2017 Meeting Posters – Technology and Innovation

Poster Award Nominee
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.

Jennifer Montemayor
Rocky Vista University College of Osteopathic Medicine

PURPOSE: Effectively interacting with a large class of medical students can be a challenge. In effort to make the large-class environment more approachable for students and promote communication with faculty as well as with other students, a discussion group was created on the social media site Facebook. The group was designed to be easily accessible for students to post questions or comments on course concepts, learn from peer questions and comments, and share additional resources.

METHODS: A five-question survey instrument was devised to assess student perception and utilization of Facebook as a discussion forum.

RESULTS: Approximately half of the Class of 2019 responded to the survey. Over 80% of respondents indicated they utilized the Facebook group. Of those, 95% agreed it was helpful. Approximately 70% of respondents who indicated it was a helpful resource attributed the benefit to being able to view questions and answers shared by peers, and approximately 30% indicated that it was beneficial to have their own questions answered as well as those of others. Of the approximately 20% of respondents who did not utilize the Facebook group, approximately two-thirds indicated they did not wish to use Facebook.

CONCLUSION: Popular social media tools, such as Facebook, can be powerful resources to supplement classroom interaction, particularly with large classes of primarily millennial-generation students. In this case, it appeared to increase a sense of camaraderie among the class through shared resources, and it provided students the opportunity not only to have their own questions answered but also to have the important opportunity to learn from each other’s questions and faculty responses. In the future, use of the Yammer social networking tool of Microsoft Office 365 will be explored to address the feedback from students who did not wish to use Facebook.

Poster Award Nominee
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.

803 – Improving Medical Education Scholarship by Improving Peer Review
Elizabeth S. Karlin and Jennifer Campi
Association of American Medical Colleges

PURPOSE: To improve peer review of medical education manuscripts and thereby improve medical education scholarship.

METHODS: The authors and their colleagues have researched available educational resources for reviewers of medical education scholarship. With feedback from reviewers, since 2013 they have created and made available a variety of resources and workshops targeting identified and complementing varying reviewer needs and learning styles.

RESULTS : A series of 10 AM Rounds blog posts with tips from expert reviewers and a video entitled “What Editors Want” are directed at reviewers who embrace social media and want to invest short amounts of time (? 5 minutes). As of December 1, 2016, the blog posts have been viewed over 1,000 times since they were posted in 2013, and the video has been watched 250 times since it was posted in February 2016. The newly revised Review Criteria for Research Manuscripts, 2nd edition, offers an in-depth look at the review process. It outlines the review process, touches upon reviewer etiquette and ethics, goes beyond quantitative research to consider qualitative research and reviews of new innovations, and provides details about reviewing each part of a medical education research report. It has been downloaded 1,249 times since May 2015. Academic Medicine‘s reviewer workshops at national and international conferences have been well attended and participants have provided positive feedback. Several participants at a 2015 workshop formed a writing group during the workshop and submitted a paper to the journal on their experience. Their article was published online in September 2016.

CONCLUSIONS: If you build it, they will come. Reviewers use reviewer resources. This may lead to better reviews and, in turn, improved medical education scholarship. Next steps include adding resources to a new “Reviewer Hub,” tracking downloads and usage, and asking reviewers about the helpfulness of the resources.

Matt Protas, Roni Manyevitch, Spandana Thenkabail, Yonatan Ghiwot, Aleksandr Myllari, Kesava Mandalaneni, and Ian V.J. Murray
St George’s University (SGU), School of Medicine, Dept of Physiology and Neuroscience

PURPOSE: Lectures have recently been labeled obsolete, with lack of students’ attention to blame. However, few of the various theories on increasing attention during lectures have actually quantified attention. This study will use neurometrics to quantify both attention and learning in order to evaluate these theories.

METHODS: Novel lecture content, not part of the medical school curriculum, was used so that students’ prior knowledge would not skew the data. A 25 minute recorded lecture was split into 2 parts: professor in video (PROF) and static PowerPoint slides. Additional teaching theories evaluated include emphasis, dissonance and pause procedure. To mimic a lecture format, student groups watched only one prerecorded lecture video format in a conference room. Learning and attention (ATT) were evaluated during the lecture via single electrode electroencephalography (EEG) and multiple choice questions (MCQ). MCQs correlated to, and probed content every 2 minutes in the lecture. ATT measurements were derived from EEG signals acquired using the Neurosky device (neurosky.com), and software was specially developed (ActiveOS.com) to simultaneously record from multiple bluetooth devices.

RESULTS: The content was novel as a difficulty index of 50.8% was calculated for students’ not viewing content, 61.0% for PowerPoint and 64.8% for PROF. MCQ errors were similar in both, correlating with ATT spikes in PROF (63.7%), and both spikes and troughs in PowerPoint (34.4, 45.56%), indicating attentional fatigue and inattention. The pause procedure did not result in increases in either ATT or learning, and actually decreased attention. Emphasizing content resulted in MCQ a decrease in MCQ errors from 50% PROF to 10% in PowerPoint. Lastly, dissonance resulted in students trusting the intentional verbal “error” over the slide content.

CONCLUSION: This neurometrics study quantitatively evaluated several different teaching methodologies, and correlated attention and learning. This experiment has implications for more effective evaluation of online and in-class learning.

805 – Learner Satisfaction with Glass Learning Board Video
Vicki McKinney, Bonny Dickinson, Jeffrey Greene, and Lisa Miller
WMU Homer Stryker M.D. School of Medicine

PURPOSE: With an emphasis on creating life-long learners, medical educators are moving preclinical content to independent learning exercises. Videos are often used to deliver curricular content but engaging medical students in learning content delivered outside the classroom can be challenging. Glass learning boards (GLB), a newer tool for creating instructor-led videos for asynchronous learning events, are designed to engage students in learning content delivered outside of the classroom. This research examines preclinical medical students’ perceptions of the use of a GLB video.

METHODS: During the six-week gastrointestinal course a topic was introduced in an independent learning using a video created with a newly acquired GLB. The remainder of the independent learning course materials were presented in traditional reading assignments, images and pre-recorded lectures. At the end of the course, six questions focusing on aspects of learner satisfaction with the GLB videos were added to the standard course evaluation.

RESULTS: 55 second year medical school students completed the anonymous survey. A majority of the students indicated the GLB enriched the quality of the content being presented. The instructor’s handwriting and drawing on the glass learning board was indicated by students to be more engaging than reading text or viewing static drawings. When compared to traditional instructional videos, students felt the GLB promoted higher quality of instruction in terms of how they personally learn most effectively. Students indicated instructors should make more use of the GLB.

CONCLUSION: Glass learning board videos offer an exciting technology for delivering content in preclinical medical education. The glass learning board offers the advantage of the instructor actively writing or drawing that actively engages the learner.

Poster Award Nominee
806 – 3D Printing In Medical Education
Mark Biro
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.

Scott Helf, Johmarx Patton, Emmaneul Katsaros, and Gerald Thrush
Western University of Health Sciences, College of Osteopathic Medicine of the Pacific (COMP) and University of Michigan Medical School (UofM)

PURPOSE: Competencies and entrustable professional activities (EPAs) represent a major shift in medical education. How will we know whether, and how well, we are accomplishing our goals? Effectively, efficiently, and continuously answering this question will significantly depend upon an information system which is proactively designed with competencies and EPAs sharply as its focus.

METHODS: Over the past decade COMP has developed a holistic student tracking and advising software, ProgressIQ, which automatically integrates data from existing internal and external systems. ProgressIQ is continuously re-engineered to accommodate increasing levels of abstraction as medical education best practices evolve and advance. Likewise, UofM has developed a Student Performance Record that provides learners and administrators with the data they need to track progress toward competency.

RESULTS: These are projects in their early stages, with many anticipated lessons to learn. One significant lesson already learned is that there seems to be no clear consensus on what EPAs readily translate from GME – from where they originated – to UME. Hence, systems designed to track EPAs must be fully abstracted, such that they readily accommodate any EPA concept, whether currently in existence or imagined for the future.

CONCLUSION: When it comes to recording, tracking, analyzing, and providing a platform for advisors, deans, and students to reflect on student competency and EPA development, staff and faculty at COMP and UofM will be ready. Additionally, developing such an IT system in the context of all other student performance academic data will create a treasure trove of information, ripe for data mining, analyses, reflection, actionable insight, and peer-reviewed publication.

Machelle Linsenmeyer and Sean Tackett
West Virginia School of Osteopathic Medicine and Johns Hopkins Bayview Medical Center

PURPOSE: Research on self-regulated learning in health professions education is sparse and no studies have explored self-regulation itself (mechanisms to foster self-regulated learning or better prepare students for future learning). Since many health profession training contexts do not typically provide trainees with opportunities to actively self-regulate their experiences and scaffold learning, the present study sought to determine what technologies or processes would expand the situations in which trainees can learn how to learn (building learning versus binge and purge) or afford them opportunities for self-regulated learning.

METHODS: A technology platform was introduced to 400+ first and second year medical students to provide them with tools to enhance their ability to self-regulate their learning and continue to build knowledge from one instructional activity to another. The platform provides mechanisms such as flashcards, quizzes, content matching to outside resources/texts, instructional videos, etc. Content in the tools was matched to the actual curricular content for each class. Both surveys and focus groups were conducted, and continue to be conducted, to better understand the items that best support (or scaffold) learning or help students develop self-regulated learning skills that they can use to prepare for both current and future learning.

RESULTS: Thus far, several tools have been highlighted that are critical for setting up processes that will help students learn how to learn and enhance their ability to self-regulate their learning. Students who struggle have shown improvement after using the tools that have been highlighted. Research continues and these points as well as new observations will be discussed in detail during the presentation.

CONCLUSION: The present study shows that there are mechanisms that can set the stage for future learning and help students develop self-regulated learning skills that will improve both their current and future learning.

Jaret M. Karnuta, William A. Cantrell, Lamont J. Wilkins, Daniel Moussa, and Neil Mehta
Cleveland Clinic Lerner College of Medicine

PURPOSE: Evaluate medical students’ impressions of the advantages and utility of Microsoft HoloLens Mixed Reality (MR) technology in medical education and their impressions on the educational settings in which the technology would be most helpful.

METHODS: Second year medical students at the Cleveland Clinic Lerner College of Medicine (CCLCM) were invited to attend a one-hour HoloLens demonstration. Students participated in a walk-through of the device and then had the opportunity to explore an interactive skeleton and cardiothoracic hologram program.

First year medical students at CCLCM were exposed to HoloLens through an instructional and interactive session during four, twenty-minute blocks of scheduled class time. Students were guided through a newly developed program that taught cardiac anatomy and physiology.

Following each session, students were asked to complete a survey that asked questions pertaining to the student’s perception on how well the HoloLens would be suited for medical education in a variety of settings and organ systems.

RESULTS: 14 out of 32 second year students and 27 out of 32 first year students completed the survey. 76% of students responded agree or strongly agree while one student responded disagree/strongly disagree to the following statement: “I believe that integrating the HoloLens in the curriculum can help me in my learning”. The remainder were neutral. The students also indicated which organ systems and educational settings might be most ideal for the use of HoloLens.

CONCLUSION: Students are welcoming towards the idea of integrating MR technology into medical school education. Students suggest that supplementing traditional curricular activities with MR will enhance their understanding of complex subjects.

Sean Flynn
University of Vermont

PURPOSE: Incorporating active learning into large lecture based, team-taught courses can be logistically challenging. Audience response systems, or clickers, provide a potential solution, allowing all students to respond to questions during lecture. Previous studies have suggested that using clickers in large lecture courses can improve overall student knowledge retention and academic performance.

METHODS: We evaluated the final weighted averages of students in our first semester anatomy & physiology course (ANPS 019) over the course of three years (Fall 2014- Fall 2016). ANPS 019 is the only integrated anatomy & physiology course offered at the University of Vermont, resulting in a broad range of students enrolled, including sophomore health-science and dietetics & food science majors. In Fall 2014, no clicker questions were given in the course. In Fall 2015 clicker questions were given, but participation was optional and no points toward the final grade were granted. In Fall 2016 clicker questions were given, but participation was required and the response to clicker questions accounted for 5% of the final grade. All students used the i <clicker system to respond to questions utilizing either a physical clicker or the online REEF polling app.

RESULTS: Over the three years studied, 1,098 students were evaluated for overall course performance. One-way ANOVA was used to compare the final weighted averages between the three years. A significant increase in weighted averages was observed between Fall 2014 and Fall 2016. However, no other significant differences were observed between the three years evaluated.

CONCLUSION: Although an increase in mean weighted averages was observed across all three years, the differences were small and only reached significance when comparing Fall 2014 to Fall 2016. These results are surprising; given the positive responses we received from students. Future investigation will evaluate specific student populations to further analyze this data set.

811 – The Use of HoloLens to Enhance the Medical School Learning Experience
Janet Adegboye, Neil Mehta, and Dileep Nair
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
PURPOSE: Medical education is an evolving field, especially with the rapidly advancing technology of

our society. This project explored the use of augmented reality with Microsoft HoloLens to enhance how anatomy is taught in medical school. We assessed three aspects of the student experience: the amount of knowledge gained, the cognitive load required to learn, and the overall satisfaction with HoloLens.

METHODS: The study population consisted of 31 second-year medical students at the Cleveland Clinic Lerner College of Medicine. This was a two-week study that took place during the neurology block. Each week, half of the students were able to use HoloLens for self-study of neuroanatomy, while the other half learned the same material in the traditional format. The groups were reversed after the first week in order to give every student an opportunity to learn with HoloLens. At the end of each week, the students took a quiz to assess their knowledge and a survey to assess their cognitive load and learner satisfaction.

RESULTS: Both groups had a similar performance on the neuroanatomy knowledge quiz; however, 30% of the students in the HoloLens group felt that it was easy to learn the concepts compared to 11% in the control group. Of the students in the HoloLens group, 80% believed that the addition of HoloLens would enhance how neuroanatomy was currently taught, assuming that the appropriate HoloLens content was available. Overall, the quiz and survey responses suggested that the students in the HoloLens group had a decreased cognitive load and that most students felt positive about their HoloLens experience.

CONCLUSION: Compared to the traditional medical curriculum, the use of HoloLens technology enhanced the learning experience of medical students by decreasing the cognitive load required to learn neuroanatomy.

812 – Themes Identified in Medical Student Essays on Professionalism through Automated Text Processing
David Allbritton, Klara Papp, Peggy Kim, and Amy Wilson-Delfosse
DePaul University, Case Western Reserve University School of Medicine, University of Wisconsin School of Medicine and Public Health

PURPOSE: Qualitative research in the grounded theory tradition has its roots in ethnographic fieldwork and relies on comparative, iterative, and interactive methods that seek to obtain meaning from qualitative data. As such, grounded theory uses text data as its source of information for making meaning, i.e., coding and interpreting results. It is labor intensive. Codes emerge as one scrutinizes the data using constant comparative methods. Our purpose was to test whether a web-based text-mining tool can be used to identify useful codes for a group of essays on professionalism written by pre-clerkship medical students.

METHODS: We studied 25 essays written by medical students in the pre-clerkship phase of the curriculum on professionalism as part of a portfolio assignment at the end of their first year. We applied a web-based text-mining tool developed by the first author using the Shiny web application framework of the R statistical programming language (https://github.com/davidallbritton/SCIP-2016-Exploratory-Text-Analysis). Text mining methods included n-gram frequency analysis and Latent Dirichlet Allocation topic modeling.

RESULTS: Our text mining tool effectively identified basic level codes for our coding tree. This automated text mining technique identified themes across student essays as starting points for more systematic qualitative analysis. Once basic level codes were identified, the text was further interpreted and classified into similar categories through traditional qualitative analysis – for example: combining “integrity”, “honesty” and “forthrightness” into a single category. We identified a variety of themes which were then further discussed and coded.

CONCLUSION: Automated text-mining software can greatly assist qualitative research methods and serves as a starting point for further analysis and comparison. Though the technology is in its infancy, applications to other text data merit further exploration.

Charles Price, Brian Baxter, and Brion Benninger
Western University of Health Sciences COMP-Northwest, Medical Anatomy Center, Departments of Medical Anatomical Sciences and Neuromuscular Medicine

PURPOSE: Knee injuries are common and associated with swelling and pain. Pain treatment is critical, often accomplished by fluid aspiration from the knee. Specialists can perform blind knee aspirations consistently. Non-surgical specialists are less successful and confident. Ultrasound has proven to be successful. The objective of this study investigated a training methodology for medical students (MS) to conduct ultrasound-guided needle (NG-US) knee aspirations.

METHODS: Literature search was conducted regarding NG-US knee aspiration training to MS. Fukuda Denshi UF-760AG ultrasound-system with 5-12MHz linear probe. 19 1st & 2nd year MS were provided an identical content video or ‘hands on’ tutorial performing NG-US knee aspiration (10-video,9-hands on). MS were scored out of 11 points based on correct syringe-needle choice, surface anatomy landmark identification, probe and needle placement, structure identification from image acquisition, and procedure success.

RESULTS: Literature search revealed no known studies. 18/19 MS successfully conducted NG-US knee aspiration, averaging a score of 10.1/11 and a time of 136s. Students who received hands-on demonstration were able to perform the procedure more quickly(-40s, p <0.1) and scored higher(+1.0 points, p <0.05). Aspirating fluid from the knee can relieve pain and improve range-of-movement, provide diagnostic sample, and expedite knee surgery. Most medical graduates become family practitioners and see a large number of knee injuries. This study investigated whether an NG-US knee aspiration was more successful after video tutorial or hands-on demonstration of identical content.Today’s MS are strong visual learners, however results revealed a multimodal stimulation (visual, auditory, proprioceptive, tactile) were preferred and yielded better results versus a video tutorial.

CONCLUSION: This pilot study comparing identical content but delivered via video versus hands-on tutorial of NG-US knee aspiration procedure suggests hand-on demonstrations with multimodal stimulation more effective than video for needle procedures.

Arun M Ram and Senthil K Rajasekaran
Eastern Virginia Medical School

PURPOSE: Students of our MPA program are exposed and expected to master a huge volume of information in a short 28-month curriculum leading up to their clinical practice. In order to maximize learning, we delivered Clinical Pharmacology (CP) course in a flipped classroom model using technology.

METHODS: CP I and II are two 3-credit courses taught over 4-month each with a two 2-hour didactic lectures every week. In its place, we introduced short 20 to 30 minute videos recorded using Explain EverythingTM or CamtasiaTM and posted them two days prior to in-class session. In addition, a complete slide deck and a list of 20 to 40 review questions designed to guide students towards the clinically relevant facts and concepts in each class were also posted. Students listened to the recording, used the slide deck and review questions to master the concepts. A survey at the end of the course collected the feedback on this new model of course content delivery and their learning experience.

RESULTS: An 82% of the respondents wanted the course to be delivered based on this new model in future. About 75% agreed that the new model allowed them more time to study other subjects. Another 76% felt the new model helped them feel prepared for the exams. Although we had reduced the student-faculty contact time by 50%, about 70% felt the new model provided them adequate faculty exposure and interaction.

CONCLUSION: Student performance metrics on our assessments and end of course feedback suggest the value and utility of this model. Along with the findings, we intend to share some of the barriers that we had to overcome in the process.

Maxwell Mirande, Sherman Chu, and Brion Benninger
Western University of Health Sciences COMP-Northwest, Medical Anatomy Center, Departments of Medical Anatomical Sciences and Neuromuscular Medicine

PURPOSE: Emergency FAST (Focused Assessment using Sonography in Trauma) exam utilizes ultrasound to observe stereostructural anatomy identifying fluid in spaces and organ morphology in the abdomen and thorax. Point-of-care ultrasound can be utilized by physicians in acute and chronic clinical settings assessing structures of the pelvis, abdomen, and thorax. Today’s learner acquires procedural skills more efficiently via multimodal stimulation. The objective of this study was to compare the effectiveness with identical content of hands-on tutorials (HOT) vs video tutorial (VT) for training medical students (MS) conducting FAST exam.

METHODS: Literature search was conducted comparing video and hands-on tutorials training medical students on FAST exam. 29 MS were exposed to FAST exam during anatomy three months prior, received a 5-min peer-to-peer tutorial (13HOT,16VT) on probe choice, probe placement, surface anatomy landmarks, structural identification and fluid accumulation of image acquisitions from Vimedix simulated ultrasound system (VSUS). MS were assessed on the FAST exam 24 hours post-tutorial on the criteria above (25-point system) and timed. MS scored their confidence on a Likert scale out of 10.

RESULTS: Literature search revealed no known studies. MS cumulatively scored between 9-25 points and completed the FAST exam in 65-219s. There were no significant differences in the points scored (p>.75) and time for completion (p>.99) between MS receiving HOT versus VT. MS who received HOT reported higher confidence performing the exam compared to VT (+1.3,p <0.05). MS received FAST exam training during anatomy, therefore tutorials appeared to serve as review, explaining similarities between HOT & VT groups on points scored and completion time.

CONCLUSION: This study demonstrated no significant difference between VT versus HOT scores for MS using VSUS with previous training of live ultrasound FAST exam during anatomy. Regardless of tutorial method, this study suggests VSUS is a powerful simulator.

Kimberly Schwartz, Wilson Chen, and Brion Benninger
Western University of Health Sciences COMP-Northwest, Medical Anatomy Center Departments of Medical Anatomical Sciences and Neuromuscular Medicine

PURPOSE: Endotracheal intubation(ETI) procedure is life-saving for trauma and routine in general anesthetic operations. Anatomical architecture of the pharynx and larynx between individuals is significantly variable. Visual-assisted ETI can be conducted safely by a trained specialist using a bronchoscope. Pre-hospital professionals lack specialist training. Considering ETI’s life-saving potential and anatomic variability, there is great need for an inexpensive and easily operable visual ETI. The objective of this study was to determine the effectiveness of a prototype flexible intubation optics (FIO) for visually-guided ETI.

METHODS: Alps Innovative Medicine(AIM) invented the FIO system, including built-in light source and lens designed to accommodate all endotracheal tube sizes. ETI was performed by trained and untrained practitioners on 3 recently deceased unembalmed cadavers (UC), 2 lightly-embalmed cadavers (LC), 2 fully embalmed cadavers (FC), and 10 fresh frozen unembalmed cadavers (FFUC). ETI’s were video-recorded. Success of intubation was assessed on visualization of the epiglottis and confirmed proper tube placement.

RESULTS: Literature search revealed use of hand-held visual laryngoscopes, but no studies on flexible intubation visual guides designed to trace endotracheal tube above and below the cords avoiding right mainstem(bronchus) intubation. ETI was successful on 3/3 UC, 1/2 LC, 0/2 FC, and 8/10 FFUC. Trained and untrained practitioners achieved the same results in a realistic life-saving time-sensitive procedure ( <2 minutes). Direct visual laryngoscopes can be effective visualizating the epiglottis, but noted it may be suboptimal because blade/light source positioning may compromise viewing. FIO provides real-time lighting(maximum illumination and optics versus laryngoscopes) above and below the cords reducing failed intubations.

CONCLUSION: This study revealed the FIO system conducted ETI successfully on unembalmed cadavers, suggesting an accessible training arena for routine and extreme conditions. This innovative technology is ready for larger research trials for field and hospital applications.

Brion Benninnger, John Carter, and Shashank Bathula
Western University of Health Sciences

PURPOSE: Live lectures compete with the acute awareness of simultaneous or sequencing digital communication tasks as texting, reflex email watching and other habits including lecture content surfing constituting multi-tasking. Adult learners predictively possess 12-18 minutes mental attention span. Successful healthcare learners exercise their metacognitive knowledge with task strategic, self-regulated and routinely reflective behaviors. The objective of this study was to develop an effective teaching method and delivery technique, incorporating lecture content and any multi-tasking habits within 1-hour lectures.

METHOD: Literature search was conducted regarding medical school lectures promoting digital communication and other multitasking habits. Design innovative sequential core learning(SCL)technique including a high image ratio applying cognitive load theory. 86 medical students(MS)received minimum of 30% anatomy lectures employing SCL technique during 3/4 regional exams. Start of each lecture hour, all electronic devices were shut off and/or closed for 12-15minute sequential core sessions(SCS)then encouraged to text, ask questions, surf etc€¦during 5-7minute protected electronic time(PET), equaling 3 sessions per hour. MS interviews and exam results assessed SCL technique and delivery.

RESULTS: Literature search revealed no known studies. SCL technique was developed and successfully delivered. MS interviews(n=27)overwhelmingly supported SCL technique. All MS supported the 5-7min PET after 12-15min SCS. MS had higher exam scores from SCL stimulation on 3 of 3 regional exams compared to 1 without SCL. Important for educators/teachers to recognize anatomy as a visual science, which requires spatial orientation and pattern recognition or stereostructural anatomy incorporating cognitive load theory to utilize and learn 3D morphological relationships. This could expedite skills for ultrasound point-of-care invasive procedures, cross-sectional image analysis and radiomics. MS wrongly use rote memorization to study anatomy, and does not correlating anatomical information with clinical conditions.

CONCLUSION: This novel pilot study demonstrated an effective new educational method SCL and delivery technique SCS/PET consistent with digital-age learners.