James Wagner

All Publications

• Attributes of an Effective Mentor in a Learning Community: Comparison of Mentor and Mentee Perspectives INTERNATIONAL MEDICAL EDUCATION Pollio, E., Abbas, L., Haque, W., Wagner, J., North, C. S., Pollio, D. E. 2025; 4 (2)

  View details for DOI 10.3390/ime4020005

  View details for Web of Science ID 001621653000001

• Using the NAM diagnostic process framework to teach clinical reasoning in computerized case presentations to 251 medical students DIAGNOSIS Covin, Y., Longo, P., Wick, N., Gavinski, K., Barker, B., Wagner, J. 2021; 8 (2): 161-166

  Abstract

  Explicit education on diagnostic reasoning is underrepresented relative to the burden of diagnostic errors. Medical educators report curricular time is a major barrier to implementing new curricula. The authors propose using concise student-identified educational opportunities -- differential diagnosis and summary statement writing -- to justify curriculum development in diagnostic reasoning.Eighteen clerkship and 235 preclinical medical students participated in a 1 h computerized case presentation and facilitated discussion. Students were surveyed on their attitudes toward the case.All 18 (100% response) clerkship students and 121 of the 235 preclinical students completed the survey. Students felt the module was effective and relevant. They proposed medical schools consider longitudinal computerized case presentations as an educational strategy.A computerized case presentation is a concise instructional strategy to teach critical points in diagnosis to clerkship and preclinical medical students.

  View details for DOI 10.1515/dx-2020-0031

  View details for Web of Science ID 000648591000006

  View details for PubMedID 32628629

• The learning community faculty experience: how longitudinal relationships with learners enhance work meaning PERSPECTIVES ON MEDICAL EDUCATION Roussel, D., Gordon, P. R., Wagner, J. M., Bardack, M., Sardesai, M. G., Colbert-Getz, J. M. 2020; 9 (6): 343-349

  Abstract

  Work meaning has gained attention as an important contributor to physician job engagement and well-being but little is known about how faculty participation in medical school learning communities might influence this phenomena. Our study goals were to determine how physician faculty members may derive meaning from serving as mentors for longitudinal learning communities of medical students, to understand how that meaning may impact other areas of their work, and relate our findings to existing literature and theoretical frameworks.The research team conducted, recorded, transcribed, and coded 25 semi-structured telephone interviews of faculty mentors from four US medical schools with curricular learning communities. The team used an iterative interview coding process to generate final themes and relate these themes to existing literature.The authors identified five themes of meaning faculty derive from participation as learning community mentors: "I am a better professional," "I am more connected," "I am rejuvenated," "I am contributing," and "I am honored." A sixth theme, "I am harmed," encompassed the negative aspects of the learning community faculty experience. The authors found that their identified themes related closely to the theoretical framework for pathways to meaningful work proposed by Rosso et al.The alignment of the themes we identified on the experience of learning community faculty to existing literature on work meaning corroborates the theoretical framework and deepens understanding of beneficial and harmful learning community effects on faculty. As learning communities become increasingly common within medical schools, this understanding may be important for leaders in academic medicine considering potential indirect benefits of this educational model.

  View details for DOI 10.1007/s40037-020-00614-z

  View details for Web of Science ID 000561237700001

  View details for PubMedID 32820415

  View details for PubMedCentralID PMC7718352

• Empirical comparison of three assessment instruments of clinical reasoning capability in 230 medical students BMC MEDICAL EDUCATION Covin, Y., Longo, P., Wick, N., Gavinski, K., Wagner, J. 2020; 20 (1): 264

  Abstract

  Several instruments intend to measure clinical reasoning capability, yet we lack evidence contextualizing their scores. The authors compared three clinical reasoning instruments [Clinical Reasoning Task (CRT), Patient Note Scoring rubric (PNS), and Summary Statement Assessment Rubric (SSAR)] using Messick's convergent validity framework in pre-clinical medical students. Scores were compared to a validated clinical reasoning instrument, Clinical Data Interpretation (CDI).Authors administered CDI and the first clinical case to 235 students. Sixteen randomly selected students (four from each CDI quartile) wrote a note on a second clinical case. Each note was scored with CRT, PNS, and SSAR. Final scores were compared to CDI.CDI scores did not significantly correlate with any other instrument. A large, significant correlation between PNS and CRT was seen (r = 0.71; p = 0.002).None of the tested instruments outperformed the others when using CDI as a standard measure of clinical reasoning. Differing strengths of association between clinical reasoning instruments suggest they each measure different components of the clinical reasoning construct. The large correlation between CRT and PNS scoring suggests areas of novice clinical reasoning capability, which may not be yet captured in CDI or SSAR, which are weighted toward knowledge synthesis and hypothesis testing.

  View details for DOI 10.1186/s12909-020-02185-3

  View details for Web of Science ID 000565071900003

  View details for PubMedID 32787953

  View details for PubMedCentralID PMC7425135

• A Team Disclosure of Error Educational Activity: Objective Outcomes JOURNAL OF THE AMERICAN GERIATRICS SOCIETY Krumwiede, K., Wagner, J. M., Kirk, L. M., Duval, T. M., Dalton, T. O., Daniel, K. M., Huffman, A. S., Adams-Huet, B., Rubin, C. D. 2019; 67 (6): 1273-1277

  Abstract

  Medical errors can involve multiple team members. Few curricula are being developed to provide instruction on disclosing medical errors that include simulation training with interprofessional team disclosure. To explore more objective evidence for the value of an educational activity on team disclosure of errors, faculty developed and assessed the effectiveness of a multimodal educational activity for learning team-based disclosure of a medical error. This study employed a methodological triangulation research design. Participants (N = 458) included students enrolled in academic programs at three separate institutions. The activity allowed students to practice team communication while: (1) discussing a medical error within the team; (2) planning for the disclosure of the error; and (3) conducting the disclosure. Faculty assessed individual student's change in knowledge and, using a rubric, rated the performance of the student teams during a simulation with a standardized family member (SFM). Students had a high level of preexisting knowledge and demonstrated the greatest knowledge gains in questions regarding the approach to disclosure (P < .001) and timing of an apology (P < .001). Both SFMs and individual students rated the team error disclosure behavior highly (rho = 0.54; P < .001). Most participants (more than 80%) felt the activity was worth their time and that they were more comfortable with disclosing a medical error as a result of having completed the activity. This activity for interprofessional simulation of team-based disclosure of a medical error was effective for teaching students about and how to perform this type of important disclosure.

  View details for DOI 10.1111/jgs.15883

  View details for Web of Science ID 000471133600029

  View details for PubMedID 30938844

• Defining Learning Communities in Undergraduate Medical Education: A National Study JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT Shochet, R., Fleming, A., Wagner, J., Colbert-Getz, J., Bhutiani, M., Moynahan, K., Keeley, M. 2019; 6: 2382120519827911

  Abstract

  Learning communities (LCs) are intentionally designed groups that are actively engaged in learning with and from each other. While gaining prominence in US medical schools, LCs show significant variability in their characteristics across institutions, creating uncertainty about how best to measure their effects.The aim of this study is to describe the characteristics of medical school LCs by primary purpose, structures, and processes and lay the groundwork for future outcome studies and benchmarking for best practices.Medical school LC directors from programs affiliated with the Learning Communities Institute (LCI) were sent an online survey of program demographics and activities, and asked to upload a program description or summary of the LC's purpose, goals, and how it functions. Descriptive statistics were computed for survey responses and a qualitative content analysis was performed on program descriptions by 3 authors to identify and categorize emergent themes.Of 28 medical school LCs surveyed, 96% (27) responded, and 25 (89%) provided program descriptions for qualitative content analysis. All programs reported longitudinal relationships between students and faculty. Most frequently cited objectives were advising or mentoring (100%), professional development (96%), courses (96%), social activities (85%), and wellness (82%). Primary purpose themes were supporting students' professional development, fostering a sense of community, and creating a sense of wholeness. Structures included a community framework, subdivisions into smaller units, and governance by faculty and students. Process themes included longitudinal relationships, integrating faculty roles, and connecting students across class years.Medical school LCs represent a collection of high-impact educational practices characterized by community and small-group structures, relational continuity, and collaborative learning as a means to guide and holistically support students in their learning and development as physicians. In describing 27 medical school LCs, this study proposes a unifying framework to facilitate future educational outcomes studies across institutions.

  View details for DOI 10.1177/2382120519827911

  View details for Web of Science ID 000462235200001

  View details for PubMedID 30937385

  View details for PubMedCentralID PMC6434432