David M Irby

Summary

Affiliation: University of California
Country: USA

Publications

  1. doi request reprint Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010
    David M Irby
    Department of Medicine, UCSF School of Medicine, San Francisco, California 94143 0410, USA
    Acad Med 85:220-7. 2010
  2. pmc Teaching when time is limited
    David M Irby
    University of California, San Francisco, CA 94143 0410, USA
    BMJ 336:384-7. 2008
  3. doi request reprint Educating physicians for the future: Carnegie's calls for reform
    David Irby
    University of California San Francisco School of Medicine, CA, USA
    Med Teach 33:547-50. 2011
  4. ncbi request reprint Developing educational leaders: the teaching scholars program at the University of California, San Francisco, School of Medicine
    Jessica H Muller
    Department of Family and Community Medicine, University of California, San Francisco, California 94143 0900, USA
    Acad Med 81:959-64. 2006
  5. doi request reprint Outcomes of different clerkship models: longitudinal integrated, hybrid, and block
    Arianne Teherani
    Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California 94107 1751, USA
    Acad Med 88:35-43. 2013
  6. ncbi request reprint Student performance problems in medical school clinical skills assessments
    Karen E Hauer
    University of California, San Francisco, 533 Parnassus Ave, Box 0131, U137, San Francisco, CA 94143 0131, USA
    Acad Med 82:S69-72. 2007
  7. ncbi request reprint Teaching points identified by preceptors observing one-minute preceptor and traditional preceptor encounters
    David M Irby
    Division of General Internal Medicine, Department of Medicine, University of California, San Francisco 94143 0410, USA
    Acad Med 79:50-5. 2004
  8. doi request reprint Consequences within medical schools for students with poor performance on a medical school standardized patient comprehensive assessment
    Karen E Hauer
    Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California 94143 0131, USA
    Acad Med 84:663-8. 2009
  9. ncbi request reprint Working Definitions of the Roles and an Organizational Structure in Health Professions Education Scholarship: Initiating an International Conversation
    Lara Varpio
    L Varpio is associate professor, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland L Gruppen is professor and faculty director, Masters in Health Professions Education program, University of Michigan Medical School, Ann Arbor, Michigan W Hu is professor and chair of medical education, Western Sydney University School of Medicine, Campbelltown, Australia B O Brien is associate professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California O ten Cate is professor and director, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, the Netherlands S Humphrey Murto is associate director, Education Research Support Unit, Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, and director of education research, Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada D M Irby is professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California C van der Vleuten is professor of education, Department of Educational Development and Research, Maastricht University, Maastricht, the Netherlands S J Hamstra is vice president, Milestones Research and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois S J Durning is professor and acting director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, UK
    Acad Med . 2016
  10. ncbi request reprint Impact of the United States Medical Licensing Examination Step 2 Clinical Skills exam on medical school clinical skills assessment
    Karen E Hauer
    University of California, San Francisco, 533 Parnassus Ave, Box 0131, U137, San Francisco, CA 94143 0131, USA
    Acad Med 81:S13-6. 2006

Detail Information

Publications46

  1. doi request reprint Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010
    David M Irby
    Department of Medicine, UCSF School of Medicine, San Francisco, California 94143 0410, USA
    Acad Med 85:220-7. 2010
    ..The authors hope that the new report will generate the same excitement about educational innovation and reform of undergraduate and graduate medical education as the Flexner Report did a century ago...
  2. pmc Teaching when time is limited
    David M Irby
    University of California, San Francisco, CA 94143 0410, USA
    BMJ 336:384-7. 2008
  3. doi request reprint Educating physicians for the future: Carnegie's calls for reform
    David Irby
    University of California San Francisco School of Medicine, CA, USA
    Med Teach 33:547-50. 2011
    ..In this article, the author describes educational innovations and educational principles relevant to each of these four recommendations...
  4. ncbi request reprint Developing educational leaders: the teaching scholars program at the University of California, San Francisco, School of Medicine
    Jessica H Muller
    Department of Family and Community Medicine, University of California, San Francisco, California 94143 0900, USA
    Acad Med 81:959-64. 2006
    ..Challenges facing the TSP include scholar release time, mentoring time, and follow-up contact to encourage TSP graduates' postgraduation productivity, continuing educational development, and support...
  5. doi request reprint Outcomes of different clerkship models: longitudinal integrated, hybrid, and block
    Arianne Teherani
    Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California 94107 1751, USA
    Acad Med 88:35-43. 2013
    ....
  6. ncbi request reprint Student performance problems in medical school clinical skills assessments
    Karen E Hauer
    University of California, San Francisco, 533 Parnassus Ave, Box 0131, U137, San Francisco, CA 94143 0131, USA
    Acad Med 82:S69-72. 2007
    ..Though most medical schools administer comprehensive clinical skills assessments to identify students who have not achieved competence, the types of problems uncovered by these exams have not been characterized...
  7. ncbi request reprint Teaching points identified by preceptors observing one-minute preceptor and traditional preceptor encounters
    David M Irby
    Division of General Internal Medicine, Department of Medicine, University of California, San Francisco 94143 0410, USA
    Acad Med 79:50-5. 2004
    ....
  8. doi request reprint Consequences within medical schools for students with poor performance on a medical school standardized patient comprehensive assessment
    Karen E Hauer
    Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California 94143 0131, USA
    Acad Med 84:663-8. 2009
    ..The consequences of poor performance on the assessment and the institutional factors associated with imposing consequences are unknown...
  9. ncbi request reprint Working Definitions of the Roles and an Organizational Structure in Health Professions Education Scholarship: Initiating an International Conversation
    Lara Varpio
    L Varpio is associate professor, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland L Gruppen is professor and faculty director, Masters in Health Professions Education program, University of Michigan Medical School, Ann Arbor, Michigan W Hu is professor and chair of medical education, Western Sydney University School of Medicine, Campbelltown, Australia B O Brien is associate professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California O ten Cate is professor and director, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, the Netherlands S Humphrey Murto is associate director, Education Research Support Unit, Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, and director of education research, Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada D M Irby is professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California C van der Vleuten is professor of education, Department of Educational Development and Research, Maastricht University, Maastricht, the Netherlands S J Hamstra is vice president, Milestones Research and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois S J Durning is professor and acting director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, UK
    Acad Med . 2016
    ..This inconsistency impedes the transferability of current and future findings related to the roles and organizational structures of HPES...
  10. ncbi request reprint Impact of the United States Medical Licensing Examination Step 2 Clinical Skills exam on medical school clinical skills assessment
    Karen E Hauer
    University of California, San Francisco, 533 Parnassus Ave, Box 0131, U137, San Francisco, CA 94143 0131, USA
    Acad Med 81:S13-6. 2006
    ..Medical schools face a new responsibility to prepare students for the United States Medical Licensing Exam Step 2 Clinical Skills (CS) exam...
  11. doi request reprint Lessons learned about integrating a medical school curriculum: perceptions of students, faculty and curriculum leaders
    Jessica H Muller
    Department of Family and Community Medicine, School of Medicine, University of California San Francisco, San Francisco, California 94143 0900, USA
    Med Educ 42:778-85. 2008
    ..This study investigated how stakeholders in a newly integrated curriculum - students, course directors and curriculum leaders - define integration and perceive its successes and challenges during its first year...
  12. doi request reprint Becoming an academic doctor: perceptions of scholarly careers
    Patricia S O'Sullivan
    Office of Medical Education, School of Medicine, University of California San Francisco, San Francisco, California 94143 0410, USA
    Med Educ 43:335-41. 2009
    ..Despite a recognised need to prepare future faculty members, little research has been conducted on how best to accomplish this task, especially among learners and faculty members within research-intensive medical schools...
  13. ncbi request reprint The academy movement: a structural approach to reinvigorating the educational mission
    David M Irby
    Office of Medical Education, School of Medicine, University of California, San Francisco, 521 Parnassus Avenue, Room C 254, San Francisco, CA 94143 0410, USA
    Acad Med 79:729-36. 2004
    ..The academy movement, as a structural approach to change, shows promise for reinvigorating the educational mission of academic medicine...
  14. doi request reprint Reframing research on faculty development
    Patricia S O'Sullivan
    Department of Medicine, and director of educational research and faculty development, Office of Medical Education, UCSF School of Medicine, San Francisco, California 94143 0410, USA
    Acad Med 86:421-8. 2011
    ....
  15. ncbi request reprint The UCSF Academy of Medical Educators
    Molly Cooke
    Academy of Medical Educators, UCSF School of Medicine, University of California San Francisco, San Francisco, CA 94143 0563, USA
    Acad Med 78:666-72. 2003
    ..The Academy of Medical Educators has been well received at UCSF and is enhancing the status of medical education and teachers...
  16. ncbi request reprint Leadership lessons from curricular change at the University of California, San Francisco, School of Medicine
    Helen Loeser
    School of Medicine, University of California, San Francisco, San Francisco, California 94143 0410, USA
    Acad Med 82:324-30. 2007
    ..Arising from this experience and the correlation of curricular change phases with leadership steps, the authors identify 27 specific leadership strategies they employed in their curricular reform process...
  17. doi request reprint Remediation techniques for student performance problems after a comprehensive clinical skills assessment
    Varun Saxena
    University of California, San Francisco, School of Medicine, San Francisco, California 94143 0131, USA
    Acad Med 84:669-76. 2009
    ..Little is known about techniques used to remedy students' skills deficits and their effectiveness. The authors identified remediation strategies used at U.S. medical schools and determined instructors' confidence in remediation...
  18. ncbi request reprint Approaches to medical student remediation after a comprehensive clinical skills examination
    Karen E Hauer
    Department of Medicine, University of California San Francisco, 533 Parnassus Avenue, San Francisco, CA 94143, USA
    Med Educ 42:104-12. 2008
    ..Most US medical schools conduct comprehensive clinical skills assessments during Years 3 and 4. This study explores strategies used to identify and remediate students who perform poorly on these assessments...
  19. doi request reprint Enacting the Carnegie Foundation call for reform of medical school and residency
    Bridget C O'Brien
    a Office of Research and Development in Medical Education, University of California, San Francisco, California, USA
    Teach Learn Med 25:S1-8. 2013
    ..Some of the conceptual work around these recommendations, coupled with a variety of external factors such as changes in health care and accreditation systems, suggests the potential for changes that are more transformative in nature. ..
  20. ncbi request reprint A national study of medical student clinical skills assessment
    Karen E Hauer
    University of California, San Francisco, 533 Parnassus Ave, Box 0131, U137, San Francisco, CA 94143 0131, USA
    Acad Med 80:S25-9. 2005
    ..This study describes comprehensive standardized patient examinations in medical schools nationally...
  21. doi request reprint Remediation of the deficiencies of physicians across the continuum from medical school to practice: a thematic review of the literature
    Karen E Hauer
    Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California 94143 0131, USA
    Acad Med 84:1822-32. 2009
    ..There is an urgent need for multiinstitutional, outcomes-based research on strategies for remediation of less than fully competent trainees and physicians with the use of long-term follow-up to determine the impact on future performance...
  22. pmc Teaching about health care disparities in the clinical setting
    Susan B Glick
    Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL 60637, USA
    J Gen Intern Med 25:S95-101. 2010
    ..The TEST model is straightforward, easy to use, and enables the incorporation of teaching about health care disparities into routine clinical teaching...
  23. ncbi request reprint Student perceptions of the one minute preceptor and traditional preceptor models
    Arianne Teherani
    Department of Medicine and Office of Medical Education, University of California School of Medicine, San Francisco, CA 94143 0410, USA
    Med Teach 29:323-7. 2007
    ..This study was conducted to determine if third- and fourth-year medical students prefer the OMP model over the traditional precepting model and what teaching points they needed from the clinical encounters...
  24. doi request reprint Perceptions of Peer-to-Peer Interprofessional Feedback Among Students in the Health Professions
    Sandrijn M van Schaik
    S M van Schaik is director, Kanbar Center for Simulation, Clinical Skills and Telemedicine Education, and Associate Professor, Clinical Pediatrics, Pediatric Critical Care Medicine, University of California, San Francisco, San Francisco, California G Regehr is associate director of research, Center for Health Education Scholarship, and Professor of Surgery, University of British Columbia, Vancouver, British Columbia, Canada K W Eva is senior scientist, Center for Health Education Scholarship, and Professor of Medicine, University of British Columbia, Vancouver, British Columbia, Canada D M Irby is professor of medicine, University of California, San Francisco, San Francisco, California P S O Sullivan is director of research and development in medical education and professor of medicine, University of California, San Francisco, San Francisco, California
    Acad Med 91:807-12. 2016
    ..This study explores perceptions among health professions students regarding interprofessional peer feedback received after a team exercise...
  25. pmc Educational innovations in academic medicine and environmental trends
    David M Irby
    Office of Medical Education and Department of Medicine DMI, University of California San Francisco, San Francisco, Calif, USA
    J Gen Intern Med 18:370-6. 2003
    ..These innovations are transforming medical education...
  26. ncbi request reprint The UCSF Academy of Medical Educators
    Molly Cooke
    University of California, San Francisco, 94143 0320, USA
    Acad Med 77:455-6. 2002
  27. ncbi request reprint Effectiveness of the one-minute preceptor model for diagnosing the patient and the learner: proof of concept
    Eva Aagaard
    Division of General Internal Medicine, Department of Medicine, University of California, San Francisco 94143 0410, USA
    Acad Med 79:42-9. 2004
    ....
  28. ncbi request reprint American medical education 100 years after the Flexner report
    Molly Cooke
    Department of Medicine, University of California, San Francisco, San Francisco, USA
    N Engl J Med 355:1339-44. 2006
  29. ncbi request reprint Promoting research in medical education at the University of California, San Francisco, School of Medicine
    David M Irby
    Office of Medical Education, School of Medicine, University of California San Francisco, 521 Parnassus Avenue, Room C 254 San Francisco, CA 94143 0410, USA
    Acad Med 79:981-4. 2004
    ..S. professional association meetings. In this article, the authors describe the changes that have occurred at UCSF to achieve these results...
  30. doi request reprint Challenges to Learning Evidence-Based Medicine and Educational Approaches to Meet These Challenges: A Qualitative Study of Selected EBM Curricula in U.S. and Canadian Medical Schools
    Lauren A Maggio
    L A Maggio is director of research and instruction, Lane Medical Library, Stanford University School of Medicine, Stanford, California, and a doctoral student in health professions education in the joint doctoral program, University of California, San Francisco, San Francisco, California, and University Medical Center Utrecht, Utrecht, The Netherlands O ten Cate is professor of medical education and director, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands, and Adjunct Professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California H C Chen is professor of pediatrics, Department of Pediatrics, University of California, San Francisco, School of Medicine, San Francisco, California D M Irby is professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California B C O Brien is associate professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California
    Acad Med 91:101-6. 2016
    ..Yet, little is known about the challenges medical students face in learning EBM or the educational approaches that medical schools use to overcome these challenges...
  31. ncbi request reprint Assessing quality and costs of education in the ambulatory setting: a review of the literature
    Judith L Bowen
    Department of Medicine, Oregon Health and Science University, Portland, Oregon 97201 3098, USA
    Acad Med 77:621-80. 2002
    ..The authors report findings from the literature on teaching and learning in the ambulatory setting and propose opportunities for further research that addresses these barriers...
  32. ncbi request reprint Charles W. Dohner, PhD: an evaluator and mentor in medical education
    David M Irby
    Office of Medical Education, School of Medicine, University of California, San Francisco, 521 Parnassus Avenue, Room C 254, San Francisco, California 94143 0410, USA
    Adv Health Sci Educ Theory Pract 8:63-73. 2003
    ..He has been a passionate spokesman for excellence in medical education and most noted for his roles as an evaluator, program developer, and mentor of academic leaders...
  33. ncbi request reprint The Health Professions Education Pathway: Preparing Students, Residents, and Fellows to Become Future Educators
    H Carrie Chen
    A Department of Pediatrics, University of California, San Francisco School of Medicine, San Francisco, California, USA
    Teach Learn Med . 2016
    ....
  34. doi request reprint Understanding trust as an essential element of trainee supervision and learning in the workplace
    Karen E Hauer
    Department of Medicine, School of Medicine, University of California at San Francisco, 505 Parnassus Ave, M1078, Box 0120, San Francisco, CA, 94143 0120, USA
    Adv Health Sci Educ Theory Pract 19:435-56. 2014
    ..Informed by the design principles offered here, entrustment can support supervisors' accountability for the outcomes of training by maintaining focus on future patient care outcomes. ..
  35. doi request reprint Health Professions Education Scholarship Unit Leaders as Institutional Entrepreneurs
    Lara Varpio
    L Varpio is associate professor, Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland B O Brien is associate professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California S Durning is professor and director, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland C van der Vleuten is professor of education, Department of Educational Development and Research, Maastricht University, Maastricht, the Netherlands L Gruppen is professor and faculty director, Masters in Health Professions Education program, University of Michigan Medical School, Ann Arbor, Michigan O ten Cate is professor and director, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, the Netherlands S Humphrey Murto is associate director, Education Research Support Unit, Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada, and director of education research, Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada D M Irby is professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California S J Hamstra is vice president of milestones research and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois W Hu is chair of medical education and professor, School of Medicine, Western Sydney University School of Medicine, Department of Psychology
    Acad Med . 2017
    ..Using institutional entrepreneurship as a theoretical lens, this study asks: Do HPESU administrative leaders act as institutional entrepreneurs (IEs)?..
  36. ncbi request reprint Parting the Clouds: Three Professionalism Frameworks in Medical Education
    David M Irby
    D M Irby is professor of medicine and of research and development in medical education, University of California, San Francisco, San Francisco, California S J Hamstra is vice president, Milestones Research and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois
    Acad Med . 2016
    ..By examining each discourse in detail, underlying commonalities and differences can be highlighted to assist educators in more effectively creating professionalism curricula, pedagogy, and assessment...
  37. doi request reprint Designing evidence-based medicine training to optimize the transfer of skills from the classroom to clinical practice: applying the four component instructional design model
    Lauren A Maggio
    L A Maggio is director of research and instruction, Lane Medical Library, Stanford University School of Medicine, Stanford, California, and a doctoral student in the health professions education program, University of California, San Francisco, San Francisco, California, and University Medical Center Utrecht, Utrecht, The Netherlands O ten Cate is professor of medical education and director, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands, and Adjunct Professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California D M Irby is professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California B C O Brien is associate professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California
    Acad Med 90:1457-61. 2015
    ..They conclude by suggesting that medical educators consider adopting the 4C/ID model to design, modify, and/or implement EBM training in classroom and clinical settings. ..
  38. doi request reprint What motivates occasional faculty developers to lead faculty development workshops? A qualitative study
    Patricia S O'Sullivan
    P S O Sullivan is professor of medicine and surgery and director, Office of Research and Development in Medical Education, University of California, San Francisco, School of Medicine, San Francisco, California D M Irby is professor of medicine and research faculty member, Office of Research and Development in Medical Education, University of California, San Francisco, School of Medicine, San Francisco, California
    Acad Med 90:1536-40. 2015
    ..This study was designed to understand the motivations of faculty developers who occasionally (one to three times each year) lead faculty development workshops...
  39. doi request reprint Does source matter? Nurses' and Physicians' perceptions of interprofessional feedback
    Sandrijn M van Schaik
    Division of Pediatric Critical Care Medicine, University of California San Francisco, San Francisco, California, USA
    Med Educ 50:181-8. 2016
    ..We used an experimental design to explore how nurses and resident physicians perceive feedback from people within and outside their own professional group...
  40. doi request reprint Identity formation of occasional faculty developers in medical education: a qualitative study
    Patricia S O'Sullivan
    Dr O Sullivan is professor, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California Dr Irby is professor, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California
    Acad Med 89:1467-73. 2014
    ..In some programs, faculty developers are clinicians and scientists who only occasionally conduct workshops. The authors examine the identity formation of such part-time faculty developers...
  41. ncbi request reprint Evidence for longitudinal ambulatory care rotations: a review of the literature
    Gregory Ogrinc
    Veterans Affairs National Health Quality Scholars Program, White River Junction Veterans Hospital and Dartmouth Medical School, White River Junction, Vermont 05009, USA
    Acad Med 77:688-93. 2002
    ..Through a structured review of the medical literature from 1966 through March 2000, the authors summarize the characteristics of, the evidence for, and the evaluation of longitudinal ambulatory care rotations...
  42. ncbi request reprint Frank T. Stritter, PH.D. Educationist: teacher, coach and researcher
    Carole J Bland
    Department of Family Medicine and Community Health, Minneapolis, Minnesota 55455 0392, USA
    Adv Health Sci Educ Theory Pract 10:157-67. 2005
  43. ncbi request reprint Educational fellowship programs: common themes and overarching issues
    Larry D Gruppen
    Department of Medical Education, University of Michigan Medical School, Ann Arbor, Michigan 48109 0201, USA
    Acad Med 81:990-4. 2006
    ....
  44. ncbi request reprint Educational continuity in clinical clerkships
    David M Irby
    N Engl J Med 356:856-7. 2007
  45. ncbi request reprint Advancing educators and education by defining the components and evidence associated with educational scholarship
    Deborah Simpson
    Office of Educational Services, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA
    Med Educ 41:1002-9. 2007
    ..This study aimed to establish documentation standards for medical education activities, beyond educational research, for academic promotion consistent with principles of excellence and scholarship...
  46. ncbi request reprint Perceptions and attributions of third-year student struggles in clerkships: do students and clerkship directors agree?
    Bridget O'Brien
    The Carnegie Foundation for the Advancement of Teaching, Stanford, California 94305, USA
    Acad Med 82:970-8. 2007
    ..To explore the congruence between students' and clerkship directors' perceptions and attributions of students' struggles during the transition to clerkships...