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

• Tips to incorporate principles of mindfulness in medical teaching.
• Defines “mindful teaching” and suggests how to practice present-moment awareness, openness, curiosity, perspective-taking, and nonjudgment with medical learners.

Why This is a Must-Read

Mindfulness has benefited patients, clinicians, and learners. Practicing mindful teaching may benefit teachers and foster an environment that promotes mindfulness.

The Gist

• Focus group discussions of medical students early in clinical years, analyzed against Glaser’s framework of child neglect.
• Examples of learner neglect were identified in Glaser’s 5 categories of psychological neglect and in physical neglect.

Why This is a Must-Read

Educators are responsible for the development and growth of learners. No one would condone child neglect; yet learner neglect may be tolerated in busy clinical environments. Awareness of how learners may experience neglect is a first step in preventing it.

The Gist

• Scoping review of 769 studies on arts and humanities (A&H) in physician and interprofessional education.
• Studies were heterogeneous, representing diversity in approaches and a lack of shared language.

Why This is a Must-Read

The use of A&H in medical education is widely encouraged but has not realized its potential. In summarizing the A&H landscape, authors indicated a need for a coherent framework that informs future A&H efforts and proposed their own in a one-page format. Please copy and paste the following link into your browser:
https://journals.lww.com/academicmedicine/
Citation/9000/The_Prism_Model_for_Integrating_
the_Arts_and.96850.aspx

Previously Featured

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.

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.