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 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. 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, Kiara Smith, Sean Tackett, Scott Wright)

Featured This Month

Management reasoning: Empirical determination of key features and a conceptual model
Academic Medicine: D. A. Cook, C. R. Stephenson, L. D. Gruppen, and S. J. Durning
The Gist
• Review of video-recorded simulated outpatient encounters to identify features of management reasoning.
• Describes 12 features, organized into 4 steps: (1) starting a management script, (2) identifying and discussing options, (3) choosing options with patients during shared decision-making, and (4) ongoing monitoring and adjustment.
WHY THIS IS A MUST READ

Medical care requires more than making an accurate diagnosis and recommending the right treatment. This study offers a framework that can be used to understand, analyze, and improve the complex processes underlying clinical management.

Health advocacy among medical learners: Unpacking contextual barriers and affordances
Medical Education: R. Kahlke, I. Scott, T. van der Goes, and M. M. Hubinette
The Gist
• Interviews of 29 medical learners to understand how they make decisions about advocating for patients.
• Engaging in health advocacy depended on learners’ knowledge, time available, perceptions of patients, social positions, and social norms.
Why This Is A Must Read

Physicians have privileged positions in health systems that can be used to improve equity for patients. This study provides practical recommendations to address barriers and empower learners to practice health advocacy.

What gets resident physicians stressed and how would they prefer to be supported? A best-worst scaling study
Postgraduate Medical Journal: A. Wu, R. S. Parris, T. M. Scarella, C. D. Tibbles, J. Torous, and K. P. Hill
The Gist
• Survey of trainees in 9 specialties at 1 institution to compare 16 causes of stress and 4 wellness interventions.
• Best-worst scaling analysis suggested work-life integration and clinical documentation were top stressors, and interventions with professional support were preferred to peer support.
Why This Is A Must Read

There are many causes of residents’ work-related stress and options to mitigate it. This study illustrates how a discrete choice modelling method can generate evidence to prioritize resources in support of resident well-being.

Featured

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Academic Medicine: L. D. Brenner, H. Wei, M. Sakthivel, B. Farley, K. Blythe, J. N. Woodruff, and W. W. Lee
Breaking the silence: A mental health initiative to reduce stigma among medical students
The Gist
• Innovation report describing one school’s 7-year initiative to improve mental health; it included a mental health panel, an “I screwed up” faculty story slam, and social media storytelling.
• Activities were highly rated and medical students' utilization of counseling services increased after the initiative started.
Why This is a Must Read

Many schools continue to struggle to create a climate that supports students’ psychological well-being. This article describes a low-cost program that may be adopted and adapted to achieve meaningful results.

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Advances in Health Sciences Education: D. Bowker, J. Torti, and M. Goldszmidt
Documentation as composing: How medical students and residents use writing to think and learn
The Gist
• Interviews and observations of medical learners in a rhetorical genre study focused on the processes in creating clinical documentation.
• Composing clinical notes supported learning by identifying knowledge gaps, synthesizing information, and clarifying thought processes.
Why This is a Must Read

It is necessary to record and communicate patient care information, and documentation can be regarded as a chore. This article highlights how the process of writing can improve thinking and have inherent educational value.

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Social Science & Medicine: N. R. Jain
The capability imperative: Theorizing ableism in medical education
The Gist
• Interviews and analysis of technical standards from 4 U.S. medical schools to conceptualize the capability imperative.
• The culture of medicine values the “selfless superhuman,” someone who can do all things and have no personal needs.
Why This is a Must Read

Providers demand much of themselves in a demanding healthcare environment. This study describes how the characteristics of the ideal physician are impossible for anyone to develop and is a reminder that all people have limitations that must be acknowledged and respected.

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Journal of Surgical Education: M. B. Nagaraj, J. Meier, R. Lefevre, D. E. Farr, and K. R. Abdelfattah 
Educational experience impacts wellness more than hours worked
The Gist
• Cross-sectional study of general surgery residents at one institution evaluating associations between number of hours worked, service vs education balance, and ratings on a well-being “full tank.”
• Well-being was associated with greater educational value but not number of hours worked.
Why This is a Must Read

The quantity and quality of time in clinical care will impact residents’ wellness. This study offers a design that can be reproduced in other programs to monitor and improve resident learning experiences.

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Advances in Health Sciences Education: Y. Mayer, M. Shalev, L. Nimmon, T. Krupa, L. Y. Bulk, A. Battalova, M. Lee, and Tal Jarus
Social support experiences of students and clinicians with disabilities in health professions
The Gist
• Interviews of 56 students and clinicians from 5 health professions who had physical, mental, cognitive, and/or sensory disabilities asking about their social support in clinical settings.
• Describes supportive and hindering social interactions and ways to promote social support.
Why This is a Must Read

All learners and practitioners benefit from a sense of belonging and encouragement. This study’s guidance, based on the perspectives of those with disabilities, can foster safe, open, and inclusive learning environments.

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Teaching and Learning in Medicine: D. N. Ricotta, J. B. Richards, K. M. Atkins, M. M. Hayes, K. McOwen, M. I. Soffler, C. D. Tibbles, A. J. Whelan, and R. M. Schwartzstein
Self-directed learning in medical education: Training for a lifetime of discovery
The Gist
• Report from a meeting of faculty from eight medical schools focused on self-directed learning in medical education (SDL-ME).
• Defines SDL-ME; discusses learner, faculty, curricular, and institutional factors that affect SDL-ME; and gives recommendations.
Why This is a Must Read

Self-directed and lifelong learning continue to be essential to effective clinical care. The model and advice in this article may help researchers and educators improve SDL-ME practices.