U.S. Medical Education
Glossary of
Terms and Acronyms
 

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developed by EK Kachur

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Scroll through the glossary or click on a letter to go directly to a specific letter.
Words in italics are cross referenced in this glossary.

This is a work in progress!
Contributions and comments to
ekachur@mededdevelopment.com would be much appreciated.

We are grateful for the assistance of Nicki Cohen-Cliffer and J Hugh Baron in the initial development of this glossary. The British Medical Association provides a similar dictionary that focuses on British medical education terms http://web.bma.org.uk/members/mededdisc.nsf/miscdocsvw. In American English the word "faculty" means teacher while in British English "faculty" refers to a branch of the university (e.g., health science faculty).

A

Accreditation Council for Continuing Medical Education (ACCME) Professional body that evaluates and approves continuing medical education agencies. In order to provide CME credits, the educational program has to be sponsored by a CME accredited agency. http://www.accme.org

Accreditation Council for Graduate Medical Education (ACGME) Professional body that evaluates and approves residency programs. In order to be able to become board certified, residents have to graduate from an accredited program. HTTP://www.acgme.org

Adult Learning Different from children, adults prefer to create their own goals for learning, they like to take advantage of their already established competencies and favor problem solving educational techniques in which they actively participate in and share the responsibility for the learning outcomes.

American Osteopathic Association (AOA) Organization that regulates and accredits osteopathic training programs. This agency is equivalent to the LCME which accredits allopathic medical schools. http://www.am-osteo-assn.org

Ambulatory Care Training Since medicine is increasingly moving into the direction of outpatient care, program requirements are changing to include more of such training. In part, this is accomplished by setting up special hospital or community clinics; in part, trainees are sent to health care settings outside the academic center (e.g., private practitioners).

Anecdotes They can be a creative teaching tool that helps illustrate an issue and might make a point more effectively than dry definitions or descriptions.

Association of American Medical Colleges (AAMC) This is a national organization that concerns itself with all aspects of medical education. They organize conferences, produce reports (e.g., GPEP) and position statements, lobby with government agencies, and maintain the journal Academic Medicine. The AAMC also organizes the NRMP. http://www.aamc.org

Attending Rounds These rounds are run by the ward attending physician, with several levels of learners present (e.g., medical students, residents). The dual goals are teaching and patient care. Since simultaneous focus on two different tasks can be difficult, some programs have teaching rounds and work rounds. Various accreditation bodies support such divisions.

Audiovisual (AV) Aids These include tape and video recordings, slides and overhead transparencies. AVs can serve illustration purposes, they are also a helpful strategy to heighten attention. A glossary of video terms can be found at the Center for Instructional Support (CIA) Web site. http://www.uchsc.edu/CIS/VidGlossary.html

Autopsy Consent Programs typically request (and provide instructions for) their trainees to get permission from relatives to perform an autopsy.

Autopsy Rates Autopsies are viewed as vital tools for educating residents about disease processes. In some specialties the average monthly numbers of autopsies performed (and organ reviews attended) have become a criteria for program accreditation.

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B

Basic Science Years This refers to the first two years of medical school. With new learning methodologies such as PBL or early exposure to patients, basic science learning has become more integrated with clinical instructions and the division between basic science and clinical years starts to become less sharp.

Bedside Teaching As part of clinical rounds, the team goes to the patient to discuss the case or demonstrate a procedure. This is an opportunity to see the attending physician relate to the patient and to get hands-on instructions in interviewing, physical diagnosis, and counseling skills. In such situations it is always important to be considerate of the patient’s emotional and physical well-being (e.g., proper draping, language the patient can understand, respecting the patient’s privacy in the face of room mates and family members).

Board Certification (BC) This usually requires proof of having successfully completed an accredited training program and having passed a board exam in that particular specialty. It permits someone to advertise him or herself as a specialist in a particular field. When a new specialty is being created (e.g., geriatrics a few years ago), board certification can occur through grandfathering.

Board Eligibility (BE) In order to be board eligible, residents need to successfully complete an accredited training program. Many employers are willing to hire someone who is board eligible with the expectation that the board exam will be taken and passed in the near future.

Board Exam After successfully completing an accredited residency program, trainees take a national evaluation in their specialty. Typically, passing the board exam is one requirement for board certification.

Brainstorming A method to quickly generate ideas while postponing judgment. It spurs on creativity and provides good starting points for discussion.

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C

Case Mix Since much of medical education occurs by working with patients, programs need to pay close attention to the types of medical encounters trainees have. Some RRCs even require that programs forward patient population data so that they can determine whether trainees get a well-rounded education.

Checklists Evaluation instruments where categories are checked off (e.g., done/not done). This can result in ordinal or nominal data.

Check-Out Rounds At the end of a shift, information about ward activities and patient status is communicated to the group of professionals who follow.

Chief Resident Each residency program has one or several such individuals who represent a bridge between residents, program director and faculty. Some are in their last year of training, others have added on an extra year to their graduate education. Typically they have administrative, teaching, and patient care responsibilities

Clerkships These are clinical rotations in medical school. Some are required (e.g., internal medicine, pediatrics, surgery) while others are electives or selectives. Typically medical students take clerkships in their third and fourth year of medical school.

Clinical Years This typically refers to the third and fourth year of medical school when students spend their time gaining basic clinical competencies in clerkships. In the past it was often not until that time that students had contact with patients. However, in recent years medical education has become more integrated and students often experience clinical settings already in the first year of medical school.

Clinico-Pathological Conference (CPC) A regularly scheduled conference where one case is presented with all its clinical data (e.g., lab results, progression of disease), and trainees as well as faculty are invited to comment on diagnosis and cause of death. At the end the pathologist, who had performed an autopsy reveals the final diagnosis.

Cognitive Maps Sometimes they are also referred to as knowledge or concept maps. They are a graphical representation of facts with vectors and symbols indicating how different aspects of a concept relate to each other (e.g., how one diagnosis requires the presence and absence of a variety of signs and symptoms).

Committee of Interns and Residents (CIR) This is a group (union) that represents the interests of interns and residents towards institutions and their residency programs. http://www.cirdocs.org/

Community-Based Education (CBE) This is becoming a very popular form of instruction where trainees learn professional competencies in a community setting. Some people also refer to it as Community-Based Learning (CBL) or Community-Based Teaching (CBT).

Competence This term defines what someone is able to do because he has the knowledge and skills necessary to perform the task. It can be different from performance which denotes what someone is actually doing in a real life situation.

Competency Assessment A process by which the learner’s knowledge, skills, and attitudes are measured against the goals of the educational program.

Computer-Assisted Instructions (CAI) These include any kind of teaching mediated through computers (e.g., decision-making programs, cases to work through).

Conference Room Teaching This can be a part of attending rounds where the team gathers in a conference room, away from the other activities of a busy ward. This is the best place for probing questions and for extrapolating from individual cases to address general rules.

Continuing Medical Education (CME) This is the level of training that follows graduate medical education. It is one pathway to life-long learning and increasingly a requirement for maintaining a medical license and certification.

Continuing Medical Education (CME) Credit Licensing agencies as well as some health care insurance providers demand a certain number of CME credits in order to continue certification or obtain contracts. CME credits can be obtained by attending lectures, conferences and workshops, as well as by working though educational materials (e.g., computer programs, journals). In order to provide CME credits agencies have to be authorized by the ACCME. In addition to a proof of attendance, there is often also an evaluation of the competencies gained (e.g., quizes). There are category I (e.g., attendance at professional seminars) and category II credits (e.g., teaching activities). A glossary of CME accreditation terms can be found on the Alliance for Continuing Medical Education web site http://www.acme.assn.org/resources/glossary.html

Credentialing Granting of privileges based on specific evidence of procedural competence. The latter consists of knowledge concerning (contra)indications, potential risks, technical skills, management of expected complications and appropriate documentation. In order to be certified, each procedure needs to be demonstrated under observation a designated number of times.

Curriculum An Educational plan that spells out what goals and objectives should be achieved, what topics should be covered and what methods are to be used for learning, teaching and evaluation.

Curriculum Implementation Matrix This is a table that relates the educational goals, topics, and objectives to the specific educational methods that are to be utilized (e.g., lectures, readings, patient care sessions). It is a plan that helps assure that there is enough cross-coverage to maximize learning opportunities and that each goal can be achieved in multiple ways.

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D

Decision Analysis This is an organized approach to clinical decision making. It utilizes decision trees that help visualize the competing considerations.

Decision Trees This graphical device helps weigh the pros and cons of each choice. When used for working through prevention and treatment decisions, the different branches may include estimates of the likelihood that each option may occur or is of benefit (e.g., survival rates).

Demonstrations Examples, experiments or performances are provided to illustrate a principle or show how to perform a specific task. Demonstrations can be live or they can be via audio-visuals aids or computers. Usually it is important to be succinct and provide adequate explanations and discussion opportunities.

Dual-Boarded Physician A physician who has achieved board certification in two specialties (e.g., Medicine and Pediatrics, Medicine and Psychiatry). Some residency programs combine two specialties and thus make the trainee eligible for two boards simultaneously (e.g., Med-Peds programs).

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E

Educational Commission for Foreign Medical Graduates (ECFMG) Amongst other activities, this non-profit organization verifies educational credentials and tests for English proficiency. In the past they also administered a special exam for foreign medical graduates. Now there is only one path (i.e., a series of exams) to medical licensure in the US, the USMLE. http://www.ecfmg.org

Educational Games Since learning should be fun, teachers may incorporate games to provide information or assess competence in a more interesting fashion (e.g., Medical Jeopardy, SimHealth). The importance here is to make the bridge between the game and the serious learning content that is to be mastered.

Elective A course or rotation trainees can choose based on their interest.

Ethics Rounds Some institutions hold special rounds to deal with ethical issues (e.g., DNR orders, conflict of interest, confidentiality, the right to die).

Evidence-Based Medical Education (EBMedEd) Similar to evidence-based medicine, this is an effort to ground educational programs in the available research. When resources are short it behooves educators to invest them wisely. Evidence-Based Medical Education

Exam Blueprint This is a matrix that relates the knowledge, skills, and attitude areas that are being assessed to the questions or stations which were designed to accomplish this task.

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F

Faculty Development Most faculty are specialists in their subject but many have not received special training in teaching. Faculty development programs try to compensate for that. They can be special workshops, readings, or individualized feedback sessions. Since teaching can be a very important aspect of a physician’s work, such educational programs are often view as a form of CME.

Faculty Evaluations Program evaluations also need to address the effectiveness of teachers. Often this is accomplished via questionnaires students complete. When dealing with a large number of trainees who are taught simultaneously (e.g., in a lecture) it is easier to make use of such data than when teaching occurs one-on-one. These evaluations need to be collected over a period of time in order to yield a reliable assessment of the faculty’s work.

Feedback A process by which the teacher provides information to the learner about his/her performance for the purpose of improvement.

Fellowships Such programs are for individuals who have completed residencies. They provide subspecialization and may lead to additional board examinations and board certifications. This term is also applied to some extensive CME programs (e.g., to perform specific research projects or get special training in teaching).

Focus Groups These are group sessions where a particular topic is explored (e.g., what should be taught on a rotation, how effective was a course). The idea is to generate as many ideas as possible. The facilitator refrains from expressing own opinions in order to encourage those of the participants to emerge. Typically such groups meet only once.

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G

General Professional Education of the Physician (GPEP) Report This 1984 document, which was produced by the AAMC, was subtitled: Physicians for the 21st Century. It evaluated medical education affairs and projected future needs.

Grandfathering At the beginning of a specialty, before adequate training facilities and testing mechanisms are developed, professionals who have practiced this particular type of medicine have the opportunity to receive board status on proof of their extensive work experience.

Grand Rounds This is a conference (usually weekly) which is attended by residents and faculty alike. It is an avenue for reviewing the state-of-the-art in specific areas and for acquainting the department with new innovations.

Graduate Medical Education (GME) This term typically refers to residency training and fellowships, the education physicians receive after finishing medical school, also known as Undergraduate Medical Education (UGME).

Gynecology Teaching Associates (GTAs) These are women (usually not health care providers but individuals trained by gynecologists) who teach clinical skills surrounding breast and pelvic exams. They utilize their own bodies for teaching and usually work in pairs. Their male counterparts are Urology Teaching Associates (UTAs). Most medical schools and increasingly more residency programs provide such training for their students.

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H

Handouts These are useful devices that help faculty to assist trainees in organizing and memorizing the information that is being disseminated. Studies have shown that partial notes that include an outline as well as the key tables and figures work better than presentation transcripts or skeleton-type outlines.

Humanistic Behavior Every program is concerned about creating humanistic physicians who uphold the high standards of the profession. There are still some controversies about how such behavior can be taught or reliably measured. Role modeling and video recall of patient encounters are viewed as the educational methods of choice. However, even if trainees gain such values, they may not exhibit them in behavior if it is not reinforced by the environment.

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I

Impaired Physician Programs Every state has an agency that helps physicians who are impaired (e.g., due to drugs or alcohol) to overcome their problems and return to the health care system.

Information Management To avoid overload, clinicians need to find ways to organize information such that it can be retrieved when needed. Filing systems, cognitive maps, manuals, and electronic databases are some devices that can prove useful. A network of consultants is another way to assure that information will be available when needed.

Information Overload This is a problem particularly acute in medicine. New articles, Web sites, drugs, and treatments are arriving daily and it takes special skills in information management to maximize their usefulness without drowning in information.

Instructional Objectives These are statements that describe what learners should be able to accomplish at the end of the program. It is important to assure that objectives are measurable and that they delineate a specific level of competence. One can distinguish knowledge, skills and attitude objectives.

Internship Year This refers to the first postgraduate year which is a requirement for licensure. For many specialties this is the first year of residency (e.g., internal medicine, pediatrics, surgery). However, there are others which are too specialized to provide a general practice experience. Thus residents have to attend a transitional year in one of the above specialties or a rotating internship.

Interdisciplinary Educational Programs Such endeavors include not just trainees from one profession but from several. As team work is becoming more prominent, learning side-by-side with future colleagues is being viewed as important preparation.

International Medical Graduate (IMG) These individuals have graduated from a medical school that is not accredited by the LCME or the AOA. In the past they have been referred to as Foreign Medical Graduates (FMGs). There are foreign born IMGs and US born IMGs. The latter are often referred to as USIMGs. In order to enter a residency program in the US, IMGs need to be certified by the ECFMG which includes documentation of medical school graduation and the successful completion of the USMLE exams, part 1 and 2. English proficiency is also a requirement. IMGWeb provides updated information on issues of concern to IMGs. http://home.earthlink.net/~alexfeo/index.html

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J

J-1 Visa This is an immigration visa that allows someone to enter the US as a Temporary Exchange Visitor. At the end of residency and fellowship, or a total of seven years, the individual needs to leave the US and can return only two years later. Recently some waivers have been granted to individuals who work in underserved communities for a specified period of time.

Journal Club In this regularly scheduled forum, articles are presented and discussed in terms of research design, presentation of data, outcome and implications for practice.

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K  L

Learner-Centered Education Here the needs of the learner have priority. Trainees are responsible for identifying knowledge gaps, actively participating in filling them, and keeping track of their learning gains. Teachers facilitate this process rather than spoon-feed information.

Learning Climate This is the tone or atmosphere of a teaching situation. It should be stimulating and supportive so that learners can freely acknowledge their limitations.

Learning Contract Here the learner makes a commitment to acquire a certain body of knowledge, skills or attitudes within a specific time period. The teacher makes a commitment to facilitate this learning process.

Learning Curve This refers to the fact that learning does not occur instantaneously but is a gradual process. Depending on the material or procedure that is to be learned, the learner, and the social and physical environment, learning curves can be steep or gradual.

Learning Styles People vary in the way they can best learn new information or skills. One classification system divides into structured, relational, energetic and analytic styles. Each style has its strength and weaknesses as well as its preferred learning environments. In order to gain competence most efficiently, it is helpful for each learner to be aware of his/her style. Similarly, teachers should pay attention to the preferences of each learner in order to maximize educational gains.

Lectures This teaching method has been quite prominent in education because it is an economic way to communicate information to large groups of learners. However, our knowledge about attendees’ ability to concentrate and to absorb information while in a passive learning mode, has brought the value of lectures under much criticism. Audiovisual aids, demonstrations, intermittent discussions and other devices can help activate learners.

Liaison Committee on Medical Education (LCME) This organization accredits allopathic medical schools by setting criteria and reviewing institutions to make sure that they meet them. Osteopathic medicine programs are accredited by the AOA. http://www.lcme.org

Life-long Learning Since medical science changes rapidly it is vital that its practitioners are committed to, and engage in, continuous learning.

Literature Search Literature reviews are taking on an important role in an era of Evidence-Based Medicine (EBM) and Evidence-Based Medical Education (EBMedEd). Computers and the development of databases such as \ MEDLINE (http://igm.nlm.nih.gov) permit a quick identification of articles pertinent to specific clinical, educational, or research problems.

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M

Medical Educator A professional who focuses on the educational process necessary to transform non-physicians into physicians and to keep them current over their years of practice. Some medical educators are physicians, but an increasing number have backgrounds in education, behavioral or other health sciences. Outside of North America such professionals are often referred to as "educationalists." They can assist with many diferent tasks including the integration of curricula ( http://www.amsmic.org/presentations/elizabeth_kachur_files/v3_document.htm

Mentor A senior level professional who provides encouragement, guidance, and professional support to a trainee or junior level professional. Different from a role model, mentoring requires a relationship that is mutually beneficial.

Metaphors They can include similes, allegories, anecdotes, stories and comparisons that help illustrate a concept. While mnemonics aid memory, metaphors increase understanding.

Microlectures These are brief presentations to clarify an issue, introduce a new framework or provide new information. They are sometimes also referred to as mini-lectures, lecturettes, or 3-minute lectures.

Mnemonics Learning aids where rules or procedural steps are organized in the form of a word or a phrase (e.g., CAGE for substance abuse history taking).

Models, Mannequins and Simulators These are used to facilitate demonstrations and hands-on learning. One famous mannequin is Resusci Annie which is used for instructions in cardio-pulmonary resuscitation. Harvey is a an electronic heart machine that permits the simulation of a variety of diagnostic and therapeutic interventions.

Morbidity and Mortality (M&M) Review This is a regularly scheduled meeting where a department discusses procedures performed, complications due to treatment, and deaths that occurred within a specified time period. Faculty as well as trainees attend.

Morning Report This is a case-based teaching program where management decisions are made concerning patients who were admitted the day and/or night before. During such sessions service and learning needs are often in conflict.

Motivation Without motivation on part of the learner it is hard, if not impossible, to teach someone. Thus, in some educational situations it may be necessary to first arouse a desire for new knowledge and skills before the teacher can proceed with the program. Motivation can be stimulated by creating needs (e.g., identifying knowledge gaps, posing challenging questions, providing positive feedback, acknowledging barriers such as stress).

Multi-Instructor Courses Rather than having just one teacher, many courses are now being taught by a multitude of instructors. The advantage here is that learners can benefit from being exposed to individuals who have different sets of expertise. Furthermore, they have the opportunity to experience more than just one teaching style.

Multiple Choice Question (MCQ) Exams These are assessments that require examinees to identify the correct answer which is placed in the midst of a variety of distractors. In US medical education this has been the most popular form of competency assessment for quite some time. There are different types of MCQ’s (e.g., true/false, single best answer, match questions). Since these tests primarily measure knowledge, they are now often being replaced with more performanced-based assessment methods.

Multiple Station Exercises/Exams (MSEs) These are instructional or assessment programs where trainees rotate through a series of stations. In each they have to perform a standardized task. Direct or indirect observations as well as checklists and rating scales measure the performance against some predetermined standards. This method can teach or assess knowledge as well as skills, and to some extent, even attitudes. Since there are various stations, competencies can be practiced or sampled multiple times which provides more thorough training or a more reliable performance assessment. Objective Structured Clinical Exam (OSCE) is another term often used for this kind of educational program.

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N

National Board of Medical Examiners Amongst other activities, this non-profit agency develops and administers the US Medical Licensing Exam USMLE (Parts 1, 2 and 3). http://www.nbme.org/

National Intraining Exams Many specialties have developed exams to be given at one or several points in residency training. Their purpose is to provide feedback on trainee knowledge as well as to help understand program strengths and weaknesses by providing comparisons within and between training level groups and residency programs nationwide.

National Resident Matching Program (NRMP) This is a program organized by the AAMC where residency applicants indicate their preferences for programs, and programs indicate their preference for residents. These are matched via computer to determine what applicant will attend what training program. Once the match has occurred, the decision is binding for both sides.

Night Float System Here one or more residents are assigned to work all or part of the night in order to provide a rest period for the remaining trainees. This scheduling system was designed in response to the limitation on resident work hours. Among the benefits one can find a decrease in fatigue and an increase in morale; on the negative side, residents lose some continuity in providing patient care and may have less opportunity to attend lecture and conference programs while on night rotation.

Noon Lectures Most residencies provide an ongoing series of lectures which are typically scheduled in the middle of the day. Programs often require attendance at these and other educational offerings since they are considered to be important avenues for imparting knowledge.

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O

Objective Structured Clinical Exams (OSCEs) This is an Multiple Station Exercise/Exam MSE where trainees rotate through a series of stations. Some people reserve this term for teaching events where the time per station is very brief (e.g., 5 minutes) and the tasks are very focused (e.g., perform a neck exam). However, many educators use the term for all MSEs since it was its prototype in medical education.

On-Call Duties In order to provide coverage for patient care around the clock, medical trainees and practicing physicians have selected evenings, nights, and weekends when they have to be available to manage admissions, medical emergencies and generally provide continuity in diagnostic and treatment activities in in- and out-patient settings.

Organ-Based Teaching Here medical competence is gained by focusing on one organ system at a time. It is an approach that integrates different subjects (e.g., biochemistry, physiology, and anatomy) and has ultimately led to the now more common problem-based learning (PBL) approach.

Organ Review After an autopsy is performed, residents need to review the results with the pathologist. This can be a partial organ review, involving only the affected body parts of the diseased or it can be a full organ review where the entire autopsy is discussed.

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P

Patient Care Logs Many programs require that trainees keep a record of the types of patients they encounter and the types of interventions they perform. This helps establish the case mix individual trainees are exposed to.

Peer Assessment Many programs require trainees to assess each other since peer review is an important aspect of professional life.

Peer Teaching or Peer Tutoring Whether informally done or formally built into an instructional program, this is an important type of education. As learners become more advanced, peer teaching becomes a more prominent form of instruction. Since teaching provides an excellent opportunity for review and reflection, this is a forum where all participants benefit.

Performance This refers to taking specific actions. They are not just contingent on competence but may also depend on environmental factors (e.g., if resources are unavailable a procedure may not be employed even if indicated and if the practitioner is able to perform it).

Performance-Based Assessment Different from MCQs, trainees have to engage in some clinical activities which permits an assessment of their ability to perform clinical tasks, not just recite medical knowledge. Typical tools for this form of testing are checklists, observation logs, critical incident forms, and anecdotal reports.

Post Graduate Year (PGY) This nomenclature designates the years after graduating from medical school. Lately the abbreviation PGY has been replaced with R (for resident), thus one refers to someone who is in the second year of postgraduate training as an R-2 rather than a PGY-2.

Preceptor Faculty member who is usually in a non-academic practice setting.

Preceptorship Trainees spend time in a practice setting outside of the academic medical center, usually an ambulatory care setting. Such rotations provide an opportunity to get real-life experience, since most physicians work outside of hospitals.

Presentation From cases to scientific topics to literature reviews and research projects, presentations make up a large portion of medical education. The ability to organize and effectively communicate information, often with the help of audio-visual aids is an important skill all health care providers and teachers need to master.

Problem-Based Learning (PBL) This is an increasingly popular educational approach in undergraduate medical education where students learn with the help of patient cases and small groups. Furthermore, they have to engage in a significant amount of self-directed learning. Lectures are kept to a minimum. A variation of this approach is case-based or situation-based learngin which also organizes the educational material around case but has less emphasis on self-directed learning.

Program Director Person directly responsible for a residency training program. This can but need not be the chairperson or department director.

Program Evaluation It is vital for every educational endeavor to measure its effectiveness on a continuous basis. This can be done via evaluation questionnaires, exit interviews, or focus groups. However, it is also important to consider attendance, test, and work performance data. Programs consist of the learner, the teacher, the material that is to be studied and the overall environment (e.g., physical, social, and political climate) in which the educational process occurs. If a program is not effective one must reserve judgment until the contribution of all of these factors has been thoroughly investigated.

Psychosocial Rounds Some institutions hold special rounds which include medical and mental health personnel to jointly address patients’ psychosocial and psychiatric needs (e.g., depression, compliance, family matters).

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Q

Questioning This is an important teaching technique because it promotes reflection and thinking. If questioning is done in a malicious way, in an attempt to put somebody down, it is also referred to as "pimping."

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R

Rating Scales/Forms Instruments where raters indicate their evaluations on a scale or provide a numerical value to the performance. The resulting data is continuous.

Recertification Some specialties now require that practitioners demonstrate their competence at various times throughout their careers.

Research Requirements Since scientific inquiry is such an important part of medicine, many programs or accreditation agencies require trainees to work on a scientific project in order to gain theoretical as well as practical competencies.

Residency Review Committee (RRC) This is a professional body that prescribes the requirements for accreditation (e.g., educational experiences that training programs need to offer, performance standards of individuals who graduate). http://www.acgme.org or http://www.acgme.org/acgme/polprod/org.htm

Role Model This is someone who provides an example. There are good role models who reinforce positive professional behavior and bad ones who lead trainees on the wrong track. The person who is providing the example may or may not have a desire to educate. Different from a mentor, a mutually beneficial relationship is not necessary.

Role Play A method, popular with some, to practice clinical skills. Learners take on different roles for playing through a clinical scenario. Usually there is an opportunity to call "time out" which stops the role play for reflection and discussion. The latter is really vital for realizing the benefits of this educational technique.

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S

Selective A course or rotation which is chosen from a list of options. Different from an elective, the choice here is not limitless.

Self-Assessment This is an important part of self-directed learning and life-long learning since it creates a need for improvement or justifies confidence in one’s competence.

Self-Directed Learning A form of education that involves the individual learner’s initiative to identify and act on his/her learning needs (with or without assistance).

Simulated Patients These are individuals who are not sick but take on a patient’s history and role for the sake of medical education. Sometimes programs use actors to accomplish this goal. However, simulated patients can also be individuals from the community or other health care providers.

Small Group Teaching This is becoming a very popular form of instruction since it permits the working through of learning material, not just in terms of knowledge, but also in terms of attitudes. Within a small group participants are bound to share and exchange their opinions and their feelings. Usually such sessions are structured with the help of specific exercises (e.g., patient interviews) or discussion topics.

Specialty Board A professional organization that defines and tests the competencies that make up its specialty (e.g., American Board of Internal Medicine). The American Board of Medical Specialties (ABMS) http://www.abms.org/ is the umbrella organization that helps coordinate the activities of its 24 member boards.

Standardized Patients These are individuals who have been trained to reliably reproduce the history and/or physical findings of a particular case. They can be real patients who have been "standardized" for the purpose of education or they can be simulated patients.

Sub-Internship This is a rotation in the fourth year of medical school that serves as an introduction to the first post-graduate year.

Subject-Based Teaching Each subject area is addressed separately. In the past this model has been very prominent in basic science education. Now, however, it is gradually being replaced with problem-based learning where knowledge and skills unfold as part of a case that illustrates real life situations.

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T

Teachable Moment These are opportunities when learners are highly receptive to new or corrective information.

Teacher-Centered Education In such an educational system the teacher dictates what is being taught and how it is to be learned. It is the opposite from a learner-centered education.

Teacher Rounds These rounds are typically run by a faculty attending. In contrast to to work rounds not all cases on a service are discussed

Teaching Style Similar to the different learning styles, there are different approaches to teaching. One classification offers the following style categories: assertive (e.g., gives direction and information), suggestive (e.g., suggests with questions and statements), collaborative (e.g., elicits and explores learner’s ideas) and facilitative (e.g., elicits and accepts learner’s feelings).

Test Taking Strategies In addition to knowing the material that is being examined, trainees can benefit from understanding how tests are developed and what glitches they may have that can help answer the questions (e.g., response options that include absolute terms such as "always" or "never" are seldom the correct ones).

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U

Undergraduate Medical Education (UGME) In US medical education this term refers to medical school. More generally, however, undergraduate refers to college education which results in a Bachelor's degree. It is the training most students have before entering medical school.

Urology Teaching Associates (UTAs) These are men (usually urologist-trained, non-health care providers) who teach clinical skills related to urologic and rectal examinations. Currently they are still less frequently used than gynecological teaching associates (GTAs), their female counterparts.

US Medical Licensing Exam (USLME) This series of three exams represent a three step approach to medical licensure. Step 1 assesses the ability to apply important concepts of the sciences basic to the practice of medicine. Step 2 focuses on the application of medical knowledge and understanding of clinical science. Step 3 evaluates competence for the unsupervised practice of mediceine. http://www.usmle.org/home.htm The exams are developed and administered by the National Board of Medical Examiners (NBME).

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V

Video Recall A popular method to learn communication skills and enhance humanistic values. Encounters with patients are video taped and subsequently reviewed and measured against predetermined criteria (e.g., checklists).

W  X  Y  Z

Work Rounds These rounds are devoted to patient management. Often they are run by a chief resident or attending. Although they do include teaching and learning, they can be juxtaposed to teaching rounds where patient management is somewhat secondary.

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