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

(Team: Kavita Chapla, Thiago Mendes, Susan Mirabal, Stasia Reynolds, Elizabeth Ryznar, Dan Sartori, Sean Tackett, and Scott Wright)

Featured This Month

A scoping review of professional identity formation in undergraduate medical education

Journal of General Internal Medicine: S. Sarraf-Yazdi, Y. N. Teo, A. E. H. How, Y. H. Teo, S. Goh, C. S. Kow, W. Y. Lam, R. S. M. Wong, H. Z. B. Ghazali, S. K. Lauw, J. R. M. Tan, R. B. Q. Lee, Y. T. Ong, N. P. X. Chan, C. W. S. Cheong, N. H. A. Kamal, A. S. I. Lee, L. H. E. Tan, A. M. C. Chin, M. Chiam, and L. Krishna

The Gist

• Scoping review that applied a systematic evidence-based approach, where a 21 person team screened 10443 titles and summarized 76 full texts.
• Describes features of professional identity formation (PIF) and factors that influence PIF.

WHY THIS IS A MUST READ

Much has been written about PIF in medicine, and this article’s well-organized tables describing barriers and facilitators for PIF can be useful to a range of readers, from researchers to educators looking for tips to foster PIF in learners.

The Gist

• Survey of medical students measuring need fulfillment, resilience, mindfulness, and coping strategies.
• Need fulfillment and resilience mediated the relationship between mindfulness and healthier coping, with need fulfillment being a stronger mediator.

WHY THIS IS A MUST READ

When we ensure that the basic psychological needs to achieve autonomy, competence, and relatedness are addressed, learners might be able to realize the benefits that come with greater mindfulness.

The Gist

• Commentary describing the concept of “sociological imagination” and how it can apply to health professions education.
• Educators are encouraged to develop “two-way thinking” that recognizes limitations in biomedical theories and appreciates frameworks grounded in human experiences.

WHY THIS IS A MUST READ

Context matters. Sociological imagination might provide a way for learners and educators to envision connections between biomedical sciences and the complex social and historical contexts in which we learn and practice medicine.

The Gist

• Overview of “co-creation,” when learners actively participate in educational design processes.
• Provides a framework linking learner involvement with expected outcomes and describes challenges to co-creation and ways to overcome them.

WHY THIS IS A MUST READ

Empowering learners as valued contributors can improve their learning experiences and benefit educators. This guide thoroughly summarizes the theory and evidence related to co-creation in medical education and provides specific direction for implementation.

Previously Featured

The Gist

• Commentary that summarizes inequities in U.S. healthcare and medical education that emerge from structural racism and reviews professional values that compel us to address them.
• Describes 4 steps - See, Name, Understand, Act – as a framework to take an antiracist stance in medical education.

Why This is a Must Read

Seeking diversity and inclusion is important but has not led to equity. Specific inequities require specific approaches; an antiracist stance can help us make progress on longstanding inequities from structural racism. The See-Name-Understand-Act framework may also help us recognize and address other inequities.

The Gist

• Comparison of machine learning algorithm assessments of medical students’ diagnostic justification essays to student and faculty ratings.
• Algorithm ratings correlated with human ratings and were more consistent than humans' across different diagnostic scenarios.

Why This is a Must Read

Artificial intelligence has the potential to revolutionize assessments in medical education, especially those that require significant human effort and expertise. This study takes a step toward realizing that potential and makes it easier to imagine how machine learning might assess clinical reasoning in educational and practice settings.

The Gist

• Commentary on challenges to reproducibility in medical education research.
• Summarizes 6 risk factors for reporting false findings and suggests ways to improve research design, conduct, and reporting.

Why This is a Must Read

We are all in trouble if we can’t trust research findings. This article describes challenges with scientific rigor as they apply to quantitative studies in medical education. Its ideas could be useful when planning and evaluating research studies.

The Gist

• Modified Delphi approach to develop competencies for coaching in medical education.
• Defines 15 competencies in 5 domains and describes observable behaviors for each.

Why This is a Must Read

Coaching may help learners become more self-aware, self-directed, and willing to experiment to develop adaptive expertise. This study’s framework can guide programs to train, assess, and cultivate coaching in medical education.

The Gist

• Interviews of physicians, residents, and nurses about experiences with fatigue in healthcare.
• Risks from fatigue were acknowledged but respondents minimized negative impacts of fatigue on their own care, some believing they were immune to fatigue.

Why This is a Must Read

We are not our best when we’re tired, yet physical, cognitive, and emotional exhaustion (and its risks) are common in healthcare. Feeling tired is not failing. Systems must change to support providers’ highest levels of performance.

The Gist

• Commentary describing “observable practice activities (OPAs)” that could be used to assess non-cognitive attributes.
• Provides a table of 18 non-cognitive attributes with 110 OPAs.

Why This is a Must Read

Some of the most important characteristics for providing excellent patient care are difficult to measure. This list of OPAs offer a practical starting point for assessments that can make these attributes easier to see and lead to feedback and improvement.