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  1. University of Arkansas for Medical Sciences
  2. College of Medicine
  3. Department of Family and Preventive Medicine
  4. Department of Family and Preventive Medicine Research Symposium
  5. 2026 Research Symposium
  6. “Raise the Floor, Raise the Ceiling”

“Raise the Floor, Raise the Ceiling”

Authors: Amber Norris, MD; Rajalakshmi Cheerla, MD, FAAFP; Leslie Stone, MD, MPH, FAAFP; Grace Chiu, MD, FAAFP; David Kelley, MD, FAAFP; Shivani Malhotra, MD, FAAFP

Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR. Dr. Malhotra is affiliated with The University of Alabama at Birmingham, Huntsville Family Medicine, Huntsville, AL.

About this page: This is the accessible text version of the poster above. All text and a description of the Arkansas regional map are provided below in screen-reader-friendly form.

Abstract

Students report inconsistent access to high-quality, actionable feedback across multiple clinical rotations, including Family Medicine. In parallel, faculty and residents have shared that they would benefit from additional support and skill-building to strengthen their teaching and feedback practices.

“Raise the Floor”: Build consistent, high-quality teaching and feedback practices.

“Raise the Ceiling”: Advance a statewide vision to lead medical student education and highlight the full scope of Family Medicine.

Background

“The Hidden Curriculum.” The set of unspoken messages students learn through culture, attitudes, and role modeling — beyond the formal curriculum. It unintentionally signals that Family Medicine is less valued or lower status, shaping student engagement and specialty choice.

Methods

This is a multiyear longitudinal process across all eight regional sites in Arkansas:

  • Residency/Medical Student Learning Network.
  • Shared curriculum, monthly meetings, retreats, and collaborative resource-sharing.
  • Creation of site directors with dedicated time for administration, teaching, and network development.
  • Improving site-director investment in standards for Clerkship and M4 rotations.
  • Training for residents and faculty to be effective clinical teachers and to give high-quality feedback.

Preliminary Results

  • Increased student satisfaction on rotations throughout their curriculum.
  • Increased student engagement with Family Medicine activities.
  • Increased students applying to Family Medicine residencies.
  • Improved faculty and resident confidence with teaching and feedback.

Challenges

  • Executing across a multi-site regional institution.
  • Faculty and resident time constraints.
  • Negative perception of additional training activities.
  • Sustaining momentum over a multiyear initiative.

Conclusions

  • Investing in faculty and resident teaching skills improves the experience for students.
  • A coordinated statewide approach can standardize educational quality across diverse settings.
  • Addressing “The Hidden Curriculum” requires intentional effort to elevate Family Medicine education.
  • Ongoing assessment will guide continued quality improvement.

Map of Arkansas Regional Sites

Map description. A color-coded outline map of the state of Arkansas divided into eight regions, each marked with a black star icon to indicate the location of a UAMS regional site. The regions and primary city for each are:

  • Northwest: Fayetteville / Springdale
  • North Central: Batesville
  • Northeast: Jonesboro
  • West: Fort Smith
  • Central (UAMS main campus): Little Rock
  • East: Helena
  • Southwest: Texarkana
  • South Central: Pine Bluff
  • South: El Dorado

References

  1. Koch R, Braun J, Joos S. Feedback in family medicine clerkships: a qualitative interview study of stakeholders in community-based teaching. BMC Medical Education. 2022.
  2. Natesan S, Jordan J, Sheng A, et al. Feedback in Medical Education: An Evidence-based Guide to Best Practices from the Council of Residency Directors in Emergency Medicine. Western Journal of Emergency Medicine. 2023.

Disclosures

Authors have no financial disclosure. This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $18,811,732 with 10 percent financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, or the U.S. Government.

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Mailing Address: 4301 West Markham Street, Little Rock, AR 72205
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