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 team is composed of 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 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. 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 Twitter to be notified when new must reads are selected.

(Reviewers: Kavita Chapla, Belinda Chen, Alaina Chodoff, Kara-Grace Leventhal, Gigi Liu, Emily Ma, Thiago Bosco Mendes, Susan Mirabal, Amin Nakhostin-Ansari, Hannah Oswalt, Stasia Reynolds, Ben Roberts, Elizabeth Ryznar, Carolina Saldanha, Dan Sartori, Sean Tackett, Scott Wright)

Featured This Month

Deconstructing racism, hierarchy, and power in medical education: Guiding principles on inclusive curriculum design
Academic Medicine: K. A. Green, R. Wolinsky, S. J. Parnell, D. Del Campo, A. S. Nathan, P. S. Garg, S. E. Kaplan, and S. Dasgupta
The Gist
• Curriculum analysis of race as portrayed in Boston University School of Medicine's 4-year medical student program.
• Recommendations to improve the curriculum included challenging the biologic framing of race, developing students’ “equity competencies,” and fostering institutional environments that support activism and dialogue.
Why This Is A Must Read

This article describes an unusually rigorous approach to critically examining a curriculum and presents several frameworks that can reduce racism and enhance equity in medical curricula.

Deliberate reflection and clinical reasoning: Founding ideas and empirical findings
Medical Education: S. Mamede and H. G. Schmidt
The Gist
• Commentary on the state of the science related to deliberate reflection as a method of working through clinical cases.
• Describes relevant evidence, provides a stepwise approach to deliberate reflection, and summarizes areas for future study.
Why This Is A Must Read

Diagnostic error remains a significant source of clinical harm and waste. Deliberate reflection offers a framework to systematically weigh clinical evidence, avoid biases, and improve diagnostic accuracy.

The impact of clinical uncertainty in the graduate medical education (GME) learning environment: A mixed-methods study
Medical Teacher: M. W. Johnson, G. Gheihman, H. Thomas, G. Schiff, A. P. J. Olson, and A. Simpkin Begin
The Gist
• Surveys, interviews, and ethnographic observations to understand clinical uncertainty in inpatient medical learning environments.
• Uncertainty was associated with discomfort and perceptions of competitive learning environments; it was often avoided, especially among less experienced physicians.
Why This Is A Must Read

Transitioning from classroom-based education to learning in complex clinical environments can be challenging. This study highlights that clinicians can be role models by acknowledging limitations and explicitly discussing clinical uncertainty.

Featured

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Medical Education: A. Bansal, S. Greenley, C. Mitchell, S. Park, K. Shearn, and J. Reeve
Optimising planned medical education strategies to develop learners’ person-centredness: A realist review
The Gist
• Realist review on formal curricular interventions to enhance person-centered clinical skills.
• Reflection and longitudinal support can reconcile learners’ biomedical perspectives, which assume that most patients are the same, with a person-centered perspective.
Why This is a Must Read

Patients have unique backgrounds and circumstances, which requires attention to individual differences. This article highlights strategies that can help learners develop the attitudes and skills needed for holistic and personalized care.

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BMC Medical Education: M. E. L. Brown, A. MacLellan, W. Laughey, U. Omer, G. Himmi, T. LeBon, and G. M. Finn
Can stoic training develop medical student empathy and resilience? A mixed-methods study
The Gist
• Surveys and interviews of medical students who completed a short online curriculum grounded in the Stoic practices of negative visualization and Stoic mindfulness and reflection.
• Pre-post measures showed Increases in stoicism, empathy, and resilience.
Why This is a Must Read

Stoic philosophy emphasizes constructive responses to emotions, especially in the unexpected and challenging situations that are common in health professions education. This study offers a curriculum that can foster Stoicism and emotional well-being.

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Academic Medicine: M. Chakroun, V. R. Dion, K. Ouellet, A. Graillon, V. Désilets, M. Xhignesse, and C. St-Onge
Narrative assessments in higher education: A scoping review to identify evidence-based quality indicators
The Gist
• Scoping review from across higher education to describe characteristics of high-quality narrative feedback.
• Suggests 7 quality indicators and 12 recommendations for writing narrative assessments.
Why This is a Must Read

Thoughtful, specific, and actionable feedback is crucial to guiding learners’ development, but written comments are often lacking. This article’s concrete recommendations can promote narrative assessments that better support learning.

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Human Resources for Health: A. Elma, M. Nasser, L. Yang, I. Chang, D. Bakker, and L. Grierson
Medical education interventions influencing physician distribution into underserved communities: A scoping review
The Gist
• Scoping review of educational interventions intended to encourage family practitioners to work in underserved locations.
• A variety of interventions can be effective, especially selecting learners from and conducting educational experiences in underserved areas.
Why This is a Must Read

Many places still have limited access to physicians. This article summarizes evidence-based strategies and highlights the need to align educational interventions with other policies and initiatives intended to improve the distribution of physicians.

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Teaching and Learning in Medicine: J. Beck, C. N. Falco, K. L. O'Hara, H. K. Bassett, C. L. Randall, S. Cruz, J. L. Hanson, W. Dean, and K. Senturia
The norms and corporatization of medicine influence physician moral distress in the United States
The Gist
• Interviews of U.S. pediatric residents and hospitalists asking about sources of moral distress.
• Hierarchies in the profession can disempower learners to speak up when something is wrong, and health system corporate influences can make it difficult to do what is right, leading to moral distress.
Why This is a Must Read

Many physicians experience dissonance between what they expect patient care to be and what it is in practice. This article helps us better understand why this occurs and encourages us to focus on structures and systems to improve clinical environments.

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Academic Medicine: A. N. Leep Hunderfund, C. P. West, S. J. Rackley, E. J. Dozois, S. M. Moeschler, B. E. V. Stelling, R. C. Winters, D. V. Satele, and L. N. Dyrbye
Social support, social isolation, and burnout: Cross-sectional study of U.S. residents exploring associations with individual, interpersonal, program, and work-related factors
The Gist
• Cross-sectional survey of 762 residents from 58 programs at one institution, analyzing variables associated with social support and isolation.
• Residents’ sense of autonomy and their relationships with faculty were linked to social support and isolation, while program characteristics were not.
Why This is a Must Read

This survey, before the COVID-19 pandemic, shows a variety of factors that may underlie residents’ sense of social well-being. These data can inform interventions and future study of changes made during the pandemic.