Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.

Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10â€"11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.

This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.

Because of changes in the health care system, the hospital has become less suitable as the primary focus of graduate medical education for primary care physicians. However, the current system of financing health care education and services makes it difficult to accomplish the needed shift to training in primary care ambulatory settings. This book suggests ways of lowering financial barriers to primary care training in ambulatory settings.

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

Tomorrow's best physicians will be those who continually learn, adjust, and innovate as new information and best practices evolve, reflecting adaptive expertise in response to practice challenges. As the first volume in the American Medical Association's MedEd Innovation Series, The Master Adaptive Learner is an instructor-focused guide covering models for how to train and teach future clinicians who need to develop these adaptive skills and utilize them throughout their careers. - Explains and clarifies the concept of a Master Adaptive Learner: a metacognitive approach to learning based on self-regulation that fosters the success and use of adaptive expertise in practice. - Contains both theoretical and practical material for instructors and administrators, including guidance on how to implement a Master Adaptive Learner approach in today's institutions. - Gives instructors the tools needed to empower students to become efficient and successful adaptive learners. - Helps medical faculty and instructors address gaps in physician training and prepare new doctors to practice effectively in 21st century healthcare systems. - One of the American Medical Association Change MedEd initiatives and innovations, written and edited by members of the ACE (Accelerating Change in Medical Education) Consortium – a unique, innovative collaborative that allows for the sharing and dissemination of groundbreaking ideas and projects.

In the United States, broad study in an array of different disciplines â€"arts, humanities, science, mathematics, engineeringâ€" as well as an in-depth study within a special area of interest, have been defining characteristics of a higher education. But over time, in-depth study in a major discipline has come to dominate the curricula at many institutions. This evolution of the curriculum has been driven, in part, by increasing specialization in the academic disciplines. There is little doubt that disciplinary specialization has helped produce many of the achievement of the past century. Researchers in all academic disciplines have been able to delve more deeply into their areas of expertise, grappling with ever more specialized and fundamental problems. Yet today, many leaders, scholars, parents, and students are asking whether higher education has moved too far from its integrative tradition towards an approach heavily rooted in disciplinary "silos". These "silos" represent what many see as an artificial separation of academic disciplines. This study reflects a growing concern that the approach to higher education that favors disciplinary specialization is poorly calibrated to the challenges and opportunities of our time. The Integration of the Humanities and Arts with Sciences, Engineering, and Medicine in Higher Education examines the evidence behind the assertion that educational programs that mutually integrate learning experiences in the humanities and arts with science, technology, engineering, mathematics, and medicine (STEMM) lead to improved educational and career outcomes for undergraduate and graduate students. It explores evidence regarding the value of integrating more STEMM curricula and labs into the academic programs of students majoring in the humanities and arts and evidence regarding the value of integrating curricula and experiences in the arts and humanities into college and university STEMM education programs.