Gayle Haischer-Rollo

Introduction: Traditional program evaluation in medical education often faces challenges with large data volumes and manual analysis, which can delay data-driven decisions. This article introduces the artificial intelligence (AI)-enhanced program evaluation (AIEPE) framework to address this gap, proposing a novel, integrated approach using both traditional and generative AI to improve efficiency and insight. Method: The AIEPE framework is a five-phase, iterative system that augments human evaluators. It begins with Multi-Modal Data Aggregation (Phase 1). Next, a Dual-Stream AI-Powered Analysis (Phase 2) uses traditional AI for sentiment and thematic analysis while generative AI synthesizes narrative summaries. These insights inform AI-Powered Strategic Formulation (Phase 3), which assists in prioritizing issues and drafting action plans. The final phases, Human-in-the-Loop Decision-Making (Phase 4) and Programmatic Implementation and Iteration (Phase 5), ensure continuous improvement with human oversight. Results: Applying the AIEPE framework to a faculty development program evaluation, we analyzed 3361 qualitative comments. Sentiment analysis revealed 87.6% positive comments and thematic analysis identified key topics. The dual-stream approach provided a deeper understanding, linking a high no show rate in an AI course to faculty feeling unprepared. This led to a top-priority recommendation to redesign the curriculum. Discussion: The AIEPE framework transforms program evaluation from a labor-intensive process into a dynamic engine for continuous improvement. It empowers academic leaders to shift from data collection to architects of data-informed strategy. Although the framework significantly increases efficiency and depth of insight, it highlights the critical need for human oversight to mitigate challenges such as bias and over reliance on technology.

Medical education's pursuit of excellence often inadvertently fosters a "hidden curriculum" of perfectionism and shame. This culture can transform adaptive striving into maladaptive perfectionism, where a fear of failure leads learners to view mistakes not as growth opportunities but as evidence of moral failings and personal inadequacy. When errors inevitably occur, the potential result is shame or an identity-focused belief that "I am bad." The resulting isolation and self-doubt potentially can lead to imposter syndrome, burnout, and depression. This paper explores the critical role of shame-informed mentorship, an approach that recognizes how shame influences learner behavior and development. By responding with intentional strategies that preserve dignity, mentors can mitigate shame's potential impact and transform it into a catalyst for professional growth. We argue that by helping learners distinguish between corrosive shame ("I am the problem") and productive guilt ("I did something wrong"), mentors can facilitate behavioral change without damaging the learner's core identity. The paper offers practical, evidence-based strategies organized into three themes: Recognition-identifying "shame primers" such as perfectionistic histories and "shame triggers" like public questioning; Navigation-using validation, self-compassion, and the practice of "failing forward" to process active shame events; Cultivation-building long-term resilience through intellectual humility and the normalization of shared narratives. Collectively, these strategies provide a framework for intentionally building psychological safety and normalizing mistakes. By equipping mentors with tools to recognize and respond to shame, and by creating a culture that prioritizes formative feedback and a growth mindset, mentors can help transform shame from a destructive force into a catalyst for professional identity development and sustainable practice.

Background: Rising disparities in maternal–child healthcare are linked explicitly to outcomes based on patients' cultural identities. Those who receive universally available health care in the military are not immune from these disparities. Practicing cultural humility has been proposed as a tool for advancing equity through improved understanding of cultural factors that may impact a patient's healthcare. How cultural humility impacts healthcare remains unexplored from the patient perspective. Methods: To examine the relationship between patient identity and experience within the Military Health System, from their own perspectives, we conducted 31 semi‐structured interviews with birthing individuals who delivered a child utilizing military health insurance within the last 5 years. Participants were recruited through physical flyers and social media blasts, with additional purposive sampling. Data was coded, and repeating patterns of experience were identified and interrogated through thematic analysis. Results: Three predominant findings were identified via the interviews. First, participants with minoritized backgrounds described instances of racism, sexism, and homophobia attributed to a lack of cultural humility and ultimately to the delivery of oppressive medical care by providers. Second, this lack of cultural humility was described further through a lack of communication, feeling unheard or dismissed, and exposure to judgment and paternalism. Third, there were described instances of shared decision making as well as autonomy and respect that contributed to culturally humble care provided to a portion of participants, which positively impacted their care. Discussion: Experiences of birthing individuals in the Military Health System qualitatively support prior quantitative studies and offer insight into the lack of cultural humility underlying care provided over the last several years. Ultimately, providers should use this information as a framework for understanding the sources of cultural humility and how they address it in individual patient–provider interactions.

Background The role of clinician educators has expanded to encompass diverse responsibilities alongside providing competent care and engaging in scholarly activities. Faculty development (FD) programs have emerged as vital tools for equipping educators with teaching skills and career advancement opportunities. However, assessing faculty development programs’ impact on organizational culture remains challenging due to their multifaceted nature. This study explores this gap to understand how faculty development influences organizational culture. Methods This qualitative study used a constructivist approach to explore faculty perspectives on the Uniformed Services University of the Health Sciences (USU) Faculty Development Program’s influence on organizational culture. Forty-three faculty members participated in nine semi-structured focus groups, selected for diversity across roles and locations. Interviews were recorded, transcribed, and anonymized to ensure accuracy and participant confidentiality. Data analysis Transcripts were analyzed using thematic analysis. A multidisciplinary team independently reviewed transcripts, identified preliminary codes, and refined themes through iterative consensus building. Coding was organized using memos and grouped into themes. Using information power principles, the team determined that nine focus groups provided sufficient data richness to meet the study’s aims. Results The research team identified and refined four central themes: professionalization, legitimization, the value of community, and leadership impact. The participants reported a greater sense of professionalization through enhanced teaching skills, increased awareness of educational literature, and heightened confidence in their educator roles. The faculty development program fostered a strong community, promoting collaboration, knowledge sharing, and mutual support across specialties and locations. Leadership impact was evident at individual and institutional levels, increasing confidence, mentorship, and organizational support. Conclusions This study provides valuable insights into the organizational impact of faculty development programs, shedding light on how such initiatives influence faculty experiences and organizational culture. Future research should explore leadership values, faculty retention, burnout prevention, and the broader value of education within academic institutions.

Purpose: In medical education, the influence of shame is largely absent from current conceptualizations of professional identity formation (PIF), even though this process is susceptible to the effects of shame experiences. This study endeavors to examine how shame influences PIF among medical learners. Method: Adopting a constructivist approach and hermeneutic phenomenology, the authors interviewed 9 final-year graduate medical trainees at 2 U.S. military medical centers between September 2022 and February 2023. The authors used a semistructured interview guide and photo-elicitation to deeply explore participants’ shame experiences and how these influenced participants’ PIF. Data analysis focused on understanding the lived experiences of these events and their impact on PIF, yielding themes central to the phenomenon of shame-induced PIF that helped characterize its deeper meaning. Results: Participants described shame events triggered by incidents like board exam failure, patient care mistakes, and needing educational remediation. Analyzing the influence of these events on PIF revealed 2 processes that helped propel identity arcs toward—and sometimes away from—an ideal version of the self: identity disruption and identity work. Identity disruption led to a distancing from the community and could lead to isolation, anxiety, and impaired belonging. These feelings of disruption often led to significant identity work, which involved modifying self-talk, leveraging agency, and engaging in identity negotiation (often in service of growth toward a modified professional identity). Conclusions: This study uncovers the potential for shame to serve as a catalyst for meaningful identity work in medical trainees. The findings expand on existing conceptualizations of PIF by highlighting that it is a dynamic, ongoing, nonlinear, and multidimensional process. The analysis points to actions educators and learners can take to support learners’ constructive navigation of shame experiences and their impact on PIF.

Medical education acknowledges our need to teach our physicians about “social determinants of health” and “health care disparities”. However, educators often lack actionable training to address this need. We describe a faculty development activity, a health disparities journal club, using the jigsaw strategy with the intent of increasing awareness, encouraging self-directed learning, and inspiring future teaching of the subject to health professional learners. We completed six workshops at six individual hospitals, with 95 total attendees in medicine and numerous other health professions. Our evaluation asked trainees to: report the number of journal articles about health disparities they had read, excluding the assigned journal club articles, in the past 12 months, and to predict future plans for reading about health disparities. In total, 28.9% responded they had “never read” a prior article on health or healthcare disparities, while 54.2% responded “1–5 articles”. Many (60%) reported they would continue to investigate this topic. Our experience has demonstrated the utility and positive impact of a “flipped classroom” jigsaw method, showing it can be used successfully in Inter-Professional (IPE) Faculty Development to increase active exposure and discussion of the content. Additionally, this method promotes individual reflection and enhances continued collective engagement.

Objectives: Current literature suggests that infant oral anatomy may impact breastfeeding outcomes. Our research seeks to evaluate superior labial frenulum (SLF) attachment site grade utilizing a modified existing system and investigate the correlation with breastfeeding outcomes. Methods: Two hundred and eight dyads were recruited from the nursery at Brooke Army Medical Center. The neonate's SLF and lingual frenulum were evaluated and photo‐documented. Photos were assessed by blinded reviewers utilizing a modified Stanford SLF grade. Breastfeeding mothers completed surveys on attitudes and associated pain with feedings 24 h postdelivery, at 2 weeks and at 2 months. Categorical data were analyzed using chi‐squared tests or Fisher's exact tests. Means and standard deviations were analyzed using analysis of variance or Wilcoxon's test. Results: At 2 weeks and 2 months, 86.8% and 72.8% were breastfeeding, respectively. At 2 months, SLF grade 1 newborn dyads had a significantly lower breastfeeding rate (50.0%) compared to SLF grade 2 (75.3%) and SLF grade 3 (85.7%) subjects ( p = 0.0384). At 2 weeks and 2 months, there was no difference between SLF groups with regard to maternal breastfeeding attitudes or pain scores. There was no significant difference in terms of weight, referrals, or lingual–labial frenulectomy between SLF groups. Conclusions: Our study shows no correlation between SLF attachment grade and breastfeeding outcomes to include length of breastfeeding, maternally reported confidence, maternal pain, or infant weight. Our findings do not support labial frenulectomy based on SLF grade alone and highlight the need for a more robust functional grading system. Level of Evidence: 2 Oxford Center for Evidence‐Based Medicine. http://www.cebm.net/index.aspx?o=5653 Laryngoscope , 132:2498–2504, 2022

In-situ interprofessional emergency team training improves participants’ with confidence and knowledge and identifies latent safety threats. This study examined the impact of a structured debrief on an interprofessional perinatal team’s ability to identify latent safety threats and assess competency in managing perinatal emergencies. It was hypothesized that latent safety threats would be reduced and checklist compliance would increase during subsequent in-situ perinatal team training. Two in-situ training sessions were held six months apart. The perinatal emergency response team provided care for a standardized patient with preterm twin gestation. Each session included off-ward delivery and resuscitation of the first infant, transportation to appropriate inpatient units, cesarean delivery, and resuscitation of the second twin. Postpartum hemorrhage ensued, requiring massive transfusion protocol activation. Medical experts assessed team performance with critical action checklists. A structured debrief identified latent safety threats, developed action plans, and reviewed checklist compliance. Checklist compliance rates were analyzed using a z-ratio test. The first training session: seven teams (75 staff) completed 75% (292/391) critical action checklist items and identified 34 latent safety threats. Second training session: four teams (45 staff) completed 89% (94/106) critical action checklist items. Ten latent safety threats were mitigated during the second session. Utilizing a z-ratio, a significant difference was detected between the overall checklist compliance rates of the two sessions, z = -3.069, p = .002. Post-hoc power calculation was <10%. In-situ interprofessional perinatal emergency team training is feasible, identifies latent patient safety threats, and may improve team competency.