A change in grading from letter grades to pass/fail in the first two years of medical school conferred distinct advantages to medical students, in terms of improved psychological well-being and satisfaction, without any reduction in performance in courses or clerkships, USMLE test scores, success in residency placement, or level of attendance.

Students' reluctance to engage in class activities is not surprising if classroom exercises are passive and not consistently well designed or executed as active learning exercises that students perceive as enhancing their learning through collaboration. Students' comments also suggest that their reluctance to participate regularly in class may be because they have not yet achieved the developmental level compatible with adult and active learning, on which the curriculum is based. Challenges include helping students better understand the nature of deep learning and their own developmental progress as learners, and providing robust faculty development to ensure the consistent deployment of higher-order learning activities linked with higher-order assessments.

Our objective was to determine the ability of the internal medicine In-Training Examination (ITE) to predict pass or fail outcomes on the American Board of Internal Medicine (ABIM) certifying examination and to develop an externally validated predictive model and a simple equation that can be used by residency directors to provide probability feedback for their residency programs. We collected a study sample of 155 internal medicine residents from the three Virginia internal medicine programs and a validation sample of 64 internal medicine residents from a residency program outside Virginia. Scores from both samples were collected across three class cohorts. The Kolmogorov-Smirnov z test indicated no statistically significant difference between the distribution of scores for the two samples ( z ‫؍‬ R esidents in internal medicine must acquire competency in many content areas during their postgraduate training, including medical knowledge, clinical skills, clinical judgment, interpersonal skills, attitudes, ethics, and humanistic qualities as they apply across a vast range of content areas. 1 To assist both residents and program directors, the American College of Physicians, the Association of Professors of Medicine, and the Association of Program Directors in Internal Medicine developed the first national In-Training Examination (ITE) in internal medicine in 1988. This examination was developed to serve as an assessment tool, primarily for residents at the midpoint of training during the second postgraduate year (PGY2). The ITE enables residents and program directors to receive feedback and identify potential deficiencies before administration of the American Board of Internal Medicine (ABIM) certifying examination.The ABIM certifying examination has been the source of a variety of studies over the last decade. Most of these studies dealt with the ability of the ABIM certifying examination to measure the construct of medical knowledge needed by an internal medicine physician. 1-3 More recently, two studies have dealt specifically with the ability of the ITE to predict outcome on the ABIM certifying examination. 4,5 Both studies demonstrated a significant correlation between the ITE and the ABIM certifying examination scores. However, neither study externally validated its results. Therefore, the purpose of this study was threefold: replicate the previous studies through an alternative mode of analysis (logistic model), develop a predictive model that is validated by external data, and develop a simple equation that can be utilized by residency directors in a spreadsheet format to provide quick and easy ABIM pass/fail probability feedback. METHODSInternal medicine residency directors from the three Virginia medical schools were asked to provide ITE scores obtained during residents ' PGY2 year in 1992' PGY2 year in , 1993' PGY2 year in , and 1994, along with the ABIM pass/fail results for the corresponding classes in 1993, 1994, and 1995 who were taking the examination for the first time. The ITE scores reflect...

Navigating the biomedical, emotional, and logistical complexity of end-of-life (EOL) care requires seamless interprofessional teamwork. Unfortunately, EOL care, interprofessional collaboration, and the role of support services such as hospice are not adequately emphasized in nursing and medical curricula. This article describes a student-run program, entitled the "HeArt of Medicine", which was designed to foster a reflective and collaborative approach to EOL care. The program consists of three workshops with a novel blend of art, science, and practical information, highlighting the need for interprofessional teamwork. Participants were surveyed before and after the workshops on their attitudes toward EOL care. Composite participant scores after workshops demonstrated increased comfort with and knowledge of EOL care topics (p = 0.001). The results show that this program has had a positive impact on participants' knowledge, comfort, and collaboration in EOL settings.