Academic medicine : journal of the Association of American Medical Colleges
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Some research shows that empathy declines during medical school. The authors conducted an updated, systematic review of the literature on empathy-enhancing educational interventions in undergraduate medical education. ⋯ These findings suggest that educational interventions can be effective in maintaining and enhancing empathy in undergraduate medical students. In addition, they highlight the need for multicenter, randomized controlled trials, reporting long-term data to evaluate the longevity of intervention effects. Defining empathy remains problematic, and the authors call for conceptual clarity to aid future research.
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Review Meta Analysis
Mastery learning for health professionals using technology-enhanced simulation: a systematic review and meta-analysis.
Competency-based education requires individualization of instruction. Mastery learning, an instructional approach requiring learners to achieve a defined proficiency before proceeding to the next instructional objective, offers one approach to individualization. The authors sought to summarize the quantitative outcomes of mastery learning simulation-based medical education (SBME) in comparison with no intervention and nonmastery instruction, and to determine what features of mastery SBME make it effective. ⋯ Limited evidence suggests that mastery learning SBME is superior to nonmastery instruction but takes more time.
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A dominant theory of clinical reasoning is the so-called "dual processing theory," in which the diagnostic process may proceed through a rapid, unconscious, intuitive process (System 1) or a slow, conceptual, analytical process (System 2). Diagnostic errors are thought to arise primarily from cognitive biases originating in System 1. In this issue, Custers points out that this model is unnecessarily restrictive and that it is more likely that diagnostic tasks may proceed through a variety of mental strategies ranging from "analytical" to "intuitive."The authors of this commentary agree that the notion that System 1 and System 2 processes are somehow in competition and will necessarily lead to different conclusions is unnecessarily restrictive. On the other hand, they argue that there is substantial evidence in support of a dual processing model, and that most objections to dual processing theory can be easily accommodated by simply presuming that both processes operate in concertand that solving any task may rely to varying degrees on both processes.
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Clinical faculty often complete in-training evaluation reports (ITERs) poorly. Faculty development (FD) strategies should address this problem. An FD workshop was shown to improve ITER quality, but few physicians attend traditional FD workshops. To reach more faculty, the authors developed an "at-home" FD program offering participants various types of feedback on their ITER quality based on the workshop content. Program impact is evaluated here. ⋯ The results suggest that faculty are able to improve ITER quality following a minimal "at-home" FD intervention. This also adds to the growing literature that has found success with improving the quality of trainee assessments following rater training.
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Although health professions worldwide are shifting to competency-based education, no common taxonomy for domains of competence and specific competencies currently exists. In this article, the authors describe their work to (1) identify domains of competence that could accommodate any health care profession and (2) extract a common set of competencies for physicians from existing health professions' competency frameworks that would be robust enough to provide a single, relevant infrastructure for curricular resources in the Association of American Medical Colleges' (AAMC's) MedEdPORTAL and Curriculum Inventory and Reports (CIR) sites. The authors used the Accreditation Council for Graduate Medical Education (ACGME)/American Board of Medical Specialties six domains of competence and 36 competencies delineated by the ACGME as their foundational reference list. ⋯ Comparison analysis led them to add 13 "new" competencies and to conflate 6 competencies into 3 to eliminate redundancy. The AAMC will use the resulting "Reference List of General Physician Competencies" (58 competencies in eight domains) to categorize resources for MedEdPORTAL and CIR. The authors hope that researchers and educators within medicine and other health professions will consider using this reference list when applicable to move toward a common taxonomy of competencies.