Medical Education Commons^™

Enhancing Clinical Care Quality Through 1-On-1 Quality Improvement Education In Family Medicine, Jude K A Des Bordes, Shira K. Goldstein, Nahid J. Rianon

HCA Healthcare Journal of Medicine

Background

Ongoing improvement and evaluation of clinical care are essential to maintaining high standards. The Accreditation Council for Graduate Medical Education (ACGME) requires all accredited family medicine programs to provide quality improvement (QI) education. Given competing educational demands, residency programs must adopt innovative approaches to teaching QI. This article describes an individualized approach to QI education that we implemented in our family medicine residency program and the outcome of its evaluation.

Methods

Guided by a logic model and evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, this quasi-experimental 1-group pre-test-post-test study (July 2022-June 2023) involved all second-year …

Assessment And Intervention For Health Behavior Change In Primary Care Across The Lifespan: A Guide For Residents In Primary Care Specialties, Stacy A. Ogbeide, Alexis Ramos, Bridget Murphy, Angel Ogbeide

HCA Healthcare Journal of Medicine

More than 45% of Americans have at least 1 chronic disease, with chronic disease also being a leading cause of death in the United States. In primary care settings, about 75% of visits are for management of multiple chronic diseases. Due to the increasing medical complexity of patients who present to primary care, these numbers make it more challenging for Primary Care Clinicians (PCCs) to manage these conditions alone and point to the need for innovative solutions to chronic disease care. One evidence-based innovation is team-based care to improve the treatment of these conditions. Clinicians such as clinical pharmacists, registered …

Under Chiron's Care, Deethya Trivedi

HCA Healthcare Journal of Medicine

This painting depicts young Asclepius under the guidance of Chiron, the wise centaur renowned for his knowledge of healing and medicine. In Greek mythology, Asclepius was entrusted to Chiron after Apollo recognized his potential. Within the nurturing environment of Chiron’s home, Asclepius absorbed lessons on the use of medicinal herbs, wound treatment, and the foundational principles of care, skills that would eventually elevate him to become the Greek God of Medicine. The herbs symbolize hands-on learning and the practical foundation of healing, while the book signifies the accumulation and sharing of knowledge, showing how medical innovation progresses through study, collaboration, …

Ethical Use Of Artificial Intelligence For Clinical Vignettes, Henna Iqbal, Jennifer J. Park, Yelena Burklin

HCA Healthcare Journal of Medicine

The purpose of this report is to introduce a systematic process model for publishing clinical vignettes through vignette-based learning (VBL), with an emphasis on the ethical use of artificial intelligence (AI). We have provided a comprehensive walk-through outlining the process from initial case identification to the final dissemination of clinical vignettes, and we have highlighted how AI tools can support each step. This guide is intended to be especially beneficial for clinicians and early-career medical professionals aiming to develop and submit their cases for presentations, publications, and other avenues of knowledge sharing.

Artificial Intelligence In Medicine: Barriers, Solutions, And Strategies, Anil Harrison, Melissa Stradley Moreno, Caroline E. Williams, Munevver Mine Subasi, Ersoy Subasi

HCA Healthcare Journal of Medicine

The integration of artificial intelligence (AI) and machine learning (ML) into health care holds the potential to revolutionize patient care by enhancing clinical decision-making, improving diagnostic accuracy, and reducing costs. Despite this promise, adoption remains limited due to a range of technical, regulatory, educational, and cultural barriers. This paper examines these challenges and proposes strategies to support safe and effective implementation of AI in clinical practice.

Key barriers include the lack of model interpretability, often referred to as the "black box" problem, which undermines clinician trust and accountability in clinical settings, evolving regulatory frameworks and unresolved questions surrounding liability, and …

The Role Of Simulation In General Surgery Residency: Advancing Technical Proficiency And Clinical Confidence, Matthew A. Daniel, Alyssa Mcmandon, Rachel Daley, Andrew Gustetic, Alexis Howarth, Meghana Jacob, Holden Lewis, Kushali Patel, Taylor Locklear, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Surgical training has changed significantly over the past several decades, largely due to advances in technology. After the introduction of laparoscopic and robotic surgery into residency programs, simulation-based training (SBT) has become an important addition to surgical education. Simulation-based training offers a safe and structured environment to practice skills, receive feedback, and develop technical and non-technical abilities. While its benefits are well recognized, wider use of SBT continues to face challenges, including high costs, limited faculty availability, and time constraints within residency schedules. New technologies such as artificial intelligence, virtual and augmented reality, and standardized simulation frameworks may help address …

An Innovative Model For Graduate Medical Education Faculty Development Through Physician-In-Training Delivery, Daniel A. Nguyen, Dustin Wilkes, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Background

Faculty development is a core requirement for Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs. Successfully delivering content to faculty can be challenging. This pilot study aimed to assess expert-developed sessions delivered by resident physicians to faculty at the completion of their clinical rotations.

Methods

A prospective cohort project was conducted, involving precepting faculty and resident physicians in a dermatology residency program. Each resident, at the end of their rotation, delivered a faculty development program to their attending physician. Each resident participated in the program for 1-3 years. The faculty development programs were based on faculty development programs …

A Scalable Model For Resident And Faculty Well-Being: Applying Self-Determination Theory And The Job Demands-Resources Framework In Graduate Medical Education, Gregory Guldner, Adam Neufeld

HCA Healthcare Journal of Medicine

Despite growing attention to burnout in graduate medical education (GME), many institutional efforts remain fragmented and lack theoretical coherence. In response, HCA Healthcare developed a system-wide initiative grounded in Self-Determination Theory (SDT) and the Job Demands-Resources (JD-R) framework to guide leadership development, learning climate improvement, and resident and faculty well-being. What began as a single-program effort evolved into a multi-year, system-wide initiative involving more than 5800 residents across 366 programs at 85 hospitals. In collaboration with workplace psychologists from Claremont Graduate University and Immersyve Health, the initiative integrated theory-informed leadership workshops, validated assessment platforms, and continuous quality-improvement processes to help …

Fostering Leadership Competency And Professional Identity Formation Through Near Peer Educator Programs, Justin Choi, Gabriela Martin Gonzalez, Tahina Ahmed, Shirley Eisner

HCA Healthcare Journal of Medicine

Introduction

Leadership competency development is a pivotal component of physician professional identity formation (PIF), and its instruction across undergraduate medical education (UME) institutions is diverse. Near-Peer Educator Programs (NPEPs) foster experiential leadership development through teaching junior learners. We evaluated the impact of participation in a structured longitudinal NPEP on medical students’ self-reflections of their leadership growth.

Methods

Medical students serving as Near-Peer Educators (NPEs) were invited to complete a baseline survey prior to facilitating any sessions and a follow-up survey after facilitating more than 1 session. The surveys, measured using a 7-point Likert scale, were modeled on a validated clinical …

Resident Scholarly Activity Plan And Scorecard Implementation In Graduate Medical Education, Michele L. Mccarroll, Afsha Rais Kaisani, Joseph Kessler, Tasaduq H. Mir

HCA Healthcare Journal of Medicine

Background

Scholarly activity (SA) is a requirement of the Accreditation Council on Graduate Medical Education (ACGME); however, many programs struggle with interpreting ACGME trainee requirements and lack standardized tools to effectively communicate, document, and track individualized, resident-centered approaches to SA. This educational project aimed to develop a universal educational graduate medical education (GME) SA plan and scorecard tool to establish shared program expectations, provide formative and summative feedback on SA progression, track SA, and support individualized SA pathways aligned with residents’ professional goals.

Methods

In May 2022, faculty, associate program directors, and program directors within the North Texas Division of …

Building A Better Clinical Competency Committee: A Multi-Institutional Approach To Improving The Quality Of Resident Feedback Through Appreciative Inquiry, Nikita Khetan, Emma Omoruyi, Elizabeth Hanson

HCA Healthcare Journal of Medicine

Background

The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric faculty to convene twice yearly as a Clinical Competency Committee (CCC) to review resident performance and provide feedback. Variability in review processes and limited feedback quality remain common challenges. Incorporating Appreciative Inquiry within a Deliberate Practice framework may enhance the quality of summative feedback provided to residents.

Methods

This project was conducted with pediatric residents and faculty during the 2019–20 academic year at The University of Texas Health Science Center at Health San Antonio (UTHSA) and during the 2021-22 academic year at The University of Texas Health Science Center …

The Distinguished Humanitarian Society, Ashley Charales, Grace Desrochers, Lakshmi Tatineni, Shane Jenks, Rajeev Raghavan

HCA Healthcare Journal of Medicine

Background

The Gold Humanism Honor Society (GHHS) is a nationally recognized organization present at over 80% of medical schools in the United States to promote humanism, integrity, and volunteerism among students. There is no equivalent national honor society present at the majority of Graduate Medical Education (GME) training programs.

Methods

Our institution created the Distinguished Humanitarian Society (DHS) as a local honor society in 2022 to recognize trainees who exemplified the ideals espoused by GHHS. In January and February 2025, we conducted semi-structured interviews to extract themes regarding inductees’ experiences with the DHS. Both interviewers used the same list of …

Gamification To Improve Emergency Medical Service Personnel Knowledge Of Medical Capacity Determination, Ross Sinicrope, Nasim Motaghedi, Zackary Yates, Elliott Richardson, Stephanie Schiffert, Jacob Wright, Abigail Alorda, Jeffrey Katz, Linh Nguyen, Shayne Gue, Christine Van Dillen, Ayanna Walker

HCA Healthcare Journal of Medicine

Background

As medical education evolves, innovative techniques are being explored to enhance learning and engagement. While existing literature on gamification in medical education primarily focuses on graduate medical education, its application in other fields, such as nursing or emergency medical services (EMS), remains underexplored. This study evaluates the feasibility of using gamification to teach EMS personnel about patient capacity assessment and examines its impact on the frequency of pre-hospital transport.

Methods

A relay race with 3 stations was developed by emergency medicine residents, EMS fellows, and emergency medicine and emergency medical services teaching faculty to teach capacity assessment. Each station …

Impact Of Innovative Interprofessional Practice And Education Intervention Led By Graduate Medical Education Resident Physicians With School-Based Nursing In 32 School Districts, Christoffer A. Amdahl, Hans Drawbert, Sadra Forati, Tyler Fields, James Mantil, Afsha Rais Kaisani, Marci Ayers, Michele L. Mccarroll Phd

HCA Healthcare Journal of Medicine

Background

School nurses play a critical role in student well-being, underscoring their growing importance in both education and health care systems. Research consistently demonstrates their contributions to individual student care and broader population health.

Methods

This resident-led project explored community-based partnerships to facilitate mutual learning between school nurses and graduate medical education (GME) physicians. Conducted during the 2023–2024 academic year, this quality initiative (QI) involved the Medical City Healthcare (HCA Healthcare) GME programs and North Texas school districts. Educational resources were delivered through in-person teaching sessions led by resident physicians and hands-on medical simulations. School nurses who attended the Continuing …

Improving Scholarly Activity Through A Bundled Intervention Of Resident-Faculty Connection And Research Ideas, Katie Suleta, Norman W. Gill

HCA Healthcare Journal of Medicine

Background

Residents report barriers to engaging in scholarly activity despite this being a common requirement across residency programs. Two commonly reported barriers are a lack of mentorship by faculty and a lack of ideas for projects that meet the criteria for scholarly activity. The study objective is to describe the effect of an intervention to address a lack of mentorship and a lack of ideas for scholarly activities.

Methods

A retrospective cohort design was utilized to investigate changes in scholarly activity between 2 academic years. An internal medicine residency program with 30 residents and 17 faculty members participated in an …

Enhancing Resident Preparedness For The American Board Of Surgery Certifying Exam Through Low-Stakes Mock Oral Sessions, Camila R. Guetter, Taylor Locklear, Omar Haque, P Nina Scalise, Saptarshi Biswas, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

The American Board of Surgery (ABS) requires trainees to pass both a written qualifying examination (ABSQE) and oral certifying examination (ABSCE) to achieve board certification. The high-stakes nature of the ABSCE, which assesses knowledge, clinical judgment, and decision-making, necessitates extensive preparation. To address the challenges of the ABSCE format and associated trainee stress, structured mock oral programs have been developed. Here we evaluate the impact of structured mock oral sessions on residents' comfort levels and familiarity with the ABSCE at a single institution.

Methods

A mixed-methods survey was given to 50 general surgery residents in different training years who …

Medical Education As Both Process And Environment For Innovation, Gerald Wickham

HCA Healthcare Journal of Medicine

The promise of better medicine, better health outcomes, and better lives depends on a culture of innovation and implementation in medical education. HCA Healthcare Graduate Medical Education continually strives to achieve this environment, to identify the health breakthroughs of tomorrow by fostering innovation in the daily work of the residents, scientists, and physicians of our enterprise. This special issue highlights some of this important work and shares actionable programs to elevate and inspire the next generation of physicians.

Facing Dissection, Aya E. Cannon

HCA Healthcare Journal of Medicine

The summer prior to beginning medical school, our anatomy professor prompted us to reflect on the experience of dissection and create an image based on our thoughts and feelings. I was thrilled by the assignment and immediately began listing my emotions. Excitement: For so long, I had worked toward this point, and now the quintessential medical school experience was within reach. I expressed my appreciation for the beauty and complexity of the human body through color and collage, using the vibrant layers to reflect the awe and range of emotions I felt. Nervousness: Despite my enthusiasm, I was faced with …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Keratosis Pilaris, Henry Lim, Reem Ayoub, Madelyn Richards, Marshall Hall, Christian Scheufele, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Keratosis pilaris (KP) is a common benign disorder involving hyperkeratosis of the skin. It is associated with other common dry skin disorders such as atopic dermatitis and ichthyosis vulgaris. Lesions are clinically characterized as symmetrically distributed, monomorphic, folliculocentric, hyperkeratotic papules with a variable degree of perifollicular erythema. The appearance can be likened to spikey bumps that are commonly located on the arms, legs, and buttocks. Awareness of KP is important as every primary care clinician will see patients with this disorder. Identification can support the diagnosis of other associated skin diseases. Education about KP and its treatment may alleviate psychological …

Expanding Waste Segregation Initiatives To Reduce Regulated Medical Waste: A Multi-Departmental Quality Improvement Project, Emily M. Su, Anuja L. Sarode, Mohammed Sami, David R. Nehring, Erica L. Laipply, Mustafa Culcuoglu

HCA Healthcare Journal of Medicine

Background

Regulated medical waste (RMW) drives up health care costs, largely due to misclassification of general waste, especially in operating rooms (ORs), intensive care units (ICUs), and obstetrics and gynecology (OBGYN) departments. This study aimed to reduce RMW volume and costs at Akron City Hospital (ACH) through department-specific interventions aligning with Occupational Safety and Health Administration (OSHA) and Ohio Environmental Protection Agency guidelines.

Methods

Periodic analyses compared hospital-wide aggregate RMW volume, pick-up frequency, and disposal costs before and after interventions. The ORs initiated interventions in October 2022, expanding to ICUs and OBGYN by February 2024. Strategies included staff education, flyers …

Is It Retaliation Or Remediation? Educating Our Learners On The Difference, France M. Leandre, Almari Ginory

HCA Healthcare Journal of Medicine

The goal of this article is to discuss 1 of the questions in the Accreditation Council for Graduate Medical Education Resident/Fellow Survey, which assesses the fear of retaliation in a program. To better understand the needs of residents and facilitate the reporting of concerns, programs must evaluate and educate residents on the difference between remediation and retaliation.

Upper Respiratory Tract Infection Leading To A New Diagnosis Of Sweet Syndrome And Monoclonal Gammopathy Of Unknown Significance, Nidhi Rawat, Meron Gebrehiwot, Jason Raw, Jeyaprakash Ramachandran

HCA Healthcare Journal of Medicine

Background

We present a rare case of Sweet syndrome with underlying monoclonal gammopathy of unknown significance (MGUS) which initially presented as upper respiratory tract infection.

Case Presentation

A 52-year-old woman presented with a complaint of sore throat for 6 days, productive cough and fever for 5 days, and red, pruritic, circular, tender rashes on face, arms and trunk for 2 days. There was a past history of similar self-limiting rashes presenting intermittently for 1.5 years. She also reported to be taking tablet ibuprofen, as required for the past 1-2 years, for cervical spondylosis. On integumentary examination, widespread, red, tender, annular …

Response: Letter To The Editor, Exercise Is A Vital Sign, Megan Dannemiller, Anthony Shadiack, Marvin Sineath Jr, Andrew Baird, Marc Poirier, Kevin Thomas, Michael G. Flynn

HCA Healthcare Journal of Medicine

This letter is submitted in response to the letter to the editor regarding the authors’ article “Exercise Is a Vital Sign.”

Multi-Center Survey Of Medicine Residents And Self-Assessment On Cardiac Complications In Obstetric Patients, Kevyn Niu, Christie A. Tran, Robert J. Subbiondo Md, Olubenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Internal medicine (IM) residents receive significant cardiology training, and previous surveys have evaluated IM resident competency on obstetric (OB)-related subjects. However, there is minimal literature on self-reported competence of cardiac-specific complications in OB patients. Our study assessed self-reported comfort and competency regarding cardiovascular complications in OB patients with medical residents across several specialties.

Methods

We surveyed 207 residents across 3 specialties and 3 teaching hospitals on 10 questions regarding their self-reported confidence in managing cardiovascular complications in OB patients, including practice setting, specific cardiac issues, and stages of labor. We received 42 responses. Results were obtained using Google Sheets …

Understanding Challenges Faced By Female Graduate Medical Education Trainees: A Qualitative Content Analysis Of Physician Coaching Requests, Nathalie Dieujuste, Adrienne Mann, Kimiko Dunbar, Pari Shah Thibodeau, Tyra Fainstad, Brooke Dorsey Holliman

HCA Healthcare Journal of Medicine

Background

Physician burnout, particularly among female graduate medical education (GME) trainees, is a growing concern that affects physician wellness and patient safety. Professional coaching has shown promise in improving physician wellness. The Better Together Physician Coaching program (BT) is a web-based, group-coaching program, piloted using female GME trainees, aimed at improving key indicators of well-being, including burnout and impostor syndrome. In this qualitative study, we aimed to understand the challenges faced by female physician trainees shared in the pilot of the BT coaching intervention.

Methods

A total of 101 female physician trainees participated in the BT pilot. A sample of …

Converting Usmle Step 1 To Pass Or Fail: The Potential Impact On Applicants Who Are Female Or From Underrepresented Groups, Haris Ahmed, Peter Yu, Brendan Rosamond, Jonathan Lall, Scott Zimmerle, Said Maldonado, Nicole Lyons, Ashlynn N. Mills, Yoolim Alex Seo, Angelica C. Rodriquez, Jacqueline E. Levesque, Oluwatunmininu A. Anwoju, Zuhair Ali, Rajeev Raghavan, Mike Liang

HCA Healthcare Journal of Medicine

Background

In January 2022, the United States Medical Licensing Examination (USMLE) Step 1 exam became pass/fail and the transition to using USMLE Step 2 scores for residency interview screening appeared imminent. While this change was intended to result in holistic reviews of residency applicants, the impact remains unclear. In this study, we aimed to determine how USMLE scoring changes might affect female candidates and applicants from underrepresented groups (URM).

Methods

We performed a retrospective cross-sectional study of all applicants to a single institution. Data for applicants were extracted from their 2021-2022 residency applications and included age, race, sex, medical school, …

A Case Of A Massive Right Atrial Thrombus Removal Under Transesophageal Echocardiographic Guidance, Justin Phillips, Max Kabolowsky, Alex M. Hendon, Samantha Arzillo

HCA Healthcare Journal of Medicine

Background

With the advent of catheter guided interventions, practitioners have added another tool alongside chemical lysis and surgical removal to reduce the clot burden of patients with large emboli and thrombi. Due to comorbid conditions, many patients are poor candidates for surgical or chemical clot treatment but may present optimally for catheter-based thromboembolectomy. In this case, we highlight the benefits of mechanical thrombectomy with transesophageal echocardiographic guidance to reduce the clot burden of a patient who would otherwise be considered a poor candidate for surgical or chemical treatment.

Case Presentation

This case follows a 78-year-old man with a past medical …

An Examination Of Health Coaching As A Developing Profession, Katie Suleta, Jonathan M. Davis

HCA Healthcare Journal of Medicine

Background

Health coaching is a field that is growing in popularity. Health coaching is not regulated and there is no standard for background, education, or training for those acting as health coaches. The purpose of this study was to investigate the burgeoning field of health coaching: who is performing it and common practices.

Methods

A total of 560 health coaching websites were reviewed to record educational backgrounds, recommendations for supplements, and the sale of supplements and/or other wellness products. Multivariable logistic regression was used to test associations between characteristics of health coaches and whether they recommend supplements, sell supplements, or …

Harmonizing Innovation: The Beatles, Emi, And The Birth Of Computed Tomography Imaging, Matthew A. Daniel, Alexander Holland, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Computed tomography (CT) imaging has become a cornerstone of modern medical diagnostics, thanks to the groundbreaking work of Sir Godfrey Hounsfield. However, the significant role played by his employer, Electric and Musical Industries (EMI), in providing financial support for his research is often overlooked. In this paper, we explore the connection between EMI's success in the music industry, particularly its signing of the Beatles, and Hounsfield's pioneering work on CT imaging. EMI’s success in the music industry provided the financial stability for Hounsfield's research endeavors. In 1971, he developed the first CT scanner, which revolutionized diagnostic medicine. His collaboration with …

Treatment Analysis Of Very Early And Early Onset Psychosis In The Youth Inpatient Setting, Acelyne Marie Summerson, Jordan Kalosieh, Sindhura Kompella, Clara Alvarez-Villaba, Yukthi Kodali

HCA Healthcare Journal of Medicine

Background

The United States Food and Drug Administration approved 6 atypical antipsychotics for pediatric treatment of schizophrenia. However, little has been published on the effectiveness of these medications in the acute treatment setting of adolescents with psychosis. Since the clinical uncertainty and poor prognosis proceeding the early onset of schizophrenia has a significant impact on a child’s development, there is a critical need for evidence-based data on this population. The aim of our study was to investigate the effect of various antipsychotics on young patients admitted to the inpatient ward presenting with acute psychosis.

Methods

A retrospective analysis was performed …