Search

Background: Competencies-based education has gained global recognition, emphasizing the need for educators to align educational outcomes with healthcare system requirements. However, limited literature exists on competency frameworks and Entrustable Professional Activities (EPAs) specific to health professions educationists, hindering the development of tailored Master's programs., Aim: This study aimed to develop a competency framework outlining the roles and functions for Master's learners in Health Professions Education (MHPE) and identify the key EPAs that form the foundation of a task-based MHPE curriculum, along with the expected levels of entrustment., Methods: An international Delphi study was conducted involving three rounds of surveys and qualitative discussions with an expert panel of health professions educationists from diverse contexts (n = 29). The Delphi technique, including open-ended and quantitative rating scales, was employed to reach consensus on the EPAs and their levels of entrustment. The final list of EPAs was validated using the EQual rubric., Results: A total of 16 EPAs were identified and validated, mapped to core and potential roles and functions of health professions educationists. There is less agreement on the level of entrustment that should be attained at the master level, resulting in EPAs that must be fully entrusted before graduation and others which need further development afterwards., Conclusion: The study presents a comprehensive competency framework and a set of EPAs tailored for MHPE programs, providing a structured approach to curriculum design and learner assessment. The findings underscore the importance of incorporating context-specific considerations and aligning educational objectives with the evolving roles and responsibilities of health professions educationists., Competing Interests: Declarations. Ethics approval and consent to participate: The principal investigator obtained ethical approval from the Institutional Review Board in the Armed Forces College of Medicine (AFCM) (Issuance no. 120 on 12/11/2022). Participants were invited by email, and informed consent was obtained from each volunteer. Consent for publication: All authors agreed on the final manuscript for publication. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Abstract: The importance of the clinician educator (CE) role in delivery of competency-based medical education is well recognized. There is, however, no formal mechanism to identify when faculty have the knowledge, skills, and attitudes to be successful CEs. In 2020, the Accreditation Council for Graduate Medical Education, Accreditation Council for Continuing Medical Education, Association of American Medical Colleges, and American Association of Colleges of Osteopathic Medicine convened a workgroup of 18 individuals representing multiple medical specialties and diverse institutions in the United States, including nonphysician educators, a medical student, and a resident, to develop a set of competencies, subcompetencies, and milestones for CEs.A 5-step process was used to create the Clinician Educator Milestones (CEMs). In step 1, the workgroup developed an initial CEM draft. Through brainstorming, 141 potential education-related CE tasks were identified. Descriptive statements for each competency and developmental trajectories for each subcompetency were developed and confirmed by consensus. The workgroup then created a supplemental guide, assessment tools, and additional resources. In step 2, a diverse group of CEs were surveyed in 2021 and provided feedback on the CEMs. In step 3, this feedback was used by the workgroup to refine the CEMs. In step 4, the second draft of the CEMs was submitted for public comment, and the CEMs were finalized. In step 5, final CEMs were released for public use in 2022.The CEMs consist of 1 foundational domain that focuses on commitment to lifelong learning, 4 additional domains of competence for CEs in the learning environment, and 20 subcompetencies. These milestones have many potential uses for CEs, including self-assessment, constructing learning and improvement plans, and designing systematic faculty development efforts. The CEMs will continue to evolve as they are applied in practice and as the role of CEs continues to grow and develop., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Association of American Medical Colleges.)

The release of biological agents, including those which could be used in biowarfare or bioterrorism in large urban areas, has been a concern for governments for nearly three decades. Previous incidents from Sverdlosk and the postal anthrax attack of 2001 have raised questions on the mechanism of spread of Bacillus anthracis spores as an aerosol or contaminant. Prior studies have demonstrated that Bacillus atrophaeus is easily transferred through simulated mail handing, but no reports have demonstrated this ability with Bacillus anthracis spores, which have morphological differences that may affect adhesion properties between spore and formite. In this study, equipment developed to simulate interactions across three generations of envelopes subjected to tumbling and mixing was used to evaluate the potential for cross-contamination of B. anthracis spores in simulated mail handling. In these experiments, we found that the potential for cross-contamination through letter tumbling from one generation to the next varied between generations while the presence of a fluidizer had no statistical impact on the transfer of material. Likewise, the presence or absence of a fluidizer had no statistically significant impact on cross-contamination levels or reaerosolization from letter opening.

The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) assesses the competence of osteopathic physicians in training. It is designed to protect the public by setting minimum competence standards. All osteopathic medical students must pass COMLEX-USA Level 1, Level 2-Cognitive Evaluation, and Level 2-Performance Evaluation before being allowed to graduate from an osteopathic medical school. Residency training programs use COMLEX-USA scores as a major factor in deciding whom they will interview and admit into their programs. In addition, colleges of osteopathic medicine use student COMLEX-USA scores as an external assessment of their success in educating students. Because COMLEX-USA is a high-stakes examination series, it is important to understand predictive factors for performance. The authors review the literature on the relationship between COMLEX-USA scores and correlated student variables. Results from the Council on Osteopathic Student Government Presidents' survey on students' preparation methods and performance are also provided.

Physician education in the United States must change to meet the primary care needs of a rapidly transforming health care delivery system. Yet medical schools continue to produce a disproportionate number of hospital-based specialists through a high-cost, time-intensive educational model. In response, the American Osteopathic Association and the American Association of Colleges of Osteopathic Medicine established a blue-ribbon commission to recommend changes needed to prepare primary care physicians for the evolving system. The commission recommends that medical schools, in collaboration with their graduate medical education partners, create a new education model that is based on achievement of competencies without a prescribed number of months of study and incorporates the knowledge and skills needed for a twenty-first-century primary care practice. The course of study would occur within a longitudinal clinical training environment that allows for seamless transition from medical school through residency training.

It is often assumed that cardiovascular disease is due to issues related to lifestyle. While lifestyle does contribute to the expression of cardiovascular issues, a genetic etiology to Marfan's syndrome, hypertrophic cardiomyopathy and long QT syndrome have been shown. It is unclear as to what role genetics plays in hypertension and hyperlipidemia, although it is felt that genetics contributes to these pathologies as well.

Successful management of transplant patients requires an informed primary care provider with a good working relationship with the patient's medical home. Primary care physicians who are aware of the policies and criteria that regulate transplants will help their patients obtain the organs as treatment of end organ damage.

Anti-Hu antibodies, also known as ANNA-1, are well characterized in paraneoplastic neuropathies. We present here the first known case of anti-Hu seropositivity, cerebellar ataxia, and sensory neuropathy in association with cervical cancer.

The assessment for pulmonary emboli is still Stone Age. History and physical findings are not sensitive or specific making it difficult to establish the diagnosis. PE is still potentially fatal. Death most often results from the severity of the clot, although delay in treatment may play a role. Clots, including deep venous thrombosis and pulmonary emboli, are the first disease that falls clearly under the Hospitalist specialty. An argument over what imaging is ideal continues to rage on, without any clear leader at this point. The CT scan and Ventilation/Perfusion scan are the two modalities being used most often. However without the use of a pretest probability the sensitivity and specificity can go down to less than 80%. The many new anticoagulants and oral therapies have widened the armamentarium, without increasing the success of therapy.

Quinine is often used as a treatment for benign nocturnal cramps. The use of Quinine remains controversial with conflicting studies regarding its efficacy. Quinine has a side effect profile that cannot be ignored. Cinchonism, or quinine toxicity, includes nausea, vomiting, and tinnitus. Many other side effects have been reported in the literature. A case report demonstrating the side effects of quinine is presented. We briefly review the literature on quinine and alternative medications.