2018 Meeting Posters – Student Support

601 – Motivations, expectations, and experiences of new peer tutors in a Caribbean medical school
Amitabha Basu
St Matthews University School of Medicine

PURPOSE: Increased demand and popularity required our university, to engage inexperienced students as peer tutors. I conducted this research to explore motivations, anticipations, and experiences of new peer tutors as there has been a gap in existing literature exploring these perceptions of new peer tutors. This abstract describes the research methods, results and conclusions.

METHODS: Qualitative research methodology was adopted to conduct this research. 11 students, who were appointed as new peer tutors based on their grades, were selected for the study. After obtaining ethical approval and individual written consent, a semi-structured interview was conducted in a neutral location after completion of their tutorships. Each interview lasted for 40-50 minutes. A Sony voice recorder was used to record interviews and transcribed using the secretarial service. Each transcript was randomly numbered for anonymity, thematically analyzed using NVivo software to develop codes and themes that could address aims of the study.

RESULTS: Motivating factors include the prospect of relearning courses materials, liking a particular course, better access to faculty or improving the resume; students mostly used the didactic method to teach. Peer-tutors described anxiety, feeling challenged and disappointments. Apparently, tutors self-learned or followed teaching techniques of the faculty. Tutors reported learning new study techniques, time management, team building and communication skills.

CONCLUSION: Motivating factors, teaching methods supported previous studies on experienced tutors. Anxiousness might be due to high self-expectations, lack of teaching skills and time constraints.  Disappointments might be due to perceived lack of tutees’ interest. Tutoring apparently enhanced their communication skills and some made new friends. The research suggested a standardized tutor-training programme might boost tutor’s confidence and enhance the experience for peer-tutors and tutees. Improving teaching skills of the faculty might improve students’ teaching skills. Further study is required to explore if tutoring improves these peer tutors’s grades.

602 – Early introduction of self-care techniques and their perceived benefit to medical students
Audrey A. Vasauskas, Amanda L. Robinson, and Rebekah Morrow
Alabama College of Osteopathic Medicine

PURPOSE: Evidence links physician well-being and patient care, wherein physician stress and burnout negatively affect empathy. Stress often starts in medical school, manifesting as anxiety, depression, substance abuse, or suicide.  These issues underscore the importance of teaching students self-care. Exercise, yoga, and meditation are effective stress-reduction techniques. ACOM curriculum introduces multiple self-care practices including yoga and meditation, with a free weekly yoga class on campus.  Self-care activities provide an immediate benefit to students, and may also lead to long-term practices that benefit both caregivers and patients.

METHODS: We surveyed medical students about their perceived well-being, stress and anxiety levels, and self-care practices, and asked whether students found yoga and/or meditation beneficial to their well-being.  First through fourth year medical students voluntarily completed a comprehensive survey addressing stress, depression, and anxiety (DASS-21), physical activity (International Physical Activity Questionnaire), mindfulness (Freiburg Mindfulness Inventory), and yoga/meditation practices and their perceived benefit.

RESULTS: One hundred seventy six students responded to the survey.  A significant number reported moderate levels of stress and anxiety; a subset indicated high levels of stress, depression, and anxiety. Students averaged more than 30 minutes a week engaged in moderate exercise or walking.  Forty-two percent practiced yoga; 77% indicated they felt calm and strong (63%) after practicing and believed it beneficial for managing medical school stress.  Sixty-five percent felt that having an easily accessible yoga class on campus was beneficial for them.

CONCLUSION: These data suggest that a regular yoga practice may contribute to medical student well-being.  Introducing students to self-care early via optional yoga and mindfulness sessions may not only improve student health, but can also lead to long-term mindfulness practices.

Gabrielle Deehan, Danny Beech, Jessie Lee, and Julia Sawatzky
King’s College London, United Kingdom, The University of Manchester, United Kingdom, and University of Alberta, Canada

PURPOSE: Four medical students took a year’s leave of absence after completion of pre-clinical studies at the University of St Andrews to pursue self-planned projects of personal interest. This study aims to capture and explore the impacts of such projects on a student’s medical education.

METHODS: Upon completion of diverse year-long projects – including a world record cycling attempt, medical outreach work, and explorations of rural medicine and culture/the arts in healthcare – the four students created a structured reflection about their experiences. The outcomes discussed include the educational, professional and personal learning objectives proposed and achieved by each student, the lasting impacts of each student’s projects on their on-going medical studies, and a reflection on the mentorship and support from medical schools and educators that enabled each student to be successful. The qualitative information from these reflections was compiled and reviewed to identify similarities, differences, and central themes.

RESULTS: The reflections compiled by this work demonstrate the range of benefits that may be derived from a self-planned interruption in medical studies. These benefits – such as a better understanding of world cultures and advanced organizational and collaborative skills – were commonly gained despite vastly different experiences. This may provide medical educators and students with a more robust understanding of what can be achieved with self-planned projects. Disadvantages and challenges faced by the students were also analysed and discussed, resulting in the creation of a set of suggestions for future students.

CONCLUSION: While the sample size is small, this qualitative data indicates that the unique and relatively rare addition of a self-planned year-long project to medical students’ studies can be extremely beneficial. These opportunities should be supported by medical schools and educators.

Jennifer M. Carbrey, Mara McAdams, Woo Kia Mun, Sulochana Naidoo, Deborah Engle, Nancy Weigle, Soh Chai Rick, and Goh Sok Hong
Duke University School of Medicine and Duke-NUS Medical School

PURPOSE: Understanding what medical students perceive as mistreatment is important for preventing mistreatment and for providing effective ways for students to report mistreatment.

METHODS: We surveyed medical students at Duke University in the United States and students at Duke-NUS Medical School in Singapore, asking students to rate the severity of mistreatment of several scenarios and their likelihood of reporting the mistreatment to a school official or an anonymous reporting system. We also asked students to rate the influence of various factors on their decision to report.

RESULTS: There were several instances when the responses from Duke students and Duke-NUS students differed in a statistically significant manner. In a scenario where a faculty member criticized medical students in general, Duke-NUS students rated it as more severe mistreatment. In contrast, Duke students rated a scenario where the faculty member criticized an individual student as more extreme mistreatment. In a set of scenarios describing humiliation of a student, the Duke students rated the scenarios as more severe mistreatment compared to the Duke-NUS students. When asked how likely they were to report the mistreatment to a school official, the Duke students responded that they were more like to report to a school official compared to the Duke-NUS students for almost every scenario. When students were asked how various factors affected their decision to report the scenarios as mistreatment, Duke-NUS rated factors such as “fear of consequences for me,” “fear of consequences for faculty,” “reporting is ineffectual,” and “it is not my duty to report” as more important in their decision to report.

CONCLUSIONS: Different populations of students have differing perceptions of what constitutes mistreatment and how likely they are to report it. This highlights the importance of considering student population when implementing mistreatment policies and reporting systems.

605 – Fail Heme, Fail Surgery? Regression analysis to predict end of Surgery clerkship shelf scores.
Leslie R. Ellis, Andrea Vallevand, Kim Askew, and Claudio Violato
Wake Forest Baptist Health, Wake Forest School of Medicine, and University of Minnesota

PURPOSE: An ongoing problem for medical schools is the early detection of students at risk of academic difficulties so that advising strategies can be implemented [1].  Researchers have attempted to identify students at academic risk in the clerkship years, but have met with limited success [2].

Year 3 at Wake Forest School of Medicine is comprised of eight mandatory clerkships that administer a National Board of Medical Examiners (NBME) clinical science (“shelf”) examination.

The purpose was to investigate the predictive validity of premedical school admissions data, preclinical course performance, and USMLE Step 1 scores for performance on the Surgery shelf examination and to investigate the validity of these predicted scores to identify students at risk of performing at or below the NBME documented 10th percentile rank.

METHODS: A backward stepwise regression was conducted with data from two clerkship cohorts. Stepwise methods are recommended for exploratory analysis and are purely mathematical with the predictor variables correlating highest with the outcome variable. [3] The regression equation produced a roster of predicted scores for the subsequent clerkship cohort.

Accuracy of a predicted score was operationalized as the actual score falling within the NBME’s documented Standard Error of Measurement (SEM) of ±4 points.

RESULTS: The regression analysis produced moderately strong results (multiple r equaled .732 and variance accounted 53.5%). The two predictor variables were the USMLE Step 1 and Hematopoietic/Lymphatic block scores.

Applied to the subsequent cohort, the results showed 64/108 (59.3%) of the actual scores fell within ±1 SEM of the predicted scores (Figure).

The 10th percentile rank was operationalized as an equated percent correct score of 62. 9/10 (90%) students flagged as 10th percentile risks had actual scores within the ±1 SEM range or lower.

CONCLUSION: Despite Hematopoietic/Lymphatic and Surgery being seemingly unrelated, the regression equation produced effective predictions; particularly for the “at risk” student.

Poster Award Nominee:
Sarah Lerchenfeldt, Berkley Browne, Patrick Karabon, and Rodney Nyland
Oakland University William Beaumont School of Medicine

PURPOSE: Effective learning techniques are critical to academic success in medical education; students must possess a wide range of study skills, and know how and when to use them appropriately. Although several studies have evaluated the relationship between learning approach and academic performance, few studies have looked at barriers students face when attempting to incorporate effective learning techniques. The objective of this study was to identify barriers that students experience when applying different learning techniques.

METHODS: An electronic survey, created through Qualtrics®, was emailed to 350 medical students at Oakland University William Beaumont School of Medicine scheduled to graduate in 2018, 2019, and 2020.  This cross-sectional study assessed implementation barriers for eight learning techniques that were either low utility (highlighting, mnemonics, rereading, and summarization) or moderate to high utility (elaborative interrogation, imagery for text, practice testing, and self-explanation). For each learning technique, participants identified all implementation barriers they experienced from a list of common barriers.

RESULTS: 60 students completed the survey, in which 95% of students faced at least one barrier.  Of the four higher utility techniques, few barriers existed for practice testing and self-explanation.  Two barriers, “requires too much time” and “not knowing how to apply,” were commonly encountered for both elaborative interrogation and imagery for text.  “Afraid it would not be effective” was a barrier observed most frequently with highlighting and rereading.  “Tried the technique but it wasn’t useful” was also reported most frequently for highlighting and mnemonics.

CONCLUSION: Effective study skills are essential in helping students achieve their educational goals. In our study, students reported barriers to using eight learning techniques, including highly effective techniques, such as practice testing and elaborative interrogation. Instruction and support on the appropriate use of effective learning techniques may be necessary to help students succeed in a challenging medical school curriculum.

607 – Assessing Academic Tutoring in Academically At Risk Students: A Quality Improvment Project
Mallorie Davis, Libby Saxon, and Elizabeth McClain
William Carey University College of Osteopathic Medicine

PURPOSE: Identifying and providing resources for students experiencing academic at-risk status can be a challenging task. This quality improvement project assessed the academic at-risk protocol and utilization of academic counseling and tutoring services over a three medical student cohorts in their first academic year.

METHODS: This educational quality improvement project used a non-experimental design to retrospectively review three student cohorts. At-risk status was formally identified as failing course average. Descriptive statistics were used to identify percentage of the students in each cohort, number of courses failing, frequency of peer tutoring sessions and final grade in identified courses. Correlations assessed association between failing courses and peer tutor usage.

RESULTS:164 students across three class cohorts were formally identified as at-risk in their first year. Over 2353 tutoring hours were utilized by students. Small negative correlations were identified such that as number of failing course averages increased the number of tutoring hours decreased. Approximately 10% of students experienced course failures with required remediation.

CONCLUSIONS: The results of this study suggest that student behavior may impede ability to access academic support services in a timely manner. There may be a tipping point where students who are failing multiple courses engage in avoidance behaviors instead of reaching out for academic support services. The results from this project will be used to restructure the process of academic at-risk status and will propose required tutoring sessions for students with failing course averages in order to provide early intervention with the goal to provide additional supports for academic success.

Tiffany Reid, ReyLynn Reid, Jonathan J. Wisco, Heather M. Seferovich, and Emily S. Darowski
Brigham Young University and University of Utah School of Medicine

PURPOSE: Social media has been an increasingly common tool used by medical students for greater communication and means for learning, both academically and socially. Studies have shown, however, that social media use can have a negative impact on mental health. The aim of this review was to contrast problematic use of social media with the benefits of mindfulness practice toward improving medical student wellness.

METHODS: We performed a literature review to examine 1) the outcomes of Problematic Social Media Use (PSMU) — operationally defined to describe excessive and habitual internet/social media use– on student mental health; and 2) the effect of mindfulness as a remedy for the effects of PSMU.

RESULTS: Only nine studies examined the association of PSMU and mindfulness. Additional research exhibited that negative outcomes from PSMU—specifically, depression, anxiety, low self-esteem, and poor sleep quality—are similar to the mental health problems that mindfulness-based interventions have been used to ameliorate. Incidentally, there are limited studies on measurement scales and descriptor terms used for excessive social media usage and the overall research on mindfulness, indicating a need for standardized operational definitions and discrete experimental designs.

CONCLUSION: Concerns with use of social media have been raised in regards to professionalism in medical students, but there is little to no research on how social media has an effect on the wellbeing of medical students. Previous research done with adolescents and emerging adults that have shown negative effects from PSMU raise the following questions: Does the use of social media, either personally or academically, have a negative impact on the mental health of medical students? Can the practice of mindfulness in regards to social media improve mental wellbeing in medical students? More research is certainly needed to determine whether mindfulness can have a positive influence on medical student wellness.

609 – Learning Community Pilot Study: A Cocktail for Student Thriving
William G. Pearson, Jr., Carol A. Nichols, J. Cole Philips, John L. Braucher, Thaddeus Y. Carson, and Renee T. Page
Medical College of Georgia

PURPOSE: Distress among medical students, especially concerning their academic performance, is highly documented. Cultivating intrinsic factors such as vocational identity and learning communities contribute to trainee wellness. As in treating a complex disease, a mixed approach may be merited. A cocktail of healthy interpersonal relationships, mentoring, early clinical experience, promotion of physician identity, and practical help achieving content mastery may immunize students from burnout or worse. The aim of this efficacy study is to test the hypothesis that a supportive learning environment, technology assisted content mastery, and promotion of intrinsic factors will contribute to medical student wellbeing.

METHODS: IRB approval was granted for recruiting a cohort of 1st years Spring 2018. A rubric to evaluate technology assisted content mastery platforms was constructed and utilized. A workgroup of faculty and students developed a course involving self-reflection and patient interactions featuring a newly developed THRIVE model to cultivate intrinsic factors for wellness. A Year 3 control group was put in place during the internal medicine clerkship to evaluate the effect of the THRIVE model only. Validated survey items measuring burnout, educational environment, personal development, and vocational identity were chosen. These data along with academic performance will be used to determine the efficacy of this wellness approach.

RESULTS: The cohort includes 12 Year 1 medical student volunteers selected using an algorithmic randomization to match academic performance and diversity of the cohort with the class.  The mean and standard deviation of fall module grades for the cohort and class were 81.93±4.93 and 81.86±6.13, respectively.

CONCLUSION: Mixed model results indicating the efficacy of combining a learning community experience, content mastery platform, and the THRIVE course on well-being will be presented followed by a discussion of scalability and extensibility throughout the curriculum.

610 – Myers-Briggs (MBTI) Personality Types and Effective Learning Strategies in Medical School
Zaneta Franklin and Ihuoma Njoku
University of Pittsburgh School of Medicine

PURPOSE: Medical school can be a difficult transition for students as they adapt to the higher volume of information to be learned within significant time constraints. Our aim is to help students better identify effective learning strategies, specifically by analyzing variation in effective learning strategies for medical students based on their Myers-Briggs Type Indicator (MBTI) results.

Our hypothesis is that students with similar MBTI types likely experience similar challenges transitioning to medical school and find success with similar strategies.

METHODS: We completed a review of existing literature and developed a survey to (1) validate whether medical students identify with established learning strategies recommended for their MBTI type and (2) compile the specific strategies medical students have found to be effective.

After an initial needs assessment, we will distribute this survey and compile a resource guide of these strategies, analyzing patterns by MBTI type.

RESULTS: Donna Dunning, PhD has published a resource guide with detailed analysis of suggested learning strategies for each type [1] and John Pelley, PhD emphasizes the applicability of understanding MBTI to academic success in medical school [2]. However, there is no resource guide for medical students with specific strategies for MBTI types; this project will begin to fill this void. The MBTI assessment is limited by bias from external and internal factors [2].

CONCLUSION: All incoming students who are routinely given an MBTI assessment would benefit from a streamlined resource of strategies for their MBTI type results. Students can evaluate their existing learning strategies as they complete this survey.

Amy Seegmiller Renner
Mayo Clinic

PURPOSE: The study examined experiences health professions educators have had with utilizing role modeling to develop student’s empathetic abilities.  Role modeling has been identified as an optimal teaching strategy to assist students with developing their empathetic abilities.  Previous research studies have been conducted to examine the process of role modeling; however, there is limited knowledge on the experiences instructors have had with utilizing role modeling to teach empathy.

METHODS: A basic qualitative methodology was utilized to capture the lived experiences of instructors within laboratory-based education programs.  These programs were specifically targeted as they do not have empathetic education within their curriculum.  Study participants self-identified as being empathetic role models.  Data was gathered through semi-structured interviews examining the experiences, challenges, and successes study participants have had with utilizing role modeling to teach empathy.

RESULTS: Findings from the study highlighted three key components.  First, the impact the practice of reflection has on educator development.  Participants described how past experiences (e.g., being a student, learning from role models) assisted with the development of their role modeling and empathetic abilities.  Second, the creation of a safe and positive learning environment directly impacts student learning.  Participants utilized role modeling of empathy to create this environment which then provided the ability for them to stay abreast of student development (e.g., knowledge, skills, and attributes). Third, the impact role modeling has on student development.  Through the deliberate practice of role modeling, participants demonstrated empathy and then witnessed students utilizing empathy to create a connection to the patient thereby promoting high quality patient care.

CONCLUSION: The study highlighted the importance of utilizing role modeling to teach empathy.  Specific strategies (e.g., reflection) were discovered that may assist educators with developing their role modeling and empathetic abilities.

Frances Jack-Edwards and Linda R Adkison
Trinity School of Medicine, St. Vincent and the Grenadines, West Indies

PURPOSE: At Trinity School of Medicine, students must achieve several benchmarks on diagnostic tests prior to registering for USMLE Step 1.  For students not achieving these benchmarks, they leave campus to continue studying on their own.  Some students become distracted in this non-structured environment and struggle with appropriate preparation and achievements leading them to become discouraged about advancement in their clinical education.  The purpose of this pilot has been to work one-on-one with students who have trouble meeting the benchmark requirements with a defined, structured program with self-assessments at shorter intervals to measure improvement.

METHOD: Students self-identified and asked for help from the administration often citing distractions, declining motivation to study linked to poor outcomes, increasing anxiety, and limited improvements in outcomes.  A study plan was recommended for all students that included the same format for practice questions, short breaks, lunch, and study for two weeks. Also addressed were ways to minimize anxiety.  A self-assessment in a simulated test situation was then recommended and results were reviewed with the student afterwards.

RESULTS: The structured format provided results that were improved each two weeks for students.  At the same time, the confidence of students became clearly evident in communications.  Students achieved benchmarks and were successful on USMLE Step 1.

CONCLUSIONS: Some students become disengaged from proper study techniques when leaving the structure of the medical school community.  This leads to self-doubt, depression, and anxiety.  Refocusing students with a very structured program and scheduled interactions with a mentor can reverse the trends and move students successfully forward in their medical education.

Phu Luong Vo, Christian Wong, Sonu Sahni, and Tipsuda Junsanto-Bahri
Touro College of Osteopathic Medicine – Harlem

PURPOSE: Mental health is documented extensively in medicine; however, little research involves osteopathic medical students. Our study investigates whether knowledge of osteopathic principles plays a role in the mental health of students.

METHODS: A mental health (Beck Depression Inventory) and exercise (Morganstern) survey was given to OMS-1/OMS-2/OMS-3 students at TouroCOM. BDI scores were calculated and reported exercise hours were averaged. Students were also asked to rate how well their own values towards mental health aligned with osteopathic principles. This survey is currently in its second year of dissemination. Results from the previous year were compared to this year’s data.

RESULTS: Of 174 responses, BDI analysis shows 15.1%, 19.4%, and 28.5% of OMS-1, OMS-2, and OMS-3 students suffer from some form of depression, respectively. Data also shows a trend that a greater amount of exercise is related to a lower depression score. Regarding osteopathic principles and their influence on mental health, results show that the more a student’s personal values align with osteopathic principles, the more they exercise. These results are similar to those obtained from the previous year’s survey. Upon comparison of BDI and exercise hours of the same respondent across both years, it was found that in 52% of participants, a decrease in exercise hours matched an increase in BDI score and vice versa.

CONCLUSIONS: Our data shows a relationship between exercise and depression, and suggests that osteopathic principles are an influencing factor in how many hours students exercise. By obtaining data on the mental health of students, schools can better adjust to the psychological needs of students, therefore setting the tone for future healthy doctors.

614 – PILLAR: Pilot of a year-1-summer academic support program
Marieke Kruidering, JonathanPai, Joel Valencia, Jenny Crawford, and Susan Masters
UCSF, Department of Cellular & Molecular Pharmacology, UCSF, MS4, UCSF, Fellow, UCSF, Office of Medical Education, UCSF, Dean of Curriculum

PURPOSE: Medical students, particularly early learners, can experience challenges with academic performance. Many institutions have created robust, validated programs to support learners. Our recent curricular revision required redesigning our support program to incorporate several new elements, including the use of open-ended questions as assessments, and the move of USMLE Step 1 to after the core-clerkship year (1). Here we describe a pilot Program In Learning with Lifelong Approach to Review (PILLAR) incorporating support in this context.

METHODS: Setting: First-year medical students (n=152) from the inaugural class of UCSF’s Bridges Curriculum were invited to apply, via whole class messaging and targeted discussion with student’s coaches. Applicants were chosen based on academic or personal need.

The 8-week summer program included: A) small groups led by MS4s, B) individual faculty mentoring and C) resources

  • Weekly review of year-1 small group material & USMLE Step 1 question-bank
  • Faculty mentor meetings: review of Independent Learning Plan and year-1 open-ended-question (OEQ) assessments
  • Summer stipend & USMLE Step 1 question bank subscription


  • 5 students enrolled and recommend PILLAR to peers
  • Program well received overall (>4/5)
  • Ave Pre-Post-PILLAR NBME Comprehensive Basic Science Exam (CBSE) scores trended upwards

Specific Items evaluated

  • Consolidation and Question bank use in group
  • Individual remediation answering essay questions
  • MS4s valuable peer instructors

CONCLUSION: Lessons learned

  • Self-nomination introduced variety in need
  • Late announcement hindered enrollment
  • Focus in small groups diffuse (general review versus question bank)

Conclusion: The described early intervention pilot is feasible and can be adapted for other schools.

Sara Rabie, Debbi Johnson-Rais, Randall Waechter, Gabriel Stahl, Bora Colak, and Barbara Landon
St. George’s University and Florida Atlantic University

PURPOSE: Medical students experience elevated rates of reported anxiety and emotional stress compared to other student populations. Distress and burnout is, in turn, associated with higher rates of medical errors and a greater likelihood of unethical conduct upon graduation. Thus, reducing stress and supporting resilience during medical training is a critical priority for medical programs. Previous studies within and beyond the medical literature provide empirical support for a number of stress reducing activities that are based on physical exertion (i.e., moderate exercise such as jogging or playing sports), mental techniques (i.e., mindfulness meditation), or a combination of these (i.e., yoga). No studies have directly compared the impact of exercise, mindfulness practice and yoga – a key question for students who may have limited time for such practice under a heavy academic load.

METHODS: This study compared the impact of moderate exercise (walking/jogging), mindfulness practice, yoga, or no intervention (control) on emotional stress among medical students who were randomly assigned to one of the intervention groups over a 4-month term of basic sciences training.

RESULTS: Unfortunately, the attrition of participants, particularly from the exercise group,  limits the conclusions which can be drawn from this study.  However the relatively consistent levels of perceived stress, depression, and burnout during the term of study for the intervention groups compared to the Control group is supportive of findings of other studies. Results indicated a negative correlation between time spent in these intervention activities and grades at the end of the term.

CONCLUSION: Provide options and warn students that there can be  “too much of a good thing” when it comes to de-stressing activities.