2019 Meeting Posters – Student Support

400 – Assessing the Mental Health Well-Being amongst Lake Erie College of Osteopathic Students
Jennifer Allen, Molly A Johannessen, and Melanie Dunbar
Lake Erie College of Osteopathic Medicine

Purpose: To assess the mental health well-being amongst Lake Erie College of Osteopathic Medicine (LECOM) students in programs of Medicine, Pharmacy, Dentistry, and Graduate work across all campuses.

Methods: A cross-sectional web-based survey conducted in October 2018 among all students enrolled at LECOM (N= 247). Seven measures were utilized to assess the mental health status and stigma of mental health illness of LECOM students: Patient Health Questionnaire (PHQ-9) Depression Questionnaire, GAD-7 Questionnaire, Suicide Behaviors Questionnaire-Revised (SBQ-R), SCOFF Questionnaire, CAGE-AID Questionnaire, Life Event Checklist, and a modified version of the Community Attitudes Towards the Mentally Ill (CAMI) questionnaire.

Results and Conclusion: The literature paints a grim picture of the status of mental health amongst medical students and physicians.  Using the seven measures, the survey data was compared amongst and between various demographic identifications, educational programs, and various educational levels to identify any correlations between these factors and anxiety, depression, suicidality, eating disorders, drug and alcohol abuse, or stigma towards the mentally ill.  Various comparisons revealed differences between programs and across educational level within programs as well as difference amongst demographics.  Although the data observed through this survey is only a single snapshot of the mental health and well-being at LECOM, it is the first of this type to compare and contrast the mental health and well-being within one institution at various locations and across various areas of study all related to health care. The improvement of mental health within healthcare is imperative for the future of patient’s health and this study takes a great step towards gathering data towards this effort.

401 – MS4s Teach & Improve UCSF Bridges’ year-1-Summer Academic Support Program
Marieke Kruidering, Laila Fozouni, Evan Whitehead, and Jacquelyn Withers
Department of Cellular and Molecular Pharmacology University of California, San Francisco

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 core-clerkships. Here we describe a revision of the inaugural summer program incorporating support in this context.   

METHODS First-year medical students (n=152) from the second cohort of UCSF’s Bridges Curriculum were invited to apply, via messaging and targeted discussion with students’ coaches. Applicants were chosen based on academic or personal need. MS4s reviewed the 2017 summer program and implemented revisions in 2018.   The 8-week summer program included: A) MS4-led small groups, B) individual faculty mentoring, C) resources, D) CBSE-exit exam  A. Small groups: MS1 & MS4 presentations on year-1 material Discussion of MS4 selected-Qs  from USMLE Step 1 Q-bank B. Faculty mentor meetings: Review Learning Plan C. Summer stipend &Q- bank subscription   

RESULTS 7 MS1s enrolled All recommend program to peers CBSE scores trended up Program well received overall (<4/5): “Great way to synthesize first year topics with thoughtful and experienced MS4s and clinicians. It is good blend of first-year medical knowledge, STEP-1 -oriented learning, clinically relevant focus, and advice about the aforementioned categories.” Specific Items evaluated<4 Peer & MS4 presentations Guided Question bank use in group MS4s valuable peer instructors Lessons learned MS1 rated review of year-1 materials (i.e. small groups and/or checkpoint questions) as not useful and preferred Peer & MS4 presentations on preassigned year-1 topics. Q-bank overwhelming for MS1s without MS4 guidance.   

CONCLUSIONS MS4 are superb near peer teachers Students prefer creating new presentations instead of passive review U-World questions can be used effectively for early remediation

402 – Easing the Transition: Facilitating the Development of Effective Studying Strategies within the Medical School Curriculum
Taylor Barber, Stephen DePaul, Ryan Schwartz, Gregory Skedros, Kathleen Ackert, Michael McGuinness, and Marina D’Angelo
Principle Investigator, TISSUE lead facilitator, TISSUE course facilitator, TISSUE course facilitator, Contributor, Key personnel, Lead mentor

PURPOSE Many students matriculate into medical school without having prior exposure to courses such as anatomy, histology, or embryology, which often serve as the foundation of the entire curriculum. Not properly preparing for these courses can lead to high levels of undue stress and poor academic performance. An optional two week pre-matriculation course designed to expose students to the content and difficulty of these topics was implemented to address this issue. Its success will be measured in terms of the effectiveness of various studying strategies that enrolled students developed as a result.

METHODS The pre-matriculation course, Teaching Introductory Study Skills Utilizing Experience (TISSUE), debuted in the summer of 2017. Four rising second-year medical students facilitate the course and introduce content that students typically struggle with, while helping the incoming class experiment with different studying strategies in a low pressure environment. Three google surveys were administered to the Class of 2020 throughout their first term to gauge the perceived effectiveness of studying strategies that students were developing as the term progressed. 

RESULTS Surveys were administered to the Class of 2020 during the first trimester of Structural Principles of Osteopathic Medicine (SPOM), which includes anatomy, histology, and embryology. Data analysis is currently underway.

CONCLUSIONS We hope to find that the TISSUE course helps incoming students develop effective studying strategies earlier on in the term. The literature suggests that more efficacious studying techniques can improve academic performance and therefore lower levels of stress in the student population. This may also translate to better COMLEX and USMLE exam scores. Additionally, in allowing a select group of second year students facilitate the course, it opens up the line for communication, peer mentorship, and provides a support network to guide students through the often challenging transition into their first year of medical school.

Vivian Stevens, Sarah Hall, Jesse Chaffin, Kelly Dunn, Alicia Ford, and Rachel Hardy
Oklahoma State University Center for Health Sciences

PURPOSE Alarming rates of burnout, suicide, and mental health concerns within the medical profession have ushered in an urgent call to address well-being strategies during medical training. While several excellent models for wellness programs have been described, the medical education community lacks a standardized approach for bringing this information to its medical trainees. As such, medical schools and residency programs are tasked with developing curriculum, guided by the literature and accreditation requirements. Additionally, wellness efforts may be siloed within institutions, diluting the robustness of a wellness culture on campus. This presentation will discuss the evolution of a wellness program being tailored to four years of medical school and the residency years.

METHODS A plan for rolling out an integrated wellness program will be presented. Emphasis is placed on the initial convening of the Wellness Committee, steps towards integrating wellness offerings, and creation of new programming. Assessment measures, program content, and institutional collaboration will be discussed.

RESULTS Within two years, this effort among students, faculty, and staff has led to a palpable campus-wide program. Focused committees, strong unit infrastructures, available adjunctive services, didactic/extracurricular programming, and various independent efforts anecdotally have spawned rapid growth of the wellness message on campus. A description of current efforts to solidify these gains will be presented.

CONCLUSION We attribute the success of the program to the support of leadership, campus-wide collaboration, high student involvement, and faculty/staff expertise. While wellness offerings existed prior to this effort, partnering with these programs and creating a wellness blueprint is contributing to a unified presence on campus. We believe this approach may serve as a useful model for institutions in the early-to-mid phases of wellness program development.

404 – Using Improv as a Tool for Fostering Mentorship Among Medical and Pre-medical Students
Kathleen Herring
AU/UGA Medical Partnership

PURPOSE: Advising for pre-medical students can be reinforced and strengthened by involving current medical students. Medical students can improve their own communication skills and give back to medical community by mentoring students interested in healthcare. We focus here on the development of a structured series of activities, based on improv theater techniques to facilitate this relationship. A strong medical community depends upon open, safe relationships between colleagues; these workshops aim to create a foundation for this space and an area where students feel comfortable interacting and asking about current practices in medical education.

METHODS: Both medical and pre-medical students participate together in a series of  integrated improv workshops focused on communication skills using curriculum developed in a previous study with medicals students and faculty at the medical school. The workshops take place over multiple, facilitated, 2-hour sessions, and students build communication and deep listening skills over time by participating in increasingly complex exercises. Focus groups with workshop participants will be conducted to gauge the viability of improv as a medium for mentorship.

RESULTS: Focus groups will be conducted with both pre-medical and medical students and feedback will be collected at the end of the sessions. It is anticipated that these results will lead to further refinement of the improv workshops with a special emphasis on fostering a sense of community and identifying methods of reinforcing communication between groups.

CONCLUSION: Mentorship between medical and pre-medical students is an important component of medical education. Improv theater is a useful tool for creating mentorship opportunities while also teaching the communication skills that are crucial for a successful career in medicine.

Claudio Cortes, A.Celeste Farr, Virginia E. Uhley, Alyssa Perozich, Cheyenna Espinoza, Mallory Peterson, Belinda Asare, and Connor Whitaker
Oakland University William Beaumont School of Medicine

PURPOSE There is a need in medical schools to establish outcome-based student associations.  Here, we describe the process of how the Latino Medical Student Association (LMSA) has been organized and created faculty and student-driven programs in partnership with the Catholic Charities of Southeast Michigan to promote learning for both the community and medical students.

METHODS Program evaluation consisted of assessments to determine the effectiveness of learning through health educational activities, surveys using Behavioral and Emotional Rating Scale-2 to measure participants’ behavioral and social skills, and to determine changes in communication skills with children, understanding of their needs, mentoring skills, and intercultural development.

RESULTS LMSA has developed into an outcome-based student association benefiting both medical students and the surrounding community. Eightyseven M1-M2 medical students participated in two programs, mentoring and anatomy summer, where they mentored/tutored 120 children for 2,900 service hours.  Medical students participated in 25 health-related educational activities, 9 field trips, weekly phone calls and direct interaction with mentees. Results of surveys in medical students (n=42) showed high levels of student satisfaction (M=5.13, STD=0.69), increased communication skills (M=5.1, SD=0.69) and understanding of the needs of Hispanic children (M=4.87, SD=0.65), high likelihood of recommending the program to other medical students (M=5.48, SD=0.74), and improved proficiency in mentoring(From M=2.69, SD=0.46 to M=3.47, SD=0.5, z=5.26, p<0.001, r=0.574). Of those surveyed 83%  stated they had learned new health information during the program. Parents felt their children improved in interpersonal skills, family involvement, intrapersonal strength, school functioning, and affective strength. Children’s scores on pre/post-tests increased significantly in 6 out 8 sessions.

CONCLUSIONS We have established an outcome-based student association that successfully  partnered with the Hispanic community. Both mentors and mentees have benefited in their interactions with each other, which include but are not limited to improvements in confidence, communication skills, and possible cultural humility.

Ahmed Hamed, Umair Syed, Joseph Mort, Selina Noramly, and Deborah Barry
University of Virginia

PURPOSE Cooperative learning has been shown to increase achievement and wellbeing in learners at a variety of levels. Medical students who form study groups tend to benefit from the social and academic support that these groups offer. However, there exists a paucity of research on cooperative learning and student-led study groups in medical education. The current research focuses on how best to create peer-led study groups, the impact on academic achievement, student self-efficacy, and student well-being.

METHODS Medical students are invited to complete a questionnaire to participate in the study group program, and assigned to a study group. Students are assigned to a group based on their intake questionnaire which includes questions related to student demographics, study habits, goals for participation, self-reported academic performance, self-efficacy, and student wellbeing. Participants are asked to complete follow up surveys every four months, and results will be analyzed using appropriate statistical techniques.

RESULTS This completely student-led initiative is in its final stages of development. Project leaders have completed the survey development and are currently completing the recruitment process. Based on preliminary recruitment, we expect 20 study groups to be formed including approximately 85 students.

CONCLUSION This research will make a vital contribution to the literature related to both academic and social wellbeing of medical students. Finally, we expect that student-led study groups will encourage students to participate in a program designed and developed by their peers, and ultimately result in improved academic standing, reduced levels of stress, and greater perceived social integration amongst the participants, as well as be readily adaptable to other institutions.  

Rebecca Grohman, Jason M. Golbin, Barbara Capozzi, Patrick M. O’Shaughnessy, and Jerry Balentine
New York Institute of Technology College of Osteopathic Medicine, Catholic Health Services of Long Island, and Touro College of Osteopathic Medicine

PURPOSE A novel two-week course was designed to give third year medical students an introduction to the practice of medicine and to aid in the preparation for clerkships. The course was designed, in collaboration with Catholic Health Services of Long Island (CHSLI), to expose students to various topics not typically addressed within the traditional preclinical curriculum. As a secondary benefit, the course provided students with the opportunity for professional development through a flexible schedule to complete coursework on their own time.

METHODS A two-week online course was designed at NYITCOM through a collaboration with CHSLI. An interdisciplinary team of providers including physicians, nurses, quality leaders, and administrators were enlisted to provide students with an overview of common topics in the current practice and business of medicine. During this course, students complete online technology-mediated learning assignments, reading assignments, and self-assessment. The course focuses on medical documentation, writing orders, communication skills, patient safety issues, and diagnostic errors. Students also learn the fundamentals of medicolegal issues, risk management, and aspects of medical billing and coding. The course recurs every two weeks throughout the academic year for new groups of students.

RESULTS After more than 100 hours of collaboration with CHSLI, the course was completed and is currently integrated in the third year curriculum for the class of 2020. Initial feedback from faculty and students has been positive. Additional analysis of student feedback regarding preparedness for approaching relevant topics during clerkships will be completed throughout the year.

CONCLUSION An innovative collaboration between NYITCOM and Catholic Health Services of Long Island provided a novel approach to teaching third year medical students about topics related to the practice of medicine.

David Ramnaraign, Raza Sagarwala, and Sara Barnett
Co-author, Co-author, Principal Investigator

PURPOSE The formula for optimizing the probability of successfully matching to a top residency program has accrued an increasing emphasis on board exam performance (USMLE Step 1 in particular). Although there are many studies examining how Step 1 scores are affected by third-party study resources, practice exam scores, and studying habits, there are none that have examined how involvement in non-academic activities during the preclinical years can influence Step 1 scores. The primary purpose of this study is to therefore address the pervasive ideal that more time spent studying-at the sacrifice of volunteering, exercising, or research-will provide more long term benefit through higher board scores.

METHODS The participants in this study are medical students at Saint Louis University School of Medicine who have recently taken Step 1 and voluntarily completed an online survey. The survey asked participants to report their average hours spent per week during their preclinical years on activities such as: volunteering, research, leadership, athletics, studying, and sleep. Further data on participants’ gender, age, and Step 1 score were also collected.

RESULTS Preliminary results from 43% of respondents (n=76) reveal a significant difference in the average step scores of male and female respondents (241 vs. 226). Additionally, female students on average reported spending more hours per week volunteering (9.7 vs. 4.3), whereas male students prioritized studying (53 vs. 48), research (4.4 vs. 3.2), and athletics (7.7 vs. 6.4). No statistical difference is seen in time spent sleeping between genders (52.5 vs. 52.3).

CONCLUSION When stratified by gender, there seems to be a significant difference in how third year medical students spend their time during the preclinical years and score on USMLE Step 1. These preliminary data suggest that current medical education curriculums may be suboptimal for female students who wish to spend more time engaged in their communities than their male counterparts.

Dr. Saleh Rahman and Mark J. Hernandez
University of Central Florida College of Medicine

PURPOSE Around 1500 medical graduates responded this year in a survey that they would not pursue a career in medicine if they could revisit this career choice.  This abstract aims to compare the aggregate data available from national graduation questionnaires for graduating seniors for the past 10 years to try to comprehend some of the reasons for this effect.

METHODS The feedback from the “All Schools Summary Report of the Medical School Graduation Questionnaire”, published by the American Association of Medical Colleges (AAMC), and “Survey of Graduating Seniors Summary Report”, published by American Association of Osteopathic Medical Colleges (AACOM), was analyzed for similarities and differences. The reports published between 2008 and 2018 were reviewed.  These reports provide a snapshot of the student’s self-reported experiences and satisfactions with their medical education and are readily available online to the public.

RESULTS Of the 19,537 MD graduates 83% completed the AAMC survey, and of the 6,350 DO graduates 77% completed the AACOM survey.  In 2018, 7.9% of MD graduates who completed the survey would not, or probably not, have chosen to become a physician, and 4% of DO graduates wished they had pursued something else.  In 2010, around 7.5 % of MD graduates and 6% of DO graduates responded in the same manner.

CONCLUSION The satisfaction score analysis for the past ten years (2008-2018) indicated a progressive improvement in the overall student satisfaction with the quality of medical education.  It is unclear however of what factors led to the dissatisfaction with completion of the medical degree in a small, but significant, number of medical graduates during the past eight years.

411 – Predictors of Retention in the Occupational Therapy Assistant Program Admissions Process
Leah N. Sowers
Jefferson College of Health Sciences

Background: The field of occupational therapy (OT) is fast-growing and in high demand. The need for occupational therapy assistants (OTAs) is expected to grow 28% by 2026, creating further demand for OTAs (U.S. Department of Labor, n.d.). Currently, there are only nine accredited OTA academic programs in the state of Virginia. As a result, the number of OTA program applicants far exceeds the number of available openings at Jefferson College of Health Sciences (Jefferson College) in Roanoke, Virginia. This places pressure on the OTA program to admit the best candidates who will complete the program in its two-year timeframe, thus securing retention rate and pass-rate statistics. In order to achieve this, in 2015 the OTA program at Jefferson College created and implemented a Selective Admissions Process (SAP) to screen and admit the most qualified candidates for the program. The purpose of this research is to identify criteria of applicants that predict successful competition of the OTA program. Implications of this research are manifold and include increased retention at Jefferson College’s OTA program, an increase of employable OTAs in Southwest Virginia, and development of a model selective admissions process for similar OTA programs. The purpose of this study was to identify criteria within the selective admissions process that predict success in the OTA program.

Methods: The study involved analysis of data for 90 students (45 pre- and 45 post-selective admissions process) admitted to Jefferson College’s OTA program between 2013 and 2016. Areas identified for admissions screening included the following criteria: high school or previous college grade point average (GPA), previous healthcare exposure and experience, community service and volunteer work, letters of recommendation, honors, awards, recognition, resume, personal statement, special skills, sample works, admissions interview, and on-site writing sample. Criteria were scored by OTA program faculty according to rubrics. A total score, which included all criteria, was used to rank applicants within their cohort and offer admissions to the highest scoring applicants until the class was filled.

Results: Scores on criteria identified for admissions screening and the total score were analyzed. The total score was determined to be a significant predictor (p = .016) of program completion for the 45 students who went through the selective admissions process, accounting for approximately 26% of the variability in degree completion for those students.

Conclusion/Discussion: The results of this study validate the current SAP process used by the OTA program at Jefferson College to select applicants. The results establish that criteria identified in the selective admissions process are significant predictors of completion of the OTA program.

413 – What’s my Role: Medical Student Risk and Suicide Prevention
Cynthia A. Standley and Rebecca E. Fisher

PURPOSE: The presence of suicidal ideation in healthcare training students is a source of concern. Depression or depression symptoms affect nearly 27% of medical students.   Do you know what to do when you see a student in your classroom struggling?  A court ruling in Massachusetts in 2018 found that colleges have an obligation in some cases to prevent suicides and that there are situations where professors could be sued for failing to do so.  Importantly, suicide rates vary by age, gender, race, and ethnicity.  Classroom environments are places where students may come across aggressive comments that are disparaging and may affect their mental health.  While macroaggressions are blatant, microaggressions are often unconscious. A challenge for education practitioners is how to effectively address such microaggressions in the classroom.

METHODS: Through 3 interactive sessions with health professions students, faculty and staff, we captured participants responses to questions on campus culture and suicide risk.  In this poster, we will provide an overview of medical student risks, including microaggressions that are more subtle and macroaggressions that are more blatant and how these can affect depression and suicide risk.   We will provide a sense of what students may face in the classroom, vs what they may face in the clinical setting and then discuss what educators can do to mitigate some of these risk factors for students. 

RESULTS: Our sessions have led to a more positive campus culture, increased the number of informed faculty and influenced a new formal curricular session on targets of bias.

CONCLUSION: Suicide is the second leading cause of death among medical students (second to accidents), yet no medical organization is tracking these suicides. Our hope is for the non-clinician to gain confidence in becoming someone students can check in with, look up to, and talk openly with, giving them hope and reducing their stress.