Academic Medicine[JOURNAL]
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200 papers
Training Apart, Together: Team Dynamics in Individual Sports and Surgical Residency.
Palmer WJ, Bertoni D, Cottrill EE … +1 more , Huntley CT
Acad Med · 2026 Mar · PMID 41871451 · Publisher ↗
Surgeons in training share notable parallels with competitive athletes, including rigorous training, skill specialization, and functioning under pressure. Surgical educators have leveraged this comparison, incorporating...
Surgeons in training share notable parallels with competitive athletes, including rigorous training, skill specialization, and functioning under pressure. Surgical educators have leveraged this comparison, incorporating techniques from sports psychology, such as mental imagery and mindfulness, to improve trainees' individual performance and well-being. Surgical trainees and athletes also both rely on effective teamwork for optimal outcomes, suggesting that residency leaders can glean valuable team-level insights from sports psychology. This article examines how the structure of surgical residency influences team dynamics, using concepts from sports psychology to identify evidence-based strategies for improving program cohesion and resident well-being. The surgical literature typically conceptualizes surgery as an interdependent (or, colloquially, team) sport, such as soccer, in which participants collaborate toward a shared goal. Although valid for the operating room, the broader structure of surgical residency often functions more like an individual sport (eg, track or swimming), with residents training and working independently. This structure exposes residency programs to the unique dynamics observed in individual sports teams, including excessive individualism, exclusionary subgroup formation, and detrimental social hierarchy. These phenomena can undermine team building, weaken individual performance, and accelerate burnout. Evidence from the sports psychology literature suggests that program leaders can combat these trends by fostering a sense of interdependence, promoting socialization and development of a collective identity, cultivating a flexible and egalitarian culture, and developing faculty coaching skills to reframe individualism, facilitate inclusion, and model context-dependent hierarchy. Recognizing that the structure of surgical residency often mirrors that of an individual sport provides a valuable framework for understanding threats to team building and appropriate interventions in this setting. This Scholarly Perspective may allow program leaders to build more cohesive resident teams, ultimately improving trainee education, well-being, and performance.
Reframing Professionalism Around Trustworthiness: A Practical Approach to Professionalism Curriculum Development.
Triplett AD, Malisse CE, Kamanda H … +12 more , King JI, Warner SM, Zieser-Misenheimer E, Soltany KA, Popoli DM, Whiting E, Peters TR, Schafer KR, Burns CA, Strowd RE, Wofford MM, Jackson JM
Acad Med · 2026 Mar · PMID 41871450 · Publisher ↗
Many well-recognized challenges exist in medical professionalism education, including highly variable and fragmentary definitions that lack adaptation to changing norms, a focus on lapse detection, and assessments with l...
Many well-recognized challenges exist in medical professionalism education, including highly variable and fragmentary definitions that lack adaptation to changing norms, a focus on lapse detection, and assessments with limited validity, reliability, or standardization. To address local concerns related to the professionalism curriculum and student performance, in May 2022 a working group of faculty and medical students from Wake Forest University School of Medicine collaborated to develop and iteratively refine a revised definition of professionalism and an associated conceptual framework centered on establishing trustworthiness in one's workplace relationships. Within this framework, professionalism performance is categorized into 4 domains: trustworthiness in competence development, trustworthiness in humanity, trustworthiness in morality and ethics, and trustworthiness in duty fulfillment. Each domain is mapped to professional value commitments that are demonstrated through observable skills, tasks, and behaviors. The framework also emphasizes professionalism's connection with the developmental process of professional identity formation and the importance of demonstrating character, thus incorporating the 3 dominant frameworks of professionalism in the literature (virtue based, behavior based, and professional identity formation). This trustworthiness-based professionalism framework offers benefits to learners and educators, including improved clarity and comprehensiveness in defining medical professionalism, observable actions to guide learners toward successful achievement of trustworthiness, and connection to a shared purpose. Importantly, reframing professionalism around the goal of earning others' trust provides learners with an explicit, evidence-based rationale: one's professionalism performance-and the trust it generates-impacts other people. This framework provides medical educators with a practical tool for longitudinal professionalism curriculum development using a competency-based approach, with defined competencies, subcompetencies, and milestones that can be used to create meaningful training experiences, performance feedback, and assessments.
Defying gravity: moving from a scarcity mindset toward sustainability.
Farkas AH, Bonnema R, Donovan AK … +2 more , Yang Y, Noronha C
Acad Med · 2026 Jul · PMID 41871444 · Publisher ↗
Medical education and clinician educators find themselves in a time of scarcity, with increasing threats to academic medicine, higher educational demands and expectations, and decreasing resources. A scarcity mindset can...
Medical education and clinician educators find themselves in a time of scarcity, with increasing threats to academic medicine, higher educational demands and expectations, and decreasing resources. A scarcity mindset can lead to distress among both educators and learners, inhibiting the learning environment. However, the objective remains the same: to develop the next generation of high-quality physicians. How, then, can clinician educators themselves and the institutions they work for promote sustainability in a time of scarcity? This "scholarly perspective" outlines both individual actions and institutional initiatives that can mitigate the current scarcity mindset and promote efficient use of the resources already held. At the individual level, clinician educators can adapt their mindset and focus on the decisions that are within their control, knowing that many of the challenges they face require system-level changes. Additionally, they can automate tasks, set boundaries for themselves, and stay in touch with the "why" that drives their work. At the institutional level, greater interinstitutional collaboration in curricular development, broader teaching-workforce development in both undergraduate and graduate medical education, and better use of educational specialists could improve efficiency and allow clinician educators to work to their full potential. Finally, it is critical for educators to build strong relationships with institutional leaders and to maximize their leadership potential to advocate for the importance of clinical education as a cornerstone of academic medicine worthy of resource investment.
How Supervisors Work With Video of Clinical Practice to Influence Learning Conversations.
Huang AY, Bearman M, Castanelli DJ … +1 more , Molloy E
Acad Med · 2026 Mar · PMID 41871442 · Publisher ↗
PURPOSE: Feedback in clinical practice is often sub-optimal due to workload, time constraints, and interpersonal dynamics. Recent work has explored the concept of 'learning conversations' as a way to bring the learner in...
PURPOSE: Feedback in clinical practice is often sub-optimal due to workload, time constraints, and interpersonal dynamics. Recent work has explored the concept of 'learning conversations' as a way to bring the learner into the dialogue. Video recording of clinical practice has been proposed to capture observational data and facilitate constructive learning conversations. However, how video influences these conversations remains underexplored. This study investigates how learning conversations are influenced by supervisors' use of video in postgraduate medical education. METHOD: This qualitative study explored how supervisors work with video using semi-structured interviews which were conducted with 26 participants between November 2021 and May 2023. Data were analyzed with Reflexive Thematic Analysis. RESULTS: The sample comprised thirteen supervisors and thirteen trainees from four Anglophone countries, representing diverse specialties. Four themes were generated. (1) Bringing clinical encounters into the conversation: video appeared to enable indirect observation and more accurate focus on specific moments of practice. (2) Inviting trainees to observe themselves: supervisors described encouraging trainee self-reflection and using "objective" evidence to foster consensus. (3) Navigating emotional risks of video review: supervisors noted emotional challenges and described strategies-such as building trust and avoiding assessment framing-to mitigate anxiety. (4) Negotiating control in the learning process: supervisors balanced educational goals with trainee autonomy in context-sensitive ways. CONCLUSIONS: Video can enhance learning conversations, but positive impacts depend on thoughtful implementation. Poor use may increase trainee discomfort or defensiveness, while skillful application can enrich dialogue, shift perspectives, and promote reflection. These findings highlight the complexity of integrating video and the need for considered educational design decisions to optimize its impact on learning conversations.
The Latina physician wage chasm: a secondary analysis of the American Community Survey.
Anaya YB, Hsu P, Castellon-Lopez Y … +3 more , Mora Pinzon M, Byington CL, Hayes-Bautista DE
Acad Med · 2026 May · PMID 41863259 · Full text
PURPOSE: Research examining compensation patterns among Latina physicians is scarce. To address this gap, the authors analyzed patterns in wages and income in a nationally representative sample of physicians who identify...
PURPOSE: Research examining compensation patterns among Latina physicians is scarce. To address this gap, the authors analyzed patterns in wages and income in a nationally representative sample of physicians who identify as female and Latina compared with non-Hispanic White male and female and Latino male physicians in the United States. METHOD: This secondary analysis of a cross-sectional study used American Community Survey (ACS) data from 2018 to 2022. The authors described wages and income for Latina physicians and differences in these between Latina physicians and non-Hispanic White males and females as well as Latino male physicians. The authors summarized median total income, income bracket, and median salary according to gender, ethnicity, employment setting, weekly hours worked, and age group. The authors used an analysis of those who work 40-60 hours a week to account for work hour outliers. RESULTS: The ACS population estimates identified 1,083,177 physicians in the United States, which included 758,901 physicians who self-identified as non-Hispanic White or Hispanic. Of these 1,083,177 physicians, 29,416 (2.7%) were Latina. Latina physicians earned the lowest median total income of all physician groups analyzed. Median salary for non-Hispanic White male physicians was 1.9 times more than for Latina physicians ($218,161 vs. $120,563). Latina physicians comprise 19.4% of earners in income brackets above $300,000, whereas non-Hispanic White male physicians comprise 45.7%. These salary differences amount to an estimated median $3.9 million less income for a Latina physician over 40 years. CONCLUSIONS: Descriptive analysis revealed that Latina physicians consistently had the lowest median salary among physicians identified in population estimates from the ACS, regardless of employment setting, hours worked, and age. This compensation gap underscores the need for research, including causal inference and intervention studies, to help achieve equal pay for equal work, a fundamental element in fair workplace practice and policy.
A framework for scholarly development in health professions education.
Hunt S, Blanchard R, McOwen K
Acad Med · 2026 May · PMID 41838568 · Publisher ↗
The framework presented in this Last Page offers a scaffolded, iterative approach to scholarly development in health professions education, supporting educators as they progress from foundational skills to national leade...
The framework presented in this Last Page offers a scaffolded, iterative approach to scholarly development in health professions education, supporting educators as they progress from foundational skills to national leadership.
Development and implementation of a pre-clerkship value-added health systems science program: the value-added for inpatients by students and interdisciplinary teams consult service.
Aldrich DJ, Boudreau RM, Cerasale M … +13 more , Schram AW, Tang JW, Kostas T, Betancourt G, Terman E, Winters C, Xie TH, Gier N, Hu DA, Kalidoss S, Farnan JM, Arora VM, Martin SK
Acad Med · 2026 Apr · PMID 41837661 · Publisher ↗
PROBLEM: Health Systems Science (HSS) is increasingly recognized as a pillar of medical education. Few medical schools, however, have implemented experiential HSS learning opportunities where pre-clerkship medical studen...
PROBLEM: Health Systems Science (HSS) is increasingly recognized as a pillar of medical education. Few medical schools, however, have implemented experiential HSS learning opportunities where pre-clerkship medical students contribute value clinically. APPROACH: The Value-added for Inpatients by Students and Interdisciplinary Teams (VISIT) Consult Service, implemented in January 2024, is an HSS program at the Pritzker School of Medicine (PSOM) where first- and second-year medical students manage psychosocial barriers in discharge planning on Hospital Medicine and Trauma Surgery services at UChicago Medicine. The program was evaluated using post-VISIT student and patient surveys assessing student HSS knowledge and attitudes, student communication skills, and patient experience; psychosocial interventions proposed by students and integrated into care plans were categorized and counted. OUTCOMES: First-year students (89/90) in academic year 2023-2024 completed a VISIT consult between January and May 2024. Second-year students (88/88) the following academic year completed a consult between September and December 2024. All students interviewed a patient and documented an electronic health record note for each consult. The student survey response rate was 81% (81/100). All respondents (81/81) rated VISIT as valuable to their education, with 52% (42/81) rating it as "extremely valuable." From September to December, 44 patients participated, of whom 91% (40/44) completed surveys. Patients gave students mean ratings of 3.3 or higher on relational and technical communication skills (4-point scale) and a mean rating of 4.7 for their overall experience (5-point scale). The mean number of student-led interventions per consult from January to December was 5.2 (SD 2.5). The most common interventions were setting up insurance--covered transportation to medical appointments, arranging establish-care primary care follow-up appointments, and providing -substance cessation resources. NEXT STEPS: VISIT demonstrates how we can educate pre-clerkship students in HSS while empowering them to deliver -patient care. Next steps include expanding VISIT to pediatric and outpatient settings and clerkship and post-clerkship phases of -medical school.
Suicidal ideation in Residency: Recommendations for building a Supportive Learning Environment.
Thomas LR, Shanafelt T
Acad Med · 2026 Mar · PMID 41834105 · Publisher ↗
Although overall suicide risk for physicians may be decreasing from historical estimates, each physician suicide is a tragic loss of life for the affected individual and their family and has a profound impact on their co...
Although overall suicide risk for physicians may be decreasing from historical estimates, each physician suicide is a tragic loss of life for the affected individual and their family and has a profound impact on their colleagues, their team, and their organization. Work-related problems appear to be more common prior to instances of physician suicide relative to suicide occurring in other workers, and Nasca and colleagues' study, "One Is Too Many: Suicidality Among General Surgery Residents," elucidates several factors that were associated with increased risk for suicidal ideation in the previous 12 months among surgical residents. While all of the causal mechanisms and inter-relationships among burnout, depression, suicidal ideation, and work environment are incompletely understood, it seems clear that there are factors in the training and practice environment that influence the risk of burnout, depression, and possibly suicidality, beyond individual risk factors. Programs and institutions can work to improve the training environment by fostering belonging and social connection at work; striving for a culture that fosters psychological safety and reduces shame after adverse events or suboptimal performances; ensuring a manageable workload that allows adequate time for sleep, self-care, and personal relationships; and providing opportunities for developing progressive autonomy and maintaining meaning in work. For example, institutions can ensure that mental health services have a low barrier to access and are free or low cost. In addition, they can prioritize providing adequate time for faculty to engage in teaching and mentoring to support trainees' progressive development of autonomy and connection to meaningful work. In the post-COVID landscape, policy and advocacy efforts locally and nationally that protect health care workers from bullying, harassment, and workplace violence are additional important components of creating a sustainable and thriving clinical environment.
Exploring the confidence curve: teaching self-efficacy across the careers of award-winning health professions educators.
Usher EL, Cornelius KE, Alamy NH … +2 more , Scholl LM, Rindflesch AB
Acad Med · 2026 Jun · PMID 41834100 · Publisher ↗
PURPOSE: Clinicians and scientists often take a different path in developing competence and confidence as educators compared with peers who have received formal pedagogical teaching. This study explores how award-winning...
PURPOSE: Clinicians and scientists often take a different path in developing competence and confidence as educators compared with peers who have received formal pedagogical teaching. This study explores how award-winning health professions educators reflect on the development and fluctuation of their teaching self-efficacy over time. Guided by social cognitive theory, the study investigates how educators notice, make meaning of, and respond to diverse teaching-related experiences across their careers. METHOD: Between May and August 2023, 31 Mayo Clinic educators in clinical medicine, basic science, and allied health who had been recognized for teaching excellence in the past 10 years were invited to participate in semistructured interviews. Each participant first completed a preinterview survey and created a graph of their teaching confidence over time, which served as an anchor for the interview discussion. Reflexive thematic analysis identified patterns in how participants described sources of fluctuation in teaching self-efficacy. RESULTS: Of the 31 invited educators, 21 (11 women, 10 men) took part in an interview. Educators described varied trajectories of teaching self-efficacy over time shaped by different experiences, interpretations, and instructional experimentation. Four themes were identified: (1) interpreting implicit and explicit feedback, (2) revising beliefs in response to successes and setbacks, (3) adapting to changing contexts, and (4) using social models to gauge effectiveness. Participants reported becoming more responsive to situational demands and learner needs over time. CONCLUSIONS: For these award-winning educators, teaching self-efficacy was constructed and reconstructed through an adaptive, socially situated process of interpretation and reflection. The same events may have affected self-efficacy differently, depending on how individuals framed and acted on their experiences. Findings support a model that emphasizes adaptive expertise and offers implications for faculty development.
Responsible artificial intelligence in medical school admissions: a case study of the predictive assessment and summary tool.
Turner L, Mahtani AU, Mracek DL … +1 more , Koutroulis I
Acad Med · 2026 Jun · PMID 41832990 · Publisher ↗
The integration of artificial intelligence (AI) in medical school admissions offers transformative potential, but its responsible implementation is critical to ensure fairness and effectiveness. To guide institutions, th...
The integration of artificial intelligence (AI) in medical school admissions offers transformative potential, but its responsible implementation is critical to ensure fairness and effectiveness. To guide institutions, this article provides practical implementation strategies for the 6 core principles of responsible AI outlined by the Association of American Medical Colleges. Moving from principle to practice, the analysis is grounded in a concrete case study: a hypothetical predictive assessment and summary (PAS) tool that combines quantitative scoring with qualitative, evidence-based summaries of application materials. Through the lens of implementing the PAS tool, the authors examine key challenges and actionable solutions across all 6 principles. The discussion includes balancing data-driven prediction with holistic understanding, incorporating human judgment and oversight, and ensuring transparency through explainable AI. Furthermore, the article addresses strategies to protect applicant data privacy, mitigate algorithmic bias through the use of representative datasets and fairness-aware techniques, and establish robust monitoring frameworks for continuous evaluation. By providing this actionable framework, the article aims to empower medical education institutions to leverage AI's capabilities, upholding their commitment to a fair, transparent, and mission-driven selection process that fosters a competent and representative future physician workforce.
Transitioning from a leadership position: why, when, and how.
Sanfilippo F, Pomeroy C, Bailey DN
Acad Med · 2026 Jun · PMID 41832972 · Publisher ↗
Transitioning from a leadership position (eg, chair, chief, director, dean, executive officer) at an academic health center can be both challenging and, when done successfully, rewarding to all concerned. Successful tran...
Transitioning from a leadership position (eg, chair, chief, director, dean, executive officer) at an academic health center can be both challenging and, when done successfully, rewarding to all concerned. Successful transitions require that the leader carefully consider why they may want (or need) to make a change, define when is the best time to leave, and plan how their transition is made. Leaders may leave their positions for numerous reasons, including attractive new opportunities and experiences, problematic issues in their current role, completion of their term, unplanned termination, and dismissal. It is prudent for leaders at the outset of their position to anticipate and plan for their eventual transition. To determine when and how to transition, leaders should consider their personal satisfaction, their professional development, and the potential effects on the people, programs, and units they lead. Considering a career move requires appropriate assessment of personal and professional factors plus substantial self-awareness, as well as candid advice and assistance from others. Effective leaders understand when they have served for too long or too short a time and when it is best to move on in the interests of those they serve as well as their own career development. It is important for both the leader and the organization to ensure that the leadership transition process is smooth and well organized, with appropriate planning and communications. Knowing why, when, and how best to move on from one's leadership position can open new career opportunities, enhance one's legacy, and provide satisfaction in what the leader and others have accomplished.
When the Math Does Not Add Up: Rethinking the Small-Grant Economy in Medical Education.
Artino AR, Maggio LA
Acad Med · 2026 Mar · PMID 41832965 · Publisher ↗
In academic medicine, extramural grant funding is widely regarded as a hallmark of scholarly success. Yet, in medical education (MedEd), the economics of grant funding are poorly matched to the scale and cost of most sch...
In academic medicine, extramural grant funding is widely regarded as a hallmark of scholarly success. Yet, in medical education (MedEd), the economics of grant funding are poorly matched to the scale and cost of most scholarly projects. Small-dollar MedEd grants, typically under $10,000, have low success rates that rival those of large clinical awards, but still require time-intensive applications. Using an illustrative economic model, the authors estimate that the faculty labor required to prepare a typical MedEd application, approximately 40 hours, often costs the institution more than the proposal's expected monetary value. These conservative estimates exclude indirect cost limitations, the added burden of reviewer time, and the applicant's opportunity cost: every hour invested in a low-probability application is an hour not spent designing studies, collecting data, analyzing results, or publishing scholarship. Thus, for most small MedEd projects, the math does not add up. Repeated applications can drain time, money, and energy, while constant grant chasing risks undermining the very scholarship that funding is intended to support. The authors encourage institutions to reconsider blanket expectations for extramural MedEd funding, shifting instead toward more sustainable support models. These include internal micro-funding to cover modest research costs, protected-time awards that address the major constraint on faculty productivity (ie, time), scholarship-first mindsets that reward contributions irrespective of external dollars, collaborative funding mechanisms that pool institutional resources, and scholarly communities of practice that offer ongoing mentorship and infrastructure. The authors further argue that institutions supported by student tuition and public funds have an ethical obligation to subsidize educational research and innovation, as the quality of educational practice is inseparable from the quality and safety of healthcare itself. Redirecting faculty efforts from low-probability, low-yield grant chasing toward scholarship can foster a more sustainable research culture that rewards quality, drives innovation, and delivers lasting educational impact.
One is too many: suicidality among general surgery residents.
Nasca BJ, Hunt ML, Ramirez RT … +5 more , Eng JS, Li RD, Agarwal G, Bilimoria KY, Hu YY
Acad Med · 2025 Dec · PMID 41819820 · Publisher ↗
PURPOSE: Suicide was the leading cause of death in residency from 2015 to 2021. This study sought to investigate the -prevalence of suicidality as well as individual- and program-level factors associated with suicidality...
PURPOSE: Suicide was the leading cause of death in residency from 2015 to 2021. This study sought to investigate the -prevalence of suicidality as well as individual- and program-level factors associated with suicidality among general surgery residents. METHOD: A voluntary, cross-sectional survey was administered in January 2019 immediately after the 2019 American Board of Surgery In-Training Examination to all clinically active residents in ACGME-accredited US general surgery programs. Respondents were asked about demographics, their perceptions of the learning environment, mistreatment experiences, and whether they had considered suicide in the past year. Associations of individual- and program-level characteristics (learning environment and mistreatment domains) with suicidality were assessed. RESULTS: Of 8,129 clinically active residents, 6,956 (85.6%) from 301 surgical programs responded to at least part of the survey. Of the 6,567 (94.4%) residents who completed the suicidality question, 289 (4.4%) responded affirmatively. Residents were statistically significantly more likely to have suicidal thoughts if they were single (odds ratio [OR] 1.45, 95% confidence interval [CI] 1.06-2.00) or identified as LGBTQ+ (OR 1.67, 95% CI 1.02-2.75). Resident suicidality was also statistically significantly associated with frequent duty hour violations (OR 1.47, 95% CI 1.08-2.02), program emphasis on blame over learning after adverse events (OR 1.57, 95% CI 1.12-2.20), and a lack of meaning in work (e.g., low operative autonomy; OR 1.63, 95% CI 1.15-2.29), as well as mistreatment experiences (sexual harassment: OR 2.18, 95% CI 1.61-2.96; bullying: OR 2.42, 95% CI 1.55-3.79). CONCLUSIONS: Individual factors (that may be non-modifiable), including being single and LGBTQ+ status, as well as modifiable aspects of the learning environment (frequent duty hours violations, program emphasis on blame over learning after adverse events, lack of meaning in work) were found to be associated with suicidality in general surgery residents. Systemic improvement may be possible with interventions and changes at the program level.
Beyond yes or no: elevating mentor-mentee dialogues with open-ended questions.
Topor DR, Chang G
Acad Med · 2026 Jun · PMID 41818699 · Publisher ↗
Abstract loading — click title to view on PubMed.
Voluntirement: an untapped resource to the academic health center.
Greenberg L
Acad Med · 2026 Jun · PMID 41818687 · Publisher ↗
Abstract loading — click title to view on PubMed.
Respect for candidates and ethical practice in rater-mediated assessments.
Tavakol M, Stewart C
Acad Med · 2026 Jun · PMID 41818670 · Publisher ↗
Abstract loading — click title to view on PubMed.
Reply to Topor and Chang.
Freeland DG, Verbsky J, Babbott S
Acad Med · 2026 Jun · PMID 41818669 · Publisher ↗
Abstract loading — click title to view on PubMed.
Current practices and challenges associated with student remediation: results of a national survey of clerkship directors.
Montgomery MW, Callahan DG, Petersen EM … +5 more , Ratcliffe T, Kisielewski M, Krupat E, Osman NY, Weinstein AR
Acad Med · 2026 Jun · PMID 41812056 · Publisher ↗
PURPOSE: This study investigates current remediation practices in US internal medicine (IM) clerkships, focusing on how clerkship directors (CDs) identify, diagnose, remediate, and reassess struggling students and explor...
PURPOSE: This study investigates current remediation practices in US internal medicine (IM) clerkships, focusing on how clerkship directors (CDs) identify, diagnose, remediate, and reassess struggling students and explores strategies for improving remediation processes in undergraduate medical education. METHOD: Study data were derived from an annually recurring, nationally representative survey of IM core CDs at 140 fully and provisionally Liaison Committee on Medical Education-accredited schools fielded from September to December 2023. One section included 16 questions on identification of struggling learners and remediation strategies for IM clerkship students. Quantitative data were analyzed using descriptive statistics. Free-text responses were analyzed using qualitative inductive content analysis. RESULTS: A total of 118 of 140 CDs (84%) responded to the survey section that informed this study. These CDs reported that students most frequently had deficiencies in test-taking (72 [61%]), differential diagnosis generation (70 [59%]), oral presentations (67 [57%]), and time management (61 [52%]). Deficiencies were identified in multiple ways, most frequently through faculty communication (76 [64%]), shelf examination performance (74 [63%]), and narrative evaluations (70 [59%]), but only 26 CDs (22%) thought that struggling students were identified early enough to initiate remediation during clerkship. The most commonly reported remediation method was retaking a failed examination without other remediation (80 of 117 [68%]). The CDs called for centralized remediation processes to improve resource allocation and better tools, including sharing information about learners' past performance, to improve early identification and support for struggling students. CONCLUSIONS: The prevailing clerkship remediation model is conducted episodically and in silos, which has contributed to persistent challenges, including delayed identification of struggling learners, limited sharing of learners' educational needs across clerkships, and inadequate resources for CDs. A programmatic and collaborative remediation model should be embedded centrally in the school's overall educational program and conducted longitudinally to support all students' continuous growth.
Assessing Core Entrustable Professional Activities in the pre-clerkship Phase of Undergraduate Medical Education.
Nixon LJ, Poeppelman RS, Traxler M … +1 more , Violato C
Acad Med · 2026 Mar · PMID 41812055 · Publisher ↗
PURPOSE: To describe the implementation of selected core Entrustable Professional Activities (EPAs) for entering residency in the pre-clerkship program of undergraduate medical education and analyze the growth curves of...
PURPOSE: To describe the implementation of selected core Entrustable Professional Activities (EPAs) for entering residency in the pre-clerkship program of undergraduate medical education and analyze the growth curves of these EPAs over 12 months. METHOD: A total of 242 (128 women-53.0%; 114 men-47.0%) first and second year University of Minnesota Medical School students, with mean age = 24.6 (SD = 2.81) at matriculation, participated. Students enrolled in a required Early Clinical Experience course requested EPA assessments by supervisors (residents, faculty members) while working on a patient case together. Assessments were depicted as curves describing student performance over the course of their ECE from November 2023 to November 2024. Regression models were employed to fit the curves, and reliability was examined with a generalizability analysis (Ep2 coefficients). RESULTS: There were 6,689 EPA-based assessments with a mean number of 28 (SD = 8.2) assessments per student, provided by 786 assessors (residents and faculty members). Growth curves of the EPA ratings follow predicted negative exponential learning theory with baseline performance, a latent phase, subsequent rapid growth and eventual rate of learning deceleration. The slope of the growth curves demonstrates considerable variation by EPA. For a subset of the EPAs assessed on at least 8 occasions, adequate reliability (Ep2 coefficient >0.7) was achieved with 4 raters assessing on 4 occasions. CONCLUSIONS: The results of this analysis are consistent with learning theory and suggest EPA ratings provide reliable and valid data about acquisition of clinical skills for learners in the pre-clerkship phase of training. These results provide further evidence for the value of early clinical experiences and demonstrate EPA assessments can be a meaningful method of assessment for these early learners. This early EPA program has promise as a standardized learning and assessment system during pre-clerkship experience in medical education to guide curriculum and teaching improvement.
Designing a Digital Education Track for Medical Residents Using the Four Component Instructional Design Model.
Trivedi SP, Maggio LA, Rodman A … +1 more , Smith CC
Acad Med · 2026 Mar · PMID 41812048 · Publisher ↗
PROBLEM: Medical educators must teach effectively in strained clinical environments while meeting residents' growing preference for digital resources. However, there is limited guidance on teaching with digital platforms...
PROBLEM: Medical educators must teach effectively in strained clinical environments while meeting residents' growing preference for digital resources. However, there is limited guidance on teaching with digital platforms. APPROACH: In 2021, the authors developed and implemented a two-year Digital Education Track (DET) at Beth Israel Deaconess Medical Center's internal medicine residency program. Using the Four Component Instructional Design (4C/ID) model, they created a curriculum that combines foundational and hands-on digital education skills. The program includes a one-week intensive bootcamp and monthly sessions, where residents learn to create various digital teaching products, including podcasts, infographics, tweetorials, and whiteboard animation videos. The curriculum employs scaffolded learning tasks, supportive information, just-in-time guidance, and part-task practice to build complex teaching skills. OUTCOMES: Five cohorts totaling 29 residents have participated in the DET, with 17 graduates to date. Guided by Kirkpatrick's framework, evaluation emphasized Levels 2-4. At Level 2 (learning), graduated residents reported increased self-efficacy in using digital platforms and applying principles of cognitive load theory to their teaching. At Level 3 (behavior change), residents produced a substantial body of digital scholarship, including 22 podcasts (35,000-84,000 downloads each), 16 social media threads (26,500-542,400 impressions), 25 infographics, and 20 whiteboard animations. Faculty reviewed these resources using the revised METRIQ score, independently determining they were of high caliber (mean scores 2.5-2.9/3 across domains). At Level 4 (results), unsolicited post-publication feedback suggested these resources influenced teaching behaviors and, in some cases, patient care. NEXT STEPS: The DET offers educators a model for scaffolding instructional design for hands-on skills as medical education adapts to technological change, evolving learner needs, and clinical demands. Future work will include tracking long-term outcomes such as career trajectories and sustained teaching effectiveness and integrating explicit instruction on AI tools within each class.
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