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 we are and why are we doing this?

Our multidisciplinary 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

(Core team: Kavita Chapla, Alaina Chodoff, Benjamin Roberts , Elizabeth Ryznar, Sean Tackett, and Scott Wright)

Featured This Month

The Gist

• Survey of residents at 3 U.S. academic institutions finding that over a third experienced mistreatment, women more commonly than men.
• Few reported mistreatment incidents when they occurred, often because they feared reprisal or felt nothing could be done about them.

Why This is a Must-Read

Mistreatment of medical learners has received much attention over recent years, but it remains common. More must be done to ensure that mistreatment is not accepted as normal in clinical training environments and that residents feel empowered to take action.

The Gist

• Interviews of patients who were seen by a resident observed by a supervising physician in an outpatient encounter.
• Patients valued being part of the resident’s education and sought involvement of the supervisor during the encounter.

Why This is a Must-Read

Clinical supervisors traditionally attempt to be a “fly on the wall“ to avoid interfering with resident-patient interactions. This study suggests that acknowledging the supervisor as a participant in the encounter may better align with patient expectations and enhance resident learning.

The Gist

• Focus groups of medical students who wrote letters saying what they liked and didn’t like about the concept of empathy for patients, then read them aloud and discussed.
• Empathy was perceived as virtuous, but burdensome, and “fake empathy” was common.

Why This is a Must-Read

We should seek empathic relationships with all patients, but attempts to standardize empathy may be at odds with authenticity. Teaching learners phrases intended to convey empathy is well-intentioned, but learners must also be encouraged to express caring suited to their own personalities and each patient’s unique circumstances.

The Gist

• Tips for facilitating asynchronous discussions drawn from a study of Massive Open Online Course (MOOC) educators and the literature.
• Provides advice for systematically planning, leading, and facilitating discussions online.

Why This is a Must-Read

A great deal of medical education has moved to online platforms, some perhaps permanently. While this paper focuses on MOOCs, many of its tips would apply to any online forum and be relevant to the facilitation of any discussion.

Previously Featured

The Gist

• Meta-ethnography of the professional identity formation literature from a post-colonial perspective.
• Highlights how this literature rarely acknowledges issues of minoritized individuals.

Why This is a Must-Read

Dominant perspectives in academic literature can leave us blind to important issues. Critical studies like this can help us see in new light and remind us to be aware of how social and historical factors can empower some and marginalize other individuals and ideas.

The Gist

• RCT comparing an app-based mindfulness program, in-person training, and no intervention in healthcare students.
• Improvements in anxiety, self-compassion, and mindfulness with the app were similar to in-person training and greater than no intervention.

Why This is a Must-Read

Few interventions have been shown to improve well-being among healthcare trainees. App-based interventions have unique advantages over in-person training. As data emerges that app-based interventions can be effective, they may become more common in medical education.

The Gist

• Commentary describing increasingly detailed guidance for assessment in graduate medical education.
• Suggests that prescriptive rubrics and rules can restrict creativity and discourage faculty.

Why This is a Must-Read

Frameworks for assessment are useful and necessary, but they must balance qualitative / holistic and quantitative / instrumentalized aspects, so educators are entrusted and empowered to be flexible, creative, and innovative.

The Gist

• Overview of the genre of educational design research (EDR) and the family of approaches that it encompasses.
• Provides a generic model of EDR and examples of how it can be applied.

Why This is a Must-Read

This article provides a clear rendering of how EDR can advance theory while addressing real problems in education and provides useful guidance on how we can apply EDR in health professions program development and research.

The Gist

• Commentary that questions our understanding of the concept of wellness and the current practice of treating impaired wellness like a disease.
• Proposes that impaired wellness can be a normal response to challenging health care environments.

Why This is a Must-Read

We need to understand how and why impaired wellness happens before attempting to eradicate negative emotions. Adversity and struggle are natural when trying our best to care for patients and can catalyze personal growth.

The Gist

• Exploratory study to correlate eye-tracking in resident physicians with their thought processes when “eyeballing” patients in the rapid assessment of illness severity.
• Supports that both fast / intuitive and slow / deliberate thinking in the dual-process model take place.

Why This is a Must-Read

All healthcare professionals must make rapid judgments about illness severity. Measuring dual processing modes through the objective measures of how long trainees fixate on specific visual cues is a methodological advance that may have implications for clinical reasoning research and education.