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One way practitioners learn ethics is by reflecting on experience. They may reflect in the moment (reflection-in-action) or afterwards (reflection-on-action). We illustrate how a teaching clinician may transform relationships with patients and teach person-centered care through reflective learning. We discuss reflective learning pedagogies and present two case examples of our preferred method, guided group reflection using narratives. This method fosters moral development alongside professional identity formation in students and advanced learners. Our method for reflective learning addresses and enables processing of the most pressing ethical issues that learners encounter in practice. [ABSTRACT FROM AUTHOR]

This paper examines how illness narratives are used in medical education and their implications for clinicians' thinking and care of patients. Ideally, collecting and reading illness narratives can enhance clinicians' sensitivity and contextual thinking. And yet these narratives have become part of institutionalizing cultural competency requirements in ways that tend to favor standardization. Stereotyping and reductionistic thinking can result from these pedagogic approaches and obscure structural inequities. We end by asking how we might best teach and read illness narratives to fulfill the ethical obligations of listening and asking more informative clinical interview questions that can better meet the needs of patients and the community. [ABSTRACT FROM AUTHOR]

Patients with limited English proficiency (LEP) are among the most vulnerable populations. They experience high rates of medical errors with worse clinical outcomes than English-proficient patients and receive lower quality of care by other metrics. However, we have yet to take the issue of linguistic inequities seriously in the medical system and in medical education, tacitly accepting that substandard care is either unavoidable or not worth the cost to address. We argue that we have a moral imperative to provide high-quality care to patients with LEP and to teach our medical trainees that such care is both expected and feasible. Ultimately, to achieve linguistic equity will require creating effective systems for medical interpretation and a major culture shift not unlike what has happened in patient safety. [ABSTRACT FROM AUTHOR]

Human trafficking is a global human rights issue with long-range health consequences about which physicians are largely uneducated. Medical schools are uniquely positioned to address this gap. All future physicians, regardless of specialty, must learn to identify victims and refer them to trauma-informed treatment. Research and advocacy are needed to address the lack of rigorously evaluated curricula in this area, impact policy, and improve services for victims of this heinous form of exploitation. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses the importance of human trafficking education among health care workers.

This paper examines how an overseas medical student can improve the life of a kamlari, an indentured servant girl in Nepal. I argue that physicians and students should not only provide care for the health and well-being of patients but also act to ameliorate the suffering of their patients, particularly when patients' social, cultural, economic, and political vulnerabilities overshadow their immediate clinical needs. I also address the point that medical schools need to offer courses on health advocacy and activism in order to promote health equity and social justice for all. [ABSTRACT FROM AUTHOR]

Human trafficking is a global human rights issue with long-range health consequences about which physicians are largely uneducated. Medical schools are uniquely positioned to address this gap. All future physicians, regardless of specialty, must learn to identify victims and refer them to trauma-informed treatment. Research and advocacy are needed to address the lack of rigorously evaluated curricula in this area, impact policy, and improve services for victims of this heinous form of exploitation. [ABSTRACT FROM AUTHOR]

Although progress has been made in diversifying medical school admissions and faculty, this has not extended to physicians with physical disabilities. To improve our understanding of medical students and physicians with physical and sensory disabilities, the authors propose systematically gathering information on the needs and experiences of four groups: physicians who had disabilities before beginning practice, physicians whose disabilities were incurred during their medical careers, physicians drawn from those two groups, and patients of physicians with disabilities. It is hoped these data would be used by counselors, administrators, and admissions committees in advising medical school applicants with disabilities and in revising institutional policies with a view to increasing matriculation and graduation rates of medical students with disabilities. [ABSTRACT FROM AUTHOR]

Students with sensory and physical disabilities are underrepresented in medical schools despite the availability of assistive technologies and accommodations. Unfortunately, many medical schools have adopted restrictive "organic" technical standards based on deficits rather than on the ability to do the work. Compelling ethical considerations of justice and beneficence should prompt change in this arena. Medical schools should instead embrace "functional" technical standards that permit accommodations for disabilities and update their admissions policies to promote applications from qualified students with disabilities. Medical schools thus should focus on what students with disabilities can do, rather than what they cannot do, because these students further diversify the health care profession and improve our ability to care for an expanding population of patients with disabilities. [ABSTRACT FROM AUTHOR]

Applicants to medical schools who are deaf and hard of hearing (DHoH) or who have other disabilities face significant barriers to medical school admission. One commonly cited barrier to admission is medical schools' technical standards (TS) for admission, advancement, and graduation. Ethical values of diversity and equity support altering the technical standards to be more inclusive of people with disabilities. Incorporating these values into admissions, advancement, and graduation considerations for DHoH and other students with disabilities can contribute to the physician workforce being more representative of the diverse patients it serves and better able to care for them. [ABSTRACT FROM AUTHOR]

This article will discuss the legal obligations of medical schools to accommodate applicants and students with disabilities. The article begins by describing the problem of denial of medical education to such students, a problem that results from both discrimination in admissions and denial of accommodations to incumbent students with disabilities. The article then discusses the disability rights legislation that prohibits discrimination against-and requires reasonable accommodation of- qualified medical students with disabilities. It concludes by reviewing a number of lawsuits involving requests for accommodation and how disability rights law was applied in those cases. [ABSTRACT FROM AUTHOR]

The article focuses on the significant hurdles faced by persons with physical, cognitive, or sensory disabilities in entering, continuing, and completing training in health professional fields.

Health care workforce development is a key pillar of global health systems strengthening that requires investment in health care worker training institutions. This can be achieved by developing partnerships between training institutions in resource-limited and resource-rich areas and leveraging the unique expertise and opportunities both have to offer. To realize their full potential, however, these relationships must be equitable. In this article, we use a previously described global health ethics framework and our ten-year experience with the Makerere University-Yale University (MUYU) Collaboration to provide an example of an equity-focused global health education partnership. [ABSTRACT FROM AUTHOR]

Recent efforts to expand medical training in resource-constrained settings are laudable, but change that transforms health systems will require new educational approaches. Today's physician-leaders need to leverage clinical and global health knowledge with a nuanced understanding of the social forces that impact health, the ability to marshal political will, and the capacity to manage dynamic programs and institutions. In establishing the University of Global Health Equity, we have identified three reform principles. First, equipping medical schools with the tools and technology to deliver is imperative. Second, the mismatch between the skills taught in most medical schools and those needed to improve fragile health systems must be addressed. Finally, medical schools that strive to eliminate health inequities should "walk the walk," adopting progressive practices to institutionalize equity. [ABSTRACT FROM AUTHOR]

The author discusses the role of student ethics committees in preparing medical students for their future responsibilities based on her experience of creating the Student Clinical Ethics Committee at King's College in London, England.

The article focuses on the Call to Caring program organized by the Associated Medical Services (AMS) Phoenix Project, which reemphasize the importance of compassionate, person-centered care in medical practice while providing high quality health care services.

The article describes a collaborative learning model for medical and law students at Johns Hopkins University and the University of Baltimore in Maryland.

The article focuses on what trainees need know for medical education to create value with the patient and family-centered care practice and methodology.

The article offers information on the National Clinician Scholars Program (NCSP) which focuses on health services research and provides overview on the program's partners, legacy, and community engagement.

The article explores the initiatives that incorporate high value care HVC principles into medical training which include proposal to better integrate value assessments into undergraduate medical education and novel approaches to teaching value.

The article offers information on the controversies in the views of a graduated with a joint Doctorate of Medicine and of Philosophy MD/PhD and a hematologist related to cost-consciousness for various lab tests in teaching hospitals.

The article discusses intellectual ability as a prominent value of the medical profession, and how valuing of intellectual ability presents the notion of good life and its implications for people with cognitive or intellectual disabilities, and offers suggestions on how to challenge biases.

The article offers information on the case-based curriculum in medical business ethics (MBE) "Exploring Integrity in Medicine: The Bander Center for Medical Business Ethics Casebook," published by the Bander Center for Medical Business Ethics.

The article focuses on the education of autism spectrum disorder (ASD) patients and include topics on their medical care, teaching of communication skills to them, and the teaching methodologies for them.

The article focuses on the role of education in preventing racial bias in pain treatment, citing the aspects of health care disparities, commonality of racial bias in the social institution, and the several factors to be considered in studying bias reduction such as time, data, and collaboration.

The authors discuss aspects of equity for DREAMers, undocumented immigrants who live in the U.S. since childhood, in medical school admissions and mentions topics including the Loyola University Chicago Stritch School of Medicine, barrier to medical practice, and federal aid.

The article offers the author's insights on the communication skills training of medical students in the 21st century in the U.S. and mentions topics including the paracentesis, assessment of communication quality among trainees, and quality of patient-centered care in the country.

A review of the article "The role of the student-teacher relationship in the formation of physicians: the hidden curriculum as process," by P. Haidet and H. F. Stein, which appeared in the "Journal of General Internal Medicine" in 2006 is presented.

The article discusses the court case Jung v. Association of American Medical Colleges (AAMC), which challenges the process for securing a physician residency.

The article examines the role of the hidden curriculum (HC) in on doctoring (OD) courses, a type of medical education format.

The article discusses a study which examined the outcomes of technology-enhanced simulation training for health professions learners. Particular focus is given to the assessment of quality and abstracted information on learners, instructional design and outcomes. Results of the study showed a total of 609 eligible studies, of which 137 were randomized and 67 were non-randomized. Findings also revealed that pooled effect sizes were 1.20 for knowledge outcomes, 1.14 for time skills and 1.09 for process skills. The study also found no significant interactions between simulation training and instructional design features.

The article discusses a study which examined lesbian, gay, bisexual and transgender (LGBT)-related medical curricula and associated curricular development practices, as well as deans' assessments of their institutions' LGBT-related curricular content. It cites the participation of allopathic or osteopathic medical schools in Canada and the U.S. in the study. Results of the study showed that five hours are the median reported time dedicated to teaching LGBT-related content. Findings also revealed lower teaching frequency of LGBT-specific topic areas in the required curriculum.

The article reports on the results of research which was conducted in order to identify behaviors that distinguish highly professional medical residents from their peers. Researchers used a comparative study to evaluate 148 first year internal medicine medical residents at Mayo Clinic from July 1, 2004 through June 30, 2007. Researchers found that observation-based assessments of professionalism were associated with residents' medical knowledge, clinical skills and conscientious behaviors in residency.

The article discusses Internet-based learning within health professions, conducting a review and meta-analysis of studies that have been conducted about the subject. Internet-based learning has had large positive effects, as compared to no intervention, the article indicates. Topics include learners participating at their own convenience, instruction tailored to the individual needs of the student, and the use of the Internet within medical education. Also discussed are studies on Web-based learning and the effectiveness of such educational techniques.

The article reports on the study results of a hypothesis stating that more medical education research funding would result in higher quality and quantity of medical publications. Reportedly, two-thirds of the medical education studies published are not funded and greater resource allocation is necessary. The study concluded that the funding is associated with the quality of published medical education research. The design, setting, participants, outcome measures, results and conclusion are detailed.

The article presents information on the Department of Surgery (DoS) at the University of Minnesota in Minneapolis, Minnesota. The DoS is on the first floor of the Phillips-Wangensteen Building. More than 50,000 undergraduate, graduate and professional students get the surgical education in the University. The Department of Medicine was established by the university in 1888.

Presents various abstracts from studies published in recent editions of major medical journals. Study of chronic depression in the "Archives of General Psychiatry"; Study of the interaction of stressful life events and a serotonin transporter polymorphism in the prediction of depression on the "Archives of General Psychiatry"; Study of the use of atorvastatin for the treatment of alzheimer's disease in the "Archives of Neurology"; Others.

Over the past decade, many observers predicted the demise of the academic medical center (AMC) due to competition from community hospitals and physicians, fragile finances, inefficiency, and organizational complexity. In 2004, we interviewed 23 AMC and community hospital administrators to determine why those predictions have proven unfounded, learn the leaders’ current concerns and priorities, and to identify desirable changes. Chief concerns were reimbursement uncertainty, federal research policy, ineffective internal decision-making, and clinical quality (mentioned in more than 75% of interviews). Priorities included ensuring sufficient investment capital, revising undergraduate and graduate curricula, strengthening ties with physicians and community hospitals, attracting faculty, and meeting regulatory requirements. We advocate that the AMC: (1) modify the research model to allow greater collaboration with institutions and researchers; (2) enhance free and open export of new and proven clinical techniques and knowledge; (3) devote greater attention to meeting patients’ increasing needs for counsel and guidance, not just intervention, given the plethora of complex new technologies and their promotion in the popular media; and (4) simplify their organizations. To accomplish this, it is desirable for future leaders to gain experience outside the AMC, and for faculty and institutions to be less inwardly focused and more attentive to preserving the public’s trust. [ABSTRACT FROM AUTHOR]

Discusses challenges in graduates medical education in surgery. Highlights of the report on "Medical Education in the United States and Canada"; Decline in applications to medical schools in the United States; Decrease in salary compensation.

Background Performance of procedures on the recently dead for physician training is controversial. It has been suggested that permission be obtained. We investigated whether patients and family members would grant such permission or if even this request might anger the recently bereaved. Methods Physicians administered identical surveys to adult emergency department patients and family members in Brooklyn and Oslo to determine their willingness to consent for teaching of specific invasive techniques in the event of their own death or that of a family member. Demographic factors and location (culture) were assessed for effects. Results Willingness to consent was directly related to age of decedent and inversely related to perceived invasiveness of the procedure at both sites. In every scenario, respondents in Brooklyn were much less willing to grant permission (2- to 2.5-fold) than were those in Oslo. In Oslo, respondents were more willing to consent for their own bodies to be used as training tools than that of a relative. In Brooklyn, 48.5% would be angry if approached for permission compared with only 8.4% in Oslo (P<.001). Conclusions Asking for permission to perform procedures on the recently deceased for physician training purposes may often anger the bereaved. The emotional response to the consent request may be culturally determined. Increased willingness of individuals to permit the use of their bodies in the immediate postmortem period suggests that a preauthorization program similar to organ donor cards might be acceptable, successful, and ethical. [ABSTRACT FROM AUTHOR]

Objectives To assess how the surgical skills of residents are taught and evaluated within dermatology residency programs in the United States; to assess which surgical techniques training directors and residents consider important for residents to perform or at least understand by the end of residency training. Methods A 126-question survey was sent to all 106 of the US dermatology residency programs accredited by the Accreditation Council for Graduate Medical Education. Contact was initially made via e-mail. Surveys were addressed to the program director, surgical training director, and chief resident of each program. A follow-up survey was mailed to nonresponders. Results Ninety-five surveys were returned representing 71 (67%) of 106 programs. Eighty-nine percent of programs (n=63) reported having a formal curriculum in dermatologic surgery. Among programs represented, 97% (n=69) taught surgical skills in the procedure room, 84% (n=57) used pigs’ feet, and fewer than 10% (n=6) used human cadavers. Ninety-four percent of programs (n=61) scheduled surgical lectures; two thirds (n=41) formally assigned surgical reading, and over half (n=36) used Web-based lectures to teach skills. To assess training, most programs (86%; n=50) used subjective global evaluation at the end of a surgery rotation. Fewer than 30% (n=15) discussed specific objectives prior to the rotation. Only about 25% of programs (n=17) reported the use of written or oral examinations to assess resident surgery skills. Traditional biopsy and simple surgical procedures were reported as most important to know and perform. Interest by both faculty members and residents in more advanced surgical techniques was more limited and variable. Cosmetic surgery techniques were most likely to be viewed as unimportant. Conclusions Most dermatology programs teach surgical skills by traditional apprenticeship methods supplemented by work in pigs’ feet laboratory classes and regularly scheduled lectures. Skill assessment is mainly done through subjective means. Almost all respondents thought that basic biopsy and excisional skills were essential for residents to know and perform. More complex surgical techniques and the use of lasers were considered less important. Cosmetic techniques were those most frequently viewed as unimportant. [ABSTRACT FROM AUTHOR]

Presents a list of medical schools in the United States, by state. Year established; Total tuition costs; Dean's name.

Presents a list of graduate medical education degrees and programs and the number of physicians in each category. Total number of programs per category; Percentage of female physicians in each program.

Context US medical schools continue to change their organizational structures, staffing patterns, and educational programs. Objective To review the status of US medical school educational programs in the 2003-2004 academic year, compared with 1993-1994. Data Sources The Liaison Committee on Medical Education (LCME) Annual Medical School Questionnaire for 2003-2004 and the Association of American Medical Colleges Directory of American Medical Education for the years 1983-1984, 1993-1994, and 2003-2004. Data Synthesis The number of full-time faculty members in the 126 LCME-accredited medical schools increased from 90 975 in 1993-1994 to 114 549 in 2003-2004 (+26%), whereas the number of enrolled students remained essentially unchanged (66 453 in 1993-1994 and 67 166 in 2003-2004). In 2003-2004, 48% of medical school deans held another title at the medical center or university level, such as vice president for health affairs. There are 94 medical schools that have a comprehensive clinical examination using the standardized patient/objective structured clinical examination format; 59 schools require students to pass this examination for graduation. As of spring 2004, 58 schools will require students in the class of 2005 to pass the new US Medical Licensing Examination Step 2 Clinical Skills examination. Conclusions The role of the medical school dean has expanded over time and is associated with the creation of a discrete administrative structure for the educational program. The number of full-time medical school faculty continues to increase, whereas the number of enrolled students remains steady. Considerable variability exists among medical schools in their use of standardized clinical evaluations. [ABSTRACT FROM AUTHOR]

Focuses on the methods of teaching that best suit clinical medicine. Idea on what constitute the best medical school and teaching hospitals; Results of poor teaching in research universities; Goal of a true teacher to stimulate students to think and talk rather than listen to the teacher talk.

Background Examination of knowledge, attitudes, and beliefs of house staff physicians will be important in developing interventions to improve antimicrobial use and prevent resistance. Methods A 75-item survey was distributed to house staff physicians on nonpediatric services in a university teaching hospital. Knowledge was assessed with a 10-question quiz. Results The survey was completed by 179 (67%) of 269 house staff physicians on 5 specialties. Outside and inside the intensive care unit, 21% and 25% of respondents, respectively, reported that they were using antibiotics optimally. Surgeons were significantly more likely than other physicians to report that they were regularly seeking input into antimicrobial selections (P<.001). Of the 170 physicians who completed the survey, 88% agreed antibiotics are overused in general and 72% also agreed this was the case at their institution (r = 0.56; P<.05); 96% agreed that hospitals in general face serious problems with antibiotic resistance and 93% agreed that their hospital faces these same problems (r = 0.57; P<.05); 97% agreed that better use of antibiotics would reduce resistance; 32% stated that they had not had formal teaching on antimicrobial agents in the last year (medicine residents reported significantly more formal teaching than others [P = .001]); and 90% wanted more education about antimicrobials and 67% wanted more feedback on antimicrobial selections. The mean antimicrobial quiz score was 28%, with medicine residents scoring significantly higher than others (P = .04). Upper-level residents did not perform better than interns. Conclusions This survey (1) revealed that house staff are aware of the importance of antimicrobial resistance and believe better antimicrobial use will help this problem and (2) demonstrated differences between specialties with respect to antimicrobial use and knowledge. House staff at our hospital have suboptimal knowledge about antimicrobials, and this knowledge did not increase appreciably over the course of their training. Antimicrobial education is needed and is likely to be well received by house staff physicians in academic centers but may be more effective if it is tailored to specific specialties. [ABSTRACT FROM AUTHOR]

Presents a list of medical schools in the United States. Year established; Tuition; Name of Dean; Names of schools given alphabetically.