Seeing with greater clarity: Stakeholder ratings of blind spots in U.S. medical education

Abstract

Background

Although medical education is affected by numerous blind spots, there is limited evidence to determine which blind spots to prioritize.

Methods

In summer 2022, we surveyed stakeholders from U.S. medical education who had identified 9 domains and 72 subdomains of blind spots. Respondents used 4-point Likert-type scales to rate the extent and magnitude of problems caused for each domain and subdomain. Respondents also provided comments for which we did content analysis.

Results

A total of 23/27 (85%) stakeholders responded. The majority of respondents rated each blind spot domain as moderate-major in both extent and problems they cause. Patient perspectives and voices that are not heard, valued, or understood was the domain with the most stakeholders rating extent (n = 20, 87%) and problems caused (n = 23, 100%) as moderate or major. Admitting and selecting learners likely to practice in settings of highest need was the subdomain with the most stakeholders rating extent (n = 21, 91%) and problems caused (n = 22, 96%) as moderate or major. Respondents’ comments suggested blind spots may depend on context and persist because of hierarchies and tradition.

Discussion

We found blind spots differed in relative importance. These data may inform further research and direct interventions to improve medical education.

Keywords:

• Biases
• blind spots
• medical education reform
• innovation

Acknowledgments

Authors would like to thank the survey respondents for contributing to this study.

Disclosure statement

Dr. Wright is the Anne Gaines and G. Thomas Miller Professor of Medicine supported through Hopkins’ Center for Innovative Medicine, and he is the Mary & David Gallo Scholar for Hopkins’ Initiative to Humanize Medicine.

The authors report there are no competing interests to declare.

Additional information

Funding

This work was developed with support from the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education grant for Medical Education Transformation Collaboratories.

Notes on contributors

Sean Tackett

Sean Tackett, MD, MPH, is Associate Professor of Medicine and International Medical Education Director for Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.

Yvonne Steinert

Yvonne Steinert, PhD, is a professor of Family Medicine and Health Sciences Education, former director of the Institute of Health Sciences Education, and the Richard and Sylvia Cruess Chair in Medical Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada. Email: [email protected]

Susan Mirabal

Susan Mirabal, MD, MS, is assistant professor of medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. Email: [email protected]

Darcy A. Reed

Darcy A. Reed, MD, MPH, is a consultant, Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, and professor of medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota. Email: [email protected]

Scott M. Wright

Scott M. Wright, MD, is professor of medicine, Johns Hopkins University School of Medicine, and chief, General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. Email: [email protected]