The inhibiting and enabling factors to failing an underperforming trainee were common across the professions included in this study, across the 10 years of data, and across the educational continuum. We suggest that these results can inform efforts aimed at addressing the failure to fail problem.

No abstract

Objective Colorectal cancer (CRC) is the third leading cause of cancer death for Latino men and women; and Latinos are more likely to be diagnosed at a later stage, which is most likely due to underutilization of CRC preventive screening. The purpose of this study was to determine whether a brief, clinic-based intervention by a community health advisor (CHA) would increase CRC knowledge compared with traditional educational methodologies (eg, use of print materials). Methods Latino adults 50 years and older attending a San Diego community health center were recruited while waiting for their primary care provider routine visit and were randomly assigned to receive 1 of 3 CRC educational interventions: community health advisor (CHA) plus CRC educational brochure (CHA intervention group), CRC educational brochure (minimal intervention group), or 5-a-day nutrition brochure (usual care). CRC knowledge was assessed before and after the primary care provider visit for 130 participants. Results Results demonstrate that the CRC educational brochure (minimal intervention group) was effective at increasing CRC screening knowledge as compared to usual care. Conclusions Future research is needed to explore innovative health education strategies that improve knowledge and subsequent CRC screening behaviors among low-income, low-literacy, unacculturated Latinos.

No abstract

Problem: Medical schools across the country have suspended in-person student clinical rotations in light of the ongoing COVID-19 pandemic to reduce transmission of infection, protect students, and preserve personal protective equipment (PPE) for health care workers on the front lines of care. The COVID-19 pandemic has led to a rapid expansion of outpatient virtual visits. While involving students into these visits will provide meaningful clinical experiences, and help offset the provider burden of increased virtual visits, students and preceptors alike may initially struggle initially in adapting to these new modalities due to the lack of a formal telemedicine curriculum.Approach/Method: The U.S. Department of Health & Human Services has relaxed HIPAA rules to allow for the use of audio and video communication technologies. This study aims to evaluate if ambulatory virtual visits can replicate key elements of the teaching model of in-person visits. Patient consent, preference for virtual visits (audio vs. video), and student involvement are documented in a virtual encounter note template created for this study. We evaluated several platforms to maximize patient access to visits including FaceTime, WhatsApp, Doximity, and Google Voice. Two virtual scenarios were evaluated: one in which students virtually interview patients alone first, and another in which students interview patients with their preceptors for the entire virtual visit. Outcome: Following our initial implementation of this virtual model, students and preceptors were able to replicate the general in-person clinic workflow with the exception physical exam maneuvers and procedures. Students saw patients virtually, completed notes, and participated in feedback sessions with preceptors for each visit. While this pilot study is ongoing, we wanted to share our workflow, note templates, and challenges in order to help other programs initiate implementation of their own student virtual visit encounters. Next Steps: The unique ability for students and preceptors to practice telemedicine with a variety of platforms in light of the COVID-19 pandemic has provided insight into the difficulties in implementing and obtaining access to telemedical visits. To ensure that our most vulnerable patients (those who rely on home health visits) will have access to virtual outpatient care, we aim to enlist medical students in outreach to patients to help them set up various technology platforms or better understand how virtual visits take place prior to their scheduled visit. Lastly, we plan to survey patient, student, and preceptor satisfaction with virtual encounters, to further develop our telemedicine curriculum and implementation for the future.

Health professions educators have the opportunity and responsibility to teach and stimulate scientific knowledge and curiosity in a context that eliminates bias towards minoritized communities and informs emerging understanding of race in research and healthcare. Through the key elements of curiosity, humility, and accountability, the authors propose methods to change the narrative that may otherwise perpetuate biases and inappropriate presentations of race as purely biological rather than a social construct. The evolution of scientific discovery has brought to question our understanding and teaching of race in health, clinical decision-making, and health outcomes. Through case presentations, the authors invite the reader to reflect on their teaching materials and apply methods to 1) decrease bias in case presentations and 2) explain racial health disparities in the context of longstanding structural racism. A Q&A section will draw on resources to advance health equity in health professions education.

The summer of 2020 riveted the attention of our nation with a sense of urgency to address structural racism. Cities declared racism a public health crisis, and organizations called for increased awareness of persistent historic racial inequities and advocacy for change. In medical education, students and institutional leaders felt compelled to transition from passive advocacy to energetic action in order to build a culture of anti-racism. In our institution, we applied J Mierke and V. Williamson's 6-step framework to achieve organizational culture change which is as follows: 1. Identify the catalyst for change; 2. Strategically plan for successful change; 3. Engage and empower organizational members; 4. Cultivate leaders at all levels; 5. Foster innovation, creativity, and risk-taking; 6. Monitor progress, measure success, and celebrate (even the small changes) along the way. In addition, we noted two key considerations for the success of the process: A. Transparency in communication, and B. Flexibility and adjustment to emerging situations. We share our approach using this framework which we believe is generalizable to other organizations. We draw from literature on organizational psychology and lastly call for the continuation and sustainability of the work that will continue to build a diverse, equitable, inclusive, antiracist and vibrant education community.