Medical education in the U.S. is at a crossroads. There’s an urgent need to evolve to meet the changing needs of patients and communities, yet building and disseminating innovative curricula, assessments and evaluation techniques is often limited by lack of funding.
A report published in Academic Medicine, “Supporting Medical Education Innovation: Evaluation of a Grants Initiative,” looks at an AMA grant program to help stimulate research, implement innovations and disseminate effective approaches in medical education to prepare future physicians to succeed in the rapidly evolving U.S. health care system.
One of its biggest takeaways: Not everyone succeeded. And that’s just how it should be.
Big focus on systems thinking
The AMA Innovation Grant Program disbursed more than $600,000 in $10,000 and $30,000 grants to 28 medical schools in 2018 and 2019. Many of them piloted innovations related to health systems science—an understanding of how care is delivered, how health professionals work together to deliver that care and how the health system can improve patient care and health care delivery.
“The grant program has advanced health systems science through projects that developed teaching vignettes, student assessments, practical population health teaching modules, patient safety teaching toolkits and concept mapping for systems thinking,” wrote the authors, who included faculty and staff at Rush University System for Health Medical College, University of Cincinnati College of Medicine, and the University of Michigan Medical School, as well as staff at the AMA.
“While it can be difficult to find the time, leadership capital and resources to innovate in medical education, funding from innovation grants supported 17 programs in developing educational innovations in health systems science,” they wrote.
Other projects focused on coaching, the learning environment, well-being, competency-based medical education and emerging technology.
"Some projects had local impact, such as producing a training course about mistreatment attended by over 30 faculty and residents, creating health systems science toolkits and delivering curricula,” the authors wrote. “Others had broader impact; for example, It Takes Two: A Guide to Being a Good Coachee is a coaching handbook for learners that is freely available on the AMA website and has been downloaded more than 1,000 times. A training program on mistreatment of students posted 14 videos on YouTube, which have garnered over 2,200 views.”
Download It Takes Two: A Guide to Being a Good Coachee now.
No fear of failure
The measures of success included completion of the grant project, achievement of its objectives, development of a transferable educational product that could be shared, and dissemination of the innovations. Across the two years, 15 projects created educational products that could be shared, such as new assessment tools, curricula and teaching modules. In addition, five projects resulted in published articles and 15 led to presentations at national conferences.
Not all the projects met every one of their objectives—in fact, some 30% of projects did not—and that was to be expected. It was even desirable.
“The innovation space is a failure space,” said Kevin Heckman, MBA, director of product development in medical education at the AMA and co-author of the report. “Not everything you do is going to work. In fact, if everything you do does work, chances are you're not really innovating.”
Normalizing failure in medicine and medical education is vital, Heckman said.
“In patient care, failure is really bad, and that creates a fearful mindset around all the things that go into it,” he said, noting that grantees can fail on one project and still expect to get funded by the AMA on another. “When it comes to structuring education, sometimes you just have to try something and be OK that it didn’t work. You’re learning, and that's great.”
In 2023, the focus of the initiative’s grants had shifted. The majority were focused on precision education, or using data to create customized pathways for learners. And residency-oriented grants started in 2018.
“Tell us what you're working on,” Heckman said, noting that the AMA has disbursed more than $1.5 million in grants since the initiative launched. “Tell us what you’re excited about.”
