The goal of alcohol research is to improve overall health and well-being. Alcohol misuse causes an estimated 178,000 deaths annually in the United States, involves over 4 million emergency room visits annually, and contributes to or exacerbates 200 medical disorders and conditions. Reducing and preventing the pathology and other consequences of alcohol misuse can significantly reduce morbidity and mortality. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) was created in 1970 in response to national interest in fundamental research to address these challenges. The mission of NIAAA is to generate and disseminate fundamental knowledge about adverse effects of alcohol on health and well-being and apply that knowledge to improve the diagnosis, prevention, and treatment of alcohol-related problems, including alcohol use disorder, across the lifespan. Major advances have been made in the prevention and reduction of alcohol misuse, alcohol use disorder, and their consequences by (1) identifying patterns, trends, and public health impacts of alcohol misuse and designing effective interventions, (2) elucidating biological mechanisms of alcohol misuse and its consequences, including alcohol-related pathology, and (3) improving the diagnosis and treatment of alcohol use disorder and other alcohol-related conditions. Such efforts require an iterative process whereby the National Institutes of Health and NIAAA interact with medical schools and academic health systems of academic medicine to engage health professionals and health sciences students, clinical trainees, and faculty to meet these goals. Major challenges remain in translating fundamental research in diagnosis, prevention, and treatment into clinical practice in the academic medical community and into information for the public at large. The present commentary is a brief overview of recent alcohol research from a translational perspective for the academic medical community, described by: Quod Facimus, Quid Fecimus, et Quo Vadimus (Where Do We Come From? What are We? Where Are We Going?).
PURPOSE:Biomedical and health sciences master's programs are increasingly used by premedical students as transitional pathways to medical school admissions, often as part of a structured gap year. Despite their growing prevalence, little is known about how these programs influence students' career readiness and science identity. This study comprehensively evaluates the experiences of students engaging in a gap year as a pathway to medical school admittance through the lens of career development and science identity. METHOD:Using an exploratory qualitative case study design grounded in Social Cognitive Career Theory and science identity frameworks, the authors conducted semi-structured interviews with 9 students enrolled in biomedical and health sciences master's programs at a U.S. research-intensive institution in fall 2024. Participants represented both pre-professional and discipline-specific programs. Interview data were analyzed using an iterative coding method to identify patterns related to motivations, career readiness, and science identity. RESULTS:Findings were organized into four themes: (1) leveraging the master's degree for academic and application enhancement, (2) strengthening confidence for medical school, (3) engagement in the pursuit of professional aspirations, and (4) challenges on the career path. Participants primarily framed the master's program as a strategic tool to improve competitiveness for medical school. Motivations were extrinsically driven (e.g., boosting medical school competitiveness) versus intrinsic (e.g., subject interest). CONCLUSIONS:These findings highlight the need for greater transparency in program outcomes, stronger undergraduate advising, and intentional career development support to ensure meaningful returns on investment for students pursuing medical careers.
Combining the power of artificial intelligence (AI) and the clinical data within Electronic Health Records is an innovation that may provide actionable educational insights on learners' experiences in the clinical learning environment. However, the adoption of such processes highlights significant systemic challenges. The "digital divide" poses a risk of inequity, as institutions with sophisticated data architectures can provide superior precision feedback compared to resource-limited centers. Also, the generalizability of AI models remains a concern, as tools trained on local coding patterns and patient populations may not translate across diverse clinical learning environments without rigorous calibration. Finally, the ability to quantify learners' clinical exposures raises fundamental questions regarding who defines the "adequacy" of clinical experiences. This commentary articulates how the medical education community must thoughtfully address these policy and technical challenges to help AI reach its potential to enhance physician training.
PURPOSE:Failure is inevitable in medical training, yet what comes next remains poorly understood. This study examined how fourth-year medical students experienced self-perceived failure and moved through recovery or sustained distress. METHOD:Between November 2023 and February 2024, 20 fourth-year medical students at a single private, urban, allopathic medical school in the United States completed semi-structured interviews. Using reflexive thematic analysis, the research team coded transcripts inductively and interpreted findings through the lens of Transformative Learning Theory. RESULTS:Students described failure as a recognizable arc: an event, a response of shame, a period of processing, and a transformation in how they understood themselves as learners. Three domains shaped how students moved through this arc, stalled, or recovered without transformation. Personal intrinsic factors included the identity, mindset, and support that students brought to the moment. The immediate clinical environment, through team relationships and dynamics, steered students toward recovery or stalling. The broader external environment set the bar at which students perceived themselves as failing. We developed a conceptual model that situates the failure cycle within these three domains and maps the arc onto Transformative Learning Theory. CONCLUSIONS:Failure can be transformative in medical training, but only under the right conditions. Personal factors alone helped students survive failure. Whether students transformed depended on their clinical teams, who could offer safety, feedback, and a meaningful role. The broader external environment, meanwhile, set the stakes of failure itself.
PROBLEM:Diagnostic errors are common in healthcare and often stem from a failure to consider the social and contextual factors that influence clinician decision-making. Systemic inequities and clinician bias disproportionately contribute to diagnostic inaccuracies among marginalized communities. Medical schools are well-positioned to address this challenge by providing curricula that explore the impact of social context on diagnostic reasoning and equip students with strategies to mitigate harms associated with clinician bias. APPROACH:The authors developed a novel curriculum grounded in situated cognition theory and evidence-based bias mitigation strategies to enhance diagnostic reasoning among medical students. Third-year medical students on their Internal Medicine clerkship explored key cognitive concepts, engaged in case-based discussions to explore the impact of social context on the diagnostic process, and learned bias mitigation strategies. Instructors prompted students to apply these skills in clinical settings through a written assignment, and authors analyzed responses using qualitative methods. OUTCOMES:Thirty students participated between January 2023 and June 2024. Students demonstrated a clear understanding of how patient identity, clinician bias, and systemic barriers influence diagnostic processes. Students identified how language, substance use disorders, mental health, and health literacy impacted the diagnostic process of patients they had cared for. Students applied strategies such as individuation, promoting positive emotions, and enhancing motivation to mitigate bias. They also engaged in patient advocacy and highlighted opportunities for system-level improvements. NEXT STEPS:This curriculum is the first to combine the framework of situated cognition theory with practical bias mitigation strategies to teach diagnostic reasoning. Next steps include expanding educator training, introducing the curriculum earlier in medical education, and longitudinal integration across clerkships and clinical sites. Repeated exposure to these concepts throughout training can help solidify the importance of recognizing social contexts and utilizing bias mitigation strategies as a fundamental component of diagnostic reasoning and patient care.
Since its inception in the 1950s, medical education research has evolved to become a distinct field with its own culture and traditions. Throughout this history, the Research in Medical Education (RIME) program has played an instrumental role in advancing the field by elevating the rigor of empirical studies and increasing the inclusivity of the research community. In this commentary, the authors-writing as members of the RIME program committee-reflect on the last decade of published articles in the RIME program (RIME articles) to serve as a lens for examining how medical education research has evolved from 2016-2025. The authors conducted a content analysis of all RIME articles exploring four key areas: topics, methodology, theory, and application to practice. A total of 135 RIME articles were reviewed. Assessment (n = 34, 25%), learning environment (n = 27, 20%), and instructional design (n = 21, 16%) were the most common topics. Qualitative research (n = 54, 40%) was the most frequent methodology, while quantitative studies declined in recent years and review articles became more prominent. Theory use increased substantially across the decade (from 25% in 2016 to 88% in 2025), whereas application to practice remained consistently represented. These findings suggest important patterns in the modern era of medical education research, including the increasing importance of qualitative research and the value of both theoretical grounding and practical application. As RIME and the Association of American Medical Colleges enter a period of structural transition, these findings offer an opportunity to reflect on how the field can continue advancing scholarly excellence while supporting inclusion, access, and the next generation of medical education researchers.
Medical education transmits more than formal knowledge; it signals what matters through formal, informal, and hidden curricula. Drawing on Schein's theory of organizational culture, this commentary synthesizes insights from three 2026 Research in Medical Education (RIME) studies to examine how artifacts, values, and underlying assumptions shape learning environments. The reviewed studies-on multimorbidity in undergraduate medical education, ritualized group handoff in residency, and learner recovery from failure-illustrate how educational practices encode organizational priorities in distinct ways. In curricular structures, multimorbidity is often marginalized or abstracted, signaling the privileging of specialized over integrative, generalist care. In clinical routines, ritualized handoffs align shared values with practices while simultaneously reinforcing hierarchical assumptions. In learner-teacher interactions, responses to failure communicate whether growth and psychological safety are genuinely supported. Together, these studies highlight three mechanisms through which the hidden curriculum operates: invisibly through structural design, explicitly through tightly aligned rituals, and relationally through interpersonal enactment. Highlighting these mechanisms, this research underscores the need for deliberate alignment between educational artifacts and espoused values. Ongoing attention to these signals is essential to cultivating organizational cultures that prepare physicians to navigate complexity, engage meaningfully in practice, and develop resilient professional identities.
PURPOSE:The transition of patient care responsibility-known as handoff-is a critical moment of information transfer for ensuring appropriate care and patient safety. Often occurring in group settings during residency due to the presence of multiple trainees, it is an essential skill for physicians to develop. Structured approaches to handoff have been developed and are considered best practice, yet implementation remains a challenge. The aim of this study was therefore to examine resident experiences with group handoff. In particular, as handoff is a shared experience, the authors sought to illuminate its underlying social aspects in hopes of elucidating implicit parts of the process that may impact resident education and structured handoff implementation. METHOD:Residents from 2 emergency medicine residency programs were invited to participate in the study between August 2024-November 2025. Using constructivist grounded theory, the authors employed semi-structured interviews exploring participant experiences with group handoff. Through constant comparison, the authors identified the theoretical framework of ritual practice, and subsequently generated a theory regarding how residents engage with and experience group handoff. RESULTS:The authors interviewed 14 residents from across the PGY spectrum. Residents noted group handoff as distinct from other routine clinical tasks. They described a ritualized practice that led to the evolution and reinforcement of underlying social structures. This was achieved by maintaining consistency throughout handoff, ensuring boundaries were respected, and engaging in choreography. Residents thereby integrated community, established norms, and cemented the hierarchy of those involved. CONCLUSIONS:Residents ritualize handoff as part of their learning during training, resulting in outcomes separate from the information transfer that has traditionally been studied. Reframing handoff as a form of ritualized behavior has implications for how group processes are implemented within training environments, and provides fertile ground to rethink other practices in medical education that face similar barriers to change.
PURPOSE:Multimorbidity is an increasingly common clinical and public health challenge, yet undergraduate medical education (UME) frequently emphasizes single-disease models. Using Cultural Historical Activity Theory (CHAT), this review maps how multimorbidity is conceptualized within UME to inform more deliberate teaching and curriculum design. METHOD:The authors conducted a scoping review to map the existing medical education literature on multimorbidity in the undergraduate setting. Search terms were developed using a Cochrane Multimorbidity Review as a foundation. Five databases were searched from inception to March 31, 2026: EMBASE, MEDLINE, CINAHL, ERIC and Web of Science. Data extraction was informed by CHAT, and findings were organized on whether articles positioned multimorbidity as a central or peripheral phenomenon of interest. RESULTS:A total of 3636 articles were identified; 348 underwent full-text review, and 30 met inclusion criteria. Included publications comprised original research (17 [56.7%]), conference abstracts (5 [16.7%]), innovation reports (3 [10%]), opinion pieces (3 [10%]), one short communication, and one letter. Sixteen articles (53.3%) discussed multimorbidity as a central phenomenon of interest, while 14 (46.7%) addressed it as a peripheral phenomenon. When discussed as a central phenomenon, multimorbidity was consistently conceptualized, primarily addressed in formal classroom settings, frequently linked to clinical reasoning, and described as a curricular challenge. When addressed as a peripheral phenomenon of interest, conceptualizations were variable. Multimorbidity appeared within clinical teaching environments, was connected to diverse skills and topics, but educational initiatives were developed with minimal patient involvement. CONCLUSIONS:This review reveals a core tension: although multimorbidity is common in clinical practice, its presence in UME remains limited and fragmented. It is inconsistently conceptualized and often disconnected from clinical contexts. Strengthening multimorbidity education through stronger conceptual foundations and better integration across curricula and authentic clinical environments is essential to preparing learners to deliver effective care to people living with multimorbidity.
Abstract Problem Integrating research into medical education fosters critical thinking and evidence-based practice. However, student participation in research can be limited by the lack of centralized, up-to-date project opportunities and mentor availability. Although Baylor College of Medicine established the Student Opportunities for Advancement in Research (SOAR) database to connect students with faculty-led projects, limited faculty participation persisted. An intervention was designed to increase faculty engagement in medical student research. Approach The SOAR office developed and implemented an eLearning module supported by a multipronged marketing campaign. This intervention aimed to increase awareness of SOAR resources, clarify mentorship expectations, and streamline project submission. The module was developed using Backward Design and consisted of 7 lessons incorporating multimedia elements in a 15-30 minutes learning experience. The marketing campaign included emails, newsletter announcements, and flyers. The eLearning and marketing campaign were implemented over a 6-week period from October 1 to November 11, 2024. Outcomes Faculty engagement was evaluated using project submission records and Kirkpatrick-based surveys. After launching the SOAR database in 2021, an average of 5 projects were submitted per month. In the 6 weeks following the October 2024 eLearning implementation, 178 projects were submitted. Of these submissions, 69.7% (124/178) were from faculty who completed the module, 7.9% (14/178) from faculty who viewed but did not complete the module, and 22.5% (40/178) from faculty with no interaction. At the participant level, 85.0% (108/127) of faculty who completed the module submitted at least one project. Over the subsequent 10-month period (December 2024-September 2025), submissions increased to 14 projects per month. Next Steps Future efforts include longitudinal evaluation of mentor recognition, project submissions and project updates over time, and the impact of outreach strategies on sustained faculty participation in medical student research.
PROBLEM:Within health science education, arts and humanities interventions are used to teach compassion, yet the connection between methodologies and outcomes is often tenuous. While evidence-based methods for cultivating compassion exist, they are rarely described as guiding frameworks for arts-based or humanities interventions. Additionally, arts practitioners and humanities educators familiar with the theory, pedagogy, and practices of their disciplines are often absent from interventions that could benefit from their expertise. Educational models that are grounded in the available evidence from social neuroscience and informed by creative writing theory and pedagogy can address these gaps. APPROACH:In 2024 and 2025, 2 "Dear Human" workshops were conducted for 25 health professions students, staff, and faculty associated with the Medical University of South Carolina in collaboration with the Gibbes Museum of Art. The workshop approach was informed by evidence-based frameworks for cultivating compassion, museum-based education, and creative writing. The educational session incorporated a sequence of creative writing exercises designed to promote presence, perspective-taking, and affective connection, a motivator of compassionate action. OUTCOMES:The authors constructed themes based on analysis of 25 participants' written workshop responses and found in those responses attitudes and motivations proximal to affective connection, common humanity, and applied compassion. They also determined that revision of the educational design could ensure the model aligns with best practices in compassion training, specifically by being more directive in the call to respond to imagined suffering. NEXT STEPS:Next steps involve revising the final prompt of the "Dear Human" sequence to be more directive in its call to recognize and respond to the imagined suffering of humans depicted in visual art. After revision, the goal is to assess the new version, offer the innovation to larger groups of health science students and practitioners, and encourage mixed-methods research of the approach.
