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PurposeTo examine the variability among medical schools in ranking systems used in medical student performance evaluations (MSPEs).MethodThe authors reviewed MSPEs from U.S. MD-granting medical schools received by the University of California, Irvine emergency medicine and internal medicine residency programs during 2012-2013 and 2014-2015. They recorded whether the school used a ranking system, the type of ranking system used, the size and description of student categories, the location of the ranking statement and category legend, and whether nonranking schools used language suggestive of rank.ResultsOf the 134 medical schools in the study sample, the majority (n = 101; 75%) provided ranks for students in the MSPE. Most of the ranking schools (n = 63; 62%) placed students into named category groups, but the number and size of groups varied. The most common descriptors used for these 63 schools' top, second, third, and lowest groups were "outstanding," "excellent," "very good," and "good," respectively, but each of these terms was used across a broad range of percentile ranks. Student ranks and school category legends were found in various locations. Many of the 33 schools that did not rank students included language suggestive of rank.ConclusionsThere is extensive variation in ranking systems used in MSPEs. Program directors may find it difficult to use MSPEs to compare applicants, which may diminish the MSPE's value in the residency application process and negatively affect high-achieving students. A consistent approach to ranking students would benefit program directors, students, and student affairs officers.

Changing the culture of medicine through the education of medical students has been proposed as a solution to the intractable problems of our profession. Yet few have explored the issues associated with making students partners in this change. There is a powerful hidden curriculum that perpetuates not only desired attitudes and behaviors but also those that are less than desirable. So, how do we educate medical students to resist adopting unprofessional practices they see modeled by supervisors and mentors in the clinical environment? This paper explores these issues and, informed by the literature, we propose a specific set of reflective competencies for medical students as they transition from classroom curricula to clinical practice in a four-step approach: (1) "Priming"--students about hidden curriculum in their clinical environment and their motivations to conform or comply with external pressures; (2) "Noticing"--educating students to be aware of their motivations and actions in situations where they experience pressures to conform to practices that they may view as unprofessional; (3) "Processing"--guiding students to analyze their experiences in collaborative reflective exercises and finally; (4) "Choosing"--supporting students in selecting behaviors that validate and reinforce their aspirations to develop their best professional identity.

In this article, part of the "Exemplar" series in "Advances in Health Sciences Education," we profile the career of Christine McGuire, and capture her perspectives on the status of medical education practice and research. Her career was prototypical of other exemplars in the series--a pathway characterized by serendipity. As an exemplar, her contributions of leadership, scholarship, and innovations have changed the face of medical education. We describe our methods of data collection--literature reviews and in-depth interviews. We provide a portrayal of her career and accomplishments. Finally, we characterize her perspectives on medical education, including her views of significant innovations, contributions of professional educators, lessons learned, and needed future efforts.

Objectives: To examine the impact of dental students' usage patterns within an adaptive learning platform (ALP), using ALP-related indicators, on their final exam performance. Methods: Track usage data from the ALP, combined with demographic and academic data including age, gender, preand post-test scores, and cumulative grade point average (GPA) were retrospectively collected from 115 second-year dental students enrolled in a blended learning review course. Learning performance was measured by post-test scores. Data were analyzed using correlation coefficients and linear regression tests. Results: The ALP-related variables (without controlling for background demographics and academic data) accounted for 29.6% of student final exam performance (R2=0.296, F(10,104)=4.37, p=0.000). Positive significant ALP-related predictors of post-test scores were improvement after activities (β=0.507, t(104)=2.101, p=0.038), timely completed objectives (β=0.391, t(104)=2.418, p=0.017), and number of revisions (β=0.127, t(104)=3.240, p=0.002). Number of total activities, regardless of learning improvement, negatively predicted post-test scores (β= -0.088, t(104)=-4.447, p=0.000). The significant R2 change following the addition of gender, GPA, and pre-test score (R2=0.689, F(13, 101)=17.24, p=0.000), indicated that these predictors explained an additional 39% of the variance in student performance beyond that explained by ALP-related variables, which were no longer significant. Inclusion of cumulative GPA and pre-test scores showed to be the strongest and only predictors of post-test scores (β=18.708, t(101)=4.815, p=0.038) and (β=0.449, t(101)=6.513, p=0.038), respectively. Conclusions: Track ALP-related data can be valuable indicators of learning behavior. Careful and contextual analysis of ALP data can guide future studies to examine practical and scalable interventions. [ABSTRACT FROM AUTHOR]

Curiculum deliberation involves weighing and examining the reasons for and against a curriculum and giving careful consideration and mature reflection to choices. It also often involves considered action by a group of persons. The predominant forms of discourse--persuasive, theoretical, and descriptive--used to codify curriculum deliberations are examined. (RM)

Identifies four types of theory and their potential roles in communications for guiding teachers; delineates generic characteristics of theories and their implications for such communications; and suggests strategies for communicating theories in guides for practice. (MCG)

Schon has contributed significantly to knowledge in the areas of curriculum and supervision. Discussed are three concerns about Schon's formulations on teacher education: (1) the practical format in practice; (2) the dichotomy between reflection-in-action and technical knowledge and science-based knowledge; and (3) the dichotomy between tacit and codified knowledge. (SI)

Factors which affect communication with teachers via curriculum guides include how authors and readers conceptualize educational practice and teaching and audience characteristics. Although each of the predominant forms of discourse (persuasive, descriptive, theoretical) used to communicate practice prescriptions for teachers is flawed, the three forms combined do have potential. (RM)

The University of Minnesota's required six-week ambulatory medicine clerkship provides a comprehensive orientation to ambulatory care through planned integration of patient care with academic work. Responses of both students and faculty have been enthusiastic, with the benefits compensating for high costs in preceptor time. (MSE)