Medical Science Educator March Article Review from Dr. Louis Justement

Each month the IAMSE Publications Committee reviews published articles from the archives of Medical Science Educator or of its predecessor JIAMSE. This month’s review, written by Dr. Louis B. Justement, is taken from the article titled Analysis of Strategies for the Teaching of Difficult Threshold Concepts in Large Undergraduate Medicine and Science Classes, published in the Medical Science Educator, Volume 27, (pages 673-684), 2017.

A critical issue that underpins teaching in undergraduate medical and science classes, particularly large format classes, relates to the fact that one needs to identify effective ways to help students grasp threshold concepts. Threshold concepts are those concepts that are often difficult to fully understand but are critical for transforming one’s appreciation of a larger topic or area of science. Studies have yet to be performed to identify the most effective methods for helping students grasp threshold concepts in large classroom settings. Moreover, it is also not clear whether the same approaches will be equally effective in settings where the student populations are distinct in terms of their background and future career path. This question is particularly relevant in those introductory classroom settings where there is limited individual instruction and where other resources may be limited on a per student basis to support the educational mission.

One such study to better understand the association between multiple interventions to teach a threshold concept and their relative effectiveness in an undergraduate medicine versus science class environment is discussed in a recent paper entitled Analysis of Strategies for the Teaching of Difficult Threshold Concepts in Large Undergraduate Medicine and Science Classes, published in the Medical Science Educator, Volume 27, (pages 673-684), 2017, by authors SK Delaney, J Mills, A Galea, R LeBard, J Wilson, KJ Gibson, G Kornfeld and B Ashraf.

In this study, the authors focus on the field of genetics and teaching the threshold concept associated with the Hardy-Weinberg law, or equilibrium as it is often referred to. The study was conducted in large format medicine and science classes at the University of New South Wales and multiple interventions were employed to assist students in grasping the concept, including lecture-based simulation, small group tutorials, computer simulation and a variety of learning resources. Student knowledge was then assessed and students were surveyed to determine student perceptions of various learning interventions and their effectiveness.

This study provides important understanding of the complexities associated with teaching threshold concepts. It was determined that students achieve a similar level of understanding of threshold concepts regardless of background if a variety of teaching interventions are offered. However, the authors did determine that different student groups may exhibit preferences for distinct types of teaching interventions depending on the type of class and their individual learning style. Most importantly, the degree of preference for specific types of teaching interventions is more varied within any given group of students, for example medicine or science student groups, than across different types of students, i.e. medicine versus science. Based on these findings the authors conclude that it is more effective to teach threshold concepts by employing a combination of interventions, e.g. lecture-based simulations and small group tutorials, in a given setting than by using one or the other.

Want access to over 40 archived issues and more than 800 medical science articles? Visit Medical Science Educator online here for access to every issue since 2011!

#IAMSE18 – Plenary Speaker Highlight: Aviad Haramati

Wrapping up our plenary speaker highlights for the 22nd Annual IAMSE Meeting is Dr. Aviad Haramati. Keenly eyeing the meeting’s focus of integrating nutrition and wellness education in teaching the health sciences, Dr. Haramati’s presentation titled “Fostering Well-being in the Learning Environment: the Imperative for Medical Science Educators” will discuss issues surrounding physician stress and burnout.

Aviad Haramati: Fostering Well-being in the Learning Environment: the Imperative for Medical Science Educators
[Georgetown University Medical Center, Washington, DC]

More than half of practicing physicians exhibit characteristics of chronic stress and burnout. This trend may begin earlier with the observed decline in empathy during medical student training and the alarming rates of burnout in medical and other students in the health professions. Research findings suggest that there is an important link between the culture and state of the learning environment and the health of learners and teachers. In this presentation, Dr. Haramati will review the elements that impact on the well-being and resilience of students and faculty in the health professions and highlight interventions that are being implemented to help learners manage stress, foster empathy and build resilience, with a particular emphasis on the critical role that medical science educators can play.

For more information on Dr. Haramati, please click here.

Be sure to register for the 2018 IAMSE Meeting! The Meeting will be held at the Green Valley Ranch and Resort, just outside of Las Vegas, Nevada on June 9-12, 2018. Registration may be found online here.

#IAMSE18 – Plenary Speaker Highlight: Hanno Pijl

This year the 22nd Annual IAMSE Meeting’s focus is integrating nutrition and wellness education in teaching the health sciences. Our fourth plenary speaker, Dr. Hanno Pijl, will highlight that message with his address “Lifestyle Medicine: Why Do We Need It?

Hanno Pijl: Lifestyle Medicine: Why Do We Need It?
[Leiden University Medical Center, The Netherlands]

Almost all of the major non-communicable diseases which we are faced with today are the result of gene-environment-lifestyle interactions. Dr. Pijl will sketch the science supporting this knowledge, and argue that not only are public health efforts needed to prevent non-communicable disease from occurring, but also that doctors should be aware of the power of lifestyle intervention to treat a variety of chronic diseases. This is why knowledge of lifestyle and nutrition in relation to health and disease should be taught in medical schools. Dr. Pijl and his team are currently working on an international (master) course for bachelor medical students and doctors interested in the topic. He will explain more about the ideas concerning the structure and content of that course.

For more information on Dr. Pijl, please click here.

Be sure to register for the 2018 IAMSE Meeting! The Meeting will be held at the Green Valley Ranch and Resort, just outside of Las Vegas, Nevada on June 9-12, 2018. Registration may be found online here.

Medical Science Educator Call for Announcements in June Issue

In every issue of Medical Science Educator, we publish an announcements section. In this section we share information that is of interest to the readership of the journal. Individual IAMSE members wishing to post medical education related announcements in the Journal are invited to send their requests to the Editorial Assistant at Announcements may be IAMSE-related, announcements from other medical education organizations, medical education conference information or international issues affecting medical education. Announcements will be published at the Editor’s discretion.

Deadline for inclusion in the June issue: April 6, 2018

IAMSE Spring 2018 WAS Session 3 Highlights

In case you missed yesterday’s Webcast Audio Seminar (WAS) Session, here are the highlights of this session:

Integrating Wellness & Nutrition: Lessons from University of Cincinnati
Presenter: Sian Cotton, PhD
March 22, 12 PM ET


  1. Briefly review the crisis of chronic disease and minimal attention to lifestyle education in medical schools and healthcare provider burnout as background
  2. Highlight 2 programs at UC that constitute a preventive and educational approach to fostering well-being
  3. Provide overview of first program: Turner Farm Student Wellness retreats
  4. Provide overview of second program: Mind-Body course, modeled after Georgetown University
  5. Present information on development, outcomes, and sustainability plans for both programs as models

Program #1

Teaching Kitchen: idea is to pair the culinary science with the nutritional science.

  • To transform Disease Care to Wellness Care, need to educate health providers
  • Transformation starts with education of students -traditional curriculum does not emphasize lifestyle modification
  • Inter-professional learning grows into inter-professional team-based care
  • Turner Farm’s Teaching Kitchen as platform

Have Student Wellness Retreats

  • Retreats are 6 hours usually on a Saturday
  • Evaluations are over whelming supportive of the Wellness Retreats with regards to presentations, experience and opportunities for both professional and personal changes.

Conclusion/Future Directions

  • Student Wellness Retreats at Turner Farm were highly successful
  • Sought after –Student Affairs promotes
  • Development of personal wellness skills
  • Increasing interest in Integrative Health
  • Greatest challenge: funding/faculty time to sustain
  • Future longitudinal student teaching kitchen sessions for continued healthy behavior change and knowledge

Program #2

Mind-Body Course

  • One out of two physicians experience burnout
  • This is not just limited to physicians but to all health care professionals
  • “Burnout is a response to chronic stressors that wear on a person over time – not acute ones such as a big event or a big change” Christina Maslack, PhD
  • According to John Kabat-Zinn Mindfulness is “The awareness that emerges through paying attention, in a particular way, on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment to moment.”

Conclusion 1

  • Although the rates of chronic stress and burnout among physicians are rising, practicing mindfulness can reduce burnout and increase empathy
  • Student outcomes saw increase in mindfulness, empathy, positive affect, resilience and a decrease in perceived stress and negative affect.

Summary and Final Thoughts

  • Wellness, through nutrition, movement, mindfulness and connectivity is critical to expose students to early on
  • Experiential versus didactic-only
  • What is Required?
    • Faculty modelling
    • Integration, rather than “one-offs”
    • Resources

“Tell me and I forget, teach me and I may remember, involve me and I learn”

For more information on the next session or to register, please click here.

IAMSE Spring 2018 WAS Session 2 Highlights

In case you missed the March 15th Webcast Audio Seminar (WAS) Session, here are the highlights of this session:

Fat Chance for Obesity Medicine Education in Medical Schools
Presenter: Nicholas Pennings
March 15, 12 PM ET

  • Obesity trends are rising at alarming rates across the United States.
  • 57% of children today are projected to have obesity by age 35 (NEJM, 2107)
  • The WHO projects that the worldwide cost of obesity will be $1.2 trillion dollars by 2025.
  • Obesity can be framed as a disease process, a chronic condition with pathological consequences, which is responsive to lifestyle changes.
  • Obesity is both a physical and psychological condition.
  • Obesity education is relevant for all medical specialties as it impacts all body systems.
  • Currently, 23% of medical schools in the US cover obesity medicine across their undergraduate curriculum and 66% of US medical schools dedicate 2-6 hours to obesity medicine in the their curriculum.
  • Barriers to integrating an adequate obesity curriculum into undergraduate medical education include: not enough time, competing curricular demands and lack of prioritization.
  • According to studies, there is a predominant “weight bias” in health care that leads to “weight stigma,” which negatively impacts patients with obesity from seeking health care.
  • According to the Gayer study (2018), early introduction of an obesity curriculum for students in health care professions demonstrated a sustained reduction in weight bias over four years.
  • A brief synopsis of the 2007 AAMC guiding principles for obesity education in undergraduate medical education includes the following:
    • Vertically and horizontally integrate obesity education into the medical school curriculum.
    • Highlight the universal importance of weight management and the prevention of obesity.
    • Utilize a multidisciplinary team to provide social support and behavioral treatment.
    • Provide self-awareness training about weight bias and weight stigma.
    • Employ population-based/community efforts to better prevent, support, and control obesity.
    • Direct basic science instruction to identify and explore the metabolic, genetic and environmental effects of obesity and the metabolic and immunologic responses to obesity.
    • Provide opportunities for learners to do a history and physical on patients with obesity and assess these patients in terms of nutrition (impact of different diets), physical activity, behavioral interventions and surgery.
  • The ongoing expansion of knowledge in the science of obesity has created a growing chasm between knowledge acquisition and knowledge application for practitioners in the real world.
  • Northwestern University, Oklahoma State University College of Osteopathic Medicine and Campbell University College of Osteopathic Medicine are three institutions that have longitudinally integrated Obesity Education. For further details about these, please contact Dr. Nicholas Pennings (
  • Additional resources for Obesity Education include the following:
    • Obesity Medicine Association (provides free obesity educational materials)
    • The Obesity Society
    • American Society of Metabolic and Bariatric Surgeons
    • Obesity Action Coalition (gives voice to patients with obesity)

For more information on the next session or to register, please click here.

#IAMSE18 – Featured Members: Stephanie Wragg & Chris Burns

During the upcoming IAMSE meeting in Las Vegas, there will be a number of terrific pre-conference sessions for your consideration. We are very excited to offer this workshop on the topic of enhancing leadership skills in medical education, presented by Chris Burns and Stephanie Wragg:

Each of us has the opportunity to be a leader in medical education, whether it is establishing a vision for a course, an office or modeling behaviors that others may emulate. Our success depends on identifying leadership opportunities within our area of influence. The fast pace of medical education often leaves little time for reflection or for developing and practicing the skills needed to be intentional and authentic leaders.

The goal of the session is to offer participants a facilitated opportunity to explore their leadership behaviors. Participants will also be able to identify the styles of their colleagues, a skill that can help further their own growth as a leader. Practical cases will be analyzed in small groups to identify leadership opportunities and explore how different styles can potentially address the described challenge. There will be time to share challenges with the group and seek solutions, in addition to using a worksheet to record consider how they can apply the lessons learned to bring enhanced leadership to their own position.

By the end of the session, participants will be able to consider in a given situation:

  • What are the leadership opportunities that I can address?
  • What factors will influence selecting a leadership approach?
  • Which leadership frame would be most helpful?
  • Which leadership frame would be least helpful?

Speakers will introduce themselves and the session objectives. A brief activity will allow participants to determine their personal leadership orientation using the Bolman and Deal four frame model (Reframing Organizations: Artistry, Choice and Leadership. Bolman and Deal, 2008). Participants will then be broken into groups to practice applying the different frames in scenarios designed to test skills and behaviors related to good practices in educational leadership. To deliver each case, Team-Based Learning (TBL) style application exercises will be used. Focusing on core issues and decision making will be emphasized for each case.

Have you registered for the 2018 IAMSE Meeting? If not, there’s still time to do so! For more information on the 2018 IAMSE Meeting and to register, click here.

We look forward to seeing you there!

IAMSE Spring 2018 WAS Session 1 Highlights

In case you missed the March 8th Webcast Audio Seminar (WAS) Session, here are the highlights of this session:

The Importance of Nutrition in Physician Performance and Well-Being
Presenters: Angela M. Cheung and Maryam S. Hamidi
March 8, 12 PM ET

The Importance of Nutrition in Physician Performance and Well-Being

  • Improving physician dietary habits and hydration is a novel approach to supporting wellness and preventing burnout.
  • According to a 2017 AMA survey, the burnout rate for physicians had increased to 51%, up from 40% in 2013. Conservative estimates show that physician suicide rates in the US are between 300 and 400 per year.
  • Physician burnout negatively affects patient care.
  • Emergent studies demonstrate a link between nutrition and physician performance.
  • Physicians report that inadequate nutrition and hydration impact their work performance.
  • Diet is important in brain health.
  • High cognitive demands require proper nutrition for optimal performance.
  • Physicians identify the following barriers to healthy eating: lack of nutrition breaks, limited healthy food options in the workplace, limited food storage and eating areas in the workplace, prioritization of clinical work over self-care.
  • Nutritional strategies for improving short-term cognitive performance include: hydration, meal timing, meal composition, meal size and strategic use of caffeine.
  • Hydration enhances the nervous system. Dehydration can impair cognitive function and mood modulation.
  • Coordinating meal times with one’s own circadian rhythms optimizes nutritional effectiveness.
  • Thoughtfully balanced meal composition and portion control can enhance cognitive and functional performance.
  • Nutritional strategies for increased alertness include: eat larger meals before 10 pm, eat light snacks after lunch that contain protein and carbs, hydrate often, drink coffee or tea (caffeine increases core body temperature), chew gum (improves blood flow to the brain).
  • Sustainable individual and institutional interventions are needed to support and improve physicians’ nutrition.
  • These nutritional strategies can be applied across all health professions.
  • Taking care of oneself leads to better patient care.

For more information on the next session or to register, please click here.

#IAMSE18 – Plenary Speaker Highlight: Christina Puchalski

The 22nd Annual IAMSE Meeting is just around the corner, and we would like you to get to know some of our keynote speakers! We have five plenary speakers this year, and we hope you enjoy their presentations.

Christina Puchalski: Connecting to Our Call: A Profession of Service and Love [George Washington Institute for Spirituality and Health]

In this talk I will cover what gives meaning to us as MDs— being in relationship with our patients, accompanying them in the midst of their suffering, and then our reflection rounds program which help med students reconnect with their call to serve by reflecting on their patients.

For more information on Dr. Puchalski, please click here.

Be sure to register for the 2018 IAMSE Meeting! The Meeting will be held at the Green Valley Ranch and Resort, just outside of Las Vegas, Nevada on June 9-12, 2018. Registration may be found online here.

We look forward to seeing you there!

IAMSE – ScholarRx Student Grant Information

The International Association of Medical Science Educators (IAMSE) is pleased to announce the “ScholarRx-IAMSE Student Educational Research Grants” Program, developed in partnership with ScholarRx to promote student participation in medical education research. Up to two (2) student grants will be awarded for up to $2500.

Applicants will need to have a faculty mentor sign off on the proposal confirming that all policies will be met. Proposals must be accompanied by a letter from an appropriate institutional official confirming that the institution will pay to send the student to the IAMSE meeting the year following project completion to present the results of the proposed work; timing of the presentation is flexible as to be appropriate for the completion of the project.

We encourage faculty members to forward this message to their students. Applications are to be submitted on the submission page found here by 11:59 PM Eastern Time on March 31, 2018.

Students who are enrolled in a degree/certificate program (such as BS, MS, PharmD, PhD, MD, DO) at a school or institution are eligible for this grant program. Persons with advanced/terminal degrees (such as postdocs, PhD, MD, MBA) who are employed in their field, or who have faculty appointments, are not considered to be students. The recipient needs to be an IAMSE student member in good standing. However, ScholarRx will generously provide a one year IAMSE membership to non-member student grant applicants at no cost.

All information regarding the ScholarRx-IAMSE Student Educational Research Grant Program, including the application process, eligibility, proposal format, and evaluation criteria, can be found on the IAMSE website here.

#IAMSE18 – ESME Program with Ron Harden and Adi Haramati

IAMSE is once again pleased to offer the very successful, AMEE-sponsored course: Essential Skills in Medical Education (ESME), led by two distinguished educators: Prof. Ronald Harden, University of Dundee and Prof. Aviad Haramati, Georgetown University. The ESME course requires a separate registration and is held on a full day prior to the IAMSE conference, continues with special discussion sessions during the conference, and concludes with a full afternoon on the final conference day.

This course explores numerous themes including: learning outcomes and curricular planning, teaching and learning methods, assessment strategies, educational scholarship and the teacher as a leader. The course is ideal for faculty educators who are eager to learn about the principles of health professions education or for seasoned individuals interested in exploring new ideas and trends. Upon completion of the ESME course (with certificate), participants are eligible to enroll in the IAMSE Fellowship program.

Have you registered for the 2018 IAMSE Meeting? Don’t forget that the Early Bird Deadline is April 1st! Be sure to register before then to receive the reduced rate. Register online today at

We look forward to seeing you there!

#IAMSE18 – Plenary Speaker Highlight: Stuart Slavin

The 22nd Annual IAMSE Meeting is just around the corner, and we would like you to get to know some of our keynote speakers! We have five plenary speakers this year, and we hope you enjoy their presentations.

Stuart Slavin: Medical Student Mental Health: Challenges and Opportunities [Saint Louis University School of Medicine]

Educators have increasingly recognized the problem of poor mental health of medical students. High rates of depression, anxiety, burnout, and suicidal ideation appear to be endemic and begin in the pre-clinical years. New programs are being implemented to address this but to date have largely focused on individuals and their capacity to manage stress with approaches such as mindfulness and resilience training. While these interventions are appropriate and much needed, they may be insufficient. The situation needs to be viewed as an environmental health problem and efforts should be made to try to reduce the toxicity of the learning environment itself. This presentation will describe the approach and outcomes of a multi-faceted, integrated program implemented at Saint Louis University School of Medicine focused primarily on the pre-clinical years designed to improve student well-being that could serve as a model for change in other medical schools.

For more information on Dr. Slavin, please click here.

Be sure to register for the 2018 IAMSE Meeting! The Meeting will be held at the Green Valley Ranch and Resort, just outside of Las Vegas, Nevada on June 9-12, 2018. Registration may be found online here.

We look forward to seeing you there!