Academic medicine : journal of the Association of American Medical Colleges
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The clinical skills needed to practice high-value care (HVC) are core to all medical disciplines. Medical students form practice habits early, and HVC instruction is essential to this formation. The purpose of this study was to describe the state of HVC instruction and assessment in internal medicine clerkships and identify needs for additional curricula. ⋯ Internal medicine clerkship directors reported that HVC is insufficiently taught and assessed in medical school, despite relevance to practice. Developing generalizable curricular materials, faculty development, and dedicated curricular time may enhance HVC education.
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To describe attitudes of first- and second-year U.S. medical students toward value-added medical education, assess their self-reported desire to participate in value-added activities, and identify potentially modifiable factors influencing their engagement. ⋯ First- and second-year medical students agree they should add value to patient care, but their desire to participate in value-added activities varies depending on the nature of the tasks. Medical schools may be able to increase students' desire to participate by enabling face-to-face interactions with patients, embedding students in health care teams, and providing dedicated curricular time.
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To explore how academic physicians perform social and professional identities and how their personal experiences inform professional identity formation. ⋯ Professional identity formation is an ongoing process, and the negotiation of personal experiences is integral to this process. This negotiation may be more complex for physicians with minoritized identities. Implications for medical education include providing students, trainees, and practicing physicians with intentional opportunities for reflection and instruction on connecting personal experiences and professional practice.
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As U. S. medical educators know, it has been exceedingly difficult over the past decade to train medical students to document in the electronic health record (EHR) yet remain compliant with Centers for Medicare and Medicaid Services (CMS) guidelines. Indeed, some institutions have interpreted the guidelines to prohibit all medical student documentation in the EHR. ⋯ Therefore, the CMS policy transmittal Pub 100-04 Medicare Claims Processing Manual, released on February 2, 2018, which now explicitly allows appropriately supervised student documentation to be submitted for billing, is a welcome policy change. U. S. medical educators need to seize this opportunity, encourage their health systems to revise their internal precepting practices, and widely advertise to community preceptors that students can now add value in the clinical setting by assisting with documentation in the EHR.
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To explore resident and faculty perspectives on what constitutes feedback culture, their perceptions of how institutional feedback culture (including politeness concepts) might influence the quality and impact of feedback, feedback seeking, receptivity, and readiness to engage in bidirectional feedback. ⋯ An institutional feedback culture of excellence and politeness may impede honest, meaningful feedback and may impact feedback seeking, receptivity, and bidirectional feedback exchanges. It is essential to understand the institutional feedback culture before it can be successfully changed.