Enacting the Carnegie Foundation Call for Reform of Medical School and Residency
a Office of Research and Development in Medical Education , University of California , San Francisco , California , USA. Teaching and Learning in Medicine
(Impact Factor: 0.66).
11/2013; 25(sup1):S1-S8. DOI: 10.1080/10401334.2013.842915
On the 100th anniversary of the Flexner Report, the Carnegie Foundation for the Advancement of Teaching published a new study of medical education. This study, titled Educating Physicians: A Call for Reform of Medical Schools and Residency Programs, contained four primary recommendations intended to stimulate innovation and improvement in medical education. In this article, the authors examined the ways others have applied the four recommendations from Educating Physicians within and beyond medical education. In their review of 246 publications citing the Carnegie work, they found that the recommendation for integration was addressed most frequently, often through descriptions of integration of curricular content in undergraduate medical education. The recommendation to focus on professional identity formation was the second most frequently addressed, followed by standardization and individualization, then inquiry, innovation, and improvement. The publications related to these latter three recommendations tended to be conceptual rather than descriptive or empirical. Publications spanned the continuum of medical education (from medical school to residency to physicians in practice) and even into other fields, but undergraduate medical education received the most attention. The authors discuss common themes among the citing publications and highlight opportunities for further discussion and innovation. Many exciting developments have occurred in medical education and beyond since the publication of Educating Physicians in 2010. Thus far, most of the publications citing the Carnegie recommendations describe incremental changes in medical education, particularly in the area of integration. Some of the conceptual work around these recommendations, coupled with a variety of external factors such as changes in health care and accreditation systems, suggests the potential for changes that are more transformative in nature.
Available from: Noel Lynch
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ABSTRACT: Background: Peer to peer learning is a well-established learning modality which has been shown to improve learning outcomes, with positive implications for clinical practice. Surgical students from across Ireland were invited to upload learning points daily while paired with their peers in a peer-reviewing process. This study was designed to assess content accuracy and evaluate the benefit of the review process. Method: A reflective content sample was selected from the database representing all gastrointestinal (GI) surgical entries. All questions and answers were double corrected by four examiners, blinded to the “review” status of the entries. Statistical analysis was performed to compare accuracy between “reviewed” and “non-reviewed” entries. Results: There were 15,569 individual entries from 2009–2013, 2977 were GI surgery entries; 678 (23%) were peer reviewed. Marked out of 5, accuracy in the reviewed group was 4.24 and 4.14 in the non-reviewed group. This was not statistically different (p = 0.11). Accuracy did not differ between universities or grade of tutors. Conclusion: The system of student uploaded data is accurate and was not improved further through peer review. This represents an easy, valuable and safe method of capturing surgical oral ward based teaching.
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ABSTRACT: Professional identity formation is a dynamic process that begins in undergraduate nursing education and continues to develop throughout one’s professional career. In recent decades, nursing educators emphasized the social dimension of professional identity formation in which professionalization is achieved through following rules, codes, and standards set by the profession. Character or psychological development and the proper use of virtues like integrity, compassion or courage, are often part of the hidden curriculum. The purpose of this paper is to introduce a recently developed conception of professionalism that is grounded in virtue ethics and integrates both social and character development into a professional identity that is dynamic, situated, and lifelong. The conception is operationalized through the Framework for Nurse Professionals (FrNP) and the Stair-Step Model of Professional Transformation. The FrNP and the Stair-Step Model promote a robust and morally resilient professional nursing identity that will foster professional growth throughout one’s career.
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ABSTRACT: Using Bourdieu's theoretical model as a lens for analysis, we sought to understand how students experience the undergraduate medical education (UME) milieu, focusing on how they navigate transitions from the preclinical phase, to the major clinical year (MCY), and to the preparation for residency phase. Twenty-two medical students participated in this longitudinal case study. Students had similar preclinical and post-MCY experiences but different MCY experiences (rotational vs. longitudinal tracks). We interviewed students every 6 months in the preclinical phase, mid-way through MCY, and 7-8 months before graduation (101 total interviews). We inductively created codes, iteratively revised codes to best-fit the data, and thematically clustered codes into Bourdieu-informed categories: field (social structures), capital (resources) and habitus (dispositions). We found that students acclimated to shifts in the UME field as they moved through medical school: from medical school itself to the health system and back. To successfully navigate transitions, students learned to secure capital as medical knowledge and social connections in the preclinical and preparation for residency phases, and as reputable patient care and being noticed in the clinical phase. To obtain capital, and be well-positioned for the next phase of training, students consistently relied on dispositions of initiative and flexibility. In summary, students experience the complex context of medical school through a series of transitions. Efforts to improve UME would be well-served by greater awareness of the social structures (field) that students encounter, the resources to which they afford value (capital), and the dispositions which aid acquisition of these resources (habitus).
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