About
Irsk Anderson, MD, is an Associate Professor of Medicine in the Department of Medicine at The University of Chicago. His clinical interests include cardiovascular disease and diabetes prevention. Dr. Anderson has contributed to the development and implementation of an experiential longitudinal health systems science thread into an existing medical school curriculum, as documented in a publication in Academic Medicine in September 2024. His work focuses on integrating health systems science into medical education to enhance the training of future healthcare professionals. He is affiliated with the University of Chicago's Department of Medicine, located at 5841 South Maryland Avenue, MC 6092, Chicago, IL 60637. Dr. Anderson's research and educational efforts aim to improve understanding and management of complex health conditions through innovative curriculum development.
Research topics
- Medicine
- Pedagogy
- Psychology
- Political Science
- Medical education
- Internal medicine
- Family medicine
- Psychiatry
Selected publications
Journal of General Internal Medicine · 2026-03-18
articleOpen accessBACKGROUND: The internal medicine acting internship (AI rotation) is a capstone rotation for demonstrating residency readiness, yet grading inflation and rotation variability limit transparent assessment and communication of student skills to residency programs. The Association of American Medical Colleges' Core Entrustable Professional Activities for Entering Residency (EPAs) offer a shared assessment framework, but their implementation in the AI rotation is incompletely characterized nationally. OBJECTIVE: To describe national usage of EPAs in the AI rotation, identify which EPAs are emphasized, and examine associations between EPA use and assessment/grading practices. DESIGN: Cross-sectional electronic survey of AI rotation course directors (January 2023) with selected comparison to prior medicine core clerkship benchmarks. PARTICIPANTS: Course directors at LCME-accredited US schools (71/140; response rate 50.7%). MAIN MEASURES: We evaluated the presence of EPA-focused teaching and assessment in the AI rotation, as well as the correlation of EPA incorporation with institutional practices surrounding student assessment and evaluation. KEY RESULTS: Most institutions (57%) reported EPA incorporation into the AI rotation. Higher complexity EPAs such as EPA 4 (entering/discussing orders), EPA 8 (patient handover), and EPA 10 (urgent/emergent care) were more frequently assessed in the AI rotation than in the core clerkship, although assessment rates for these EPAs remained below 50%. EPA incorporation was correlated with the use of required workplace-based assessments and competency-based rubrics but showed no association with the use of narrative comments in evaluation (p = 0.76), institutional grading structure (p = 0.57), use of grading committees (p = 0.41), perceived grade inflation (p = 0.47), or inclusion of grade distributions in the MSPE (p = 0.23). Reported gaps included limited instruction and formative assessment for EPA 8 and EPA 10. CONCLUSION: Despite growing adoption, EPA incorporation during the AI rotation remains heterogeneous. Greater intentional incorporation of EPAs to align with acting intern responsibilities represents an opportunity to improve the UME-GME transition.
Journal of General Internal Medicine · 2025-01-06
letterOpen accessImplementing the H&P 360 in Three Medical Institutions: Usability Study
JMIR Medical Education · 2025-03-06
articleOpen accessBACKGROUND: The traditional history and physical (H&P) provides the basis for physicians' data gathering, problem formulation, and care planning, yet it can miss relevant behavioral or social risk factors. The American Medical Association's "H&P 360," a modified H&P, has been shown to foster information gathering and patient rapport in inpatient settings and objective structured clinical examinations. It prompts students to explore 7 domains, as appropriate to the clinical context: biomedical problems, psychosocial problems, patients' priorities and goals, behavioral history, relationships, living environment and resources, and functional status. OBJECTIVE: This study aims to examine the perceived usability of the H&P 360 outside standardized patient settings. METHODS: The H&P 360 was implemented in various clinical settings across 3 institutions. Of the 207 student participants, 18 were preclerkship, 126 were clerkship, and 63 were postclerkship; 3-8 months after implementation, we administered a student survey consisting of 14 Likert-type items (1=strongly disagree to 5=strongly agree) and 3 free-text response items to assess usability. RESULTS: Of the 207 students, 61 responded to the survey (response rate was 29.5%). Among all students, mean ratings on the 3 usability survey items ranged from 4.03 to 4.24. The 5 items assessing the impact on patient care had mean ratings ranging from 3.88 to 4.24. The mean ratings for the 2 student learning items were 4.10 and 4.16. Students' open-ended comments were generally positive, expressing a perceived value in obtaining a more complete contextual picture of patients' conditions and supporting the usability of the H&P 360. Survey response patterns varied across institutions and learner levels. CONCLUSIONS: Our findings suggest that using the H&P 360 may enhance information gathering critical for chronic disease management, particularly regarding social drivers of health. As a potential new standard, the H&P 360 may have clinical usability for identifying and addressing health inequities. Future work should assess its effects on patient care and outcomes.
Journal of General Internal Medicine · 2024-09-16 · 3 citations
articleOpen accessJournal of General Internal Medicine · 2024-07-29 · 5 citations
articleOpen accessBACKGROUND: The acting internship (AI) in internal medicine plays a key role in the transition from medical school to residency. While there have been recent changes in medical education including a pass/fail USMLE Step 1 and increasing use of competency-based assessment, there has not been a large survey of the state of the AI in many years. OBJECTIVE: To assess the current landscape of the internal medicine AI and identify areas in need of standardization. DESIGN: This was a voluntary online survey of medical schools in the United States (U.S.). PARTICIPANTS: Course directors of the AI rotation at U.S. medical schools. MAIN MEASURES: Number of AI rotations required for graduation, length of AI rotation, types of services allowed for AI, clinical responsibilities of students, curricular components. KEY RESULTS: Response rate was 50.7% (71/140 LCME accredited schools). All responding institutions require at least one AI for graduation, with nearly all schools integrating students into resident teaching teams, and almost half also allowing AI students to work on hospitalist services. Students carry 3-4 patients per day on average with a maximum of 5-6 in most institutions. Students are responsible for most aspects of patient care including notes, orders, interprofessional communication, and transitions of care. Night call or night float responsibilities are infrequently required. The structured curriculum published by AAIM is used by only 41% of schools. CONCLUSIONS: The internal medicine AI continues to be a staple in the medical school experience, but there is variation in the structure, curriculum, and expectations on the rotation. Opportunities exist to improve standardization of the AI experience and expectations to better prepare medical students for the transition from medical school to residency.
Implementing the H&P 360 in Three Medical Institutions: Usability Study (Preprint)
2024-09-16
preprintOpen access<sec> <title>BACKGROUND</title> The traditional history and physical (H&P) provides the basis for physicians’ data gathering, problem formulation, and care planning, yet it can miss relevant behavioral or social risk factors. The American Medical Association’s “H&P 360,” a modified H&P, has been shown to foster information gathering and patient rapport in inpatient settings and objective structured clinical examinations. It prompts students to explore 7 domains, as appropriate to the clinical context: biomedical problems, psychosocial problems, patients’ priorities and goals, behavioral history, relationships, living environment and resources, and functional status. </sec> <sec> <title>OBJECTIVE</title> This study aims to examine the perceived usability of the H&P 360 outside standardized patient settings. </sec> <sec> <title>METHODS</title> The H&P 360 was implemented in various clinical settings across 3 institutions. Of the 207 student participants, 18 were preclerkship, 126 were clerkship, and 63 were postclerkship; 3-8 months after implementation, we administered a student survey consisting of 14 Likert-type items (1=strongly disagree to 5=strongly agree) and 3 free-text response items to assess usability. </sec> <sec> <title>RESULTS</title> Of the 207 students, 61 responded to the survey (response rate was 29.5%). Among all students, mean ratings on the 3 usability survey items ranged from 4.03 to 4.24. The 5 items assessing the impact on patient care had mean ratings ranging from 3.88 to 4.24. The mean ratings for the 2 student learning items were 4.10 and 4.16. Students’ open-ended comments were generally positive, expressing a perceived value in obtaining a more complete contextual picture of patients’ conditions and supporting the usability of the H&P 360. Survey response patterns varied across institutions and learner levels. </sec> <sec> <title>CONCLUSIONS</title> Our findings suggest that using the H&P 360 may enhance information gathering critical for chronic disease management, particularly regarding social drivers of health. As a potential new standard, the H&P 360 may have clinical usability for identifying and addressing health inequities. Future work should assess its effects on patient care and outcomes. </sec>
JMIR Medical Education · 2023-02-21 · 4 citations
articleOpen accessBACKGROUND: Patients' perspectives and social contexts are critical for prevention of hospital readmissions; however, neither is routinely assessed using the traditional history and physical (H&P) examination nor commonly documented in the electronic health record (EHR). The H&P 360 is a revised H&P template that integrates routine assessment of patient perspectives and goals, mental health, and an expanded social history (behavioral health, social support, living environment and resources, function). Although the H&P 360 has shown promise in increasing psychosocial documentation in focused teaching contexts, its uptake and impact in routine clinical settings are unknown. OBJECTIVE: The aim of this study was to assess the feasibility, acceptability, and impact on care planning of implementing an inpatient H&P 360 template in the EHR for use by fourth-year medical students. METHODS: A mixed methods study design was used. Fourth-year medical students on internal medicine subinternship (subI) services were given a brief training on the H&P 360 and access to EHR-based H&P 360 templates. Students not working in the intensive care unit (ICU) were asked to use the templates at least once per call cycle, whereas use by ICU students was elective. An EHR query was used to identify all H&P 360 and traditional H&P admission notes authored by non-ICU students at University of Chicago (UC) Medicine. Of these notes, all H&P 360 notes and a sample of traditional H&P notes were reviewed by two researchers for the presence of H&P 360 domains and impact on patient care. A postcourse survey was administered to query all students for their perspectives on the H&P 360. RESULTS: Of the 13 non-ICU subIs at UC Medicine, 6 (46%) used the H&P 360 templates at least once, which accounted for 14%-92% of their authored admission notes (median 56%). Content analysis was performed with 45 H&P 360 notes and 54 traditional H&P notes. Psychosocial documentation across all H&P 360 domains (patient perspectives and goals, mental health, expanded social history elements) was more common in H&P 360 compared with traditional notes. Related to impact on patient care, H&P 360 notes more commonly identified needs (20% H&P 360; 9% H&P) and described interdisciplinary coordination (78% H&P 360; 41% H&P). Of the 11 subIs completing surveys, the vast majority (n=10, 91%) felt the H&P 360 helped them understand patient goals and improved the patient-provider relationship. Most students (n=8, 73%) felt the H&P 360 took an appropriate amount of time. CONCLUSIONS: Students who applied the H&P 360 using templated notes in the EHR found it feasible and helpful. These students wrote notes reflecting enhanced assessment of goals and perspectives for patient-engaged care and contextual factors important to preventing rehospitalization. Reasons some students did not use the templated H&P 360 should be examined in future studies. Uptake may be enhanced through earlier and repeated exposure and greater engagement by residents and attendings. Larger-scale implementation studies can help further elucidate the complexities of implementing nonbiomedical information within EHRs.
2022-09-11
preprintOpen access<sec> <title>BACKGROUND</title> Patients’ perspectives and social contexts are critical for prevention of hospital readmissions; however, neither is routinely assessed using the traditional history and physical (H&amp;P) examination nor commonly documented in the electronic health record (EHR). The H&amp;P 360 is a revised H&amp;P template that integrates routine assessment of patient perspectives and goals, mental health, and an expanded social history (behavioral health, social support, living environment and resources, function). Although the H&amp;P 360 has shown promise in increasing psychosocial documentation in focused teaching contexts, its uptake and impact in routine clinical settings are unknown. </sec> <sec> <title>OBJECTIVE</title> The aim of this study was to assess the feasibility, acceptability, and impact on care planning of implementing an inpatient H&amp;P 360 template in the EHR for use by fourth-year medical students. </sec> <sec> <title>METHODS</title> A mixed methods study design was used. Fourth-year medical students on internal medicine subinternship (subI) services were given a brief training on the H&amp;P 360 and access to EHR-based H&amp;P 360 templates. Students not working in the intensive care unit (ICU) were asked to use the templates at least once per call cycle, whereas use by ICU students was elective. An EHR query was used to identify all H&amp;P 360 and traditional H&amp;P admission notes authored by non-ICU students at University of Chicago (UC) Medicine. Of these notes, all H&amp;P 360 notes and a sample of traditional H&amp;P notes were reviewed by two researchers for the presence of H&amp;P 360 domains and impact on patient care. A postcourse survey was administered to query all students for their perspectives on the H&amp;P 360. </sec> <sec> <title>RESULTS</title> Of the 13 non-ICU subIs at UC Medicine, 6 (46%) used the H&amp;P 360 templates at least once, which accounted for 14%-92% of their authored admission notes (median 56%). Content analysis was performed with 45 H&amp;P 360 notes and 54 traditional H&amp;P notes. Psychosocial documentation across all H&amp;P 360 domains (patient perspectives and goals, mental health, expanded social history elements) was more common in H&amp;P 360 compared with traditional notes. Related to impact on patient care, H&amp;P 360 notes more commonly identified needs (20% H&amp;P 360; 9% H&amp;P) and described interdisciplinary coordination (78% H&amp;P 360; 41% H&amp;P). Of the 11 subIs completing surveys, the vast majority (n=10, 91%) felt the H&amp;P 360 helped them understand patient goals and improved the patient-provider relationship. Most students (n=8, 73%) felt the H&amp;P 360 took an appropriate amount of time. </sec> <sec> <title>CONCLUSIONS</title> Students who applied the H&amp;P 360 using templated notes in the EHR found it feasible and helpful. These students wrote notes reflecting enhanced assessment of goals and perspectives for patient-engaged care and contextual factors important to preventing rehospitalization. Reasons some students did not use the templated H&amp;P 360 should be examined in future studies. Uptake may be enhanced through earlier and repeated exposure and greater engagement by residents and attendings. Larger-scale implementation studies can help further elucidate the complexities of implementing nonbiomedical information within EHRs. </sec>
Supplementing the Subinternship: Effect of E-Learning Modules on Subintern Knowledge and Confidence
The American Journal of Medicine · 2021 · 3 citations
1st authorCorresponding- Political Science
- Medical education
- Internal medicine
JAMA · 2021 · 19 citations
1st authorCorresponding- Medicine
- Family medicine
- Psychiatry
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Frequent coauthors
- 5 shared
Vineet M. Arora
- 3 shared
Erin Rieger
- 3 shared
Brent C. Williams
- 3 shared
Valerie G. Press
University of Chicago
- 3 shared
Joyce W. Tang
- 2 shared
Oliver Hulland
Yale New Haven Hospital
- 2 shared
Arielle Stein
Johns Hopkins University
- 2 shared
Jeanne M. Farnan
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