Academic medicine : journal of the Association of American Medical Colleges
-
There is mounting concern that clinician-scientists are a vanishing species and that the pipeline for clinical and translational research (CTR) investigators is in jeopardy. For the majority of current junior CTR investigators, the career path involves first obtaining a National Institutes of Health (NIH)-funded K-type career development award, particularly K08 and K23, and subsequently an NIH R01. This transition, popularly referred to as K2R, is a major hurdle with a low success rate and gaps in funding. ⋯ Leadership training can empower junior investigators to thrive as independent CTR investigators. Future research should focus on delineating the difference between essential and supplemental factors to achieve this transition, and mentoring methods that foster success, including those that promote K2R transition of women and those underrepresented in biomedical research. The Clinical and Translational Science Awards National Consortium is well positioned to test existing models aimed at shortening the time frame, increasing the rate of K2R transition, and identifying strategies that improve success.
-
In an era when rates of obesity, diabetes, and other lifestyle-related diseases challenge medical educators and governments worldwide, it is necessary to consider novel educational strategies, both didactic and experiential, whereby current and future health professionals can be better prepared to proactively advise and teach patients enhanced self-care skills (e.g., diet, movement, stress management, and enhanced behavioral change). In this Perspective, the authors summarize current circumstances involving rising rates of obesity and diabetes worldwide, the lack of nutrition- and lifestyle-related curricular requirements for professional medical certification, societal trends regarding modern food culture and food availability in health care settings, and the misalignment of financial incentives to promote health. ⋯ They explore several ideas for reforming nutrition education, including "teaching kitchens" as required laboratory classes for nutrition and lifestyle instruction, wearable technologies for tracking behaviors and physiological data relating to lifestyle choices, and the prospect of hospitals and other medical venues serving as exemplars of healthy, delicious food options. Finally, the authors argue that "salutogenesis"-the study of the creation and maintenance of health and well-being-should assume its rightful position alongside the study of "pathogenesis"-disease diagnosis and treatment-in medical education and practice.
-
Comparative Study
The Use of Task-Evoked Pupillary Response as an Objective Measure of Cognitive Load in Novices and Trained Physicians: A New Tool for the Assessment of Expertise.
Task-evoked pupillary responses (TEPRs), or changes in pupil size, correlate with changes in cognitive processing demands. The magnitude of this change is a reliable marker of cognitive load. The authors used TEPRs to compare cognitive load between novices and trained physicians as they answered clinical knowledge questions. ⋯ Novices require more mental effort to answer clinical questions than trained physicians, even when both respond correctly. Measuring TEPRs has the potential to be a valuable assessment tool by providing objective measures of expertise and is worthy of further study.
-
Professional identity formation (PIF) within medical education is the multifaceted, individualized process through which students develop new ways of being in becoming physicians. Personal backgrounds, values, expectations, interests, goals, relationships, and role models can all influence PIF and may account for diversity of both experience and the active constructive process of professional formation. Guided reflection, including reflective writing, has been used to enhance awareness and meaning making within the PIF process for both students and medical educators and to shed light on what aspects of medical education are most constructive for healthy PIF. ⋯ Medical students (years 1-4) and a first-year resident in pediatrics respond to a variety of questions based on prevalent PIF themes extracted from the literature to reflect on their personal experiences of PIF. Topics queried included pretending in medical education, role of relationships, impact of formal and informal curricula on PIF (valuable aspects as well as suggestions for change), and navigating and developing interprofessional relationships and identities. This work aims to vividly illustrate the diverse and personal forces at play in individual students' PIF processes and to encourage future pedagogic efforts supporting healthy, integrated PIF in medical education.
-
The transition of a medical student or a nursing student into a health care practitioner requires many changes. Among these is the development of an appropriate professional identity, which assists in the establishment of a sound base for professional practice and therefore should be a focus for health professions educators. There is evidence, however, that medical education and nursing education face challenges in guiding students' development of appropriate professional identities. ⋯ In this Perspective, the authors explore the importance of and the pedagogical strategies used to facilitate professional identity formation for medical and nursing students. They argue that medical and nursing educators aim to instill in their students strong occupational identities which may perpetuate hierarchical disciplinary boundaries. They suggest that health professions educators should move beyond current disciplinary silos and create interprofessional education opportunities for medical students and nursing students to learn together to facilitate the development of the collaborative interprofessional identities necessary for the delivery of high-quality, patient-centered health care.