Fifty Years of Findings from the Jefferson Longitudinal Study of Medical Education

This book assembles research findings accumulated over the span of half a century from the Jefferson Longitudinal Study (JLS). This study, initiated in 1970, is the most comprehensive, extensive, and uninterrupted longitudinal study of medical students and graduates maintained in a single medical school. The study was based on the conviction that medical schools have a social responsibility and ethical obligation to monitor the quality of their educational programs, to assess their educational outcomes, and to ensure that their educational goals have been achieved for the purposes of public safety. The JLS has resulted in a large number of publications in professional peer-reviewed journals and presentations in national and international meetings. Some medical schools have expressed interest in learning more about the JLS, requesting copies of the instruments we used in the study, information about how to set up a longitudinal study of medical education, and other needed resources. In response to a request from Academic Medicine [2011, 86(3), p. 404], we prepared and published in that journal a schematic snapshot of the JLS for those interested in a model for the development of a longitudinal study of medical students and graduates. The JLS is well-known to the medical education research communities. A recent Google search using keywords “Jefferson Longitudinal Study” resulted in 1,550,000 hits, an indication of its broad popularity among researchers. At the present time, the JLS database contains academic information, assessments, and educational and career outcomes for 13,343 medical students and graduates of Sidney Kimmel (formerly Jefferson) Medical College of Thomas Jefferson University. There are presently 502 variables in the JLS analytic database. This book presents a collection of 207 abstracts of major publications from peerreviewed journals, books, and book chapters in which data and information from the JLS were used. In this book, we classified the abstracts, based on their primary contents, into the following categories: Admissions of the Applicants to Medical School (e.g., standardized tests, academic preparation, other admission variables). Demographic Composition (e.g., gender, age, race/ethnicity). Performance Evaluations in Medical School (e.g., preclinical and clinical phases). Postgraduate and Career (e.g., assessment of clinical competence in residency training, career choice, specialization, professional activities). Psychosocial Attributes (e.g., personal qualities, indicators of physical and mental well-being). Professionalism (e.g., assessment of elements of professionalism in medicine, such as clinical empathy, attitudes toward interprofesssional collaboration, and orientation. Foreword Preface The Jefferson Longitudinal Study of Medical Education: 50 Years of Research and Service A Historical Perspective Goals of the Jefferson Longitudinal Study The Scope of the Jefferson Longitudinal Study Database Current Faculty and Staff of the Center Involved in the Jefferson Longitudinal Study Grouping the Jefferson Longitudinal Study Publications in Different Chapters Productivity of the Jefferson Longitudinal Study Final Remarks References Appendix A Appendix B Experts’ Remarks About the Book A Brief Description of the Book’s Cover Design and Its Artist Acknowledgments Contents About the Authors Chapter 1: Admissions 1.1 Standardized Tests 1.1.1 The Predictive Validity of Three Versions of the MCAT in Relation to Performance in Medical School, Residency, and Licensing Examinations: A Longitudinal Study of 36 Classes of Jefferson Medical College 1.1.2 Science, Verbal, or Quantitative Skills: Which Is the Most Important Predictor of Physician Competence? 1.1.3 A Validity Study of the Writing Sample Section of the Medical College Admission Test 1.1.4 Predictive Validity of the MCAT for Students with Two Sets of Scores 1.1.5 Delays in Completing Medical School: Predictors and Outcomes 1.1.6 The Overall Validity of the New MCAT 1.1.7 Long-Range Predictive and Differential Validities of the Scholastic Aptitude Test in Medical School 1.1.8 Predictive Validity of the MCAT as a Function of Undergraduate Institutions 1.1.9 The Relationship Between MCAT Science Subtest Scores and Performance in Medical School: The Impact of the Undergraduate Institution 1.2 Academic Preparation 1.2.1 Reexamination of Relationships Between Students’ Undergraduate Majors, Medical School Performances, and Career Plans at Jefferson Medical College 1.2.2 The Jefferson-Penn State BS-MD Program: A 26-Year Experience 1.2.3 Evaluation of an Enrichment Program for Entering Medical Students Predicted to Be in Need of Academic Preparation 1.2.4 Preparing for the MD: How Long, at What Cost, and with What Outcomes? 1.2.5 Premedical Training, Personal Characteristics, and Performance in Medical School 1.2.6 Assessments of Empathy in Medical School Admissions: What Additional Evidence Is Needed? 1.2.7 Postbaccalaureate Preparation and Performance in Medical School 1.2.8 A Program to Recruit and Educate Medical Students to Practice Family Medicine in Underserved Areas 1.2.9 Evaluation of a Selective Medical School Admission Policy to Increase the Number of Family Physicians in Rural and Underserved Areas 1.2.10 Demographic, Educational, and Economic Factors Related to Recruitment and Retention of Physicians in Rural Pennsylvania 1.2.11 Using Postgraduate Clinical Performance to Monitor Change in the Medical School 1.2.12 Baccalaureate Preparation for Medical School: Does Type of Degree Make a Difference? 1.2.13 Levels of Recommendation for Students and Academic Performance in Medical School Chapter 2: Demographics 2.1 Standardized Patient Assessment of Medical Student Empathy: Ethnicity and Gender Effects in a Multi-institutional Study 2.2 Gender Segregation by Specialty During Medical School 2.3 Comparing the Accuracies of Entire-Group and Subgroup Model to Predict NBME I Scores for Medical School Applicants 2.4 African-American and White Physicians: A Comparison of Satisfaction with Medical Education, Professional Careers, and Research Activities 2.5 Performance and Career Expectations of Women Medical Students: A Comparison with Men 2.6 Gender Comparisons of Medical Students’ Psychosocial Profiles 2.7 Gender Comparisons of Income Expectations in the USA at the Beginning of Medical School During the Past 28 Years 2.8 Salary Inequities and Healthcare Costs 2.9 Gender Comparisons of Young Physicians’ Perceptions of Their Medical Education, Professional Life, and Practice: A Follow-Up Study of Jefferson Medical College Graduates 2.10 Gender Comparisons Prior to, During, and After Medical School Using Two Decades of Longitudinal Data at Jefferson Medical College 2.11 Change of Interest in Surgery During Medical School: A Comparison of Men and Women 2.12 Prediction of Students’ Performance on Licensing Examinations Using Age, Race, Sex, Undergraduate GPAs, and MCAT Scores 2.13 A National Study of Factors Influencing Primary Care Career Choices Among Underrepresented Minority, White, and Asian-American Physicians 2.14 Performance on the NBME Part I Examination 2.15 Board Certification: Associations with Physicians’ Demographics and Performances During Medical School and Residency 2.16 Longitudinal Comparison of the Academic Performances of Asian-American and White Medical Students Chapter 3: Medical School Evaluations 3.1 Preclinical 3.1.1 An Empirical Study of the Predictive Validity of Number Grades in Medical School Using Three Decades of Longitudinal Data: Implications for a Grading System 3.1.2 The Fate of Medical Students with Different Levels of Knowledge: Are the Basic Medical Sciences Relevant to Physician Competence? 3.1.3 Sooner or Later? USMLE Step 1 Performance and Test Administration Date at the End of the Second Year 3.1.4 Using Ratings of Resident Competence to Evaluate NBME Examination Passing Standards 3.2 Clinical 3.2.1 Students’ Ratings of Otolaryngology Clerkship Activities: The Role of Residents 3.2.2 A Comparison of Medical Students’ Self-Reported Empathy with Simulated Patients’ Assessments of the Students’ Empathy 3.2.3 The Relationship Between Performance on a Medical School’s Clinical Skills Assessment and USMLE Step 2 CS 3.2.4 Validity of Faculty Ratings of Students’ Clinical Competence in Core Clerkships in Relation to Scores on Licensing Examinations and Supervisors’ Ratings in Residency 3.2.5 Subtest Scores of a Comprehensive Examination of Medical Knowledge as a Function of Retention Interval 3.2.6 Evaluation of the Validity of Medical Students’ Self-Assessments of Proficiency in Clinical Simulations 3.2.7 Students’ Gender and Examination of Patients in a Third-Year Family Medicine Clerkship 3.2.8 Evaluations of Medical Students’ Clinical Experiences in a Family Medicine Clerkship: Differences in Patient Encounters by Disease Severity in Different Clerkship Sites 3.2.9 USMLE Step 2 Performance and Test Administration Date in the Fourth Year of Medical School 3.2.10 A Comparison of the Modified Essay Question and Multiple-Choice Question Formats: Their Relationships to Clinical Performance 3.2.11 Documenting and Comparing Medical Students’ Clinical Experiences 3.2.12 Student Ratings of Clerkship Activities as a Basis for Curriculum Modification: A 4-Year Comparison of Six Departments 3.2.13 Identifying Students at Risk of Failing the USMLE Step 2 Clinical Skills Examination 3.2.14 Evaluation of the Surgical Clerkship Experience in Affiliated Hospitals: Performance on Objective Examinations 3.2.15 Do Global Rating Forms Enable Program Directors to Assess the ACGME Competencies? 3.2.16 A Preliminary Study of the Validity of Scores and Pass/Fail Standards for USMLE Steps 1 and 2 3.2.17 Evaluation of the Congruence Between Students’ Postencounter Notes and Standardized Patients’ Checklists in a Clinical Skills Examination 3.2.18 Attendings’ and Residents’ Teaching Role and Students’ Overall Rating of Clinical Clerkships 3.2.19 Influence of Previous Clerkship Experiences on Students’ Satisfaction with Their Current Clerkship 3.2.20 A Correlation Study of Students’ Perception of Their Active Role as Related to Their Clerkship Experiences Chapter 4: Postgraduate and Career 4.1 Clinical Competence 4.1.1 Class Ranking Models for Deans’ Letters and Their Psychometric Evaluation 4.1.2 Further Psychometric Evaluations of a Class Ranking Model as a Predictor of Graduates’ Clinical Competence in the First Year of Residency 4.1.3 Relationship Between Performance in Medical School and Postgraduate Competence 4.1.4 A Case of Mistaken Identity: Signal and Noise in Connecting Performance Assessments Before and After Graduation from Medical School 4.1.5 What Have We Learned and Where Do We Go from Here? 4.1.6 Assessment Measures in Medical School, Residency, and Practice: The Connections 4.1.7 The Role of Resident Performance Evaluation in Board Certification 4.1.8 Measuring the Contribution of Medical Education to Patient Care: A Review 4.1.9 Validity and Importance of Low Ratings Given to Medical School Graduates in Noncognitive Areas 4.1.10 Cognitive and Noncognitive Factors in Predicting the Clinical Performance of Medical School Graduates 4.1.11 Is the Glass Half Full or Half Empty? A Reexamination of the Associations Between Assessment Measures During Medical School and Clinical Competence After Graduation 4.1.12 Components of Postgraduate Competence: Analyses of 30 Years of Longitudinal Data 4.1.13 Components of Clinical Competence Ratings of Physicians: An Empirical Approach 4.1.14 Conceptualization and Measurement of Clinical Competence of Residents: A Brief Rating Form and Its Psychometric Properties 4.1.15 Relationships Between Performance in Medical School and First Postgraduate Year 4.1.16 Affirmative Action and Special Consideration Admissions to Medical Education 4.1.17 A Validity Study of Part III of the National Board Examination 4.2 Specialization and Professional Activities 4.2.1 Correlates of Young Physicians’ Support for Unionization to Maintain Professional Influence 4.2.2 Stability and Change of Interest in Obstetrics-Gynecology Among Medical Students: 18 Years of Longitudinal Data 4.2.3 Medical Education and Health Services Research: The Linkage 4.2.4 The Impact of Early Career Specialization on Licensing Requirements and Related Educational Implications 4.2.5 The Impact of Early Specialization on the Clinical Competence of Residents 4.2.6 Should Half of All Medical School Graduates Enter Primary Care? Perceptions of Faculty Members at Jefferson Medical College 4.2.7 Family Medicine and Primary Care: Trends and Student Characteristics 4.2.8 Primary Care and Non-primary Care Physicians: A Longitudinal Study of Their Similarities, Differences, and Correlates Before, During, and After Medical School 4.2.9 Differences in Professional Activities, Perceptions of Professional Problems, and Practice Patterns Between Men and Women Graduates of Jefferson Medical College 4.2.10 A Program to Increase the Number of Family Physicians in Rural and Underserved Areas: Impact After 22 Years 4.2.11 Critical Factors for Designing Programs to Increase the Supply and Retention of Rural Primary Care Physicians 4.2.12 Who Is a Generalist? An Analysis of Whether Physicians Trained as Generalists Practice as Generalists 4.2.13 A Statewide System to Track Medical Students’ Careers: The Pennsylvania Model 4.2.14 Generalist Career Plans: Tracking Medical School Seniors Through Residency 4.2.15 Choice of First-Year Residency Position and Long-Term Generalist Career Choices 4.2.16 Assessment of Physicians’ Interest in Primary Care Training/Retraining 4.2.17 Changing Specialties: Do Anesthesiologists Differ from Other Physicians? 4.2.18 Migration of Physicians to and from Anesthesiology 4.2.19 Academic Performance of Psychiatrists Compared to Other Specialists Before, During, and After Medical School 4.2.20 Board Certification in Obstetrics and Gynecology: Associations with Physicians’ Demographics and Performances During Medical School 4.2.21 Performance on the NBME Part II Examination and Career Choice 4.2.22 Medical Students Who Enter General Surgery Residency Programs: A Follow-Up Between 1972 and 1986 4.2.23 Perceptions of Practice Problems Encountered by Family Physicians, Pediatricians, and Orthopedic Surgeons 4.2.24 Primary Care and Non-primary Care Physicians’ Concerns in Practice and Perceptions of Medical School Curriculum 4.2.25 Factors Associated with Changing Levels of Interest in Primary Care During Medical School 4.2.26 Emergency Medicine Career Change: Associations with Performances in Medical School and in the First Postgraduate Year and with Indebtedness 4.2.27 The Changing Healthcare System: A Research Agenda for Medical Education 4.2.28 A National Study of the Factors Influencing Men and Women Physicians’ Choices of Primary Care Specialties 4.2.29 A Comparison of Jefferson Medical College Graduates Who Chose Emergency Medicine with Those Who Chose Other Specialties 4.2.30 Factors Influencing Physicians’ Decisions to Remain in Emergency Medicine 4.2.31 Comparing the Academic Performances of Geriatricians and Other Family Physicians and Internists 4.2.32 Comparisons Among Three Types of Generalist Physicians: Personal Characteristics, Medical School Experiences, Financial Aid, and Other Factors Influencing Career Choice 4.2.33 Changing Interest in Family Medicine and Students’ Academic Performance 4.2.34 Physicians’ Intention to Stay in or Leave Primary Care Specialties and Variables Associated with Such Intention 4.2.35 Factors Influencing Primary Care Physicians’ Choice to Practice in Medically Underserved Areas 4.2.36 Factors Influencing Physicians’ Choices to Practice in Inner-City or Rural Areas Chapter 5: Psychosocial Attributes 5.1 Effects of a Brief Curricular Intervention on Medical Students’ Attitudes Toward People with Disabilities in Healthcare Settings 5.2 Psychostimulant Drug Abuse and Personality Factors in Medical Students 5.3 Volunteer Bias in Medical Education Research: An Empirical Study of Over Three Decades of Longitudinal Data 5.4 Economic Diversity in Medical Education: The Relationship Between Students’ Family Income and Academic Performance, Career Choice, and Student Debt 5.5 Characteristics of Medical Students Completing an Honors Program in Pathology 5.6 Biotechnology and Ethics in Medical Education of the New Millennium: Physician Roles and Responsibilities 5.7 Medical Students’ Opinions Concerning the Healthcare System 5.8 Medical Students’ Opinions on Economic Aspects of the Healthcare System 5.9 Professional Attitudes and Interpersonal Relationships of Physicians: Are They a Problem? 5.10 Perception of Maternal Availability in Childhood and Selected Psychosocial Characteristics in Adulthood 5.11 Satisfaction with Early Relationships with Parents and Psychosocial Attributes in Adulthood: Which Parent Contributes More? 5.12 Medical Students’ Personal Values and Their Career Choices a Quarter-Century Later 5.13 Students’ Personality and Ratings of Clinical Competence in Medical School Clerkships: A Longitudinal Study 5.14 Personality Assessments and Outcomes in Medical Education and the Practice of Medicine: AMEE Guide No. 79 5.15 Associations Between Selected Psychosocial Attributes and Ratings of Physician Competence 5.16 Physicians’ Perceptions of the Changing Healthcare System: Comparisons by Gender and Specialties 5.17 Medical Student’s Cognitive Appraisal of Stressful Life Events as Related to Personality, Physical Well-Being, and Academic Performance: A Longitudinal Study 5.18 Career Satisfaction and Professional Accomplishments 5.19 Psychosocial Characteristics of Female Students in the Allied Health and Medical Colleges: Psychometrics of the Measures and Personality Profiles 5.20 Empathy Scores in Medical School and Ratings of Empathic Behavior in Residency Training 3 Years Later 5.21 Can Empathy, Other Personality Attributes, and Level of Positive Social Influence in Medical School Identify Potential Leaders in Medicine? 5.22 A Comparison of the Personality Profiles of Internal Medicine Residents, Physician Role Models, and the General Population 5.23 Students’ Psychosocial Characteristics as Predictors of Academic Performance in Medical School 5.24 Empathic and Sympathetic Orientations Toward Patient Care: Conceptualization, Measurement, and Psychometrics 5.25 Attitudes Toward Managed Care: A Brief Instrument to Measure Attitudes of Medical Students Toward Change in the Healthcare System 5.26 Perceptions of Medical School Seniors of the Current Changes in the US Healthcare System 5.27 Underlying Construct of Empathy, Optimism, and Burnout in Medical Students 5.28 The Devil Is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School 5.29 Effects of Academic and Psychosocial Predictors of Performance in Medical School on Coefficients of Determination 5.30 Personality and Specialty Interest in Medical Students 5.31 The Relationship Between Grit and Selected Personality Measures in Medical Students 5.32 Predicting Peer Nominations: A Social Network Approach 5.33 Identifying Potential Engaging Leaders Within Medical Education: The Role of Positive Influence on Peers 5.34 How Much Do Medical Students Know About Physician Income? 5.35 Correlates of Physicians’ Endorsement of the Legalization of Physician-Assisted Suicide 5.36 Peer Nominations as Related to Academic Attainment, Empathy, Personality, and Specialty Interest 5.37 Intra- and Intercultural Comparisons of Personality Profiles of Medical Students in Argentina and the USA 5.38 Persistent Impostor Phenomenon is Associated with Distress in Medical Students 5.39 Income Expectations of First-Year Students at Jefferson Medical College as a Predictor of Family Practice Specialty Choice 5.40 Mindfulness-Based Stress Reduction Lowers Psychological Distress in Medical Students 5.41 The Income Expectations of Medical Students in the Time Period 1970–1980 5.42 Students’ Certainty During Course Test-Taking and Performance on Clerkships and Board Exams Chapter 6: Professionalism 6.1 Medical Students’ Self-Reported Empathy and Simulated Patients’ Assessments of Student Empathy: An Analysis by Gender and Ethnicity 6.2 Comparisons of Nurses and Physicians on an Operational Measure of Empathy 6.3 Change in Empathy in Medical School 6.4 Enhancing and Sustaining Empathy in Medical Students 6.5 Patient Perceptions of Clinician’s Empathy: Measurement and Psychometrics 6.6 Empathy of Medical Students and Compassionate Care for Dying Patients: An Assessment of “No One Dies Alone” Program 6.7 Empathy: An NP/MD Comparison 6.8 Attitudes Toward Physician-Nurse Alliance: Comparisons of Medical and Nursing Students 6.9 Psychometric Properties of an Attitude Scale Measuring Physician-Nurse Collaboration 6.10 An Instrument for Measuring Pharmacist and Physician Attitudes Toward Collaboration: Preliminary Psychometric Data 6.11 Eleven Years of Data on the Jefferson Scale of Empathy-Medical Student Version (JSE-S): Proxy Norm Data and Tentative Cutoff Scores 6.12 Letter to the Editor: In Reply to Quinn and Zelenski 6.13 What Matters More About the Interpersonal Reactivity Index and the Jefferson Scale of Empathy? Their Underlying Constructs or Their Relationships with Pertinent Measures of Clinical Competence and Patient Outcomes 6.14 Physician Empathy in Medical Education and Practice: Experience with the Jefferson Scale of Physician Empathy 6.15 Empathy in Medical Students as Related to Academic Performance, Clinical Competence, and Gender 6.16 Comparisons of American, Israeli, Italian, and Mexican Physicians and Nurses on the Total and Factor Scores of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaborative Relationships 6.17 The Jefferson Scale of Physician Empathy: Further Psychometric Data and Differences by Gender and Specialty at Item Level 6.18 Physician Empathy: Definition, Components, Measurement, and Relationship to Gender and Specialty 6.19 Rebuttals to Critics of Studies of the Decline of Empathy 6.20 Developing an Instrument to Measure Attitudes Toward Nurses: Preliminary Psychometric Findings 6.21 Exploration and Confirmation of the Latent Variable Structure of the Jefferson Scale of Empathy 6.22 The Jefferson Scale of Empathy (JSE): An Update 6.23 Editorial: Empathy and Health Care Quality 6.24 Empathy in Medical Education and Patient Care 6.25 Relationships Between Scores of the Jefferson Scale of Physician Empathy (JSPE) and the Interpersonal Reactivity Index (IRI) 6.26 The Jefferson Scale of Physician Empathy: Development and Preliminary Psychometric Data 6.27 An Empirical Study of Decline in Empathy in Medical School 6.28 Attitudes Toward Physician-Nurse Collaboration: A Cross-cultural Study of Male and Female Physicians and Nurses in the USA and Mexico 6.29 An Operational Measure of Physician Lifelong Learning: Its Development, Components, and Preliminary Psychometric Data 6.30 Psychometrics of the Scale of Attitudes Toward Physician-Pharmacist Collaboration: A Study with Medical Students 6.31 Measurement and Correlates of Physicians’ Lifelong Learning 6.32 Physician Lifelong Learning: Conceptualization, Measurement, and Correlates in Full-Time Clinicians and Academic Clinicians 6.33 Assessing Physicians’ Orientation Toward Lifelong Learning 6.34 The Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JEFFSATIC): Development and Multi-institution Psychometric Data 6.35 Empathy in Medical Students as Related to Specialty Interest, Personality, and Perceptions of Mother and Father 6.36 Enhancing Student Empathetic Engagement, History-Taking, and Communication Skills During Electronic Medical Record Use in Patient Care 6.37 Assessment of Empathy in Different Years of Internal Medicine Training 6.38 Evaluating the Relationship Between Participation in Student-Run Free Clinics and Changes in Empathy in Medical Students 6.39 Measuring Professionalism: A Review of Studies with Instruments Reported in the Literature Between 1982 and 2002 6.40 Linguistic Analysis of Empathy in Medical School Admission Essays Chapter 7: Miscellaneous 7.1 Medical Education, Social Accountability, and Patient Outcomes 7.2 AM Last Page: The Jefferson Longitudinal Study of Medical Education 7.3 Viewpoint: Guiding Medical Students Toward Empathetic Patient Care 7.4 Jefferson Medical College Longitudinal Study: A Prototype for Evaluation of Changes 7.5 Creating a Longitudinal Database in Medical Education: Perspectives from the Pioneers 7.6 Disciplinary Action by Medical Boards and Prior Behavior in Medical School 7.7 The Jefferson Longitudinal Study of Medical Education: Five Decades of Outcome Assessment Bibliography Name Index Subject Index This book assembles research findings accumulated over the span of half a century from the Jefferson Longitudinal Study (JLS). This study, initiated in 1970, is the most comprehensive, extensive, and uninterrupted longitudinal study of medical students and graduates maintained in a single medical school. The study was based on the conviction that medical schools have a social responsibility and ethical obligation to monitor the quality of their educational programs, to assess their educational outcomes, and to ensure that their educational goals have been achieved for the purposes of public safety. The JLS has resulted in a large number of publications in professional peer-reviewed journals and presentations in national and international meetings. A recent Google search using keywords "Jefferson Longitudinal Study" resulted in 2,140,000 hits (as of September 2021), an indication of its broad popularity among researchers. Some medical schools have expressed interest in learning more about the JLS, requesting copies of the instruments used in the study, information about how to set up a longitudinal study of medical education, and other needed resources. A schematic snapshot of the JLS was published in Academic Medicine [2011, 84(3), p. 404] for those interested in a heuristic model for the development of a longitudinal study of medical students and graduates. Potential readers of the book include medical education researchers, faculty of medical schools and of other health professions academic centers, postgraduate medical education institutions (e.g., residency training programs, training hospitals and institutions), medical students, and readers of medical education journals (e.g., Academic Medicine, Advances in Health Sciences Education, Evaluation and the Health Professions, International Journal of Medical Education, The Journal of the American Medical Association, Medical Education, Medical Teacher, The New England Journal of Medicine, Teaching and Learning in Medicine, in which findings from the JLS have been published). .