Journal of general internal medicine
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Morbidity and Mortality (M&M) conferences are widely utilized clinical teaching forums across the USA. Recent literature demonstrates heterogeneity in the educational objectives of M&M, with prior authors suggesting a variety of overarching purposes of the conference, including teaching quality improvement methods; promotion of patient safety; enhancement of clinical knowledge and skills; and reflection on humanistic aspects of medical practice. There is less information in the published literature regarding learning outcomes of M&M participants. ⋯ Participants derived several types of learning from this Internal Medicine M&M conference. Although clinical knowledge and skills represent the most common type of learning, the conference also produces rich learning in other domains as well as reflections on the humility, challenges, and meaning of being a physician.
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Despite similar performance metrics, women medical trainees routinely self-assess their own skills lower than men. The phenomenon of a "confidence gap" between genders, where women report lower self-confidence independent of actual ability or competency, may have an important interaction with gender differences in assessment. Identifying whether there are gender-based differences in how confidence is mentioned in written evaluations is a necessary step to understand the interaction between evaluation and the gender-based confidence gap. ⋯ Narrative evaluations of women residents were more likely to contain references to confidence, after adjustment for numerical score, PGY level, and faculty gender, which may perpetuate the gender-based confidence gap, introduce bias, and ultimately impact professional identity development.
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Disparities in objective assessments in graduate medical education such as the In-Training Examination (ITE) that disadvantage women and those self-identifying with race/ethnicities underrepresented in medicine (URiM) are of concern. ⋯ Differences in ITE over training were associated with resident gender and race/ethnicity. Women and URiM residents had smaller ITE score gains across PGY translating into greater odds of potentially being seen as at-risk for not passing the ABIM-CE. Differences in ITE over training may reflect differences in experiences of women and URiM residents during training and may lead to further disparities.
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COVID-19 disrupted undergraduate clinical education when medical schools removed students from clinical rotations following AAMC recommendations. Clerkship directors (CDs) had to adapt rapidly and modify clerkship curricula. However, the scope and effects of these modifications are unknown. ⋯ Curricular adaptations occurred in IM clerkships across US medical schools as a result of COVID-19. More research is needed to explore the long-term implications of these changes on medical student education and clinical learning environments.