Academic Medicine最新文献

Problem: Effective postexamination psychometric analysis plays an important role in supporting medical education assessments and is critical for ensuring reliability, dependability, validity, and fairness, which ultimately contribute to patient safety. However, many medical educational settings face significant barriers to achieving this, including expensive or complex software, limited psychometric expertise or programming skills, and increasing budgetary constraints regarding the need for rapid score release and quality control. This report describes a free, user-friendly tool that enables health education professions to conduct rapid and accurate postexamination analysis using classical test theory (CTT), generalizability theory (GT), and the Rasch model (RM).

Approach: The web-based tool, developed and tested in 2025 at the University of Nottingham, removes the need for complex postexamination data processing and provides real-time item performance metrics, reliability coefficients, and diagnostic reports, enabling educators to rapidly compare 3 measurement theories simultaneously for a comprehensive postexamination review.

Outcomes: A dataset from a high-stakes final medical assessment (489 students, 200 items) was uploaded. The tool rapidly produced CTT measures, GT variance components, and a decision study, including G-coefficient and phi-coefficient, as well as the absolute standard error of measurement and RM calibrations. Under CTT, the tool also outputs individual outcomes, histograms of marks, the true score and 68% or 95% bounds, rank scores, z scores, percentiles, and deciles. The tool also identified misfit items and persons, item-person maps, separation coefficients, and Rasch reliability. Additionally, the tool produced item characteristics curves, test characteristic curves, and test information function.

Next steps: Future work includes expanding the tool by adding categorical responses to fully evaluate the quality of single-best-answer questions or multiple-choice question distractors. This aim will be achieved by analyzing plausible and implausible options and displaying the correlation between the total scores and the occurrence of each answer option for each question.

In light of increasing legislation aimed at prohibiting diversity, equity, and inclusion (DEI) efforts at publicly funded universities in the United States, women-only leadership programs (WOLPs) have come under increasing pressure, which could undermine gender equity advancements, particularly in academic medicine. Women-only leadership programs have traditionally offered a unique advantage for women over mixed-gender leadership programs by fostering psychologically safe spaces to share experiences, teaching leadership competencies while using a gender equity lens in areas where it makes sense, and providing essential support in the form of mentorship and sponsorship. Women-only leadership program participation is also -associated with increased promotion rates, retention rates, and leadership roles. Given the current political environment, this is a pivotal moment-and a key opportunity-to elevate the work of WOLPs by expanding their reach to include all individuals who can benefit from their programming and help build a more inclusive and equitable field. To this end, WOLPs must reimagine, reframe, and rebrand their work to continue cultivating the future generation of health care leaders, focusing on a central tenet of WOLPs: different people have different experiences and are treated differently. As the national focus on DEI work evolves, it is imperative that WOLPs evolve and expand spaces for leadership development for all talented individuals to ensure that there continues to be progress in gender representation and leadership advancement. Amid growing legislative threats to diversity, equity, and inclusion, women-only leadership programs (WOLPs) too have faced scrutiny. WOLPs must reimagine, reframe, and rebrand their work to continue cultivating the future generation of healthcare leaders. As part of this evolution, the progeny of WOLPs should maintain that different people have different experiences and are treated differently.

Succession planning facilitates leadership transitions that allow for the continuation of mission-critical processes with minimal disruption. This AM Last Page contains tips to improve succession planning at academic medicine institutions to support candidates and maintain organizational efficiency.

Purpose: The number of medical degree candidates who obtain a second advanced degree via combined degree or dual--degree programs is increasing. This scoping review examines existing literature on dual-degree programs in undergraduate medical education to summarize findings and identify research gaps to help guide future academic pursuits.

Method: Publications on dual degrees in medicine were searched in MEDLINE, ERIC, CINAHL, Scopus, and Web of Science on April 2, 2025. Two investigators independently reviewed and extracted data from eligible studies. Inclusion criteria were doctor of medicine (MD) or doctor of osteopathic medicine (DO) as one of the dual degrees, both degrees earned concomitantly at institutions in the United States, and published in 1964 or later. A qualitative content analysis was conducted.

Results: A total of 3501 studies were identified. After removing duplicates and irrelevant articles, 69 articles were included. Of the 69 articles, 43 discussed doctor of medicine (MD)/doctor of philosophy (PhD) programs, 23 discussed MD/master of public health programs, 18 addressed MD/master of business administration programs, 13 examined MD/master of science programs (including 1 combined MD and master of engineering), 3 analyzed MD/juris doctor programs, 3 examined MD/doctor of dental surgery programs, and 2 discussed osteopathic medicine/PhD programs. Across all dual-degree types, 35 articles discussed student perceptions, 24 examined curricular challenges, 19 addressed match outcomes, and 23 explored career choices and outcomes compared with standard medical school programs.

Conclusions: This scoping review synthesizes the dual-degree program literature and identifies common themes addressed in these articles. Furthermore, this scoping review identifies areas for further research in medical education regarding dual-degree -programs, including longitudinal outcomes of dual-degree graduates, perceptions of prospective and current students in such programs, evaluation of curricular challenges, and challenges of academic progress faced by students while completing 2 graduate degrees.

The demand for high-quality faculty development in medical education is more acute than ever. Faculty developers' responsibilities are growing exponentially as they are called upon to help medical faculty maintain expertise in an evolving array of content domains, curricular and assessment strategies, education technologies, and active learning methods. Faculty development has a long history of supporting medical education colleagues in times of change. More recently expectations for faculty developers are expanding due to (1) increasing enrollment of learners, (2) emphasis on learner-centered teaching practices and competency-based assessment methods, and (3) heightened accreditation standards for training faculty. Yet, faculty development in medical education lacks the conventional structures of a profession, such as an adopted set of competencies. In 2023, a series of sessions at regional, national, and international medical education conferences were held to generate ideas and collect examples of faculty developer competencies from over 100 stakeholders. More than 500 responses were gathered from prompts such as "What are the competencies faculty developers need?" and "What is one of the most valuable faculty developer competencies today?" This perspective offers both a rationale for establishing faculty development in medical education as a profession and a path forward through the provision and broad promotion of clearly defined core competencies. The competencies outlined are intended to help inform those entering or currently working in the profession, recruiters of faculty developers, medical education leaders, institutional partners, those conducting performance appraisals of faculty developers, and the broader medical education community. The aim of this work is to generate discussion among vested medical education and faculty development stakeholders who seek to provide structure, clarify roles, and further define medical education faculty development as a profession.

Academic health centers (AHCs) face unique challenges regarding freedom of expression, a topic that recently has caused considerable public controversy at universities across the United States. Little has been published on institutional responses to these controversies. To inspire conversation, reflection, and policy development at other AHCs, in this article, the authors outline steps taken by the Medical College of Wisconsin (MCW) in 2023 and 2024 to respond to an immediate challenge to freedom of expression and to develop a long-term response that will support the institution's commitment to freedom of expression as an essential element of education, patient care, and scientific inquiry. The authors describe the work of the MCW Committee on Freedom of Expression, including its formation, the steps it took to develop guiding principles, and the reaction of faculty, staff, and particularly medical students to initial educational programming around applying the newly developed principles. As a private institution, MCW has greater legal latitude than public AHCs, which allowed the committee to engage leaders and stakeholders in a reflective process, asking questions about the institution's position as a "public square," how to best address the needs of institutional and clinical partners, and the impact of power and inequity on broad protections of freedom of expression. To date, among stakeholders, students have been the most hesitant to embrace the new principles and consistently have shared concerns. Feedback from students has demonstrated that self-censorship is widespread, social justice concerns are a high priority, and structured programming can support and scaffold constructive conversations. The authors conclude that providing opportunities for engagement with institutional freedom of expression principles, especially when uncomfortable, is an essential step in integrating them into educational and clinical practices.

Problem: Although the use of artificial intelligence (AI) as a diagnostic aid is increasing in clinical practice, medical education provides little training on how to incorporate AI-generated information into diagnosis and use it effectively in shared decision-making (SDM) with patients.

Approach: The authors developed and piloted a simulation-based course to train AI-assisted SDM to final-year medical students preparing for residency. Conducted between June and October 2023, the course combined online prelearning with onsite simulations using clinically approved AI tools (Lunit INSIGHT CXR, version 3.1.4.1 and MMG, version 1.1.4.3; Lunit Inc, Seoul, South Korea; used November 16 and 27, 2023). Scenarios portrayed asymptomatic patients with incidental findings (eg, pulmonary nodules, breast microcalcifications). Students engaged in two 12-minute simulated patient encounters featuring SDM with 2 management options. Sessions concluded with simulated patient-written feedback and expert-facilitated debriefing. Twenty-seven students from 3 medical schools participated.

Outcomes: Program evaluation showed significant improvements in participants' comprehension and confidence in SDM (t = 6.51 and t = 7.56, P < .001, respectively) and AI-assisted SDM (t = 5.72 and t = 5.80, P < .001, respectively). Students found AI tools helpful for facilitating SDM and patient communication. Thematic analysis of interviews highlighted strengths, such as structured course design and reflective debriefing. Participants noted that prior education focused on diagnostic algorithms, whereas this course emphasized patient communication and preference-based decisions. They found AI tools useful for diagnosis and supporting discussion with patients through visual outputs. However, they identified limitations, including their own clinical knowledge gaps and lack of explainability in AI tool shortage. They suggested integrating SDM and AI-assisted diagnosis training into formal curricula to better prepare students for clinical practice.

Next steps: Future efforts should focus on integrating this course into undergraduate curricula or transition training programs to provide experiential learning opportunities in AI-assisted clinical practice.