Evolution of the New Pathway curriculum at Harvard Medical School: the new integrated curriculum

In 1985, Harvard Medical School adopted a "New Pathway" curriculum, based on active, adult learning through problem-based, faculty-facilitated small-group tutorials designed to promote lifelong skills of self-directed learning. Despite the successful integration of clinically relevant material in basic science courses, the New Pathway goals were confined primarily to the preclinical years. In addition, the shifting balance in the delivery of health care from inpatient to ambulatory settings limited the richness of clinical education in clinical clerkships, creating obstacles for faculty in their traditional roles as teachers. In 2006, Harvard Medical School adopted a more integrated curriculum based on four principles that emerged after half a decade of self-reflection and planning: (1) integrate the teaching of basic/population science and clinical medicine throughout the entire student experience; (2) reestablish meaningful and intensive faculty-student interactions and reengage the faculty; (3) develop a new model of clinical education that offers longitudinal continuity of patient experience, cross-disciplinary curriculum, faculty mentoring, and student evaluation; and (4) provide opportunities for all students to pursue an in-depth, faculty-mentored scholarly project. These principles of our New Integrated Curriculum reflect our vision for a curriculum that fosters a partnership between students and faculty in the pursuit of scholarship and leadership.     

A Concept of a Pathology Institute

Scholarly achievement is the aim of a pathology institute. In a medical faculty it serves undergraduate, postgraduate teaching, practice and research. Historically, scholarly achievement in these fields has been promoted through the teaching responsibility of the university and hospital. With the increasing volume of work, knowledge and complexity of research, adequate performance in these fields is best obtained by limiting the volume of fixed duties for each individual. At the same time, depth of knowledge is gained by encouraging specialization to complement clinical specialties. This arrangement will guarantee that the teaching and research of the department are disease-oriented, which is the central theme of pathology. With a highly specialized staff there must be a core of intradepartmental conferences common to all staff and those in training. With this form of organization dedicated to the undergraduate and postgraduate teaching, the objectives of scholarly achievement in teaching practice and research will be obtained.     

In the Faculty of Psychology

From the editors: We continue to acquaint the readers with the organization of scholarly and teaching life in the faculty. Galina Mikhailovna Andreeva, Director of the Department of Social Psychology, tells about the work at the All-Faculty Philosophical (Methodological) Seminar that she chaired. Nina Ivanovna Naenko, Lecturer, Department for Advanced Training, Faculty of Psychology, tells about the work of the psychological section of the Department for Advanced Training at Moscow University.     

Promoting collaborations between biomedical scholars in the U.S. and sub-Saharan Africa

The premise of this piece is that a priority of international health should be to increase the number of investigators in the US and other developed countries who engage in research and other kinds of scholarly work in underdeveloped parts of the world, particularly sub-Saharan Africa where the overall disease burden is the highest and the gap in biomedical research infrastructure is the widest. The author's aim is to encourage medical students, resident doctors, and medical school faculty to devote a part of their career to teach, acquire clinical skills, or participate in research with health professionals at teaching hospitals in Africa. After briefly describing the thinking that led the author to Nigeria 30 years ago to teach and study biochemical aspects of health problems in rural and urban areas, he discusses some of the factors one needs to consider before entering into an international partnership, including identifying the right foreign collaborators, selecting a suitable research site, setting realistic goals, learning the local culture and indigenous language, and defining a theme for your program. Lastly, the piece points out potential pitfalls and problems that are often overlooked or underestimated in the early phases of planning an international partnership, including lukewarm institutional support at home, inflexible institutional review boards, dominance of the program by the US partner, maintaining continuity, and striking the right balance between scholarly work and humanitarian efforts. My hope is that US students and faculty in the health professions who read this piece will be stimulated and encouraged to consider how they might integrate into their curriculum or academic life visits lasting several months or more each year during which they would teach or train others or engage in research at a teaching hospital in some country in Africa.     

How to have an effective academic sabbatical: recommendations for what to do and what to avoid

Sabbaticals - i.e., academic sabbaticals, sabbatical leaves, sabbatical semesters - provide faculty members with a unique opportunity to engage in scholarly projects. Ranging from a year to shorter periods, these time windows - usually free of rigid day-to-day obligations - can be powerful means to reflect on past and present projects, to renew perspectives, and to receive fresh impetus for both your research and teaching. When reading the literature on sabbaticals, it is somewhat surprising that relatively small amounts of space are devoted to this important part of academic life. Here we provide practical recommendations [1-4: pre-sabbatical; 5-8: intra-sabbatical; 9-10: post-sabbatical] for making your sabbatical a satisfying endeavor.     

Changes in undergraduate attitudes toward medical ethics.

To detect any change in medical students'' attitudes toward medical ethics, students from the same class were given a questionnaire on their first day of medical school and again near the end of their fourth year of study. The results showed a strong shift away from the students'' initial expectations that they would rely on specialists or scholarly sources in the future; the need for a medical ethics course in the curriculum, while still felt, was less important to them by the fourth year. The reasons for these changes were not apparent, for the students'' levels of knowledge and perceptions of the role of ethics in medicine in the first and fourth years did not differ. It is recommended that medical school faculty actively reinforce the initially positive attitudes of students during clinical supervision.     

COVID-19 threatens faculty diversity: postdoctoral scholars call for action

Despite substantial investment and effort by federal agencies and institutions to improve the diversity of the professoriate, progress is excruciatingly slow. One program that aims to enhance faculty diversity is the Institutional Research and Academic Career Development Award (IRACDA) funded by the National Institutes of Health/National Institute of General Medical Sciences. IRACDA supports the training of a diverse cohort of postdoctoral scholars who will seek academic research and teaching careers. The San Diego IRACDA program has trained 109 postdoctoral scholars since its inception in 2003; 59% are women and 63% are underrepresented (UR) Black/African-American, Latinx/Mexican-American, and Indigenous scientists. Sixty-four percent obtained tenure-track faculty positions, including a substantial 32% at research-intensive institutions. However, the COVID-19 pandemic crisis threatens to upend IRACDA efforts to improve faculty diversity, and academia is at risk of losing a generation of diverse, talented scholars. Here, a group of San Diego IRACDA postdoctoral scholars reflects on these issues and discusses recommendations to enhance the retention of UR scientists to avoid a “lost generation” of promising UR faculty scholars.     

Biochemistry at mercer

Our curriculum is a problem-based, self-learning case-oriented approach in which the students raise issues and answer them. The faculty set limits on the depth and breadth of the information via the tutors, resource sessions, one-on-one interactions, and written objectives. Both students and faculty learn in a multidisciplinary fashion consistent with the practice of medicine. The students are evaluated at three levels: by tutor, by interdisciplinary orals and by written multidisciplinary exams. The students excel in their problem-solving ability and in their application of basic science information to patient cases that they encounter not only in the junior and senior years, but also during the first two years as they participate in preceptor rotations in physicians' offices.     

Life,the universe and everything

The Formal Darwinism project probes the connections between the dynamics of natural selection and the design of organisms. Here, I explain why this work should be of interest to philosophers, arguing that it is the natural development in a long-running scholarly enquiry into the meaning of life. I then review some of my own work which has applied the tools of Formal Darwinism to address issues concerning the units of adaptation in social evolution, leading to a deeper understanding of the adaptation of individual organisms. Finally, I sketch some directions Formal Darwinism to explore beyond the biological sciences, with a focus upon cosmology.     

PRESIDENTIAL ADDRESS: THE ETHICS OF RECOGNITION, RESPONSIBILITY, AND RESPECT

Ethics can be understood as a code of behaviour or as the study of codes of behaviour. While the mission of the International Association of Bioethics is a scholarly examination of moral issues in health care and the biological sciences, many people in the field believe that it is also their task to create new and better codes of practice. Both ways of doing bioethics are sound, but it is important to be aware of the distinction. In this paper, I will study the sources and aims of ethics and suggest a code of conduct for bioethicists based on recognition, responsibility, and respect.     

Reviews of Functional MRI: The Ethical Dimensions of Methodological Critique

Neuroimaging studies involving human subjects raise a range of ethics issues. Many of these issues are heightened in the context of neuroimaging research involving persons with mental health disorders. There has been growing interest in these issues among legal scholars, philosophers, social scientists, and as well as neuroimagers over the last decade. Less clear, however, is the extent to which members of the neuroimaging community are engaged with these issues when they undertake their research and report results. In this study, we analyze the peer-reviewed review literature involving fMRI as applied to the study of mental health disorders. Our hypothesis is that, due to the critical orientation of reviews, and the vulnerability of mental health population, the penetrance of neuroethics will be higher in the review literature in this area than it is in the primary fMRI research literature more generally. We find that while authors of reviews do focus a great deal of attention on the methodological limitations of the studies they discussed, contrary to our hypothesis, they do not frame concerns in ethical terms despite their ethical significance. We argue that an ethics lens on such discussion would increase the knowledge-value of this scholarly work.     

Two Renowned Nigerian Scholars: Ikenna Nzimiro and Victor Chikesie Uchendu

The article honors two Nigerian anthropologists of Igbo background who recently passed away. Both scholars made major contributions to a broad range of scholarly thought in anthropology and in general social science to crucial issues in Nigerian politics, society and life. Nzimiro is considered in terms of his traditional anthropological training in Germany and England, through which he investigated four Niger River basin communities, and then his emergence as a Marxist anthropologist for the rest of his life in Nigeria, where he consistently critiqued neocolonialism in Nigeria. He explored issues of ethnicity, the Nigerian civil war, militarism, the state of the social sciences, the environment, Oguta culture, where he was born, ethnic conflicts, conditions at Nigerian universities, and other issues. Nzimiro generally rejected the post-colonial world, arguing that it was not revolutionary enough. Uchendu dealt with many of the same issues, but in contrast to Nzimiro he did so by accepting the existence of post-colonial Nigeria, though suggesting many ways to improve education, the environment, cultural and national transition, dependency theory, and to study urbanization and ethnicity, while also writing a major work on Igbo culture. Both authors are honored for their critiques of Nigerian society, as well as their contributions to Igbo ethnology.     

Implementing academic detailing for breast cancer screening in underserved communities

Background

Canadian funding agencies are no longer content to support research that solely advances scientific knowledge, and key directives are now in place to promote research transfer to policy- and decision-makers. Therefore, it is necessary to improve our understanding of how researchers are trained and supported to facilitate knowledge translation activities. In this study, we investigated differences in health researcher characteristics and knowledge translation activities.

Methods

Our sample consisted of 240 health researchers from three Alberta universities. Respondents were classified by research domain [basic (n = 72) or applied (n = 168)] and faculty [medical school (n = 128) or other health science (n = 112)]. We examined our findings using Mode I and Mode II archetypes of knowledge production, which allowed us to consider the scholarly and social contexts of knowledge production and translation.

Results

Differences among health researcher professional characteristics were not statistically significant. There was a significant gender difference in the applied researcher faculty group, which was predominantly female (p <.05). Research domain was linked to translation activities. Applied researchers reported engaging in significantly more Mode II activities than basic researchers (p <.001), and scored higher than basic researchers regarding the perceived importance of translation activities (Mode I, p =.01; Mode II, p <.001). Main effects of faculty were limited to engaged dissemination (medical school < other faculties; p =.025) and number of publications (medical school > other faculties; p =.004). There was an interaction effect for research domain and faculty group for number of publications (p =.01), in that applied researchers in medical faculties published more than their peers in other faculty groups.

Conclusion

Our findings illustrate important differences between health researchers and provide beginning insights into their professional characteristics and engagement in Mode I and Mode II activities. A future study designed to examine these dimensions in greater detail, including potential covariates across more varied institutions, would yield richer insights and enable an examination of relative influences, needs and costs of each mode of activity.     

The Scope of Public Discourse Surrounding Proposition 71: Looking Beyond the Moral Status of the Embryo

Human embryonic stem cell research has generated considerable discussion and debate in bioethics. Bioethical discourse tends to focus on the moral status of the embryo as the central issue, however, and it is unclear how much this reflects broader community values and beliefs related to stem cell research. This paper presents the results of a study which aims to identify and classify the issues and arguments that have arisen in public discourse associated with one prominent policy episode in the United States: the 2004 Californian Stem Cell Research and Cures Initiative (also known as Proposition 71). The findings show that public discourse about Proposition 71 is characterised by a broader range of issues than those usually addressed in scholarly publications and public policy documents. While attention to the moral status of the embryo is an important issue in stem cell research, making it the main focus of public discourse has a polarising effect. This also limits opportunities to identify shared values, understand how political alliances are forged, and develop social consensus. Implications for future research and policy are discussed.     

A brief report: Yale Research Symposium on Complementary and Integrative Medicine

The 2010 Yale Research Symposium on Complementary and Integrative Medicine highlighted original research in related areas by Yale faculty and provided a forum to discuss and debate issues of evidence and plausibility. In this brief report, we describe selected presentations on such diverse foci as nutritional influences on cancer, acupuncture for low back pain, protein intake's effects on bone consumption, Chinese herb-derived adjuvant chemotherapy, and the relationship between anger and cardiac arrhythmia. This symposium demonstrated that rigorous research methods are being used to study unconventional therapies and that an integrative medicine approach requires a solid scientific foundation.     

Impact beyond the impact factor

The journal impact factor is an annually calculated number for each scientific journal, based on the average number of times its articles published in the two preceding years have been cited. It was originally devised as a tool for librarians and publishers to provide information about the citation performance of a journal as a whole, but over the last few decades it has increasingly been used to assess the quality of specific articles and the research performance of individual investigators, institutions, and countries. In addition to this clear abuse of the journal impact factor, several conceptual and technical issues limit its usability as a measure of journal reputation, especially when journals are compared across different fields. An author’s decision regarding the suitability of a scholarly journal for publication should, therefore, be based on the impact that this journal makes in the field of research, rather than on the journal impact factor.     

A strategic development model for the role of the biomedical physicist in the education of healthcare professionals in Europe

This is the third of a series of articles targeted at biomedical physicists providing educational services to other healthcare professions, whether in a university faculty of medicine/health sciences or otherwise (e.g., faculty of science, hospital-based medical physics department). The first paper identified the past and present role of the biomedical physicist in the education of the healthcare professions and highlighted issues of concern. The second paper reported the results of a comprehensive SWOT (strengths, weaknesses, opportunities, threats) audit of that role. In this paper we present a strategy for the development of the role based on the outcomes of the SWOT audit. The research methods adopted focus on the importance of strategic planning at all levels in the provision of educational services. The analytical process used in the study was a pragmatic blend of the various theoretical frameworks described in the literature on strategic planning research as adapted for use in academic role development. Important results included identification of the core competences of the biomedical physicist in this context; specification of benchmarking schemes based on experiences of other biomedical disciplines; formulation of detailed mission and vision statements; gap analysis for the role. The paper concludes with a set of strategies and specific actions for gap reduction.     

El duro peregrinaje de las revistas biomédicas españolas hacia la excelencia: ¿quién nos ayuda? Calidad,impacto y méritos de la investigación

Biomedical journals must adhere to strict standards of editorial quality. In a globalized academic scenario, biomedical journals must compete firstly to publish the most relevant original research and secondly to obtain the broadest possible visibility and the widest dissemination of their scientific contents. The cornerstone of the scientific process is still the peer-review system but additional quality criteria should be met. Recently access to medical information has been revolutionized by electronic editions.Bibliometric databases such as MEDLINE, the ISI Web of Science and Scopus offer comprehensive online information on medical literature. Classically, the prestige of biomedical journals has been measured by their impact factor but, recently, other indicators such as SCImago SJR or the Eigenfactor are emerging as alternative indices of a journal's quality. Assessing the scholarly impact of research and the merits of individual scientists remains a major challenge. Allocation of authorship credit also remains controversial.Furthermore, in our Kafkaesque world, we prefer to count rather than read the articles we judge. Quantitative publication metrics (research output) and citations analyses (scientific influence) are key determinants of the scientific success of individual investigators. However, academia is embracing new objective indicators (such as the “h” index) to evaluate scholarly merit. The present review discusses some editorial issues affecting biomedical journals, currently available bibliometric databases, bibliometric indices of journal quality and, finally, indicators of research performance and scientific success.     

The Rutgers Computational Grid: A Distributed Linux PC Cluster

The Rutgers Computational Grid (RCG) project is aimed at providing high throughput performance to Rutgers university faculty and students. The RCG employs dual processor PCs, with Pentium II and III processors, as computational nodes, running the Linux RedHat operating system. The Load Sharing Facility (LSF) scheduling system from Platform Computing is used for job control and monitoring. The nodes are grouped into subclusters physically located in several departments and controlled by a single master node through LSF. The hardware and software used in RCG are described. Utilization and performance issues, including parallel performance, are discussed based on the experience of the first two years of RCG operation.     

RETRACTED ARTICLE: Comment on Anthropology: Why it Matters

We, the Editors and Publisher of Anthropological Forum, have retracted the following article:

Maurice Godelier (2019) Comment on Anthropology: Why it Matters, Anthropological Forum, DOI:10.1080/00664677.2019.1615255

Due to some communication issues, another version of this review has been published elsewhere. Accordingly, this version of the review has been retracted from publication.

We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions.

The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”.