Volume 17: Issue 1

Introduction

Graduate medical education (GME) evolves continuously, and sponsoring institutions (SIs) must navigate this landscape, making strategic planning essential for compliance, aligning educational outcomes with health care needs, fostering innovation, and ensuring financial sustainability. The Accreditation Council for Graduate Medical Education (ACGME) and the Association of American Medical Colleges (AAMC) inform GME priorities,¹ while only the 2023 AAMC Group on Resident Affairs GME Leadership Competencies² explicitly mentions strategic planning and the Group on Institutional Planning offers a related suite of resources.³

Recent literature highlights the importance of GME strategic planning for health educators engaged in

Background Global health (GH) interest is rising among graduate medical education (GME) trainees, yet GH engagement is marred by the impact of colonization or racism, and there remains a lack of training to confront these challenges.

Objective To develop a modular, open-access curriculum that provides training in decolonization for GH GME and evaluate its feasibility and impact on learners’ critical reflection on decolonization.

Methods From 2019 to 2022, 40 GH educators, including international and indigenous scholars from diverse organizations, created the Global Health Education for Equity, Anti-Racism, and Decolonization (GHEARD) curriculum. Using Kern’s 6 steps of curriculum development, critical gaps were identified and shaped into 8 modules, including a facilitator training module. Learning objectives and activities were developed using strategies grounded in transformative learning theory and trauma-informed educational approaches. The curriculum was peer-reviewed and piloted at multiple national conferences and institutions to assess feasibility and effectiveness in fostering critical reflection on decolonization.

Results Pilot testing demonstrated GME implementation feasibility. Based on initial educator feedback, facilitator tools and an implementation guide were incorporated to enhance usability. Nearly all (59 of 61) trainees felt GHEARD was effective or very effective in encouraging reflection on decolonization, and 72% (32 of 44) felt GHEARD encouraged reflection on motivations for engaging in GH. GHEARD was launched as a free online resource in June 2023 and garnered 3192 views by December 2024.

Conclusions To our knowledge, GHEARD is the first comprehensive decolonization curriculum designed specifically for GME. Program evaluation indicates GHEARD is feasible to implement and effective in promoting critical reflection on decolonization.

Background The COVID-19 pandemic forced an abrupt reevaluation of traditional subinternship models in surgical education, with the adoption of virtual subinternships (VSIs) emerging as a prominent response. This review assesses VSIs as a cost-effective, equitable alternative, especially as virtual education continues since the end of the Federal COVID-19 Public Health Emergency and may be crucial in future crises.

Objective Our research question asks how curriculum delivery, learner outcomes, and interpretation of program fit occur within the VSI model.

Methods A thorough systematic review was conducted across multiple databases, including PubMed, Web of Science, Google Scholar, and Embase, adhering to PRISMA guidelines, and spanning publications in English from January 2020 to June 2023. Studies were selected based on review of VSI curriculum content, delivery formats, evaluation techniques, and student outcomes. Exclusion criteria encompassed non-original research or articles lacking comprehensive curriculum descriptions and associated outcomes. We assessed bias in study selection through independent double review and synthesized findings using thematic analysis.

Results Of 1436 articles, 13 met the inclusion criteria. They encompassed a range of surgical fields and highlighted the diverse approaches to VSI implementation. Key themes included the integration of interactive learning sessions, balance between imparting knowledge and program familiarization, and mixed methods of program evaluation. Despite high student satisfaction reported, faculty feedback indicated it was difficult to provide an evaluation of student skills in this context and more challenging to assess students’ fit for residency programs.

Conclusions VSIs were effective in delivering curriculum and engaging learners, highlighting diverse implementation approach challenges in assessing student skills and program fit.

Background Racism pervades the medical system, contributing to health inequities, lack of Black, Indigenous, and people of color (BIPOC) entering medical education, and poor retention of BIPOC physicians. Racial affinity caucusing (RAC) is a tool to address and dismantle cultural and institutional racism by providing space for individuals with shared racial identities to engage in conversations about their racialized identities and experiences. Little is published on RAC facilitation and training.

Objective The authors aimed to evaluate an RAC facilitator training program.

Methods Program directors from 32 residency programs nominated 12 faculty for RAC facilitation training, and all participated in virtual trainings and RAC sessions from September 2021 to March 2022. Training consisted of foundational concepts of anti-racism and RAC, and practice co-leading an RAC session. All 12 participated in semistructured interviews. Interview transcripts were evaluated for identified themes. This qualitative study used directed content analysis to discern patterns and cross-walked code categories with constructs from social cognitive theory.

Results Interview transcripts for all 12 participants, who included 7 BIPOC faculty and 5 White faculty, were reviewed to discern patterns. Patterns were coded revealing themes for participants’ motivations and perceived benefits of facilitator training, critical skills needed for successful facilitation, and resources necessary to implement RAC at home institutions.

Conclusions In addition to identifying motivations for participation in training, key skills and resources for successful facilitation were identified, including small group facilitation, managing one’s own emotions, understanding principles of anti-racism, and practice and debrief of RAC facilitation.

The Accreditation Council for Graduate Medical Education (ACGME) and ACGME International (ACGME-I) are pleased to announce the publication of International Clinical Learning Environment Pathways to Excellence: Expectations to Achieve Safe and High-Quality Patient Care. ¹

The International Clinical Learning Environment Pathways to Excellence document is intended to accelerate conversations among educators, health care leaders, policymakers, and patients regarding the importance of continually assessing and improving the environments in which resident and fellow physicians learn and train, as well as the role of graduate medical education (GME) in promoting safe, high-quality patient care. This publication reflects the review