2017 Meeting Posters – Student Support

600 – Perceived benefit of yoga on medical school student well-being
Audrey A. Vasauskas
Alabama College of Osteopathic Medicine

PURPOSE: Research points to a direct correlation between patient care and physician well-being, suggesting that patient empathy is inversely related to physician stress, depression, and burnout. Medical students and healthcare practitioners are under a great deal of stress, often leading to detrimental health effects including anxiety and depression. The effects of stress on students, healthcare professionals, and patient care have led to a number of initiatives that promote well-being. The practice of yoga has been highlighted for its stress-reducing benefits, and notably yoga has been shown to increase empathy and reduce perceived stress for medical students.

METHODS: In this pilot study, we surveyed medical students to assess the perceived benefit of yoga on their well-being. First and second year medical students were asked to complete a survey regarding their feelings post-yoga practice. The survey also included questions about students’ overall stress levels.

RESULTS: Thirty-six first and second year medical students responded to the survey. Forty-two percent of respondents reported feeling stressed at least half the time and 18% reported feeling stressed some of the time. Sixty-seven percent of respondents practice yoga at least one to two times a month, with 18% reporting practicing at least once a week. The majority of yoga practitioners reported feeling calm and less stressed. The majority of respondents who practiced yoga reported feeling that yoga contributed to their well-being (84%) and helped them manage school-related stress (72%). Finally, 46% of respondents have incorporated yoga and 78% responded that they plan to incorporate yoga into their stress-reduction routine. These data suggest that a regular yoga practice may contribute to medical student well-being. Optional medical school-sanctioned yoga and mindfulness sessions for students may not only improve student health, but may also lead to long-term mindfulness practices that benefit caregivers and patients alike.

Mikaela L Rodriguez, Andrew K Corse, and Lee D Rosen
University of Vermont College of Medicine

PURPOSE: Medical students experience significant rates of depression, anxiety, and burnout during their training, yet they are often reluctant to seek mental health treatment. This study evaluated the use of mental health services among University of Vermont (UVM) medical students, identified barriers to use, including perceptions of stigma, and compared to the previous literature on utilization at other institutions.

METHODS: A cross-sectional online survey was administered to all enrolled University of Vermont medical students in the spring of 2016. Outcome measures included use of mental health services, barriers to use, and items exploring attitudes towards seeking care and perceived stigma.

RESULTS: Of the 44.8% (202 of 463) students who participated in the study, 42.1% reported using mental health services in the past 12 months. The most commonly reported barriers to use of services were lack of time (72.8%) lack of convenience (48.5%), and concerns about what supervisors (45%) and other students (41.1%) would think. Students who used mental health services concerns related to supervisors. First-years were more likely to report lack of effective treatment. One-third of students agreed/strongly agreed that other students would view them less favorably if they knew that they had used mental health services. One-third of students also agreed/strongly agreed that supervisors would view them less favorably. More than 1 in 10 students disagreed/strongly disagreed that they would seek mental health treatment if needed. These students were more likely to have agreed/strongly agreed that students would view them less favorably.

CONCLUSIONS: UVM medical students use mental health services at a high rate, relative to reports from previous studies. Nevertheless, their beliefs and attitudes suggest that there remain significant barriers to the use of mental health services, including perceptions of stigma and negative impact on their careers.

Poster Award Nominee
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.

Leonard A. Haas, Anjali Bhagra, Alexandra P. Wolanskyj, and Amit Sood
Mayo Clinic School of Medicine

PURPOSE: Wellness initiatives to promote well-being and prevent burnout are a recognized requirement for future physicians. To that effect, we have developed a Student-Initiated Wellness Activity (SIWA) grant program, under the direction of our Student Life and Wellness Committee (SLWC) at the Mayo Clinic School of Medicine.

METHODS: The SLWC is comprised of students, physicians, and paramedical staff and has created the SIWA grant program, which provides students across all four years with competitive monetary grants for student-led initiatives for physical, mental, emotional, and spiritual wellness. SIWA applications are evaluated and scored on the following criteria using a four point, Likert-type scale for each category: how well they address student wellness, create significant impact to draw students to participate, assure access to all through financial support, include as many students as possible for the funds provided, and the application’s uniqueness and clarity with a well thought-out budget and time frame. Applications are then voted on by all members at monthly SLWC meetings.

RESULTS: Nineteen of twenty-seven grants were funded in the first school year 2015-2016 (70.4%) and eleven of fourteen grants were funded in the first half of the 2016-2017 school year (79%). As defined by the applicant, wellness activities were approximately 40% physical wellness, 73% mental wellness, 53% emotional wellness, and 20% other. Students across all four medical school years participated in these events. In a follow-up survey, 100% of student SIWA applicants (n=15) responded that SIWA was a successful method to promote wellness and actually did improve the wellness of attendees who participated in the activity.

CONCLUSION: Empowering medical students to create and lead their own wellness-promoting activities improves well-being and fosters a healthy learning environment. This innovative, inclusive, diverse, student-organized, and student-led model to increase wellness allows students to prioritize and engage in high yield activities based on their perceived needs.

Poster Award Nominee
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.

YunXiang Chu, Lauren Rothkopf, Kristine Krafts, Catherine Johnson, and Tao Le
Harvard Medical School, ScholarRx, University of Minnesota, and University of Louisville School of Medicine

PURPOSE: Medical students are often involved in medical education but typically receive little formal training. We have created an online, international New Educator Program (NEP) to identify and support medical students with an interest in medical education.

METHODS: We completed a survey of US and international medical students participating as returning authors or editors on ScholarRx or First Aid publications to determine areas of interest. Based on the responses, we designed and developed the NEP which currently features e-learning activities and later will include mentoring and capstone projects. The certificate program includes 10-12 activities each year, each requiring two hours of total time commitment per activity.

RESULTS: 37 medical students participated in the survey and identified the following areas of high interest: 1) curriculum design and development; 2) small group/individual teaching; 3) leadership skills in an academic setting; 4) large group teaching/lectures; and 5) teaching in an inpatient setting. We enrolled 15 medical students in NEP in September 2016 and successfully completed the first activity in October 2016, which had two components focused on curriculum design. First, students were asked to read a journal article with three open-ended “thought questions.” Thirteen students wrote 37 short essay responses to the thought questions averaging 298 words each. The second component was a webinar presentation with group discussion. We conducted a focus group feedback session at the end of the webinar and received overwhelmingly positive responses from participants. Additional NEP monthly activities are scheduled to take place through the end of 2017.

CONCLUSION: The New Educator Program may serve as a model for developing medical students in the US and internationally into effective physician-educators.

Pamela O’Callaghan, Kelly McCarthy, and Jennie Ariail
USF Health and Medical University of South Carolina

PURPOSE: Struggling medical students have low self-efficacy beliefs and negative feelings about learning that directly influence their motivation to persevere through difficult learning tasks (Cleland, et al., 2013). The study explores the relationships between the specific affective factors of self-efficacy, resilience, and self-compassion in physicians who successfully transitioned to residency training after experiencing failure in medical school.

METHODS: This study utilizes a cross-sectional design to capture information about residents who completed mandated remediation while in medical school. Data has been collected on participant’s self-efficacy, resilience and self-compassion, academic and professionalism-related deficiencies, remediation strategies, and residency match outcomes.

RESULTS: Initial comparisons of the rating scale results indicate that students who successfully complete remediation coursework have higher ratings of self-efficacy and self-compassion than reported in samples of high functioning physicians.

CONCLUSION: Understanding how to best remediate medical students is critical because those who exhibit poor clinical judgment, knowledge, and/or skills may pose a risk of significant harm to the public at large.

607 – Evaluation of a Mentoring Program: Should Mentoring be Limited to ‘At Risk’ Medical Students?
Carol Haase, Xia Wang, and Amina Sadik
Touro University Nevada

PURPOSE: The goal of this project is to evaluate the criteria for mentor assignment and the effectiveness of the program from both mentors and mentees perspectives, and to identify any potential areas of improvement.

METHODS: The recruitment email message was structured to link participation consent. An interview of the program administrator and faculty members who participated in mentoring was conducted. First-through fourth-year medical students were asked to complete a survey to identify students with mentors, both assigned and self-selected. Using Fisher’s Exact Test for Count Data, the participants’ cumulative GPA, and COMLEX Steps 1 and 2 scores were analyzed to determine whether there is any correlation between mentoring and the academic performance. The comments obtained from the administration, faculty members, and students were coded for pattern.

RESULTS: Among the participants, 53% of low-performing students have mentors, 80% of these mentors are assigned through the mentoring program. Only 25% of high-performing students have mentors, the majority of these mentors are self-selected. There is significant association between student performances and whether or not they have a mentor or how mentor is assigned. The majority of survey participants identified their mentor as “having a positive impact on their career” and “personal goals”. Approximately 50% felt their mentor was “key to their academic success”.

CONCLUSION: Both students and faculty members indicated a need for a more robust mentoring program throughout the four years of medical school instead of limiting it to the two first years and only to “At Risk” students. Faculty members indicated a need for a formal training for more effective and efficient mentoring. A feedback process would also be necessary to ensure that the training was sufficient and the mentoring is well received and perceived by mentees.

608 – Medical School Transition Program Improves Student Outcomes
Margaret Maimone, Lauren Germain, Mary Ann Grandinetta, Thomas Poole, Nicholas Runeare, Nour Sahraoui, and Mary Lou Vallano
SUNY Upstate Medical University

PURPOSE: Literature suggests that pre-matriculation programs can enhance the academic success of educationally disadvantaged medical students. To help such students at SUNY Upstate Medical University, we developed a 4-week summer transition program that immerses students in selected basic science topics while they hone pertinent skills in study strategies, time management, resource utilization, and reflective practice. The course is a collaboration between basic science faculty and student support services, and also includes medical student teaching assistants.

METHODS: All accepted medical students may apply for a seat in the program, though academically disadvantaged students are specifically encouraged to participate. The program has grown from 13 to 22 students since it began in 2014. Time spent on basic science vs skills development is similar. Grades (pass/fail) are based on multiple choice exams, homework, reflections and participation. Course evaluation methods include focus groups, surveys and academic year exam score analyses.

RESULTS: To date, 52 students have completed the program. Student surveys and feedback sessions indicate that the program enhances readiness and academic outcomes. Specifically, 100% of students in the 2015 and 2016 cohorts indicated that they would recommend the course. Students reported increased confidence, improved time management and study skills, and increased understanding of support services. They indicated that basic science content was helpful and appropriate. Student and faculty feedback has informed changes to the course to improve the quality and meet the students’ needs. Based on faculty feedback, basic science content was changed to address more challenging material in 2016. Subsequent fall 2016 data indicated improved outcomes in these areas. For example, there was a +11.13% increase in students’ scores on relevant physiology items when comparing the class of 2016 to 2015.

CONCLUSIONS: Our medical school transition program has resulted in positive student feedback and improved student outcomes.

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

PURPOSE: Endotracheal intubation (ETI) is widely used in various situations including emergency, prehospital, and hospital care as a method of maintaining an airway in critical patients and/or those undergoing general anaesthesia. The gold-standard ETI equipment visualizes upper airway, including, vallecula, epiglottis, trachea and vocal cords from above. Most common malignancy of the lungs is at the primary bronchi below the cords, and just past the carina. SECTRA Visualization Table (SVT) renders CT DICOM files into interactive 3D images. The objective of this study was to assess whether SVT can reveal the anatomy of the upper and lower airway as a continuous film inside and outside the lumen of the airway.

METHODS: Literature search was conducted regarding interactive visualization of the airway using 3D-CT technology. Once SVT rendered CT DICOM files into 3D, various filters were applied to illuminate air space, fascial layers, bone, and lumen in and around the airway. 104 medical students received 10-minute tutorials in groups of 6-8 on anatomy of the airway, levels of the airway, and metrics used during ETI. Students received ETI training from American Medical Response (AMR) professionals using modern ETI equipment.

RESULTS: Literature search revealed no known interactive 3D programs. However, computer-aided diagnoses for airway and pathology visualization effectively assisted radiologists in early cancer detection. SVT rendered 1mm slices, generating high-resolution 3D interactive images. All attending AMR professionals confirmed the educational value of SVT. Students acknowledged the mental template constructed by the SVT interactive 3D airway tutorials.

CONCLUSION: This pilot multimodal education study allowed a visual journey down the lumen of the airway with its surrounding anatomy. Feedback from prehospital airway experts and medical students suggested the value of integrating SECTRA’s interactive 3D-CT technology beyond anatomy course.