Academic medicine : journal of the Association of American Medical Colleges
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Despite considerable attention to professionalism in medical education nationwide, the majority of attention has focused on training medical students, and less on residents and faculty. Curricular formats are often didactic, removed from the clinical setting, and frequently focus on abstract concepts. As a result of a recent curricular innovation at the University of Washington School of Medicine (UWSOM) in which role-model faculty work with medical students in teaching and modeling clinical skills and professionalism, a new professionalism curriculum was developed for preclinical medical students. ⋯ At the UWSOM, heightened attention to professionalism at the medical student level led to awareness of the need for increased attention to teaching and modeling professionalism among faculty, residents, and staff. This new understanding of professionalism as an institutional responsibility has helped UWSOM teachers and administrators recognize and promote mechanisms that create a "safe" environment for fostering professionalism. In such an institutional culture, students, residents, faculty, staff, and the institution itself are all held accountable for professional behavior, and improvement must be addressed at all levels.
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Predictors of U.S. allopathic medical-school graduates' board-certification plans have not been characterized. ⋯ Specialty-board certification does not appear to be among the professional goals for a growing proportion of U.S. medical graduates.
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Medical schools face a new responsibility to prepare students for the United States Medical Licensing Exam Step 2 Clinical Skills (CS) exam. ⋯ An external licensing requirement engenders debate and motivates changes in clinical skills assessment and, in some cases, curricula.
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Randomized Controlled Trial
Are discharge summaries teachable? The effects of a discharge summary curriculum on the quality of discharge summaries in an internal medicine residency program.
Interns are often required to dictate discharge summaries without formal training. We investigated the impact of a curriculum aimed at improving the quality (i.e., complete, organized, succinct, internally consistent, and readable) of interns' discharge summaries. ⋯ Interns who received instruction on discharge summary skills improved the quality and of their discharge summaries. Adding feedback to the curriculum provided more benefit.
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Internal medicine residents must be competent in Advanced Cardiac Life Support (ACLS) for board certification. Traditional ACLS courses have limited ability to enable residents to achieve and maintain skills. Educational programs featuring reliable measurements and improved retention of skills would be useful for residency education. ⋯ Use of a simulation-based educational program enabled us to achieve and maintain high levels of resident performance in simulated ACLS events. Given the limitations of traditional methods to train, assess and maintain competence, simulation technology can be a useful adjunct in high-quality ACLS education.