The rapid integration of artificial intelligence (AI) in education presents a transformative opportunity to reevaluate traditional models, particularly in the realm of physician training. Despite advancements in active learning techniques, medical education largely adheres to a standardized approach, overlooking individual variations in baseline knowledge and learning preferences. As competency-based medical education gains prominence, addressing the unique needs of individual learners becomes imperative. This commentary advocates for the implementation of Precision Education (PE) in medical schools—a paradigm shift that tailors content and assessments to individual learners. PE leverages longitudinal data and learner analytics to drive personalized interventions, enhancing educational, clinical, and system outcomes. The commentary explores the impact of PE on learning outcomes, emphasizing its role in optimizing learning paths, fostering learner engagement, and promoting efficient use of time both for the faculty and the learners. Notably, PE aligns with the principles of evidence-based medicine and requires effective use of data analytics for predictive insights and actionable interventions. The equitable application of PE is crucial in addressing disparities in medical education outcomes, necessitating careful consideration of potential biases and the co-creation of interventions with and or by a diverse set of learners. The commentary also delves into practical strategies and tools, including adaptive learning platforms, learner analytics dashboards, and integration with electronic health records. However, it acknowledges barriers such as suboptimal learner engagement and the need for faculty involvement in tailoring interventions. While presenting promising evidence, the field of precision education is still evolving, requiring further research to comprehensively understand its impact, especially in the specific context of medical education. As AI continues to advance, the integration of PE in medical education stands to benefit from refined instructional design, and continuous assessment and improvement of personalized approaches.

Issue: Noting high rates of burnout, depression, and suicidality among medical students, academic medical communities are trying to identify preventive and curricular measures that protect and promote student well-being. To date, the effectiveness of these efforts is unclear. In addition, evidence increasingly suggests that the major drivers of distress appear to be factors within the social, learning, and work environments. Specific to medical schools in the United States, neither the Liaison Committee on Medical Education nor the Commission on Osteopathic College Accreditation include accreditation standards regarding well-being curricula and, as such, these curricula are not well-integrated into students' medical school experience. Current accreditation standards also do not specifically require institutions to assess or address systemic factors of the learning environment that negatively affect student well-being. Evidence: This paper proposes expanding current Liaison Committee on Medical Education and Commission on Osteopathic College Accreditation standards on professionalism to incorporate well-being as a core component of professional identity formation by requiring individual and institutional-level actions. Proposed changes to accreditation standards include (1) institutional assessment of the impact of the learning environment on student well-being; (2) continuous quality improvement efforts to address structural factors associated with student well-being and modification of practices that impair student well-being; and (3) integrated curriculum with related assessment to educate students on empirically-supported strategies for well-being. Implications: Refining undergraduate medical education accreditation standards in the United States to include language specific to student well-being will facilitate long overdue changes to the learning environment. In the end, the goal is not just to improve medical student well-being, but to provide a workforce better equipped for a sustainable and meaningful career.

Phenomenon: Chronic disease is a leading cause of death and disability in the United States. With an increase in the demand for healthcare and rising costs related to chronic care, physicians need to be better trained to address chronic disease at various stages of illness in a collaborative and cost-effective manner. Specific and measurable learning objectives are key to the design and evaluation of effective training, but there has been no consensus on chronic disease learning objectives appropriate to medical student education. Approach: Wagner's Chronic Care Model (CCM) was selected as a theoretical framework to guide development of an enhanced chronic disease prevention and management (CDPM) curriculum. Findings of a literature review of CDPM competencies, objectives, and topical statements were mapped to each of the six domains of the CCM to understand the breadth of existing learning topics within each domain. At an in-person meeting, medical educators prepared a survey for the modified Delphi approach. Attendees identified 51 possible learning objectives from the literature review mapping, rephrased the CCM domains as competencies, constructed possible CDPM learning objectives for each competency with the goal of reaching multi-institutional consensus on a limited number of CDPM learning objectives that would be feasible for institutions to use to guide enhancement of medical student curricula related to CDPM. After the meeting, the group developed a survey which included 39 learning objectives. In the study phase of the modified Delphi approach, 32 physician CDPM experts and educators completed an online survey to prioritize the top 20 objectives. The next step occurred at a CDPM interest group in-person meeting with the goal of identifying the top 10 objectives. Findings: The CCM domains were reframed as the following competencies for medical student education: patient self-care management, decision support, clinical information systems, community resources, delivery systems and teams, and health system practice and improvement. Eleven CDPM learning objectives were identified within the six competencies that were most important in developing curriculum for medical students. Insights: These learning objectives cut across education on the prevention and management of individual chronic diseases and frame chronic disease care as requiring the health system science competencies identified in the CCM. They are intended to be used in combination with traditional disease-specific pathophysiology and treatment objectives. Additional efforts are needed to identify specific curricular strategies and assessment tools for each learning objective.

Phenomenon: Because of its importance in residency selection, the United States Medical Licensing Examination Step 1 occupies a critical position in medical education, stimulating national debate about appropriate score use, equitable selection criteria, and the goals of undergraduate medical education. Yet, student perspectives on these issues and their implications for engagement with health systems science-related curricular content are relatively underexplored. Approach: We conducted an online survey of medical students at 19 American allopathic medical schools from March-July, 2019. Survey items were designed to elicit student opinions on the Step 1 examination and the impact of the examination on their engagement with new, non-test curricular content related to health systems science. Findings: A total of 2856 students participated in the survey, representing 23.5% of those invited. While 87% of students agreed that doing well on the Step 1 exam was their top priority, 56% disagreed that studying for Step 1 had a positive impact on engagement in the medical school curriculum. Eighty-two percent of students disagreed that Step 1 scores should be the top item residency programs use to offer interviews. When asked whether Step 1 results should be reported pass/fail with no numeric score, 55% of students agreed, while 33% disagreed. The majority of medical students agreed that health systems science topics were important but disagreed that studying for Step 1 helped learn this content. Students reported being more motivated to study a topic if it was on the exam, part of a course grade, prioritized by residency program directors, or if it would make them a better physician in the future. Insights: These results confirm the primacy of the United States Medical Licensing Examination Step 1 exam in preclinical medical education and demonstrate the need to balance the objectives of medical licensure and residency selection with the goals of the broader medical profession. The survey responses suggest several potential solutions to increase student engagement in health systems science curricula which may be especially important after Step 1 examination results are reported as pass/fail.

PURPOSE:Social determinants of health (SDH) are recognized as important factors that affect health and well-being. Medical schools are encouraged to incorporate the teaching of SDH. This study investigated the level of commitment to teaching SDH; learning objectives/goals regarding student knowledge, skills, and attitudes; location in the curriculum and teaching strategies; and perceived barriers to teaching SDH.METHODS:A team from the American Medical Association's Accelerating Change in Medical Education Consortium developed a 23-item inventory survey to document consortium school SDH curricula. The 32 consortium schools were invited to participate.RESULTS:Twenty-nine (94%) schools responded. Most respondents indicated the teaching of SDH was low priority (10, 34%) or high priority (12, 41%). Identified learning objectives/goals for student knowledge, skills, and attitudes regarding SDH were related to the importance of students developing the ability to identify and address SDH and recognizing SDH as being within the scope of physician practice. Curricular timing and teaching strategies suggested more SDH education opportunities were offered in the first and second undergraduate medical education years. Barriers to integrating SDH in curricula were identified: addressing SDH is outside the realm of physician responsibility, space in curriculum is limited, faculty lack knowledge and skills to teach material, and concepts are not adequately represented on certifying examinations.CONCLUSION:Despite the influence of SDH on individual and population health, programs do not routinely prioritize SDH education on par with basic or clinical sciences. The multitude of learning objectives and goals related to SDH can be achieved by increasing the priority level of SDH and employing better teaching strategies in all years. The discordance between stated objectives/goals and perceived barriers, as well as identification of the variety of strategies utilized to teach SDH during traditional "preclinical" years, indicates curricular areas in need of attention.

TOPIC: “Ethics and Stem Cell Therapy” OBJECTIVE: The audience will obtain an understanding of our current conceptions of what constitutes a stem cell, an appreciation of the shortcomings of how we currently represent advances in stem cell research, and a discussion of some concerns with the translation of stem cell treatments with particular regard to neurology. SUPPORT: No Commercial Support LOCATION: Harper University Hospital Kresge Auditorium September 9, 2011 William Coplin, MD Associate Professor Department of Neurology and Neurological Surgery Wayne State University School of Medicine Detroit, MI

1School of Osteopathic Medicine in Arizona, A.T. Still University of Health Sciences, Mesa, AZ, USA; 2Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; 3Office of Health Professions Education, Nebraska Medicine, Omaha, NE, USA; 4Academic Affairs, Eastern Virginia Medical School, Norfolk, VA, USA; 5Diversity and Inclusion, Eastern Virginia Medical School, Norfolk, VA, USA; 6Department of Family Medicine and Community Health, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA; 7Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA, USA; 8Medical Education Outcomes, American Medical Association, Chicago, IL, USA Purpose: Social determinants of health (SDH) are recognized as important factors that affect health and well-being. Medical schools are encouraged to incorporate the teaching of SDH. This study investigated the level of commitment to teaching SDH; learning objectives/ goals regarding student knowledge, skills, and attitudes; location in the curriculum and teaching strategies; and perceived barriers to teaching SDH. Methods: A team from the American Medical Association’s Accelerating Change in Medical Education Consortium developed a 23-item inventory survey to document consortium school SDH curricula. The 32 consortium schools were invited to participate. Results: Twenty-nine (94%) schools responded. Most respondents indicated the teaching of SDH was low priority (10, 34%) or high priority (12, 41%). Identified learning objectives/ goals for student knowledge, skills, and attitudes regarding SDH were related to the importance of students developing the ability to identify and address SDH and recognizing SDH as being within the scope of physician practice. Curricular timing and teaching strategies suggested more SDH education opportunities were offered in the first and second undergraduate medical education years. Barriers to integrating SDH in curricula were identified: addressing SDH is outside the realm of physician responsibility, space in curriculum is limited, faculty lack knowledge and skills to teach material, and concepts are not adequately represented on certifying examinations. Conclusion: Despite the influence of SDH on individual and population health, programs do not routinely prioritize SDH education on par with basic or clinical sciences. The multitude of learning objectives and goals related to SDH can be achieved by increasing the priority level of SDH and employing better teaching strategies in all years. The discordance between stated objectives/goals and perceived barriers, as well as identification of the variety of strategies utilized to teach SDH during traditional “preclinical” years, indicates curricular areas in need of attention.

Though intended to inform a binary decision on initial medical licensure, the United States Medical Licensing Examination (USMLE) is frequently used for screening candidates for residency positions. Some have argued that reporting results as pass/fail would honor the test's purpose while preventing inappropriate use. To date, the USMLE's sponsor organizations have declined to make such a change. In this Perspective, the authors examine the history and mission of the National Board of Medical Examiners (NBME), trace the rise of "Step 1 mania," and consider the current financial incentives for the NBME in implementing a pass/fail score-reporting policy. The NBME was founded in 1915 to address the lack of interstate reciprocity in medical licensure examination. With the creation of the USMLE in 1992, a single pathway for licensure was established, and the organization's original mission was achieved. Yet even after fulfilling its primary purpose, the NBME-classified as a nonprofit organization-has seen its revenues rise dramatically over the past 2 decades. Much of the increased revenue is derived from test products and services not required for medical licensure, with sales driven by the increasing importance of Step 1 scores in residency selection. Revenue from these products and services would likely decline if the NBME reported Step 1 results as pass/fail. A financial conflict of interest occurs when a judgment concerning a primary interest may be influenced by a secondary interest, such as financial gain. The data presented here demonstrate that the NBME has a conflict of interest in its current score-reporting policy. Possible remedies, such as disclosure, recusal, divestiture, and restructuring, are considered.

Students of our MPA program are expected to master a vast amount of information in a short 28‐ month curriculum leading up to their clinical practice. In addition, students find learning clinical pharmacology difficult as it involves memorizing hundreds if not thousands of medications, their mechanism, interactions, and adverse effects. In order to maximize learning, we delivered a Clinical Pharmacology (CP) course in a flipped classroom model using technology1.CP I and II are two 3‐credit courses taught over 4‐month each with two 2‐hour didactic lectures every week. In its place, we introduced short 15 – 20 minute videos recorded using Explain Everything or Camtasia software and posted them a couple of days prior to in‐class sessions2. In addition, a complete slide‐deck and a study guide with open‐ended questions designed to reinforce the clinically relevant facts and concepts in each class were also posted. Students listened to the recording, used the slide‐deck and study guide to master the concepts. An anonymous survey at the end of the course collected the feedback on this new model of course content delivery and their learning experience3.More than 55 students participated in the survey. An overwhelming 82% of the respondents wanted the course to be delivered based on this model in the future. About 75% agreed that the new model allowed them more time to study other subjects. Another 76% felt the new model helped them feel prepared for the exams. Although we had reduced the student‐faculty contact time by 50%, about 70% of the survey respondents felt the new model provided them adequate faculty exposure and interaction.Unlike reported by some studies that the students prefer only about half of the class sessions to be “flipped” 4; our MPA students wanted us to follow this new model for the entire course. Following our success with this new model, other Course Directors have started introducing flipped classes in their courses.Based on the favorable feedback we received from the students and performance index on their course assessments, we recommend utilizing this model of active learning in your health sciences education programs.Support or Funding InformationThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Purpose To describe the breadth of strategies U.S. medical schools use to promote medical student well-being. Method In October 2016, 32 U.S. medical schools were surveyed about their student well-being initiatives, resources, and infrastructure; grading in preclinical courses; and learning communities. Results Twenty-seven schools (84%) responded. Sixteen (59%) had a student well-being curriculum, with content scheduled during regular curricular hours at most (13/16; 81%). These sessions were held at least monthly (12/16; 75%), and there was a combination of optional and mandatory attendance (9/16; 56%). Most responding schools offered a variety of emotional/spiritual, physical, financial, and social well-being activities. Nearly one-quarter had a specific well-being competency (6/27; 22%). Most schools relied on participation rates (26/27; 96%) and student satisfaction (22/27; 81%) to evaluate effectiveness. Sixteen (59%) assessed student well-being from survey data, and 7 (26%) offered students access to self-assessment tools. Other common elements included an individual dedicated to overseeing student well-being (22/27; 82%), a student well-being committee (22/27; 82%), pass/fail grading in preclinical courses (20/27; 74%), and the presence of learning communities (22/27; 81%). Conclusions Schools have implemented a broad range of well-being curricula and activities intended to promote self-care, reduce stress, and build social support for medical students, with variable resources, infrastructure, and evaluation. Implementing dedicated well-being competencies and rigorously evaluating their impact would help ensure appropriate allocation of time and resources and determine if well-being strategies are making a difference. Strengthening evaluation is an important next step in alleviating learner distress and ultimately improving student well-being.

Word choice in health care has concrete effects on health, including greater patient well- being with the use of positive words. 5 Patient- centered language is not new, yet hierarchical and patient- blaming language persists. Now is the time to identify barriers to using language that reflects what we say we value.

To the Editor: The Invited Commentaries by Chen and colleagues1 and by Katsufrakis and Chaudhry2 highlight a much-needed debate. The United States Medical Licensing Examination (USMLE) Step 1 is used by residency programs in all medical specialties to select applicants, despite a paucity of direct empirical evidence connecting Step 1 scores and clinical performance.3 If the numerical score of Step 1 does not directly correlate with residency performance, why is it scored at all? The problem gains further perspective given the dramatic increase in residency applications submitted per individual. In internal medicine, the average number of applications per student has increased by 203% since 2010, while the proportion of positions per applicant has only increased by 8%.4,5 Reviewing more applications than ever before has become a daunting task for program directors (PDs). It is no wonder that PDs tend to rely on more “objective” data, such as the USMLE Step 1 score as a filter. Further, all available evidence suggests that medical students entering residency are more qualified today than ever before, with more well-rounded applications and exposures than other generations.6,7 However, if the USMLE Step 1 score is used as a filter to attempt to predict success in residency, it cannot be held to different standards than the rest of the medical school curriculum. We need ongoing evaluation to establish or refute a correlation between Step 1 performance and meaningful clinical outcomes. Ideally, we should try to focus our efforts on ascertaining whether residency programs make better decisions selecting residency candidates when taking Step 1 scores into consideration.3 Our medical community is facing a crisis of burnout among physicians and trainees. Any idea with the potential of alleviating some of the pressure medical students face needs to be carefully evaluated, and moving Step 1 to pass/fail scoring is no different. As such, we look forward to the upcoming discussions that will take place thanks to these meaningful publications. Bruno Alvarez Concejo, MDResident, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; [email protected]; ORCID: https://orcid.org/0000-0002-2695-8159. Stephen Philip, MD, MSResident, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; ORCID: https://orcid.org/0000-0003-4205-3787. Timothy J. Brown, MDChief resident, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; ORCID: https://orcid.org/0000-0002-4843-4639.

Seems like American Healthcare was in “crisis mode” since 1900s and value and cost that were the words used to describe crisis in 1900 are the words that we still use to describe the problems that continue to haunt us today. Despite so many advances, almost nothing has changed in controlling cost and improving value and health outcomes. At Eastern Virginia Medical School (EVMS) we have implemented our new CareForward curriculum to address health system sciences in the UME. Realizing the challenges in effectively integrating these complex topics in UME, our team at EVMS has created a set of virtual families (VF), members of which will be represented in the clinical cases that are used in the UME curriculum. These VF represent diverse patient populations (e.g., age, gender, sexual orientation, ethnicity, race, culture, belief system, literacy level, socioeconomic status and geography), and introduce variables such as veteran affairs, family dynamics, financial turbulence in families, health equity/disparity, roles within a care delivery team, access to community resources, interactions of organizations and complexities of care in specific patient populations. Each organ system module and clerkship will use longitudinal clinical cases that are drawn from the virtual families. The VF are woven together by stories that bring clinical scenarios to life and highlight patient-and family-centered, cost-conscious care for the unique needs of the elderly and those with multi-morbidity/multiple chronic conditions (MCC), as well as a host of social determinants of health. At the end of the first year of this curriculum, 146/150 students completed an optional curriculum evaluation survey. Over 80% of students either agreed or strongly agreed that VF characters were effective in introducing me to concepts of social determinants of health and health inequity and over 62% of students either agreed or strongly agreed that VF case based activity increased the understanding of the impact of family dynamics in determining the patient's health outcomes. Below are some of the comments from the student evaluation: Helped me understand social determinants of health Understanding the multidisciplinary team It incorporates many aspects of medicine nicely This approach allowed us to think of the multiple different problems associated with an illness. We had to think about cost which is equally important Support or Funding Information American Medical Association, Accelerating Change in Education grant Virtual Family This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

To the Editor: Dr. Gonzalo and colleagues1 did a thorough analysis of faculty concerns related to integration of health systems science (HSS) into medical education, especially in aligning those concerns with suggested solutions. The list of concerns is fairly comprehensive, and we are sure all medical educators reading the article can relate to many if not most of the concerns. Thus, they should find the authors’ proposed solutions helpful. Although we agree with all the authors’ suggested solutions, we want to add our own suggestions related to integration and faculty development. To make a meaningful impression on learners, we suggest that HSS-related topics be effectively integrated into other components of the curriculum where the learners are already perceiving HSS as a part of their everyday practice. At Eastern Virginia Medical School, we have implemented our new CareForward curriculum, a significant component of which is HSS. Cases used in our curriculum are drawn from the set of virtual family characters where, along with basic and clinical sciences, we also discuss HSS. Our cases address, among other things, elements of insurance, social and living environment, cost of care, a team-based/interprofessional approach to care, and design of patient-centered management plans. Other medical schools are also implementing similar models and are finding these models to be effective for integrating HSS-related topics.2 In response to the authors’ concern that “few faculty have the knowledge and skills to teach HSS,” we suggest that an incentive-based faculty development program is one way to address this. We favor a certificate program that would require a faculty member to complete a series of continuous professional development or continuing medical education sessions, as this would also help create a cadre of faculty who would then be able to train others on this topic. We recognize that HSS-related topics can be considered “unconventional” in medical education, but as Gonzalo and colleagues have highlighted, it is critical that our learners receive adequate education about HSS and its implications, as we increasingly rely on these learners to become change agents. We believe interventions like the ones suggested above may help further address barriers to improving HSS education. Senthil Kumar Rajasekaran, MDAssociate dean for academic affairs, Eastern Virginia Medical School, Norfolk, Virginia; [email protected] Lauren MazzurcoDirector of case-based learning, Eastern Virginia Medical School, Norfolk, Virginia. Marta AmbrozewiczAssociate professor, Eastern Virginia Medical School, Norfolk, Virginia.

With evidence on gaps between expectations of entering residents and their performance in both medication ordering and prescription writing, our study is an attempt to document the extent to which related topics are being covered in undergraduate medical education. Results received from an online survey conducted through the American Medical Student Association found that a high percentage of clinical year students had little or no experience in writing or ordering prescriptions. Our results suggest that there is a lack of adequate coverage of these topics and this, at least partly, could explain the higher medication errors among entering residents.

This article was migrated. The article was marked as recommended. The majority of health outcomes are determined by social determinants of health (SDOH) while medical care is responsible for as little as 20% of health outcomes. This article is an introduction to the Virtual Family (VF) approach to case based instruction; a novel strategy for addressing SDOH in medical school. The VF theoretical framework is presented and practical considerations and challenges for implementation of the VF approach at three different medical schools are offered. VFs are defined as representations of families or social groups that are not real. "Virtual," in this instance, refers to people or things that do not physically exist. The VF approach allows students and educators to adjust the "lens" of a case's focus to view the relevant determinants. The VF approach is presented as an extension of the virtual patient approach. Theoretical support for the VF approach is argued drawing on principles from modeling and simulation, effective story design, establishing a sense of human presence, serious gaming, visual design, identity leveraging, and flow theory. Challenges and benefits of the approach are described. Measures of efficacy designed to match learning goals are proposed. The VF approach is presented as practical, accessible, economical, and potentially powerful.

There is strong research evidence that supports the implementation of learner centered approach as opposed to instructor centered approach in expanding knowledge base as well as increasing motivation.This study attempts to assess student evaluation and acceptance of learner centered teaching within the basic science program of a Caribbean medical school through the use of case studies in Microbiology and Anatomy to help determine its usefulness in the basic science curriculum. In addition, we gathered data to assess differences in perception relative to the student's progression in the curriculum.In both the Microbiology ((M)(3rd Trimester) and Anatomy (A)course (1st Trimester), case studies were prepared at the end of the relevant lecture series and handed out to students during class time. Further, students were encouraged to work in small groups to facilitate collaborative thinking in solving the case. At the end of the exercise, students answer questions in the form of multiple choice questions (MCQ ) pertaining to the cases.Upon completion of the case studies, students were surveyed using a questionnaire.We found that students in Anatomy were less comfortable with the use of case studies when compared to the Micro students (46%vs 66%) imageThis difference appeared to be related to the stage of progression of the student in the curriculum with senior students being more receptive to the case studies. 55% of the Micro students felt it was a good use of their time while only 21% of anatomy students did so.There was a consistent opinion among students regardless of their stage in the curriculum that they did not want this activity to be graded (96% (A) and 81%(M)).ConclusionIt appears that more advanced students provided a more positive evaluation.

With the growing emphasis on evidence‐based medicine, medical students face the challenge of assimilating a huge volume of new information during medical school. Among the most significant trends in medical education is the emergence of high quality medical applications for smart phones and tablets. As digital natives, millennial medical students respond well to this approach.First year medical students were chosen for this activity. We chose three apps (Micromedex, Epocrates and DynaMed) and for each app, the students were assigned questions related to a clinical case and a corresponding app to answer them. The tasks included a drug interaction check, adverse effect check, cost effective alternative check and patient advice and reference the levels of evidence (I, II and III). Also, students were directed to use the apps to perform similar tasks with the prescription drugs that their family or friends were taking. The students were asked to fill out an optional online pre‐ and post‐session survey rating their level of awareness and expertise in using these apps. Out of 75 students, 42 answered both surveys.Preliminary results indicate that self‐described ratings of application expertise rose substantially, as did their knowledge about critical clinical information relevant to prescribing practices. Students' knowledge of these applications also impacted their understanding of drug indications, efficacy, reactions, and interactions. Our results suggest that pedagogical interventions like these may hold potential to improve safe medication practices in clinical settings.

Abstract Prescribing is a fundamental part of the work of new residents, who write and review many prescriptions each day. It is a complex task requiring knowledge of medicines and the diseases they are used to treat, careful judgment of risks and benefits of treatment, and attention to detail. It is also apparent in other research that this is an area new residents find challenging. Lack of prescribing skills among residents has been widely reported. Granting these new doctors prescribing privileges without adequate assessment may encourage poor prescribing habits and promote medication errors. Following AAMC recommendations to implement medication safety learning activities, we created this session on prescription writing for undergraduate medical students. This session was formatted as a small-group session within a large classroom. The instructor's guide provides a step-by-step approach to implementing this session. The PowerPoint slides have been animated and notes added for each relevant slide to help faculty to make the best use of this resource. A handout with a set of five prescriptions that have commonly identified prescribing errors is intended for the first small-group activity. The second handout is a set of blank prescriptions that each student should be required to fill out at the end of the session. This session is offered at the end of the second year, right before the students embark on their clinical training. We have plans to do follow up sessions during their third and fourth years as well.

Abstract This interactive small-group session integrates microbiology of the respiratory tract with pharmacology (antimicrobials). It is intended as a review following lectures or interactive sessions in basic microbiology, respiratory microbiology, and antimicrobials. This integrated case-based microbiology and pharmacology session reinforces the basic concepts of respiratory microbiology with basic concepts of antimicrobial therapy. The cases require students to recall clinical presentations of various microbes, microbiology laboratory tests, and appropriate antimicrobials for treatment of specific pathogens. During the inaugural year of our curriculum, the students scored lower than anticipated on the microbiology and pharmacology sections of the respiratory course final exam. During the second year of our curriculum we aimed to remedy this and strengthen both disciplines with additional microbiology and pharmacology sessions, such as this. A comparison of final exam scores from the inaugural year and the second year of the respiratory course demonstrated a rise in scores for microbiology- and antimicrobial (pharmacology)-related questions.