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Purpose: Health inequities compel medical educators to transform curricula to prepare physicians to improve the health of diverse populations. This mandate requires curricular focus on antioppression, which is a change for faculty who learned and taught under a different paradigm. This study used the Concerns-Based Adoption Model (CBAM) to explore faculty perceptions of and experiences with a shift to a curriculum that prioritizes antioppressive content and process., Method: In this qualitative study, authors interviewed faculty course directors and teachers at the University of California, San Francisco School of Medicine from March 2021 to January 2022. Questions addressed faculty experience and understanding regarding the curriculum shift toward antioppression, perceptions of facilitators and barriers to change, and their interactions with colleagues and learners about this change. Using the CBAM components as sensitizing concepts, the authors conducted thematic analysis., Results: Sixteen faculty participated. Their perceptions of their experience with the first year of an antioppression curriculum initiative were characterized by 3 broad themes: (1) impetus for change, (2) personal experience with antioppressive curricular topics, and (3) strategies necessary to accomplish the change. Faculty described 3 driving forces for the shift toward antioppressive curricula: moral imperative, response to national and local events, and evolving culture of medicine. Despite broad alignment with the change, faculty expressed uncertainties on 3 subthemes: uncertainty about what is an antioppressive curriculum, the scientific perspective, and fear. Faculty also reflected on primary facilitators and barriers to accomplishing the change., Conclusions: The shift to an antioppressive curriculum compels faculty to increase their knowledge and skills and adopt a critical, self-reflective lens on the interplay of medicine and oppression. This study's findings can inform faculty development efforts and highlight curricular leadership and resources needed to support faculty through this type of curricular change., (Copyright © 2023 the Association of American Medical Colleges.)

Purpose: Rarely do faculty members receive endowed chairs as recognition for their work as educators. In addition to the title, endowed chairholders have traditionally received discretionary income to pursue value-added work. This study assessed the impact on recipients of receiving an endowed chair for education., Method: The authors conducted a qualitative thematic analysis between 2018 and 2020, interviewing University of California, San Francisco, School of Medicine chairholders who had completed at least one 5-year term. Authors double-coded all transcripts, reconciled codes, applied social cognitive career theory during analysis, and identified themes through an iterative consensus-building approach., Results: Twenty-three of 24 (96%) eligible faculty members from 16 departments participated. Themes identified were symbolism, resources, education and educator credibility, development, and impact. The chair was a symbol that brought recognition, indicated quality, and amplified visibility and status within the institution and externally. Receiving an endowed chair conferred credibility on recipients and empowered them in the educational domain. The resources allowed chairholders the flexibility to undertake activities that were of value to them, to mentees, and to the organization. Holding the chair facilitated professional development for self and others. Chair recipients reported impact that persisted long after their term(s) concluded. A model of impact emerged, suggesting that simply possessing the chair title led to visibility and gravitas, which, combined with resources, allowed the holder to leverage opportunities in education., Conclusions: The endowed chair is an important strategy for career development in education for the chairholder and enhances the position of education institutionally. Having a plan sharpens the focus on activities, results, and impact., (Copyright © 2022 by the Association of American Medical Colleges.)

Objectives: To investigate the performance and perspectives of third-year medical students (MS3s) participating in near-peer learning (NPL) sessions during their core surgical clerkship following a 15-month preclerkship curriculum., Design: An evaluation study of 7 NPL sessions developed and implemented by fourth-year medical students (MS4s) held from March 2019 to February 2020. MS4s taught 1-2 sessions per rotation that included test taking strategies, illness script development, radiology review, case-based multiple-choice questions, and rapid review. Participants completed a questionnaire with 11 seven-point Likert and open-ended questions after each session. Analyses included quantitative comparison of shelf score averages between NPL participants and nonparticipants and qualitative content analysis for open-ended questions., Setting: Surgical clerkship at the University of California, San Francisco., Participants: Forty-eight (32%) MS3s participated, with an average attendance of 10 students per rotation. Thirty-three (69%) participants completed the questionnaire., Results: MS3s enjoyed the session (6.9 ± 0.4), improved their knowledge (6.8 ± 0.5), and felt more prepared for the surgery shelf examination (6.5 ± 0.6). MS4 leaders found that MS3s always wanted radiology review, and their interest in test taking strategies and illness script development declined across the clerkship year. Participants had lower shelf exam scores compared to nonparticipants (68.1 vs 71.4, respectively; p = 0.04, ES = 0.03). Shelf exam scores increased over time in both cohorts. Each group had 2 shelf exam failures. Qualitative analysis suggests that MS3s appreciated the NPL's tailored approach and exam demystification, with a desire for increased NPL integration into the clerkship., Conclusion: Students participating in NPL were satisfied with the sessions. Participants may have been students who struggled as indicated by shelf exam scores and appreciated the support. The shift in preferred topics across the blocks reflects the students' development during clerkships. Near-peer teachers should adjust sessions over time to fit students' evolving needs., Competing Interests: Declaration of Competing Interest Julie Ann Sosa, MD, MA, is a member of the Data Monitoring Committee of the Medullary Thyroid Cancer Consortium Registry supported by GlaxoSmithKline, Novo Nordisk, Astra Zeneca, and Eli Lilly. She receives institutional research funding from Exelixis and Eli Lilly., (Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Purpose: Medical schools responding to challenges with fairness, equity, learning environments, and student wellness have reconsidered clerkship grades. This study used the Concerns-Based Adoption Model (CBAM) to explore how faculty responded to a change in the approach to assessment from focus on grades toward focus on feedback., Method: This qualitative study used an inductive approach to analyze data from semistructured interviews with teaching faculty and education leaders at University of California, San Francisco, School of Medicine 6 months following the elimination of traditional tiered clerkship grades. Participants were recruited in 2019 using purposive sampling. Interview questions addressed participants' perceptions of the new approach to assessment and grading that emphasizes assessment for learning, including advantages and concerns. The authors analyzed data using thematic analysis informed by sensitizing concepts from CBAM., Results: Nineteen faculty participated (11 medicine, 8 surgery). Faculty expressed optimism about the impact of the change on their clinical educator roles and sought faculty development to enhance feedback and assessment skills. Perceived benefits to students addressed learning and wellness, with concern for students' motivation and professional development. Faculty shared uncertainty about their roles and larger systemic consequences involving the residency match and institutional reputation. Participants acknowledged that traditional grading is imperfect, yet felt a departure from this system represented significant culture change., Conclusions: Faculty perceptions of the assessment and grade change in 2 large departments demonstrated tensions around grading. Their descriptions of change as an ongoing process aligned with CBAM and required them to consider new approaches and perspectives. While discourse about assessment and grading frequently focuses on learners, these findings support institutional consideration of the impact of changes in assessment on teaching faculty., (Copyright © 2020 by the Association of American Medical Colleges.)

Problem: Diversity, equity, and inclusion are increasingly highlighted in medical education, but bias continues to disproportionately impact learners from racial and ethnic groups traditionally underrepresented in medicine. Many faculty struggle to engage with these concepts in their teaching and fear making mistakes, but few opportunities exist for faculty to develop their skills., Approach: To advance the goal of fostering an equitable educational environment, the authors envisioned a series of faculty development workshops to cultivate faculty skills and comfort with incorporating equity and inclusion in their teaching, assessment, and curriculum development work. The authors conducted a needs assessment and followed Kern's 6-step process for curriculum development to build the workshop series., Outcomes: Using local resources and expertise, the authors built a workshop series that culminated in a certificate in Teaching for Equity and Inclusion. The development process took 24 months; 22 faculty volunteered to design and teach 7 new workshops. Initial workshop offerings have reached 101 participants, and 120 faculty members have enrolled in the certificate. The workshops have been well received and are rated on par with or more highly than other faculty development offerings at the University of California, San Francisco., Next Steps: Future directions include assessing the impact of the certificate on participants and workshop faculty, creating opportunities for workshop faculty to share best practices, and exploring alternative models for participation. The authors' experience demonstrates the feasibility of creating a self-sustaining program that will advance faculty competence in the critical areas of diversity, equity, and inclusion.

Objective: Our previous home-video basic surgical skills curriculum required substantial faculty time and resources, and was limited by delayed feedback and technical difficulties. Consequently, we integrated that curriculum with a mobile application platform. Our purpose is to describe this application and learner satisfaction., Materials and Methods: The mobile platform incorporates a patented pedagogical design based on Ericsson's deliberate practice and Bandura's social learning theory. Instructors built step-wise skills modules. During the challenge phase, learners watched a video of surgical tasks completed by experts and uploaded a video of themselves performing the same task. In the Peer Review phase, they used a grading rubric to provide feedback. In the Recap stage, learners received individual feedback and could review their own videos. Two groups of learners, graduating medical students and matriculating surgical residents, participated in this independent learning platform, along with 2 to 4 laboratory sessions, and completed a survey about their experience. Survey responses were summarized descriptively and comments analyzed using content analysis., Results: Fifty learners submitted videos of assigned tasks and completed peer reviews. Learners reported positive experiences specifically for the Peer Review Stage, structured home practice, ease of mobile access to submit and review videos, and ongoing immediate feedback. Over half of the learners reported spending at least 10 to 30 minute practicing skills before recording their videos and over 80% rerecorded at least 2 times before submission. Content analysis revealed learners engaged with the educational concepts designed into the platform., Conclusion: Learners easily used and were satisfied with a mobile-technology teaching platform that maintained the fundamental content, educational theories, and organizational structure of our previously effective surgical skills curriculum. Prior challenges were directly addressed through the mobile application's ease of use, support of deliberate practice, and improved timeliness of feedback., (Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Purpose: The demand for faculty development is ongoing, and many medical schools will need to expand their pool of faculty developers to include physicians and scientists whose primary expertise is not education. Insight into what motivates occasional faculty developers can guide recruitment and retention strategies. This study was designed to understand the motivations of faculty developers who occasionally (one to three times each year) lead faculty development workshops., Method: Qualitative data were collected in March and April 2012 from interviews with faculty developers who occasionally taught workshops from 2007 to 2012 in the University of California, San Francisco, School of Medicine's faculty development program. The interviews were audiotaped and transcribed. The authors thematically analyzed the transcripts using a general inductive approach and developed codes sensitized by motivation theories., Results: The authors interviewed 29/30 (97%) occasional faculty developers and identified five themes: mastery (desire to learn and develop professionally), relatedness (enjoyment of working with and learning from others), duty (sense of obligation to give back and be a good academic citizen), purpose (commitment to improving local teaching and ultimately patient care), and satisfaction (fun and enjoyment)., Conclusions: Four of the themes the authors found are well addressed in motivation theory literature: mastery, relatedness, duty, and purpose. Whereas these four are motivators for occasional faculty developers, it is the fifth theme-satisfaction-that the authors feel is foundational and links the others together. Armed with this understanding, individuals leading faculty development programs can develop strategies to recruit and retain occasional faculty developers.

Purpose: Faculty developers play a crucial role in preparing faculty members for their instructional responsibilities. In some programs, faculty developers are clinicians and scientists who only occasionally conduct workshops. The authors examine the identity formation of such part-time faculty developers., Method: From April 2012 through March 2012, structured interviews were conducted with full-time faculty members who, from 2007 to 2012, periodically volunteered to teach workshops in the University of California, San Francisco School of Medicine's faculty development program. This qualitative study used a modified grounded theory approach., Results: The authors interviewed 29 occasional faculty developers who had 1 to 22 years of experience conducting faculty development programs. All faculty had an educator identity along with their professional identity. The additional faculty developer identity generally evolved over time and aligned with their identity in one of four ways: compartmentalized, hierarchical, parallel, or merged. Their roles as faculty developers enhanced their status in their work community and influenced the way they worked with others and advanced their careers. Faculty development influences the institutional culture, and the institutional culture supports faculty development., Conclusions: Most occasional faculty developers possessed a merged identity that developed over time and was moderated by the topic that they taught. Although experience contributed to this development, both junior and senior faculty developers could have a merged identity. Those who lead faculty development programs can use these findings to recruit and retain faculty developers.

This article describes the use of a brief needs assessment survey in the development of alcohol and drug screening, brief intervention, and referral to treatment (SBIRT) curricula in 2 health care settings in the San Francisco Bay Area. The samples included university medical center faculty (n = 27) and nonphysician community health and social service providers in a nearby suburban county (n = 21). Informed by curriculum development theory and motivational interviewing strategies, questions regarding clinical and educational priorities, perceived importance and confidence with screening and intervention techniques, and referral resource availability were included. Medical center faculty expressed greater concern about limited appointment time (P = .003), adequacy of training (P = .025), and provider confidence (P = .038) as implementation obstacles and had lower confidence in delivering SBIRT (P = .046) and providing treatment referrals (P = .054) than community providers. The authors describe their approach to integrating needs assessment results into subsequent curriculum development. Findings highlight potential differences between physician and nonphysician training needs.

Among the core transitions in medical education is the one from medical school to residency. Despite this challenging transition, the final year of medical school is known as lacking structure and clarity. The authors examine the preparation of medical students for the professional and personal challenges of internship in the context of transition courses. They first describe the development of a residency transition course, offered since 2001 at the University of California, San Francisco, School of Medicine (UCSF), exploring aspects of a needs assessment, course goals and content, core competencies, and course implementation. They then critically analyze the course, judging it successful based on high subjective satisfaction scores and increased perceived preparedness data. Next, the authors discuss the national context of transition courses, perspectives of various stakeholders, and lessons learned from the UCSF experience. Finally, they consider future directions, suggesting that internship transition courses be a standard part of the medical school curriculum.

Starting clerkships is anxiety provoking for medical students. To ease the transition from preclerkship to clerkship curricula, schools offer classroom-based courses which may not be the best model for preparing learners. Drawing from workplace learning theory, the authors developed a seven-day transitional clerkship (TC) in 2007 at the University of California, San Francisco School of Medicine in which students spent half of the course in the hospital, learning routines and logistics of the wards along with their roles and responsibilities as members of ward teams. Twice, they admitted and followed a patient into the next day as part of a shadow team that had no patient-care responsibilities. Dedicated preceptors gave feedback on oral presentations and patient write-ups. Satisfaction with the TC was higher than with the previous year's classroom-based course. TC students felt clearer about their roles and more confident in their abilities as third-year students compared with previous students. TC students continued to rate the transitional course highly after their first clinical rotation. Preceptors were enthusiastic about the course and expressed willingness to commit to future TC preceptorships. The transitional course models an approach to translating workplace learning theory into practice and demonstrates improved satisfaction, better understanding of roles, and increased confidence among new third-year students.