Letters to the Editor
financial need cause minorities to look for jobs elsewhere. Because of the disparity in promotion rates, minority faculty7,8 are paying a higher proportion of their incomes to student loans than faculty members from other groups. Is it any wonder that the proportions of underrepresented minority faculty have not changed in 20 years?8 Faculty loan repayment programs should be popularized and expanded to alleviate the disproportionate debt burden that minority faculty face. This way, minority students and graduates who are interested in an academic career have an opportunity to focus on their intellectual pursuits rather than on the elimination of their student debt. Disclosures: None reported. José E. Rodríguez, MD Associate professor and codirector, Center for Underrepresented Minorities in Academic Medicine, Florida State University College of Medicine, Tallahassee, Florida; [email protected].
Kendall M. Campbell, MD Associate professor and codirector, Center for Underrepresented Minorities in Academic Medicine, Florida State University College of Medicine, Tallahassee, Florida.
References 1 Elliott BA, Dorscher J, Wirta A, Hill DL. Staying connected: Native American women faculty members on experiencing success. Acad Med. 2010;85:675–679. 2 Pololi LH, Jones SJ. Women faculty: An analysis of their experiences in academic medicine and their coping strategies. Gend Med. 2010;7:438–450. 3 Rodríguez JE, Campbell KM. Ways to guarantee minority faculty will quit academic medicine. Acad Med. 2013; 88:1591. 4 Johnson A, Van Ostern T, White A. The Student Debt Crisis. Washington, DC: Center for American Progress; 2012. 5 Pololi L, Cooper LA, Carr P. Race, disadvantage and faculty experiences in academic medicine. J Gen Intern Med. 2010;25:1363–1369.
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6 Cropsey KL, Masho SW, Shiang R, Sikka V, Kornstein SG, Hampton CL; Committee on the Status of Women and Minorities, Virginia Commonwealth University School of Medicine, Medical College of Virginia Campus. Why do faculty leave? Reasons for attrition of women and minority faculty from a medical school: Four-year results. J Womens Health (Larchmt). 2008;17:1111–1118. 7 Fang D, Moy E, Colburn L, Hurley J. Racial and ethnic disparities in faculty promotion in academic medicine. JAMA. 2000;284:1085–1092. 8 Nunez-Smith M, Ciarleglio MM, SandovalSchaefer T, et al. Institutional variation in the promotion of racial/ethnic minority faculty at US medical schools. Am J Public Health. 2012;102:852–858.
Teaching Trainees to Prevent Medical Errors May Decrease the Need for Disclosure To the Editor: In the June 2013 issue, Stroud and colleagues1 reviewed 21 studies of medical error disclosure curricula delivered to medical trainees by several teaching modalities that included primarily didactic lectures and occasional group activities. Despite the need to address medical error disclosure in the most effective possible manner, an alternative approach might be to try to prevent the initial error by giving learners the tools they need to develop skills and behaviors that lead to better patient outcomes. In order to capture the greatest number of learners, and thus prevent the greatest number of errors, it would be essential to employ teaching methods that address all learning styles. As such, we have found2 that by using androgogic principles to address all learning styles, a learner-centered curriculum can be effective in transmission of skill transfer and behavioral change by reducing inpatient diabetes errors in a tertiary children’s hospital. By focusing our educational efforts on error prevention rather than error disclosure, we have learned
a number of important lessons in relation to formal training that leads to the authors’ overarching aim: “longterm effects on learner outcomes that translate into real-world clinical practice.”1 First, implementing diverse methods of instruction rooted in adult learning principles that incorporate different learning styles was a very effective approach. Second, having multiple sessions allowed for facilitator feedback and reflection by trainees. Third, understanding that skills and knowledge can deteriorate over time, a booster session six months after the initial presentation of the curriculum diminished the possibility of an increase in errors. Fourth, providing online modular learning materials for residents who may not be on-site or may not be available because of limited duty hours was important. In sum, we believe that curricula employing androgogic principles to prevent initial errors offered in conjunction with teaching error disclosure may be the most effective teaching approach to promote better patient outcomes. Disclosures: None reported. Fran Cogen, MD Director, Childhood and Adolescent Diabetes Program, Children’s National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; fcogen@ childrensnational.org.
Larrie Greenberg, MD Internal consultant, George Washington University School of Medicine and Health Sciences, Washington, DC.
References 1 Stroud L, Wong BM, Hollenberg E, Levinson W. Teaching medical error disclosure to physicians-in-training: A scoping review. Acad Med. 2013;88:884–892. 2 DeSalvo DJ, Greenberg LW, Henderson CL, Cogen FR. A learner-centered diabetes management curriculum-reducing resident errors on an inpatient pathway. Diabetes Care. 2012;35:2188–2193.
Academic Medicine, Vol. 89, No. 3 / March 2014
financial need cause minorities to look for jobs elsewhere. Because of the disparity in promotion rates, minority faculty7,8 are paying a higher proportion of their incomes to student loans than faculty members from other groups. Is it any wonder that the proportions of underrepresented minority faculty have not changed in 20 years?8 Faculty loan repayment programs should be popularized and expanded to alleviate the disproportionate debt burden that minority faculty face. This way, minority students and graduates who are interested in an academic career have an opportunity to focus on their intellectual pursuits rather than on the elimination of their student debt. Disclosures: None reported. José E. Rodríguez, MD Associate professor and codirector, Center for Underrepresented Minorities in Academic Medicine, Florida State University College of Medicine, Tallahassee, Florida; [email protected].
Kendall M. Campbell, MD Associate professor and codirector, Center for Underrepresented Minorities in Academic Medicine, Florida State University College of Medicine, Tallahassee, Florida.
References 1 Elliott BA, Dorscher J, Wirta A, Hill DL. Staying connected: Native American women faculty members on experiencing success. Acad Med. 2010;85:675–679. 2 Pololi LH, Jones SJ. Women faculty: An analysis of their experiences in academic medicine and their coping strategies. Gend Med. 2010;7:438–450. 3 Rodríguez JE, Campbell KM. Ways to guarantee minority faculty will quit academic medicine. Acad Med. 2013; 88:1591. 4 Johnson A, Van Ostern T, White A. The Student Debt Crisis. Washington, DC: Center for American Progress; 2012. 5 Pololi L, Cooper LA, Carr P. Race, disadvantage and faculty experiences in academic medicine. J Gen Intern Med. 2010;25:1363–1369.
372
6 Cropsey KL, Masho SW, Shiang R, Sikka V, Kornstein SG, Hampton CL; Committee on the Status of Women and Minorities, Virginia Commonwealth University School of Medicine, Medical College of Virginia Campus. Why do faculty leave? Reasons for attrition of women and minority faculty from a medical school: Four-year results. J Womens Health (Larchmt). 2008;17:1111–1118. 7 Fang D, Moy E, Colburn L, Hurley J. Racial and ethnic disparities in faculty promotion in academic medicine. JAMA. 2000;284:1085–1092. 8 Nunez-Smith M, Ciarleglio MM, SandovalSchaefer T, et al. Institutional variation in the promotion of racial/ethnic minority faculty at US medical schools. Am J Public Health. 2012;102:852–858.
Teaching Trainees to Prevent Medical Errors May Decrease the Need for Disclosure To the Editor: In the June 2013 issue, Stroud and colleagues1 reviewed 21 studies of medical error disclosure curricula delivered to medical trainees by several teaching modalities that included primarily didactic lectures and occasional group activities. Despite the need to address medical error disclosure in the most effective possible manner, an alternative approach might be to try to prevent the initial error by giving learners the tools they need to develop skills and behaviors that lead to better patient outcomes. In order to capture the greatest number of learners, and thus prevent the greatest number of errors, it would be essential to employ teaching methods that address all learning styles. As such, we have found2 that by using androgogic principles to address all learning styles, a learner-centered curriculum can be effective in transmission of skill transfer and behavioral change by reducing inpatient diabetes errors in a tertiary children’s hospital. By focusing our educational efforts on error prevention rather than error disclosure, we have learned
a number of important lessons in relation to formal training that leads to the authors’ overarching aim: “longterm effects on learner outcomes that translate into real-world clinical practice.”1 First, implementing diverse methods of instruction rooted in adult learning principles that incorporate different learning styles was a very effective approach. Second, having multiple sessions allowed for facilitator feedback and reflection by trainees. Third, understanding that skills and knowledge can deteriorate over time, a booster session six months after the initial presentation of the curriculum diminished the possibility of an increase in errors. Fourth, providing online modular learning materials for residents who may not be on-site or may not be available because of limited duty hours was important. In sum, we believe that curricula employing androgogic principles to prevent initial errors offered in conjunction with teaching error disclosure may be the most effective teaching approach to promote better patient outcomes. Disclosures: None reported. Fran Cogen, MD Director, Childhood and Adolescent Diabetes Program, Children’s National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; fcogen@ childrensnational.org.
Larrie Greenberg, MD Internal consultant, George Washington University School of Medicine and Health Sciences, Washington, DC.
References 1 Stroud L, Wong BM, Hollenberg E, Levinson W. Teaching medical error disclosure to physicians-in-training: A scoping review. Acad Med. 2013;88:884–892. 2 DeSalvo DJ, Greenberg LW, Henderson CL, Cogen FR. A learner-centered diabetes management curriculum-reducing resident errors on an inpatient pathway. Diabetes Care. 2012;35:2188–2193.
Academic Medicine, Vol. 89, No. 3 / March 2014
