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This chapter describes the complex process of transition from a clinician to a health professional educator. A series of reflections are provided developing an in-depth understanding of the authors' developmental journey.

Physicians frequently are early adopters of healthy behaviors based on their knowledge and economic resources. The mortality patterns of physicians in the United States, particularly suicide, have not been rigorously described for over a decade. Previous studies have shown lower all-cause mortality among physicians yet reported conflicting results about cause-specific mortality such as suicide. In this study, we compared all-cause and cause-specific mortality in a sample of physicians to the age-gender matched general U.S. population from 1948 through 1998. We also compared the mortality experience across medical specialities. The risk of all-cause mortality was 56% lower than expected in men, and 26% lower in women, compared to the general population. Standardized mortality ratios (SMRs) were markedly lower for diseases strongly linked to smoking, e.g., cardiovascular diseases, respiratory diseases, and lung cancer. Suicide was the only cause of death where risk was greater than the general population. Overall, we found that physicians are at substantially lower risk of dying compared to the general population for all causes of death except suicide. The findings for suicide are strikingly different than other causes of death and should provide impetus for new research on the mental health of physicians.

Physicians frequently are early adopters of healthy behaviors based on their knowledge and economic resources. The mortality patterns of physicians in the United States, particularly suicide, have not been rigorously described for over a decade. Previous studies have shown lower all-cause mortality among physicians yet reported conflicting results about cause-specific mortality such as suicide. In this study we compared all-cause and cause-specific mortality in a sample of physicians to the age-gender matched general U.S. population from 1948 through 1998. We also compared the mortally: experience across medical specialities. The risk of all-cause mortality was 56% lower than expected in men, and 26% lower in women, compared to the general population. Standardized mortality ratios (SMRs) were markedly lower for diseases strongly linked to smoking, e.g., cardiovascular diseases, respiratory diseases, and lung cancer. Suicide was the only cause of death where risk was greater than the general population. Overall, we found that physicians are at substantially lower risk of dying compared to the general population for all causes of death except suicide. The findings for suicide are strikingly different than other causes of death and should provide impetus for new research on the mental health of physicians.

Construct: The definition of clinical reasoning may vary among health profession educators. However, for the purpose of this paper, clinical reasoning is defined as the cognitive processes that are involved in the steps of information gathering, problem representation, generating a differential diagnosis, providing a diagnostic justification to arrive at a leading diagnosis, and formulating diagnostic and management plans. Background: Expert performance in clinical reasoning is essential for success as a physician, and has been difficult for clerkship directors to observe and quantify in a way that fosters the instruction and assessment of clinical reasoning. The purpose of this study was to gather validity evidence for the Multistep exam (MSX) format used by our medicine clerkship to assess analytical clinical reasoning abilities; we did this by examining the relationship between scores on the MSX and other external measures of clinical reasoning abilities. This analysis used dual process theory as the main theoretical framework of clinical reasoning, as well as aspects of Kane's validity framework to guide the selection of validity evidence for the investigation. We hypothesized that there would be an association between the MSX (a three-step clinical reasoning tool developed locally), and the USMLE Step 2 CS, as they share similar concepts in assessing the clinical reasoning of students. We examined the relationship between overall scores on the MSX and the Step 2 CS Integrated Clinical Encounter (ICE) score, in which the student articulates their reasoning for simulated patient cases, while controlling for examinee's internal medicine clerkship performance measures such as the NBME subject exam score and the Medicine clerkship OSCE score. Approach: A total 477 of 487 (97.9%) medical students, representing the graduating classes of 2015, 2016, 2017, who took the MSX at the end of each medicine clerkship (2012–2016), and Step 2 CS (2013–2017) were included in this study. Correlation analysis and multiple linear regression analysis were used to examine the impact of the primary explanatory variables of interest (MSX) onto the outcome variable (ICE score) when controlling for baseline variables (Medicine OSCE and NBME Medicine subject exam). Findings: The overall MSX score had a significant, positive correlation with the Step 2 CS ICE score (r =.26, P <.01). The overall MSX score was a significant predictor of Step 2 CS ICE score (ß =.19, P <.001), explaining an additional 4% of the variance of ICE beyond the NBME Medicine subject score and the Medicine OSCE score (Adjusted R2 = 13%). Conclusion: The stepwise format of the MSX provides a tool to observe clinical reasoning performance, which can be used in an assessment system to provide feedback to students on their analytical clinical reasoning. Future studies should focus on gaining additional validity evidence across different learners and multiple medical schools. [ABSTRACT FROM AUTHOR]

The article focuses on a study regarding clerkship evaluation and grading practices between the U.S. medical schools. It mentions that the grade inflation continues in the internal medicine clerkship. It also mentions that minority of programs have trained core faculty who are responsible for evaluation in balancing grading practices.

An essential part of problem-based learning (PBL) is group learning. Thus, an in depth understanding of the theoretical underpinnings of group learning in PBL allows educators to bridge theory and practice more effectively thus providing ideas and tools to enhance PBL practices and research. The theory-driven applications examined in this article establish grounds for future research in PBL. The purpose of this article is to describe and examine two theoretical perspectives of group learning in PBL and their potential applications to improve educational practice. They include: (1) social interdependence theory and the meaning of positive interdependence, (2) socio cognitive theory of networked expertise and the concept of knowledge creation in innovative knowledge communities (IKC). Potential applications include the following: development of instructional material to foster positive interdependency using concept maps; formal and structured use of peer feedback throughout PBL courses to promote individual and group accountability; creation and sharing of new knowledge about different topics within and across IKC; and use of rotating students with hybrid abilities across PBL groups to foster distributed cognition. [ABSTRACT FROM AUTHOR]