Assessment & Evaluation
120 – VALIDATION AND PRELIMINARY RESULTS OF THE VTCSOM QUADRANT INSTRUMENTA
Brock Mutcheson and Richard Vari
Virginia Tech Carilion School of Medicine
PURPOSE: The purpose of this study was to understand student perceptions of their proficiency and confidence on eight Virginia Tech Carilion School of Medicine (VTCSOM) institutional goals and objectives.
METHODS: The VTCSOM Quadrant Instrument (Quadrant) was designed to reflect the mapping of VTCSOM Educational Goals and Objectives to the six ACGME Core Competencies (Christianson, et al. Undergraduate Medical Education. Academic Medicine, 2007). Students shared perceptions of their level of proficiency and confidence on 42 items measuring eight different institutional goals. Quadrant was administered to matriculating and graduating VTCSOM students as a component of the program evaluation system. All students completed the survey anonymously. The instrument was validated using confirmatory factor analysis (Jöreskog [https://en.wikipedia.org/wiki/Karl_Gustav_J%C3%B6reskog], Psychometrika, 1969) and an analysis of internal consistency (Cronbach, Educational and Psychological Measurement, 2004). Preliminary descriptive statistics were summarized and compared across two time points (i.e. matriculation and graduation) by graduating class.
RESULTS: The instrument had a strong internal consistency (? = 0.9) and adequate model fit (RMSEA < 0.1). Although the average proficiency scores across all three graduating classes were similar within each time point (i.e. matriculation and graduation), students perceived themselves to be significantly more confident (p < 0.05) and more proficient (p < 0.05) immediately prior to graduating than students immediately prior to the first year of their medical education.
CONCLUSION: This analysis provided empirical evidence that VTCSOM students increased in proficiency and confidence on all eight over-arching VTCSOM institutional goals and objectives. Since students perceived lower proficiency and confidence on the same specific clinical skills across all graduating classes, extra academic support may be needed in these areas.
Curriculum & Evaluation
208 – “UNCOMFORTABLE, YET INCREDIBLY IMPORTANT:” A METHOD FOR CREATING CONVERSATIONS ABOUT RACE AND BIAS AMONG FIRST-YEAR MEDICAL STUDENTS
Lee Rosen, Jayne Manigrasso, Aaron Hurwitz, and Joanna Streck
Larner College of Medicine at the University of Vermont and University of Vermont Department of Psychological Science
PURPOSE: Racial bias unconscious and otherwise is a critically important issue in medicine. This study examined a curricular method, carried out in early in the first year of medical school, designed to help students increase awareness of their biases and reflect on them in facilitated small groups. This method, combining students Implicit Association Test results with small-group discussion has not appeared in the literature to date.
METHODS: 120 first year medical students at the University of Vermont are enrolled in a year-long, small-group course designed to create reflective discussion about professionalism and emotionally-complex topics in medicine. To prepare for discussion, students were instructed to take the Implicit Association Test (IAT) and read several pertinent articles. In their small groups, students then engaged in a semi-structured discussion facilitated by their faculty preceptor. After the session, all students completed an anonymous evaluation, which included Likert survey questions about session objectives and an opportunity for open-ended comments. Comments were subjected to thematic analysis, and a coding scheme was developed to capture themes.
RESULTS: 86% of the students indicated that this session encouraged them to think about their own unconscious biases, and 80% indicated that it prompted them to have a discussion that they would not have otherwise had with classmates. 64% reported that the IAT played a crucial role in the discussion. Results of thematic analyses elaborate on Likert results, demonstrating sophisticated student engagement in this activity. Themes and exemplars will be presented.
CONCLUSION: Use of the IAT combined with facilitated small-group discussion encouraged students to contemplate and discuss race and bias with peers. This method for promoting exploration of racial bias early in medical school appears useful and lays the groundwork for continued dialogue, hopefully cultivating a just and patient-centered approach in the clinical sphere.
Curriculum & Evaluation
218 – PRACTICE MAKES PERFECT: LESSONS IN MEDICAL SCHOOL PROFESSIONALISM
Shawna McCafferty, Matthew Rivera-Bloodworth, and Carol Nichols
Medical College of Georgia – Augusta University
PURPOSE: Professionalism education for medical students is often centered on clinical scenarios that are difficult for students early in their training to relate to or interpret. We designed a student led professionalism curriculum using scenarios relevant to the lives of these medical students.
METHODS: Four Professionalism Case Discussion sessions were added to the Year 1 curriculum to supplement the current professionalism curriculum delivered at the beginning of the academic year. For the first three sessions, Year 2 medical student coordinators developed and led cases based on actual incidents that could be tied to core competencies (Medical Knowledge, Patient Care, Practice Based Learning, Professionalism, Communication, and Systems Based Practice).
Each case included a professionalism scenario, 3-5 short pre/post session survey questions, a relevant article, and discussion questions. Students were asked to complete the pre-survey prior to the session and the post survey right after the session. Another element of this curriculum was a small group assignment for the Year 1 students to write a case based on an assigned core competency about an event they had witnessed during the year. The final session was led by two panels of Year 1 students, whose cases had been selected from class submissions.
RESULTS: Approximately 89% of the class completed the pre-session surveys and 75.5% completed the post-session surveys. Overall there was a 63% decrease in the number of “inappropriate” survey responses and a 9% increase in the number of “appropriate” survey responses after the sessions.
CONCLUSION: First year students have a basic understanding of acceptable professional behaviors. However, they often have difficulty identifying appropriate responses to specific situations. The sessions were useful for helping students understand their roles and responsibilities within the context of specific situations. Providing opportunities for students to discuss relevant professionalism scenarios can be a valuable teaching tool.
Curriculum & Evaluation
236 – Self-reported confidence in anatomical knowledge and dissection skills among medical students after secondary dissection experience
Anastasia Turenkov, Evan DaBreo, Craig W. Goodmurphy, and Carrie A. Elzie
Eastern Virginia Medical School
PURPOSE: Our objective was to determine medical students’ confidence in anatomical knowledge and dissection ability upon completion of the 1st year curriculum, and after further study through intensive hands-on dissection time.
METHODS: After a semester-long anatomy course with full-body dissection, students participated in a 5-week anatomy dissection elective with more-focused dissections. Participants were asked to fill out surveys before and after each dissection during the elective. Students were asked to rank their level of confidence in several aspects of anatomical knowledge and dissection, as well as perceived level of anxiety in completing the task sufficiently. Student’s confidence was then categorized as “Not Confident”, “Neutral” or “Confident” in each of the corresponding metrics.
RESULTS: Seventy-eight percent (N=14) of students participating completed the pre- and post-dissection surveys, reporting on 23 individual dissection experiences. A higher rate of students reporting as “Confident” was seen in post-dissection surveys as compared to pre-dissection. Increased rates of confidence were observed in anatomical knowledge (87% vs 12%, respectively; P <0.001), dissection ability (79% vs 12%, P <0.001), ability to accurately present a case to a peer (83% vs 4%, P <0.001), instruct a colleague through the dissection (79% vs 8%, P <0.001), consider relevant physiology (66% vs 25%, P <0.05) and possess a sufficient level of knowledge for the year’s upcoming courses (70% vs 8%, P <0.001). Students also reported reduced levels of anxiety about their ability to perform a given dissection now or in the future (83% vs 37%, P <0.01). Also noted in this study were aspects of the experience that contributed most to learning, with 74% reporting hands-on dissection time and 57% reporting Text or Atlas studying helping most.
CONCLUSIONS: Given the importance of anatomy in medical education, involvement in continued dissection experience has shown beneficial in improving students’ confidence in their anatomical knowledge.
Curriculum & Evaluation
248 – INTER-PROFESSIONAL TEAMS START EARLY: DEVELOPING STUDENTS’ TEAM SKILLS ACROSS A HEALTH SCIENCE INSTITUTION
Nana Coleman, Alana Newell, Christopher Burnett, Susan Marriott, and Nancy Moreno
Baylor College of Medicine
PURPOSE: There is a need for today’s health professionals and scientists to solve complex problems collaboratively, so it is essential that they function as effective members of high-performing teams. To address this need, Baylor developed Launch Pad – an innovative, interprofessional course designed to develop students’ teamwork skills. This abstract describes the course pilot and its outcomes.
METHODS: Launch Pad was developed during summer 2016 by an interprofessional group of faculty members, representing each of the four schools within our health sciences university. Curriculum development was a collective, creative intellectual process, characterized by shared functional ownership of curricular materials and content, and collaborative facilitation of the course. The course was piloted as four three-hour-long modules consisting of active learning experiences, student reflective exercises, and didactic instruction on team skills: 1) Foundations of Teamwork, 2) Building High-performing Teams, 3) Optimizing Team Performance: Communication, Team Cognition and Cooperation, and 4) Optimizing Team Performance: Conflict Management, Negotiation and Tools for Building High-Reliability Teams.
RESULTS: Twenty-two students from nine programs in the medical, graduate and allied health sciences schools participated in the pilot. Effectiveness was gauged through student content pre- and posttests, ratings of perceived pre- and post-module outcomes, and course ratings. Students had statistically significant mean gains on the content tests and all retrospective self-ratings of module learning outcomes, and rated the course quality highly on all indicators.
CONCLUSION: Launch Pad enhanced students’ team skills, and received positive student feedback, suggesting that it could serve as a model for interprofessional teamwork training in education. Subsequent iterations of the course will strive to incorporate a greater depth of team skills knowledge, as well as an enhanced focus on active learning.
308 – ONLINE MCAT GUIDED PROGRAM
Norma Perez, Berengaria Navarre, and Sarah Toombs Smith
University of Texas Medical Branch
PURPOSE: During a five-week summer program to prepare primarily underserved Hispanic undergraduates for the Medical College Admission Test (MCAT), we observed a gap between initial intent to prepare for the MCAT and actual time of taking the MCAT. We wanted to intensely mentor dedicated juniors during the spring semester before the MCAT, using an online format that allowed us to help students at various undergraduate institutions.
METHODS: Six cohorts of undergraduate premed students (N=49) have taken the online course, from February 2014 to May 2016. Premed advisors recommended their students for participation in the program. The program, offered online using Canvas Instructure, included online resources in subject matter, supporting subject links, and faculty coaching. Special lectures (online video with text provided) were produced to help students develop critical thinking skills and test taking strategies. Students were required to formulate a tailored study plan.
RESULTS: The 49 students were enrolled at 19 different universities in Texas and Arizona. Overall grade point averages (OGPAs) ranged 2.4-4.0 (average, 3.53) and science GPAs (SGPAs) ranged 2.0-4.0 (average, 3.44). Thirty-two (65%) reported a first language other than English. Of the 43 students who finished before 2016, 51% (22 students) have progressed in their medical careers. Of these, 16 students have entered medical school, 9 at UTMB and 7 elsewhere. Six entered other health-related fields (biomedical research, public health, EMT, etc.) Students rated their knowledge as Improved after the course and most rated aspects of the course as Very Good or Excellent. They praised both the video lectures and the mentoring.
CONCLUSIONS: A cost-effective online premed preparatory guide to the MCAT can impact the student’s chance of getting into medical school. The online premed coaching program, in particular, helps the student focus on tasks that increase the likelihood of acceptance into medical school.
404 – A SHORT COURSE IN DYSMORPHOLOGY TO IMPROVE OBSERVATION SKILLS
Maria Cole and Linda R Adkison
University of Missouri – Kansas City and Trinity School of Medicine
PURPOSE: The study of abnormal phenotypic/morphometric features has reduced emphasis in medical curricula due to the rapid advancement of sophisticated laboratory tests and because phenotypic features rely predominantly on associations with particular diagnoses. We describe a short course in dysmorphology that engages the student in active learning for a better appreciation of development and clinical diagnosis.
METHODS: The course has three components: a didactic review of craniofacial and limb development with attention given to observable phenotypic variation; videos of patients with syndromes that have recognizable variations; and a presentation of a student project that required morphological measurements.
A pretest and post-test were administered to students to assess fundamental knowledge. “Pearls” of dysmorphology associated with specific syndromes were identified. Throughout, students were presented with photographs and asked to identify dysmorphic features and suggest a diagnosis to sharpen observation skills.
RESULTS: Groups with and without prior embryology exposure were assessed. There was an improvement in understanding and using information in both groups by an average improvement of 3.7% on the post-test.
Discussions of photographs were well-received by students and demonstrated reinforcement of concepts presented and practiced through video review.
Student selected an anatomical and physical feature to investigate and defined the study population. Outcomes included comparison data supported in the literature with a discussion of observed variation and insights. Students unanimously found this part of the course the most enjoyable.
CONCLUSIONS: Detailed course discussions of phenotypic variation in an interactive format allowed students to become familiar with terms and improvement of observational skills. These skills are instrumental for clinical evaluation, particularly before laboratory data may be available.
406 – HISTOLOGY LABORATORY FLIPPING
Richard R. Lindquist
University of Connecticut School of Medicine
PURPOSE: Engaging students in the usual histology laboratory has been problematic. In order to engage students in an active learning process, the laboratory was flipped by having students learn the educational objectives prior to the histology laboratory.
METHODS: The histology laboratory experience was flipped by having students view a website, which highlighted the structure and function of tissues and organs, prior to attending the histology laboratory session. The laboratory was equipped with the Aperio virtual microscope viewable on student laptop computers. Faculty was able to annotate the slides in real time with arrows, circles, etc. and ask students specific structure or functional questions. Learners responded to faculty questions using a web based personal response system. The results were immediately available to faculty for making a decision to promote further discussion, as when the answers varied, or proceed to the next learning objective. The learner’s database stored answers along with correct answers which were available for learners to assess their progress and for faculty to use in formative and summative evaluations.
RESULTS: Students were very enthusiastic about the flipped histology laboratory and for the first time in more than a dozen years of teaching in histology laboratory using the usual method voted me a major teaching award. Since all of our students perform very well on course end exams, there was no measurable increase in student examination grades.
CONCLUSIONS: Flipping histology laboratory is a process leading to greater student participation and satisfaction with the histology laboratory.
426 – Peer-led review sessions for USMLE Step 1 preparation.
Daniel R. Webster and Brian Pomeroy
Texas Tech University Health Sciences Center
PURPOSE: Many year-2 medical students (MS2) feel unprepared to take the Step 1 exam. To aid in their preparation, we instituted a program of peer-led instruction that was delivered over the final semester of pre-clinical study.
METHODS: Students from both year 3 (MS3) and year 4 (MS4) classes volunteered to conduct review sessions for the MS2 class. We polled MS2 students early in the semester in order to conduct a topic-related needs assessment. The peer instructors developed their sessions, with help from the other instructors as well as the authors, over a series of 2-hour practice sessions before presenting the material to the class. They presented 13 sessions, informed by our needs assessment, covering topics ranging from renal physiology and pathology to the interpretation of anatomical images. MS2 attendance was voluntary and all MS2 students took the Step 1 exam within two months of the last session. We surveyed students before and after Step 1 and collected responses using 5-point Likert scales.
RESULTS: Student attendance was high at all sessions (range:71-108 students per session). From a survey taken immediately after the sessions ended (41 respondents), we found that most MS2 students would recommend them for next year’s group (88% agree/strongly agree vs. 0% disagree/strongly disagree). From a survey taken after Step 1 (69 respondents), participants felt that the sessions provided useful test-taking strategies (75% agree/strongly agree vs. 1.5% disagree/strongly disagree) and prepared them for the content on the exam (78% agree/strongly agree vs 3% disagree/strongly disagree). Finally, most of the respondents were satisfied with their exam scores (77% agree/strongly agree vs 17% disagree/strongly disagree).
CONCLUSIONS: Most MS2 participants felt that they benefited from instruction led by their peers. Ongoing analysis will determine if participants scored higher on their preparatory CBSE and Step 1 exams than those who did not attend.
430 – Assessing Integrated Instruction of New Basic Sciences and Clinical Sciences in Medical Psychiatry to Prepare Medical Students for Future Learning for Complex Problem Solving
Zarah Chaudhary, Nicole Woods, Rachael Barnett, Sanjeev Sockalingam, and Maria Mylopoulos
The Wilson Centre for Research in Education, University Health Network & University of Toronto
PURPOSE: Previous research in medical education has shown that instruction that deliberately integrates basic biomedical knowledge with clinical features (cognitive integration) leads to better diagnostic performance and preparation for future learning (PFL). In addition to traditional biomedical knowledge, it has been suggested that knowledge of ‘new’ forms of basic science (e.g. social determinants of health, knowledge of systems of care etc.) is necessary for effective care. This 3-phase study will compare the effect of ‘new’ basic sciences integrated instruction to clinically focused instruction on diagnostic performance and PFL. The purpose of Phase 1 was to define new basic sciences for integrated physical and mental health care (medical psychiatry).
METHODS: In Phase 1, five medical psychiatry expert physicians were engaged in a modified Delphi process to iteratively identify categories of comorbid diseases, their signs and symptoms and the foundational mechanistic knowledge characterizing these categories.
RESULTS: Experts reached consensus on five common medical psychiatry disorders and their defining signs and symptoms. Mechanisms for new basic sciences to describe disorders’ underlying etiology included psychological (ex. attachment styles, response factors to illness like social conditioning and cognitive repertoire of coping strategies), evolutionary biological (ex. behavioural adaptability to one’s environment with respect to illness outcomes such as harm avoidance or risk aversion), sociological explanations (ex. economic theory, socioeconomic vulnerability, downward drift) in addition to traditional biomedical explanations (ex. inflammatory processes, neuronal and endocrine systems implicated in stress, genetic factors).
CONCLUSIONS: Phase 1 expanded the definition of ‘basic science’ beyond biomedical knowledge to include behavioural and social system processes that will serve as the foundation for Phase 2 in the development of study materials. This work has implications for educational design, particularly in developing integrated instruction for chronicity and complexity in undergraduate medical education that will foster abilities to concurrently manage patients’ physical and mental health needs.
512 – The Imposter Phenomenon across the Span of Medical Training
Kayley Swope, Britta Thompson, and Paul Haidet
Penn State University College of Medicine
PURPOSE: The imposter phenomenon has been described anecdotally and empirically in medical students, but it is unclear how imposter feelings may fluctuate during times of transition in medical training. This project’s aim was to explore the imposter phenomenon during times of transition compared to non-transitional points during the school year.
METHODS: We surveyed first and second year medical students about gender, class year, and imposter feelings using the Clance Imposter Phenomenon Scale at both transition and non-transition points of the school year. First year students completed surveys upon entry to medical school (transition). Second year medical students completed surveys at the beginning of their school year (non-transition).
RESULTS: Of the total 163 students, 4.3% had minimal imposter feelings, 35.4% had moderate imposter feelings, 50% had frequent imposter feelings, and 10.4% had intense imposter feelings. The overall mean imposter score was 63.66 on a scale of 0-100 (SD=13.37) which corresponded to frequent imposter feelings. This score is comparable to or slightly greater than other medical learners reported in the literature. There was a trend toward females having higher imposter scores (p=0.13). Although second-year students (non-transition) tended to have higher imposter scores on the various subscales of the instrument, there was no significant difference between transitioning students and non-transitioning students (p=0.624).
CONCLUSION: The imposter phenomenon is an important facet of student wellness. Because transitions in education are pivotal in setting new patterns in students’ professional development, it is important for educators to know when to intervene to mitigate effects of the imposter phenomenon. At this early stage in our project, there was no difference between transition and non-transition states, but we did see a trend toward higher imposter feelings in females and second-year students. Further research is needed to understand imposter feelings and their effects on the educational experiences of medical students.
518 – Building a community of health science educators: the impact of the IAMSE webinar
Ingrid Bahner, Rick Vari, Larry Hurtubise, Michele Haight, Giulia Bonaminio, Elissa Hall, Nehad El-Sawi, Pat Finnerty, Brandi Hinkle, Robert McAuley, Veronica Michaelsen, Rebecca Rowe, and Jack Strandhoy
Morsani College of Medicine, University of South Florida, Virginia Tech Carrilion School of Medicine, Ohio State University School of Medicine, OHSU School of Medicine, University of Kansas School of Medicine, Department of Laboratory Medicine
PURPOSE: The IAMSE web based seminar (webinar) series offers a year round opportunity for educators to engage with health science education topics. Each webinar series focuses on a specific theme to foster the exchange of ideas and expertise. A series typically consists of five presentations that address different aspects of the series’ theme. To encourage engagement, during 2016 the webinar planning committee implemented an online communication platform allowing participants to type questions and comments during the webinar. The committee also piloted a ‘Twitter Chat’ before one of the webinars.
METHODS: To determine the impact of the webinars and the new interactive strategies, evaluation data from 9 webinar series dating back to fall 2013 were analyzed. The evaluation was distributed via email to webinar participants and utilizes a five point Likert scale. Data were analyzed by adding both levels of positive or negative responses. The response rate was calculated using the number of registrations. Overall response rate was 36.7%, ranging from 18.6% to 65.6% for each series. In addition to the survey, data transcripts from the communication platform and Twitter analytics were analyzed.
RESULTS: Registrations have increased steadily; registrations in the spring 2016 were 2.3 fold higher than in the fall 2013. The number of institutional registrations varied for each series considerably; institutional registrations were on average 1.55 fold higher than individual subscriptions, however the range varied from 0.77-3.33 for the different series. Overall satisfaction with each series was 77.8% +/- 6.3% including positive comments about the online communication platform. Analyses of the online dialog transcripts revealed that during each session 22.8 +/- 14 questions were asked. Additionally, requests for citations as well as communications between members of the audience were also noted.
CONCLUSION: These data indicate that the IAMSE webinar and its interactive format appear to meaningfully engage medical educators.
602 – IMPACT OF A COURSE IN MIND-BODY MEDICINE ON MINDFULNESS, PERCEIVED STRESS AND EMPATHY IN MEDICAL STUDENTS
Aviad Haramati, Kristi Graves, Christina Rush, Nicholas Talisman, and Nancy Harazduk
Georgetown University School of Medicine
BACKGROUND: Reports from various sources suggest that empathy erodes in medical students during training. The reduction in empathy is associated with a high level of student distress, which in turn is associated with higher level of unprofessional conduct in students and decreased quality of care. Certainly, the program leading to the medical degree has many aspects that contribute to student stress (academic, financial, social, etc.). However, part of the problem may relate to the lack of tools provided students to manage stress and the absence of curricular interventions to address student self-awareness and self-care.
OBJECTIVES: This study assessed whether participation in a mind-body medicine (MBM) skills course would enhance mindfulness and affect medical students’ stress and empathy.
METHODS: Georgetown University School of Medicine (GUSOM) offers an 11-week course to expose first-year medical students to mind-body approaches (e.g. meditation and guided imagery). The sessions also include sharing openly and listening without judgment. Two groups of first year medical students (n=118) completed the surveys before and after the course. Instruments included: Perceived Stress Scale (PSS), Freiberg Mindfulness Inventory (FMI), Positive and Negative Affect Scale (PANAS), and the Interpersonal Reactivity Index (IRI).
RESULTS: Course participants showed significant increases (P <0.001) in mindfulness (FMI), positive affect (PANAS) and empathic concern (IRI), while declines were seen in perceived stress (PSS) and negative affect (PANAS). Furthermore, the changes in perceived stress and affect were significantly correlated (P <0.001) with increases in mindfulness.
CONCLUSIONS/IMPLICATIONS: Fostering mindfulness through an experiential MBM course may decrease student stress and enhance elements of emotional intelligence. Such curricular interventions may sustain students’ empathy, promote better physician-patient communication and ultimately improve the quality of health care.
604 – SEA CHANGE IN MEDICAL EDUCATION: COMPETENCY BASED AND FULLY INTEGRATED
Judith Aronson, Michael Ainsworth, Judith Rowen, Lisa Elferink, Ruth Levine, Majka Woods, and Steven Lieberman
University of Texas Medical Branch (UTMB) and University of Texas Rio Grande Valley
PURPOSE: The temporal separation of pre-clinical and clinical phases of medical education impacts student appreciation for the relevance of science in the practice of medicine. As part of a University of Texas initiative for streamlining medical education, we have created a pilot competency-based curricular track (SEA CHange =Student-centered Education for Achieving Competencies in Healthcare), which abolishes the traditional separation of pre-clinical and clinical phases.
METHODS: A group of clinical and basic science faculty collaboratively envisioned the following key features of SEA CHange: 1) interdisciplinary courses emphasizing the science basic to the practice of medicine 2) active learning modalities 3) early clinical skills development and 4) longitudinal clinical experiences. Modules are organized according to life stages. Students progress through two cycles in two years. Cycle 1addresses health maintenance/ common conditions and Cycle 2 emphasizes more complex conditions. Classroom activities, clustered around patient presentations, are fully integrated with clinical experiences in modified clerkships. Students also participate in a longitudinal, community based continuity clinic. Student acquisition of key foundational science content knowledge is assessed by standardized NBME exam progress testing as well as essay examinations. Students will take USMLE Step 1 and Step 2 at the end of cycle 2, prior to a year of electives and preparation for residency.
RESULTS: Early outcomes for a small cohort in the first half Cycle include positive student perception of the linkage of classroom activities with clinical experiences and a high level of engagement with foundational science learning issues in Problem Based Learning sessions. Students demonstrate a growing ability to apply foundational science concepts to clinical problems in formative and summative essay question exams.
CONCLUSIONS: The thorough structural integration of foundational science and clinical training in SEA CHange shows early promise. Challenges include time and resource intensiveness, the need for ongoing faculty development, and continued engagement of basic science faculty.
Technology & Innovation
800 – EMPOWERING MEDICAL STUDENTS THROUGH CURRICULUM DESIGN OF THEIR OWN CLINICAL ANATOMY COURSE
Sarah A. McCarthy
The Robert Larner M.D. College of Medicine, University of Vermont
PURPOSE: After an initial integrated anatomy course during their first year of medical school, students at the University of Vermont Larner College of Medicine often do not have the opportunity to revisit human gross anatomy in depth. A fourth-year elective anatomy course was developed to allow medical students to revisit key areas of anatomy prior to graduation.
METHODS: The course has been offered twice, the first year there were 2 students with an interest in neuroanatomy and the second year there were 7 students with a full range of anatomical interests. The course allows the students to design and direct their own learning which is facilitated by the course director. The students have four weeks to develop an expertise in their chosen area of anatomy and are evaluated by an end of course oral examination. This is accomplished by designing dissections, researching and practicing surgery techniques, having anatomical discussions with their peers and course director, and presenting a clinical vignette.
RESULTS: Students felt empowered to design their own course and learning objectives. They enjoyed being able to tailor the course to their own experiences and specific needs. A reported benefit was being able to practice multiple surgical approaches to the same area allowing them to fully grasp anatomical relationships between structures, something that is rare in the operating room.
CONCLUSIONS: The course has been successful and enrollment has grown. Students all interested in the same topic made for a more cohesive course the first year; however, the students the second year were able to revisit more anatomical areas and engage in team teaching. Students have requested to be held accountable for their learning with weekly assignments rather than an end of course oral examination. This course prepares students for residency by providing an opportunity to revisit areas of relevant anatomy.
Technology & Innovation
802 – INTEGRATION OF PHARMACOTHERAPY EDUCATION INTO AN INTERNAL MEDICINE CLERKSHIP GERIATRICS HOME VISITING PROGRAM
Laurel Gorman, Andrea Berry, and Mariana Dangiolo
University Central Florida College of Medicine Medical Education, University Central Florida College of Medicine Faculty Development, and University Central Florida College of Medicine Internal Medicine
PURPOSE: In most medical school curricula, pharmacology is covered in the preclinical second year (M2) with limited reinforcement during clerkship where learners are exposed to clinical experiences ideal for therapeutics application activities. Further, most curricula struggle with where to integrate complex geriatric clinical therapeutics education.
METHOD: To address these challenges, we developed an innovative educational geriatrics home visiting program during our internal medicine clerkship. Ten third year (M3) medical students, working in groups of 2, visited geriatrics patients and completed medication reviews that addressed medication adherence, medication documentation, adverse effects, and drug interactions. Clinical pharmacology preparatory material included the Beer’s EBM criteria for inappropriate prescribing in the elderly as well as resources discussing geriatric pharmacotherapeutics. After completing home visits, the students met with a geriatrician and a pharmacologist to discuss appropriateness of prescriptions, rationale for continuing therapies, and concerns associated with their patient’s management.
RESULTS: Participants predominately reviewed therapeutics related to hypertension, heart conditions, type II diabetes, chronic pain, and drug interactions due to polypharmacy. The number of medications prescribed per patient ranged from 4 to over 20. In terms of preliminary outcomes, participants excelled in oral medication review presentations and successfully identified inappropriate medications in the elderly. They demonstrated competence in documenting medications in booklets reviewed by faculty. In focus groups, students indicated the program helped them understand the unique concerns of geriatric management. During discussion, students indicated that the program helped them to review and appreciate their M2 pharmacology education.
CONCLUSION: In summary, geriatrics pharmacotherapy was integrated into an innovative geriatrics home visiting program during M3 internal medicine clerkships. Participants in the preliminary program evaluated it positively and demonstrated competence in conducting a medication review and discussing polypharmacy issues. Further studies are ongoing assessing this program’s impact in improving knowledge and awareness of safe prescribing in the elderly.
Technology & Innovation
806 – 3D Printing In Medical Education
Case Western Reserve University School of Medicine
PURPOSE: Educational aids have helped deliver anatomic information to student-learners dating back to the Ancient Egyptians, circa 1600 B.C. Recently, 3D printing technology has become integrated into anatomical education. Several studies1-5 have compared learning outcomes utilizing 3D printed (3DP) models against various educational supplements for anatomic education and this project aims to that summarize data.
METHODS: In December 2016 PubMed search terms “3D Printing in Education” were used to find relevant articles. Inclusion parameters were multiple experimental groups, objective post-testing, and limited to education. Exclusion parameters included descriptive studies, procedural studies, or those lacking post-testing. Using these screening parameters 51 abstracts were viewed and 5 included in this review.
RESULTS: In 4 out of 5 studies, a 3DP model group significantly outperformed other educational aids. In 2 similar studies1-2, the 3DP model group had significantly higher mean post-test scores than static-imaging or digital atlas groups. In a similar study3, a 3DP model group had significantly higher mean scores, ease of use and faster time to answer scores than CT imaging or digital atlas groups. In one double-blind randomized controlled trial4, a 3DP model group had higher mean post-test scores compared to cadaveric specimens or a mixed cadaveric and 3DP specimens. A final study5 found higher post-test scores, lacking significance, in a 3DP model group vs cadaveric dissection group.
CONCLUSIONS: To date, 5 studies have evaluated anatomical learning outcomes using 3DP models against other educational aids. All of these studies have shown equal or better performance of 3DP models compared to other educational aides including cadaver, CT imaging, static imaging and digital atlases.