

Bedside teaching is a mainstay of high-quality clinical instruction. This study suggests approaches that may improve student perceptions and experiences.

The GIst

• Commentary comparing perspectives of time in the U.S. and Brazil.
• Contrasts “clock time” – linear and measured objectively - with “event time” – flexible and subjective – and considers implications for medical education.

WHY THIS IS A MUST READ

Time is not experienced the same way by everyone. This article prompts us to be more thoughtful and intentional in how we manage time in medical education and practice.

Featured

The GIst

• Analysis of 6,898 hospitalists across 455,120 admissions over 3 years in the U.S. to determine if board certification scores and ACGME milestone ratings related to inpatient outcomes.
• Board exam scores, not milestones ratings, were associated with improved patient outcomes.

WHY THIS IS A MUST READ

Attempts to tie medical education to patient outcomes on a national scale are rare. This study supports that a broad knowledge base – reflected in standardized exams - is important in clinical care and shows complexity in using milestone ratings as measures of overall clinical competency.

The GIst

• Interviews of 16 recently graduated general practitioners to identify narratives during difficult learning scenarios.
• Describes 4 common plotlines: (1) Journeyperson, (2) Hero’s Quest, (3) Solo Journeyer, and (4) Endless Struggle.

WHY THIS IS A MUST READ

We tell ourselves stories all the time. This study provides frameworks for how educators can understand where they fit into learners’ stories and provide appropriate support and feedback.

The GIst

• Survey of U.S. pre-clerkship curriculum deans to describe grading and remediation policies.
• Grading and remediation practices varied and were inconsistently reported to residency programs.

WHY THIS IS A MUST READ

Fairness in assessment is important to protect the interests of medical learners and the public. This study found that some schools may not be reporting on student performance transparently, which may result in unfair judgments and suggests reform is needed.

The GIst

• Analysis of data from interviews and clinical observations to understand how medical students make sense out of patient encounters.
• Sensemaking was cyclical with 3 steps: (1) framing a clinical problem, (2) inquiring into it, and (3) taking action.

WHY THIS IS A MUST READ

Clinical situations are full of ambiguity. Clinical sensemaking’s focus on how learners assign meaning to clinical information and arrive at concrete next steps can be useful for education and additive to models for diagnostic and management reasoning.

The GIst

• Commentary on postgraduate trainee unions and their tradeoffs.
• Pluses included better worker rights and benefits and opportunities for advocacy and leadership; minuses included taking positions against the program and being in conflict with some accreditation requirements.

WHY THIS IS A MUST READ

Residents’ roles as both practicing healthcare workers and learners in educational programs create tensions in the U.S. While residents should be actively engaged by all programs and institutions, unionizing may add credibility when residents advocate for improvements in care.

The Gist

• Commentary proposing an integrated conceptual model of clinical reasoning.
• Summarized 5 theories and implications for clinical reasoning teaching, assessment, errors, and research.

WHY THIS IS A MUST READ

Clinical reasoning is complex and relates to many existing theories. This article’s brief description of each theory and final model may enable learners and educators to better apply theory to practice.