For nearly 1000 years, lecture has been the most frequently used teaching strategy in higher education. Over the past 20 years, there has been increasing pressure to stop lecturing and instead use more active and engaged teaching strategies. An unfortunate result of the attack on the lecture is that faculty members have resisted being told to completely abandon lecturing. This has critically slowed the adoption of more contemporary evidence-based teaching strategies that would likely have advanced student learning beyond where it is today. This article includes four key challenges regarding the “active learning versus lecture” debate. Issues presented address a better understanding of what is meant by “the lecture,” a better understanding of the empirical studies comparing active learning to lecturing, a challenge to the claim that students do not learn well from the lecture, and that the comparison of active learning to lecturing is not an appropriate comparison. The primary position of this paper is that the adoption of contemporary evidence-based strategies designed to advance student learning is much more likely to be accepted and adopted by faculty members if the “active learning versus lecture” position is reframed in favor of an integrated position of combining lecture strategies with more active and engaged learning strategies. This approach would also be more consistent with existing evidence on teaching for deep learning.

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Background: The present study describes the process used to detect items for cross-cultural differential item functioning (cc-DIF) and attempts to understand cc-DIF by both statistical analysis and content review using a cultural lens. Methods: Data from the 2014 American Board of Family Medicine (ABFM) In-Training Examination (ITE). Results: cc-DIF existed in ten items on the 2014 ABFM ITE and could not be eliminated over the residency program years. International medical school graduates were benefited by seven items, whereas the United States medical school graduates (USMGs) were benefited by three items. Discussion: Cultural specificities and differential content familiarity likely are the primary reasons for items exhibiting cc-DIF. Conclusions: Investigating cc-DIF is recommended for any examination involving multicultural groups. Further, items exhibiting cc-DIF offer opportunities for students to reflect on their implicit cultural differences that may ultimately affect how they practice medicine in a multicultural society.

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Background: This study compared student ability to integrate basic science and clinical information before and after implementing a curriculum revision that introduced a problem-oriented case approach as required coursework. Materials and Methods: Student knowledge and competence were assessed just before entry into clinical training by completion of 100 multiple-choice questions mirroring the breadth and type of questions on the national licensing examination (Part I) and by completion of 10 cases to discern clinical decision-making (Part II). Scores from students from the classes of 2015 and 2016 (previous curriculum) were compared to those from students from the classes of 2017 and 2018 (current curriculum). Results: Part I scores were not significantly different between any classes in the previous and current curriculum. Part II scores for 3^rd-year students in the current curriculum were higher than those for comparable students in the past 2 years of the previous curriculum. Mean scores for the class of 2016, the last year of the previous curriculum, were significantly lower than all other classes. Conclusion: Students benefit from measured and repetitive practice in clinical reasoning.

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Obtaining sufficient survey responses to make course and instructor evaluation results meaningful is a challenge in many, if not most, health professions training programs. This paper describes a series of policy changes that significantly improved data quality at one college of veterinary medicine located in the United States. The steps consisted of minimizing the number of items appearing on the instruments, providing students adequate time and space for completion, clearly explaining the purpose and value of the evaluations, simplifying data collection, collecting verbal feedback, and closing the loop with student participants by informing them of any changes that were made as a result of their feedback. The steps outlined in this model may be easily extended to other health professions programs that involve cohort models, multi-instructor courses and limited resources with respect to time and people.

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Background: There has been a recent influx of researchers in the field of medical education coming from medical and health science backgrounds. Researchers from health fields often misunderstand that studies involving experimental designs are relatively rare throughout educational research. Experts in education research note that experimental designs largely are incompatible with educational studies due to various contextual, legal, and ethical issues. Purpose: We sought to investigate the frequency with which experimental designs have been utilized in recent medical education dissertations and theses. Methods: A bibliometric analysis of dissertations and theses completed in the field of medical education between 2011 and 2016. Results: Fewer than 10% of doctoral dissertations and master's theses involved some type of experimental design. Only 6.12% of all dissertation and master's projects involved randomized experiments. Conclusions: Randomized experiments occur only slightly more frequently in medical education than other educational fields.

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This “Perspectives” article involves the reflections of Dr. David Foster based on his nearly 40-year working experience in the assessment arena. Foster argues that, despite many innovative technology solutions, the assessment field has failed to introduce technology in creative, effective ways. This is evidenced by the fact that most modern assessments used in the high-stakes testing industry involve paper-and-pencil tests administered on computers. Foster identifies eight common reasons (and excuses) used to reject change and accept the status quo, thereby forcing the assessment field to live in the past.

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Background: Sufficient knowledge regarding presentation, clinical features, and further workup of leprosy, a stigmatized disease, is essential for physicians and other health professionals to effectively control the disease. This study aimed to investigate the current knowledge of leprosy among health professionals in India. Materials and Methods: An online survey was administered to 200 health-care professionals. Results: One hundred and thirteen health professionals representing various sectors completed the survey. Only 24% of participants correctly answered items regarding the treatment of mild reactions of Type 1 reversal reaction and Type 2 erythema nodosum leprosum. In addition, only 38% of participants correctly answered an image-based item depicting a blister calendar pack used for treatment. Conclusion: The survey results indicate that medical professionals need more educational training to combat this once declared “eliminated” disease.

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