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 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

(Team: Kavita Chapla, Thiago Mendes, Elizabeth Ryznar, Sean Tackett, and Scott Wright)

Featured This Month

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.

The Gist

• Commentary describing modern organizational approaches to employee development in relation to approaches for physician employees.
• Suggests a framework drawn from the U.S. military to guide lifelong professional development.

Why This Is A Must Read

Physicians are often on their own to navigate a variety of career options after formal training. Physician employers could learn from common approaches that explicitly value and contribute to ongoing personal and professional growth.

Previously Featured

The Gist

• Interviews of preclinical medical students asking about race in medical learning.
• Students noted (i) imprecision in how race was presented in the curriculum, (ii) insufficient explanation of causes of racial disparities in health, and (iii) mixed messages around the utility of race in diagnostic reasoning.

Why This is a Must-Read

Educators must thoughtfully consider how, when, and why race is highlighted in medical education. Attention to individual perspectives on race, and clear definitions of terms related to race, may afford constructive dialogue around how race applies to medical education and practice.

The Gist

• Observational study of ICD-10 billing codes from inpatient admissions for internal medicine residents at one institution.
• Compares resident encounters to the exam blueprint of the American Board of Internal Medicine (ABIM), showing uneven exposure to required clinical conditions.

Why This is a Must-Read

Clinical practice generates abundant data that could be used to inform educational practices. This study is an example of how such data can reveal strengths and weaknesses in programs. Their crosswalk tool that links ICD-10 codes to ABIM sections can also be applied to other programs.

The Gist

• Survey of all allopathic medical schools in the U.S. and Canada on wellness program features.
• Most schools have wellness programs, but often their components are not felt to be adequate and evaluation is not rigorous.

Why This is a Must-Read

This study describes the landscape of wellness programs in North American medical schools. While it is reassuring that many schools have programs, more must be done to develop structures and cultures that promote wellness.

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