Journal of graduate medical education
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Review
A Decade of Teaching and Learning in Internal Medicine Ambulatory Education: A Scoping Review.
Ambulatory training in internal medicine residency programs has historically been considered less robust than inpatient-focused training, which prompted a 2009 revision of the Accreditation Council for Graduate Medical Education (ACGME) Program Requirements in Internal Medicine. This revision was intended to create a balance between inpatient and outpatient training standards and to spur innovation in the ambulatory setting. ⋯ While a rich diversity of educational innovations have occurred since the 2009 revision of the ACGME Program Requirements in Internal Medicine, there is a significant need for multi-institution studies and higher-level assessment.
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A residency program's intern cohort is comprised of individuals from different medical schools that place varying levels of emphasis on Core Entrustable Professional Activities for Entering Residency (CEPAERs). Program directors have expressed concerns about the preparedness of medical school graduates. Though guiding principles for implementation of the CEPAERs have been published, studies using this framework to assess interns' baseline skills during orientation are limited. ⋯ This OSCE during orientation offers just-in-time baseline information regarding interns' critical skills and may lead to individualized feedback as well as continuous curricular improvement.
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Comparative Study
Effects of a Flipped Classroom Curriculum on Inpatient Cardiology Resident Education.
The flipped classroom is designed to reinvigorate education and utilizes "at-home" time to learn concepts and "in-class" time for clinical application. While some studies have shown positive effects of the flipped classroom in undergraduate medical education, there is a paucity of data on its use in graduate medical education. ⋯ This flipped classroom curriculum did not affect knowledge, preparedness, or number of teaching sessions for internal medicine residents on a cardiology rotation when compared to usual teaching, although residents experiencing the new model expressed high satisfaction.
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There is ongoing tension in graduate medical education between progressive resident autonomy with entrustable professional activities and the need for supervision to ensure patient safety. ⋯ Residents demonstrated decreased decision-making and technical error rates on overnight call while maintaining low complication rates.