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Background: Learning communities (LCs) are intentionally designed groups that are actively engaged in learning with and from each other. While gaining prominence in US medical schools, LCs show significant variability in their characteristics across institutions, creating uncertainty about how best to measure their effects. Objective: The aim of this study is to describe the characteristics of medical school LCs by primary purpose, structures, and processes and lay the groundwork for future outcome studies and benchmarking for best practices. Methods: Medical school LC directors from programs affiliated with the Learning Communities Institute (LCI) were sent an online survey of program demographics and activities, and asked to upload a program description or summary of the LC’s purpose, goals, and how it functions. Descriptive statistics were computed for survey responses and a qualitative content analysis was performed on program descriptions by 3 authors to identify and categorize emergent themes. Results: Of 28 medical school LCs surveyed, 96% (27) responded, and 25 (89%) provided program descriptions for qualitative content analysis. All programs reported longitudinal relationships between students and faculty. Most frequently cited objectives were advising or mentoring (100%), professional development (96%), courses (96%), social activities (85%), and wellness (82%). Primary purpose themes were supporting students’ professional development, fostering a sense of community, and creating a sense of wholeness. Structures included a community framework, subdivisions into smaller units, and governance by faculty and students. Process themes included longitudinal relationships, integrating faculty roles, and connecting students across class years. Conclusions: Medical school LCs represent a collection of high-impact educational practices characterized by community and small-group structures, relational continuity, and collaborative learning as a means to guide and holistically support students in their learning and development as physicians. In describing 27 medical school LCs, this study proposes a unifying framework to facilitate future educational outcomes studies across institutions.

Purpose: Many US medical schools have adopted learning communities to provide a framework for advising and teaching functions. Faculty who participate in learning communities often have additional educator roles. Defining potential conflicts of interest (COIs) among these roles is an important consideration for schools with existing learning communities and those looking to develop them, both for transparency with students and also to comply with regulatory requirements. Methods: A survey was sent to the institutional contact for each of the 42 Learning Communities Institute (LCI) member medical schools to assess faculty opinions about what roles potentially conflict. The survey asked the role of learning community faculty in summative and formative assessment of students and whether schools had existing policies around COIs in medical education. Results: In all, 35 (85%) LCI representatives responded; 30 (86%) respondents agreed or strongly agreed that learning community faculty should be permitted to evaluate their students for formative purposes, while 19 (54%) strongly agreed or agreed that learning community faculty should be permitted to evaluate their students in a way that contributes to a grade; 31 (89%) reported awareness of the accreditation standard ensuring “that medical students can obtain academic counseling from individuals who have no role in making assessment or promotion decisions about them,” but only 10 (29%) had a school policy about COIs in education. There was a wide range of responses about what roles potentially conflict with being a learning community faculty. Conclusion: The potential for COIs between learning community faculty and other educator roles concerns faculty at schools with learning communities, but most schools have not formally addressed these concerns.

Abstract Introduction A vital element of health care practice is evidence-based medicine, the explicit and judicious use of current, best-available evidence in making decisions about the individualized care of patients. With the use of evidence-based medicine continually increasing in clinical practice, medical schools are charged with ensuring graduates are prepared to appropriately access, appraise, and utilize clinical evidence, highlighting the need for a corresponding assessment tool. However, assessing evidence-based practice remains a challenging endeavor for medical educators. Few assessment tools capture students' ability to apply information resources in order to answer a targeted question during a medical encounter. Methods We describe a triple-jump assessment design where students access evidence, appraise information at hand, and apply it to formulate a treatment plan during an observed structured clinical encounter (OSCE). Results One hundred and five clerkship students participated in one of two OSCE scenarios. Data from this exercise underwent descriptive statistical analysis, including mean performance scores and confidence scores, and showed that accuracy and confidence in providing evidence-based care improved after the search and appraisal period. Discussion The addition of a modified triple-jump assessment to the end of the OSCE experience not only creates a more authentic experience but also allows for assessment and development of student metacognitive skills within the domain of knowledge gap assessment. The ease of integrating this assessment into the structure of an already-developed OSCE allows for different types of assessment to be achieved without writing entirely new OSCE cases, but rather by modifying existing scenarios.