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Spearheading Precision Education: Improving Communication in Medical Training

Updated on May 18, 2026 | Artificial Intelligence, Featured, OB/GYN, Primary Care, School

A recording device is being used to improve communication between medical residents and preceptors at Mount Sinai.

Precision medicine, which uses an individual patient’s genetic information to tailor treatment, has shown evidence of improving outcomes, particularly for those who don’t respond well to standard treatment. Mount Sinai educators are now exploring whether the same concept of precision can be applied to the way medical training is carried out, leading to improvements in learning efficiency.

Just as no two patients are the same, teachers and learners all differ in the way they teach, mentor, learn, and process information. A team of medical educators at the Icahn School of Medicine at Mount Sinai is developing a framework for “precision education,” leveraging artificial intelligence (AI) to establish evidence-based metrics for how mentors and trainees operate in a learning setting.

The project leverages new technologies, including AI analysis, to analyze the human-defined metrics of how patients, residents, and their attendings/preceptors communicate. A goal is to study communication patterns and explore whether certain approaches are associated with differences in patient engagement or care outcomes. Residents and their preceptors would then use these insights to try to adjust their communication styles to better match those of the people they are interacting with.

“Precision education is a relatively new concept—it started to be discussed in the post-COVID era—and in a sense, builds on the success of precision medicine,” says Deborah Edelman, MD, Associate Program Director of the Internal Medicine Residency, Mount Sinai Morningside-West.

Deborah Edelman, MD, Associate Program Director of the Internal Medicine Residency, Mount Sinai Morningside-West

“When people start residency, they don’t all start with the same levels of information, and they don’t all take the same journey to get to the end,” says Dr. Edelman. Almost all teaching programs—in medicine and other fields—aim to account for the middle of the bell curve. “Wouldn’t it be great if we can target all parts of the curve and help everyone maximize education?”

The framework that Dr. Edelman’s team is building is backed by a $1.1 million grant from the American Medical Association (AMA), which has tasked 11 institutions to develop precision education systems over four years. The grant program stems from AMA’s ChangeMedEd initiative, aimed at innovating medical education across the United States.

Linking communication styles to outcomes

Assessing the effectiveness of residency training starts with examining how feedback occurs. Currently, this is conducted with feedback forms.

“It works fine, but there are definitely areas for improvement,” says Dr. Edelman. “It can be biased—affected by whether a trainee likes the faculty member or not. The feedback is very subjective and variable, and if multiple suggestions conflict, it makes it hard for the faculty member to know what to change or improve.”

The team from the Icahn School of Medicine, as part of its AMA grant proposal, has designed a system that uses a recording device, such as a cell phone secured with HIPAA protections, to capture how residents interact with patients, and how residents discuss that patient interaction with their attending mentors.

That information is deidentified and parsed out by a large language model into structured variables relevant to the mentor, trainee, and patient. These could include:

Linguistic: talk time balance between parties, interruptions, word complexity, or sentence length
Patient outcomes: medication adherence, preventive care uptake, or visit adherence and continuity
Faculty assessment: Accreditation Council for Graduate Medical Education surveys, or narrative feedback
Demographic: race, gender, language preference, or socioeconomic status

“The idea is to gain actionable insights into how people communicate, and see how different combinations of variables are linked to patient outcomes,” says Dr. Edelman, who is also Associate Professor of Medicine (General Internal Medicine) at the Icahn School of Medicine. “When we have a collection of metrics, we can start to form phenotypes of how a person communicates, and from that point, it’s easier to see what works and what has room to improve.”

An overview of the Mount Sinai proposal for its precision education system, which uses ambient listening to improve communication skills (click here to view a larger image).

It’s important to highlight that the framework isn’t meant to cast judgment on any one communication style over others, notes Dr. Edelman. The framework is meant to demystify the process of communication by linking it to results, and to acknowledge the individual nature of each teacher, learner, or patient.

Scaling from Mount Sinai to nationwide

A pilot is underway to test the ambient listening system with Mount Sinai residents in OB/GYN and internal medicine programs. The pilot is born from a collaboration between the Departments of Artificial Intelligence and Human Health, Graduate Medical Education (GME), Digital and Technology Partners, and the various clinical departments at Mount Sinai to ensure patient information is handled safely and ethically.

“Our programs care for some of New York City’s most underserved populations, and we are committed to developing tools to advance health equity,” says Dr. Edelman.

Andrea Schecter, MD, Medical Director, Ambulatory Practices, Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System (right), with Madeleine Reznik, MD, PGY-2 Internal Medicine resident, Mount Sinai Morningside and Mount Sinai West (left), trialing a precepting session with a recording device as part of the proposed precision education framework. As residents engage in their one-on-one sessions with their preceptors, their communication styles are recorded and analyzed by large language models.

Dr. Edelman (right) is in the process of assessing ideal recording setups for different interaction types, such as using an external microphone in a trial precepting session with Alexandria Still, MD, PGY-4 Internal Medicine and Chief Resident, Mount Sinai Morningside and Mount Sinai West (left), to improve recording quality.

A road map for the four years has been drawn out, with system development and testing in the first year. This will be followed by a staggered rollout and data collection in the second year, system refinement and data analysis in the third year, and scaling for dissemination to GME programs across the country in the final year.

“Precision education could be a big step for medical education, just as precision medicine has been for patients,” says Dr. Edelman. “Everybody wants to feel seen and heard. And when we have a system that is set up to listen to them and ties their communication to evidence-based metrics, nobody has their time wasted.”

Mount Sinai West Opens New Unit to Improve the Experience of Patients After Giving Birth

Updated on Jun 30, 2022 | Featured, Mount Sinai West, OB/GYN

The new rooms feature large, digital communication boards that enhance communication among patients and families and their care teams.

Mount Sinai West has opened a new unit specifically designed to enhance the overall experience for parents and their newborns. The new unit features 21 spacious rooms with sleeping accommodations for a partner, renovated bathrooms, modern fixtures, and digital communication boards.

“We focused on providing a soothing environment for parents and babies that is conducive to bonding as well as patient healing, and optimizing the way we care for our patients,” says Holly Loudon, MD, Site Chair for Obstetrics, Gynecology and Reproductive Health at Mount Sinai West. “The new unit was specifically designed to enhance communication between patients and their care teams and provide the best possible experience.”

For example, new digital communication boards are used to improve patient and provider collaboration. The boards automatically pull key information from the patient’s medical record like names and photos of the care team.

They also display goals that the patient has identified, such as breastfeeding; goals for the baby, such as status of screenings and blood tests; and care team goals, such as progress on walking. A special touch screen section of the board allows patients, family members or others to write questions or updates. The screen serves as a reminder to both the family and the care team to address important items.

The new unit is just the latest in a number of improvements at Mount Sinai West, which has a culture that prioritizes low-intervention births and shared decision-making between providers and their pregnant patients and has a longstanding tradition of using midwives.

“We expect to have more than 4,000 births this year, so having an environment that reflects the high quality of care and service we have always provided is important,” says Evan Flatow, MD, President at Mount Sinai West, who led a recent ribbon-cutting ceremony at the new unit, known as 11A. “The new unit is among several projects to improve the full range of care for new parents and babies, including a new neonatal intensive care unit (NICU) that opened in 2019 and improvements to the labor and delivery unit.”

Mount Sinai West was included on the inaugural list of high-performing Maternity Care hospitals released recently by U.S. News & World Report. Mount Sinai West, along with Mount Sinai Morningside, which are ranked together, are among 237 of 2,700 hospitals in the United States to this achieve this rating.

The official opening of 11A was celebrated by Mount Sinai West and Maternal Child Health leadership, physicians, and staff, from left to right: Erin Figueroa, MSN, RN NE-BC, Senior Director Nursing, Obstetrics and Gynecology; Evan Flatow, MD, President, Mount Sinai West; Holly Loudon, MD, MPH, Site Chair, Obstetrics and Gynecology; Linda Valentino, MSN, RN, NEA-BC, Chief Nursing Officer, Tim Day, Chief Operating Officer, and Cheryl Seredy, Marketing and Communications.

Take a virtual tour of Mount Sinai West’s childbirth units

Learn more about pregnancy and childbirth at Mount Sinai West

Find our more about the full range of gynecology and reproductive services at Mount Sinai West

Transformational Gift Supports Obstetrics, Gynecology, and Reproductive Science at Mount Sinai

Updated on Jun 30, 2022 | Featured, OB/GYN

Raquel and Jaime Gilinski

In visionary support for women’s health, the Mount Sinai Health System has received a multimillion-dollar commitment from Raquel and Jaime Gilinski for the Department of Obstetrics, Gynecology, and Reproductive Science at The Mount Sinai Hospital.

The gift is being given in honor of Michael Brodman, MD, who for 19 years has served with distinction as the Ellen and Howard C. Katz Chairman’s Chair in Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai. Mrs. Gilinski, who serves on the Board of Trustees at Mount Sinai, and her family, have an enduring history of philanthropic support around women’s health at Mount Sinai under Dr. Brodman’s leadership.

“I am honored and thankful to Raquel and Jaime for their ongoing support and advocacy for women’s health at Mount Sinai,” Dr. Brodman says. “This gift will ensure that we continue to offer women and their families excellent care in a modern and comfortable environment”.

Oversight and implementation of the gift will be managed by Joanne L. Stone, MD, Director of the Maternal Fetal Medicine and Fellowship program for the Mount Sinai Health System, Vice Chair for Diversity and Inclusion of the OB/GYN Department, and immediate past President of the Faculty Council. Dr. Stone, a world-renowned physician-scientist with special expertise in women’s health and fetal imaging, will succeed Dr. Brodman as Chair effective January 1, 2022.

“We are ever so grateful for the tremendous gift that the Gilinskis have made to champion women’s health at Mount Sinai. Their visionary support will allow us to build upon Mount Sinai’s legacy of providing comprehensive care, research, and advocacy to women for generations to come,” says Dr. Stone.

This generous gift will establish the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at Mount Sinai. The new gift will support capital projects and renovations to elevate care and services in women’s health at The Mount Sinai Hospital.

“As the torch of leadership is passed from Dr. Brodman to Dr. Stone, we remain committed to the outstanding work of Mount Sinai in the field of Obstetrics and Gynecology that will ultimately lead to more comprehensive care and positive outcomes for women,” says Mrs. Gilinski.

What Are the Benefits of Using A Midwife?

Nov 18, 2021 | OB/GYN, Women's Health, Your Health

Midwives are health professionals who are best known for providing critical support and care for many expectant mothers, but their role is often little-known or understood. Patients may wonder if you can have a midwife and an OB/GYN, how their roles differs from a doula, and how to locate a reputable midwife.

In this Q&A, Rochelle Lipshutz, CNM, Clinical Director of Midwifery at The Mount Sinai Hospital, explains how midwives support patients before, during, and after childbirth and discusses how midwives work with consulting physicians at Mount Sinai to offer integrated care.

What is a midwife?

Midwives are licensed independent health care providers, meaning they provide care without the supervision of a physician. Certified nurse midwives are trained in both nursing and midwifery while certified midwives have graduated with a master’s-level degree in midwifery but do not have nursing training.

They offer a full range of reproductive and primary health care services for patients from adolescence through menopause. These services include independent provision of primary care, gynecological care, and family planning services; preconception, pregnancy, and postpartum care; and care of healthy, full-term infant for the first 28 days of life.

What is the difference between a midwife and a doula?

Both midwives and doulas are trained professionals. Midwives care for clients throughout the life cycle, especially during prenatal care, delivery, postpartum care, and gynecological care as well as primary care. Doulas provide non-medical physical, emotional, and informational support to a woman before, during, and shortly after the process of childbirth. A doula is an additional support during the birth process who—like a midwife—helps a woman achieve the healthiest, most satisfying experience possible.

If you are interested in working with a doula, Mount Sinai has partnered with Oula, a modern maternity care center that provides similar care.

Do midwives only provide services for child birthing?

Midwives are best known for attending childbirth. But that is not all they do. About 76 percent of midwives provide reproductive care and about 46 percent offer primary care. Reproductive care can include annual gynecological exams, Pap smears, and prescriptions including contraceptive methods, patient education, and reproductive health visits.

Midwives also treat the partners of patients in cases of sexually transmitted infections. They can also diagnose and offer initial and ongoing comprehensive care for many common health care problems as well as admit, manage, and discharge patients from hospitals. When appropriate, midwives prescribe use of medical devices, such as breast pumps. Midwives also promote health education, disease prevention, and personal wellness programs to patients and their families. They work in a variety of settings, including ambulatory care centers, hospitals, community and public health care arenas, and homes and birth centers.

What benefits do midwives offer?

Midwives are experts in ‘normal.’ For the most part, they respect and enjoy observing the natural birth process. Midwives encourage women to use their inner strength to cooperate with this process. If a woman in labor requests pain relief, midwives support her decision-making skills. In fact, the relationship between the midwife and patient focuses on shared decision making. If medical intervention is necessary, midwives will discuss the risks, benefits, and any alternatives. Together, midwives and patients reach a decision that will guide the care in a safe and comfortable manner. And, if necessary, the midwife will work closely with doctors and nurses to ensure safety throughout the birthing experience.

How do doctors and midwives work together?

Midwives participate in hospital births as well as home births and those at birth centers. In general, the midwife will focus on basic care, however, if complications develop, the midwife will work with the physician to ensure a comfortable, rewarding, and safe experience.

How do I find a midwife?

Midwifery services are available at The Mount Sinai Hospital and Mount Sinai West. Additionally, the Mount Sinai Health System partners with several well-established local midwifery groups including Central Park Midwifery, Community Midwifery Care, and Nettle Wellness.

You can also check with the American College of Nurse-Midwives to find a local midwife. This national organization lists midwifery practices and private groups in most communities. Many patients go by word of mouth. In addition, many websites that focus on local reproductive care provide information about midwives.

Learn more about Midwifery Services at Mount Sinai

Vaccine Facts: COVID-19 Vaccines Are Safe—and Essential—for Pregnant Women

Sep 23, 2021 | COVID-19, Featured, OB/GYN, Vaccines, Women's Health, Your Health

For those who are pregnant or considering getting pregnant, there are so many health questions, from “Is caffeine okay?” to “Can I still exercise?” But during the COVID-19 pandemic, some are also wondering if the COVID-19 vaccines are safe to take.

In this Q&A, Joanne Stone, MD, MS, Director of Maternal Fetal Medicine at the Mount Sinai Health System, explains the dangerous risks of COVID-19 during pregnancy, shares the facts on why you should get the vaccine, and offers reassurance for those who may be worried.

New Guidance on COVID-19 Vaccines: In April 2023, the Food and Drug Administration and the Centers for Disease Control and Prevention announced some major changes for COVID-19 vaccines. Click here to read more about what you need to know.

Update: The Centers for Disease Control and Prevention on September 29, 2021, strongly recommended COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks. Read more from the CDC

If someone is pregnant, or trying to get pregnant, should they get vaccinated?

Yes, if you’re pregnant, or thinking of getting pregnant, or even if you’re breastfeeding, this is absolutely the time to get the vaccine. I would not wait one extra day. I would get it today because there’s a lot of data that shows the vaccine is very safe and it’s not associated with miscarriage or infertility. Also, it’s the most important way to prevent COVID-19 infection.

Joanne Stone, MD, MS

Are pregnant people especially at risk for COVID-19?

Pregnant women who get COVID-19 infection are at a much higher risk for adverse outcomes, such as severe disease and even maternal death. There’s also higher risk for complications, including preeclampsia, which is high blood pressure in pregnancy, as well as increased risk for the baby, including preterm delivery. For all these reasons, the risks of COVID-19 infection are much higher for both mom and baby. So it’s extremely important to prevent this disease during pregnancy through vaccination plus other measures like mask wearing and social distancing.

What else should patients know about the vaccines and pregnancy?

Patients should understand there are a lot of myths out there that have not proven to be true. For example, there’s no increased risk of infertility if you get the vaccine prior to getting pregnant. Pregnant people should also know that there are complications associated with COVID-19 in pregnancy, and these complications that can be prevented by getting the vaccine. Also, the vaccine has been studied extensively. All the major organizations involved with women’s health care—including the Society for Maternal-Fetal Medicine and the Centers for Disease Control and Prevention—are strongly advocating that people who are pregnant get the vaccine.

Is It Safe to Eat That? — Debunking Pregnancy Dietary Myths

Updated on Jun 30, 2022 | Diet and Nutrition, OB/GYN, Women's Health, Your Health

Cropped side view portrait of pregnant African-American woman buying groceries while shopping in supermarket

Old wives’ tales about pregnancy have been around for centuries. While some myths vary from the lighthearted—carrying high? You’re having a girl—to those of a serious nature—spicy foods causes blindness in babies. Not true!—, we wanted to debunk some of those rumors.

Valerie D. Lewis-Morris, MD, Assistant Professor of the Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai, gives us the facts on what to eat and what to avoid to ensure a healthy pregnancy.

If I didn’t eat a healthy diet before becoming pregnant, is it too late to start while I’m pregnant?

It’s never too late to change your dietary habits. And once you find out that you are pregnant, it’s really important to begin eating nutritious food for the health of you and your baby. If you need help with healthy meal planning, Mount Sinai nutritionists are available to answer your questions.

Can I drink coffee while I am pregnant?

Yes, but pregnant women should not consume more than 200 milligrams of caffeine each day—that’s about two, eight ounce cups of brewed coffee. Caffeine can increase your blood pressure and can cause unusual heart rhythms, so energy drinks, energy boosters, and too much coffee should be avoided.

Is alcohol okay to drink on special occasions while I am pregnant?

Not drinking alcohol is the safest choice. However, a glass of wine—which means a six to eight ounce glass—, a beer, or a toast of champagne a couple of times during pregnancy should not harm your baby, especially if you’re not in the first trimester.

If you are in your first trimester, then abstaining from alcohol is the best, safest choice and you should avoid hard liquor.

Can eating nuts during pregnancy prevent my baby from developing a peanut allergy?

This is an old wives’ tale with absolutely no truth to it. Nuts are a nutritious snack and an excellent source of protein, but consuming them while you’re pregnant will not have an impact on whether your baby will have allergies in the future.

Is it true that you should avoid cheese while pregnant?

Not exactly. The goal here is not to avoid all cheese and dairy, but you should not consume raw cheese or unpasteurized milk as these foods may contain bacteria that is harmful to your baby. All of the dairy you consume should have been pasteurized.

Avoid raw goat cheese, or cheese that has been mold ripened such as gorgonzola, or Roquefort. Hard cheeses, such as cheddar cheese or Swiss, are a safer option. And make sure that you read your food labels to make sure that all of your dairy has been pasteurized.

In addition to dairy, make sure that eggs are completely cooked before you eat them. So, save the runny yolks for after pregnancy.

Is it safe to eat fish?

Yes, as long as it is not raw or high in mercury.

Fish is an excellent food that is low in fat and contains high-quality proteins in omega three fatty acids, which are very important for your baby’s brain development. You want to avoid fish that are high in mercury as it can interfere with your baby’s brain and spinal cord development. These are fish such as shark, swordfish, towel fish, and king mackerel. However, fish that are low in mercury are safe to consume and those are fish like salmon, tilapia, and flounder. Enjoy those as much as you want a couple of times a week.

Should I be eating for two?

Eating for two is a very common myth, but the reality is that you should not be consuming double the portions of every meal and snack. You only need about an additional 350 calories per day and that can be easily achieved by adding two or three small healthy snacks like: a banana with a couple of tablespoons of peanut butter or three to five wheat crackers with about an ounce and a half of cheddar cheese cubes. You don’t have to eat a lot of extra food while you’re pregnant; don’t feel that you have to splurge.

Is it safe to exercise?

If you’re healthy and you have a low risk pregnancy, then the risk of moderate intensity exercise is safe. Consistent exercise during pregnancy can minimize constipation as well as decrease the risk of gestational diabetes and depression. If you incorporate aerobic exercises, such as brisk walking two to three times a week for 20 to 30 minutes or flexibility and strength workouts like yoga, that is all you need.

If you have a high-risk pregnancy, you should discuss adding exercise or continuing the exercises you are doing with your provider to make sure it is safe for you and your baby.

Finally, ignore the old wives’ tales and the misinformation that’s out there. When you’re in doubt, reach out to your obstetrician or midwife to get the most accurate and up-to-date information about your pregnancy and nutritional needs.

Make an appointment with Dr. Lewis-Morris

Learn more about OB/GYN Services at Mount Sinai

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