News

A Review from Medical Science Educator from Dr. Ann Poznanski

Every month, the IAMSE Publications Committee reviews published articles from the archives of Medical Science Educator or of its predecessor JIAMSE. This month’s review is taken from MSE volume 28.

Medical Education needs to adapt to the needs of our future physicians so that we can ensure that we are preparing them to care for the health of their future patients. Because, in the words of the author, “the nature of contemporary disease has changed profoundly over the last century”, our current health care model and the methods we use to train health care providers are inadequately addressing these needs. One approach to address this challenge is discussed in a recent article entitled: Lifestyle Medicine: Why Do We Need It?, published in Medical Science Educator, December 2018, Volume 28, Supplement 1, pp 5–7, by author Hanno Pijl from the Department of Internal Medicine, Section of Endocrinology at Leiden University Medical Center, Leiden Netherlands.
 Dr. Pijl presents an impassioned argument for the inclusion of Lifestyle Medicine as an essential component of education for health care providers. The American College of Lifestyle Medicine provides a definition of Lifestyle Medicine: “Lifestyle Medicine involves the use of evidence-based lifestyle therapeutic approaches, such as a predominantly whole food, plant-based diet, regular physical activity, adequate sleep, stress management, avoidance of risky substance use, and other non-drug modalities, to prevent, treat, and, oftentimes, reverse the lifestyle-related, chronic disease that’s all too prevalent.”
 The need for education in Lifestyle Medicine is dictated by changes in disease prevalence. Due to the advances of antibiotics and anesthesia, the predominance of infectious disease and surgical emergency in the nineteenth and early twentieth century has shifted to chronic conditions. The author characterizes the profound change in the nature of contemporary disease as “a tsunami of chronic, “age-associated,” non-communicable disease.” These diseases include heart disease, stroke, cancer and diabetes. These are now the most common, costly, and preventable health problems in the world. For example, the National Diabetes Statistics Report published by the Center for Disease Control and Prevention in 2017 found that 30.3 million people have diabetes (9.4% of the US population) and 84.1 million adults aged 18 years or older have prediabetes (33.9% of the adult US population). Although Type II diabetes, which has been called a global epidemic by the World Health Organization, was once thought to be incurable, numerous studies have now reported that lifestyle interventions have been successful in reversing this disease.
 The author’s first contention is that there is a mistaken assumption that chronic and non-communicable diseases are an inevitable consequence of the aging process. He states that the accumulation of damage in aging, due to an imbalance of cell damage and repair, is influenced by lifestyle factors such as nutrition. Moreover, he argues that most chronic disease is the result of an interaction between our genes and the environment and that behavioral and environmental cues trigger illness. Examples of these cues include “too much of the wrong food, prolonged stress, lack of physical exercise, bad sleep, smoking, and toxins.”
 The author describes multiple ways in which our current health care model is unsuited to our current epidemic of chronic non-communicable disease. The author contrasts the multifactorial diseases of today with the unifactorial diseases of previous times and contends that these are less amenable to the drug-centered approach of our current health care model. In addition, he argues for the importance of the inclusion of the patient’s psychosocial aspects in the diagnosis of disease. He argues that the integration of Lifestyle Medicine into our health care model will shift us to the prevention of disease with lifestyle adaptation as a primary treatment to restore health.
 Dr. Pijl also argues for the need for patients to take responsibility for their health and that the role of the healthcare provider should be that of an advisor. The success of this change of roles rests on the necessity of ensuring that both patient and healthcare provider are well educated on the origins of disease and the possibilities for restoring health. The author concedes that “it is very difficult indeed to live a healthy life in the context of the current society.” 
 As an Endocrinologist and educator treating patients with diabetes, this article comes as a report from the front lines. The author concludes that “since our modern lifestyle plays a crucial role in the etiology of these disorders, lifestyle medicine needs to be an integral part of our strategies to tackle the huge health threats we face today.” We can hope that our leaders in medical education can embrace this challenge and champion this approach to reforming healthcare education.
 Ann Poznanski, MD, PhD
Member IAMSE Publications Committee
Member IAMSE Board of Directors

MSE Still Accepting Manuscripts on Team-Based Learning

Please note that we are still accepting manuscripts for the special journal section in the final issue of 2019. Medical Science Educator, the journal of the International Association of Medical Science Educators (IAMSE), will be publishing a special journal section dedicated to the topic of “Team-Based Learning.” In this section, the journal would like to explore best practices from institutions around the world where TBL is implemented in the health sciences curriculum.
 
Manuscripts to be considered for this special section must be submitted by May 1st, 2019 through our online submission system that can be found by visiting: www.medicalscienceeducator.org. In your cover letter, please refer to the topic “TBL Special Section” to indicate that you would like to be included in the special section.


I look forward to receiving your submissions.

Thank you,
Peter G.M. de Jong, PhD
Editor-in-Chief, Medical Science Educator

IAMSE Spring 2019 WAS Session 5 Highlights

[The following notes were generated by Mark Slivkoff, PhD]

IAMSE Webinar Series, Spring 2019

Speakers: Michelle Daniel, MD, MHPE, FACEP
Assistant Dean for Curriculum and Associate Professor of Emergency Medicine and Learning Health Sciences
University of Michigan School of Medicine, Ann Arbor, MI USA

Title: Moving USMLE Step 1 After Core Clerkships: Rationale, Challenges, and Early Outcomes
Series:
The Role of Basic Science in 21st Century Medical Education

The focus this week was once again on USMLE Step 1. Dr. Michelle Daniel of the University of Michigan School of Medicine presented this final seminar of our series which focused on the placement of Step 1 in the curriculum, a topic that has generated debate recently.

Currently, the ideal placement for Step 1 is unknown. Its current placement, usually at the end of the second year, is mainly based on tradition rather than an alignment of learning goals or outcomes. In her presentation, Dr. Daniel explained the rationale for, breaking with tradition from and altering the timing of Step 1. She also addressed early outcomes associated with the change and discussed potential challenges—and how to overcome them.

She started with a poll in which she asked the audience to choose the stage of change that describes your institution concerning the timing of Step 1:
• Pre-contemplative stage (Students take Step 1 following the preclinical curricula before entering clinical clerkships and currently, there are no thoughts of changing)
• Contemplative stage (Students take Step 1 following the preclinical curricula, but the institution is currently considering moving Step 1 after clerkships)
• Determined stage (Students take Step 1 following the preclinical curricula, but plans are currently underway to move Step 1 after clerkships)
• Action stage (Students currently take Step 1 after the core clerkships)
• N/A (Students do not take Step 1)

The results were similar to what Dr. Daniel has seen nationally. Over half (55%) of schools are in the pre-contemplative stage, about a third (32%) are in the contemplative stage, 1% are in the determined stage, while 8% are in the action stage.

As is the case with a majority of medical schools, Step 1 is given after years 1 and 2, the basic science years. Students memorize and purge the information during the examination, then promptly forget it. Schools who desire to move Step 1 usually argue that moving the timing of Step 1 after the core clinical year helps promote better retention of foundational science knowledge and basic and clinical science integration. Most schools who alter the timing of Step 1 do so as just one part of the process of determining the means by which science is delivered across the curriculum.

Anecdotally—Dr. Daniel continued—students report that when they study for Step 1 after core clerkships, the basic science information “feels stickier” since they are able to recall real patients they have encountered with certain conditions and it becomes easier to remember basic science concepts when they can create linkages to clinical care. The long question stems encountered on the USMLE are therefore easier to understand.

Another reason that schools move Step 1 is to boost their scores. As Dr. Daniel points out (and as last week’s poll also demonstrated), a majority of individuals desire making Step 1 pass/fail but the reality is that the score matters to residency directors. However, Dr. Daniel believes that this reason for change should be lowest on the list. What is critically important is that when schools have changed the timing, their scores have NOT been negatively impacted. Schools, therefore, can feel free to make sweeping changes to their curriculum, and this seems to be the trend since the list of schools who are making the change is increasing.

Dr. Daniel then took a dive into some of the data which she has published with her colleagues concerning the characteristics of schools which have moved Step 1 (Daniel et al. 2017). She then presented outcome data from a follow-up paper (Jurich et al. 2018). Specifically, they were interested in what happened to Step 1 scores and failure rates after moving the examination. Results indicated a slight increase in scores and a reduction in failure rates. Dr. Daniel additionally pointed out a highlight from the failure data in that the number of failures went down from 48 to 6. She also currently has a paper in review which focuses on Step 2 outcomes.

The conclusion of her webinar focused on the challenges (which she has published as well with her colleagues) (Pock et al. 2019). Since they lack a Step 1 study period to consolidate knowledge, students may not seem as prepared to start clerkships. Communication with clinical faculty must emphasize that learners entering the clerkships are “different” – not better or worse than historical students, but different. Curricula that foster the integration of basic and clinical sciences, as well as those that emphasize active learning in the pre-clerkship phase can help smooth this transition.

Another challenge to moving Step 1 is that weaker students may not be identified early and provided with appropriate academic support. Supplementing institutional exams with NBME basic science subject exams, the comprehensive basic science exam or comprehensive basic science self-assessment can help identify such learners before they get to Step 1.

Shelf exam performance weaknesses are another concern. Many institutions who have moved Step 1 after core clerkships report a decline in shelf exam performance, particularly in the early clerkships. The declines in shelf scores, as Dr. Daniel explained, are not surprising when one considers that students have not had as much practice with timed tests and NBME style questions.

Other challenges include students extending the Step 1 study period if there is not a firm “deadline” of when to take the exam, students becoming overly concerned about what residency specialty choices may be open to them until they know their Step 1 scores, and lastly, learners may be concerned about having enough time to take and pass Step 1, Step 2 CK, and 2 CS in rapid succession. Dr. Daniel suggested that all these things can be easily managed, however.

Dr. Daniel concluded her presentation just as she did at the beginning: with a poll. She asked now that you have learned a bit more, what would you advise your institution to do?
• Keep Step 1 after the pre-clerkship phase
• Move Step 1 after core clerkships
• It depends on the needs of curricular re-design, but I would be comfortable advocating either position

Approximately half of the respondents chose the latter, and the remaining responses were split between keeping Step 1 as is or moving it. Dr. Daniel once again emphasized the large drop in failure rates.

Similar to the previous four webinars, this one was also followed by numerous questions, too many to address before the hour concluded.

We wish to thank again all presenters and the audience who made this series such a success!

References:

• Daniel M., A. Fleming, C. O’Conner Grochowski, V. Harnik, S. Klimstra, G. Morrison, A. Pock, M. L. Schwartz, and S. Santen. Why Not Wait? Eight Institutions Share Their Experiences Moving United States Medical Licensing Examination Step 1 After Core Clinical Clerkships. Acad Med 2017;92:1515-1524.
• Jurich, D., M. Daniel; M. Paniagua, A. Fleming, V. Harnik, A. Pock, A. Swan-Sein, M.A. Barone, and S. Santen. Moving the United States Medical Licensing Examination Step 1 After Core Clerkships: An Outcomes Analysis. Acad Med 2019;94:371-377.
• Pock, A. M. Daniel, S.A. Santen, A. Swan-Sein, A. Fleming, and V. Harnik. Challenges Associated With Moving the United States Medical Licensing Examination (USMLE) Step 1 to After the Core Clerkships and How to Approach Them. Acad Med 2019. DOI: 10.1097/ACM.0000000000002651

IAMSE Spring 2019 WAS Session 4 Highlights

[The following notes were generated by Mark Slivkoff, PhD]

IAMSE Webinar Series, Spring 2019

Speakers: David Chen
Third Year Medical Student
The University of Washington, Seattle, WA, USA

Kathryn Andolsek, MD MPH
Professor, Community and Family Medicine
Assistant Dean, Premedical Education
Duke University, Durham, NC USA

Title: Stepping Beyond the Step 1 Climate
Series:
The Role of Basic Science in 21st Century Medical Education

In this week’s webinar our attention was moved away from specific curricula, as discussed during the previous two webinars, to a more global topic: Step 1 of the United States Medical Licensing Examination (USMLE). The two presenters included David Chen, a third-year medical student at the University of Washington in Seattle, Washington, and Dr. Kathryn Andolsek, a professor and assistant dean at Duke University in Durham, North Carolina. That our list of presenters included a student and experienced medical educator gave the audience a unique opportunity to hear two perspectives on the ongoing debate of the importance placed on the USMLE examinations.

Mr. Chen led off the webinar. When he went into medicine, he explained, he hoped to address health care disparities, but upon entering medical school he was surprised at how little attention was given to systemic barriers to health and social medicine. Even if they were covered in class, he and his classmates were inclined to not pay attention since the material was not relevant to USMLE Step 1 which was seen as the sole take away of the preclinical years.

He took Step 1 last year and expressed that it was “the single worst educational experience of his life”, a needless period of suffering during which self-care was neglected and burn out was real. He spent long hours memorizing the content of questionable relevance and accuracy while having physical and emotional exhaustion. Mr. Chen documented his experiences and reached out to other students and faculty members, and was invited by Academic Medicine to write a commentary on the subject (Chen et al. 2019). They wrote that the “Step 1 Climate”, a termed coined by he and his fellow authors, was a national phenomenon. It has profound effects on the learning environment, student diversity, and student well-being.

The learning environment suffers since the test-preparation materials become the de facto national curriculum, which affects students and their instructors, and the relationship between them. The examination serves as a barrier to student diversity and success of underrepresented minorities, women, and students from low-income families. Furthermore, as Mr. Chen explained, the examination sets up “tiered worthiness” among medical students in that Step 1 scores define the competitiveness for residencies and their prestige. Family medicine, for example, sits at the low end of the scale which may deter students from applying. These factors all lead to ill effects on student well-being by increasing depression, burnout, and in extreme cases, suicide.

Mr. Chen continued his discussion by addressing an article which was a rebuke to theirs (Katsufrakis and Chaudhry 2019). Briefly, he pointed out that despite their claim there have been studies which have linked residency success to Step 1 performance (Prober et al 2016; McGaghie et al. 2011; Gliatto et al. 2016). Mr. Chen also expressed that he is unsure if the authors have a conflict of interest, but he does rightly claim that taking the boards is expensive.

A group of stakeholders who need more attention in this debate is the patients. Board examinations, as is commonly claimed, help ensure quality care for patients. Mr. Chen argues that given the diversity of patients, can a multiple-choice examination truly measure competency?

The last point that Mr. Chen makes is that the time is ripe for change. Over 100 years ago, the Flexner Report was published (in 1910) and about 70 years ago the first multiple-choice NBME exam was given (in 1916). The world is much different today, and “The need for a fundamental redesign of the content of medical training is clear” (Cooke et al 2006). Mr. Chen commented that he is not sure exactly what the barriers to change are, then parted with a final note: it is an ominous sign for patients who interact with the medical establishment if we in medical education are unable to address our problems.

Dr. Andolsek then took over the screen and the webinar. She began by adding some additional details to Mr. Chen’s brief historical account of Step 1. The main role of early examinations was to serve as a common licensing examination such that physicians could practice across state borders. It was therefore initially designed as a pass/fail assessment. Dr. Andolsek reiterated that the examination is expensive, usually with related costs (Step 1 resources) greater than $800. The examination correlates with performance on subsequent examinations (such as board examinations) but not on residency progression, faculty evaluations, or clinical skills. Furthermore, groups including women, historically underrepresented persons, non-traditional students, and those with financial need perform “differently” on the examination, usually less well.

Stakeholders of Step 1, she continued, include medical students, medical licensing boards, medical schools, and program directors. Similar to Mr. Chen’s comments, Dr. Andolsek questioned patients as belonging to the stakeholder group. She mentioned that in her 40 years of practice a patient never asked her how she did on the boards.

Medical students have responded to Step 1 in that they recognize that it is the de facto curriculum. The use it to judge whether a medical school’s curriculum is relevant if it’s “high yield” and linked to Step 1 content. If it’s not, then curricular content has a tendency to get deemed as uninteresting and devalued in their medical education.

The majority stakeholders, Dr. Andolsek continued, should be the medical licensing boards since licensing was the original intent of the examination. Most states have it written into their legislation, however, the actual number of the examination is never mentioned, only if it was passed or failed. Thus, this adds to the argument that the examination should be a pass/fail assessment.  

Many medical schools use the Step 1 to determine if students are ready to enter clinical education, although this was not an intended use for the examination. Some schools also use the scores to determine gaps in their curriculum, and to determine how likely their students will “match.”

The next group which she addressed in more detail are the program directors who use Step 1 scores to identify which medical students will get full review of their application and interviewed. Some program directors use “cut off scores” frequently set at < 220-240, with higher scores for more competitive specialties. Dr. Andolsek added that 90% of residency graduates who passed Step 1 with lower scores (200-227) passed their board examinations in fairly competitive specialties, demonstrating that passing correlates with passing. Dr. Andolsek also made the point that many good residency applicants are passed up by directors since their applications are ignored when certain scores are not attained. The programs are also judged by the ACGME, the residency accrediting body, which has historically used board passing rates as one measure to judge a program’s quality. A positive change is underway, as Dr. Andolsek noted, in that the ACGME has changed the threshold for passing rates.

Program directors need More relevant measures to assess and communicate medical school performance. They need some type of test or mechanism which may include ACGME competencies and milestones, core Entrustable Professionable Activities (EPAs) and any or all tools developed for resident selection that correlates with performance.

Dr. Andolsek concluded with a polling question sent out to schools. The question asked was should the Step 1 be pass/fail? The results?

  • Yes: 71%
  • Undecided: 16%
  • No: 14%

The session was then opened up for questions, which lasted well over 20 minutes indicating the provocativeness of their webinar.  

References:

  • Andolsek KM. One Small Step for Step 1. Acad Med. 2019 Mar;94(3):309-313
  • Berner ES, Brooks CM, Erdmann JB. IV: Use of the USMLE to Select Residents. Acad Med. 1993;68:753-759
  • Chen DR, Priest KC, Batten JN, Fragoso LE, Reinfield BI, Laitman BM. Student Perspectives on the “Step 1 Climate” in Preclinical Medical Med. Acad Med. 2019;94:302–304.
  • Cooke M, Irby DM, Sullivan W, Ludmerer KM. American Medical Education 100 Years after the Flexner Report. N Engl J Med. 2006;355(13):1339–44
  • Dias RD, Gupta A, Yule SJ. Using Machine Learning to Assess Physician Competence: A Systematic Review. Acad Med. 2019 Mar;94(3):427-439
  • Gauer JL,Jackson JB. Relationships of demographic variables to USMLE physician licensing exam scores: a statistical analysis on five years of Adv Med Educ Pract. 2018;10:39-44.

medical student data.

  • Gliatto P, Leitman IM, Muller D. Scylla and Charybdis: The MCAT, USMLE, and Degrees of Freedom in Undergraduate Medical Education. Acad Med. 2016;91(11).
  • Haider SR. Beyond USMLE Step 1. Acad Med. 2018;93(4).
  • Haist SA, et al. The Evolution of the US Medical Licensing Examination (USMLE): Enhancing Assessment of Practice-Related Competencies. JAMA. 2013;310:2245-2246.
  • Haist SA, Butler AP, Paniagua MA. Testing and evaluation: the present and future of the assessment of medical professionals. Adv. Physiol. Educ. 2017;41:149-153.
  • Katsufrakis PJ, Chaudhry HJ. Improving Residency Selection Requires Close Study and Better Understanding of Stakeholder Needs. Acad Med. 2019;94:305–308.
  • Kent JA, Patel V, Varela NA. Gender Disparities in Health Care. Mt Sinai J Med. 2012;79(5):555–9.
  • Kim RH Tan TW. Interventions that affect resident performance on the American Board of Surgery In-Training Examination: A systematic review. J Surg Educ. 2015;72:418-29
  • Lewis CE, et al. Numerical Versus Pass/Fail Scoring on the USMLE: What do Medical Students and Residents Want and Why? J Grad Med Educ. 2011;3:59-66.
  • Marcus-Blank B et al. Predicting Performance of First-Year Residents: Correlations Between Structured Interview, Licensure Exam, and Competency Scores in a Multi-Institutional Study. Acad Med. 2019 Mar;94(3):378-387 28,
  • McGaghie WC et al. Are US Medical Licensing Exam Step 1 & 2 Scores Valid Measures for Postgraduate Medical Residency Selection Decisions? Acad Med. 2011;86:48-52
  • Prober CG, et al. A Plea to Reassess the Role of United States Medical Licensing Examination Step 1 Scores in Residency Selection. Acad Med. 2016; 91:12-15.
  • Rubright JD, et al. Examining Demographics Prior Academic Performance and United States Medical Licensing Examination Scores. Acad Med. 2019 Mar;94(3):364-370
  • Williams RD, Cooper AL. Reducing Racial Inequities in Health: Using What We Already Know to Take Action. Int. J. Environ. Res. Public Health 2019, 16(4), 606;
  • Zuckerman SL et al. Predicting Resident Performance from Preresidency Factors: A Systematic Review & Applicability to Neurosurgical Training. World Neurosurg. 2018;110:475-484

Education.

Say Hello to Our Featured Members!

IAMSE April Featured Members

Our association is a robust and diverse set of educators, researchers, medical professionals, volunteers and academics that come from all walks of life and from around the globe. Each month we choose a member or members to highlight their academic and professional career and see how they are making the best of their membership in IAMSE. This month’s Featured Members are the team presenting a newly-minted workshop at the 2019 IAMSE Annual Meeting in Roanoke, VA, USA.

Members Stefanie Attardi, Kara Sawarynski, Rebecca Pratt, Tracey Taylor and Sarah Lerchenfeldt of the Oakland University William Beaumont School of Medicine.

“Translator please!: Adapt your teaching for radically different and newly matriculated iGen students”
Monday, June 10
10:30 AM – 12:00 PMWhy is this a perfect topic to cover at the 2019 meeting?
The theme for the 2019 IAMSE meeting is “Adapting to Changing Times in Health Sciences Education.” Generational researchers have seen dramatic changes in trends and traits between the Millennials (born between 1980 and 1994), and the new “iGen” or “GenZ” (born after 1994). The iGen/GenZ generation are the very students forming the majority of our current health professions classes. Due to generational differences, experienced educators (most of which are Boomers, GenX or Millennials) might struggle to grasp characteristics unique to this generation; we must re-examine our curricula as what is intuitive to us may not be intuitive to them. This session will help participants to understand iGen/GenZ with an open mind and to possibly adapt our educational strategies to these changing times.

How has being IAMSE members helped you to create (or help to create) this workshop?IAMSE provides an open venue for professional development that is neither restrictive nor discipline-specific. We’ve learned a lot by attending and delivering previous IAMSE workshops and webinars and have been inspired to share this topic through this useful venue. For this reason, we specifically developed this workshop with IAMSE members in mind. Medical educators and educators in other health professions have a particular advantage in higher education in that we can work closely with our students to adapt our teaching to be as effective as possible. The members of IAMSE want to become the best educators possible, and therefore it is this group that will be openly interested in learning more about their learners and improving the educational outcomes for our students. 

What type of activity will participants engage in?
Participants will have the opportunity to complete a generational self-assessment activity and discuss where they see themselves in relation to their iGen/GenZ students. After reviewing cases of iGen/GenZ curricular issues, participants will be encouraged to explain unique characteristics of the iGen/GenZ culture and formulate strategies to both adjust their teaching and to help influence student attitudes. Participants will also be encouraged to share their own challenging iGen/GenZ scenarios and success stories from home institutions and receive feedback.

So, who should take this session with your group?Any health professions educators and/or administrator working directly with students or influencing student-related policy should attend our session.  Students are also highly encouraged to attend this session as their perspectives will add valuable contributions to our discussions. We feel that students will also benefit from understanding the perspectives of educators from a different generation.
Anything else you’d like to add or highlight about this workshop?
We think that our workshop will be a great learning experience as well as a lot of fun! We think that learning about other generations is an interesting topic for discussion and will allow us time to reflect on our own generation and experiences in our upbringing that make us who we are today. In addition, we will be providing an unbiased, literature-based overview of iGen/GenZ from multiple experts on generational research.
To learn more about the 2019 IAMSE Annual Meeting, including the plenary speakers, workshops and networking opportunities, or to register, please visitwww.IAMSEconference.org.

#IAMSE19 Faculty Development Course Highlight: Applying a Systematic Process to Enhance Student Assessment

The 23rd Annual IAMSE Meeting will feature a host of new Faculty Development Workshops on Saturday, June 8 before the official launch of the meeting. One of our first-time workshops is Applying a Systematic Process to Enhance Student Assessment: Building Faculty Skills and an Assessment Community of Practice. This half-day workshop will be given on Saturday morning, June 8 and will be led by Mary Kate Worden, James Martindale, Christine Peterson and Maryellen Gusic.00

Workshop: Applying a Systematic Process to Enhance Student Assessment: Building Faculty Skills and an Assessment Community of Practice
Time: Saturday, June 8 from 8:30 AM – 11:30 AM
Speakers: Mary Kate Worden – University of Virginia
James Martindale – University of Virginia School of Medicine
Christine Peterson – University of Virginia
Maryellen Gusic – University of Virginia
Additional Cost: $150.00 USDIn this highly interactive workshop, the audience will participate in hands-on exercises that will enhance their skills in creating, reviewing and refining effective assessments using USMLE-style multiple choice questions that assess higher-order cognition. The activities will be organized to demonstrate a systematic process for “just-in-time” faculty development so that participants can adopt/adapt the approach at their home institution to build capacity for enhancing their own assessment programs. At the end of the workshop, participants will have the opportunity to create an individual action plan that builds on what they have learned from the workshop to improve and augment the assessment programs at their home institutions.

Additional details about this and our other Faculty Development Workshops, as well as registration information, can be found at http://www.iamseconference.org.

IAMSE 2019 Elections Results

According to IAMSE bylaws, nominations for the four open positions of directors for the Board of Directors were sought from the Nominating Committee. The membership-at-large then voted toelect the directors of the association whose three-year terms will commence on July 1, 2019. It is my pleasure to announce to you the results of these recent elections.

Director – Bonnie Granat
Director – Amber Heck
Director – Jessica Jones
Director – Johnathan Wisco, re-elected

Please join me in congratulating our new IAMSE officers and in thanking them for their past and ongoing dedication and service. We’d also like to extend a sincere thank you to Carol Nichols, Paula Smith and Sandy Cook, who will be leaving office, for their service to IAMSE.

Also, the measures put forth to revise the IAMSE Bylaws were voted on by the general membership and those revisions have passed. Thank you all for your consideration of the candidates, bylaws revisions and for exercising your right to vote in this important endeavor.

Thank you,
Rick Vari, PhD
President, IAMSE

Donate Items For the 2019 IAMSE Raffle

As you may know, IAMSE conducts a silent auction at the annual meeting each year. Because the format of our Gala Dinner has changed slightly this year, we will instead hold a raffle of donated items. The purpose of the raffle is to raise money to fund scholarships for attending the annual meeting. It is important to support and foster the interests and scholarly activities of the younger generation who will one day step into our shoes. We hope this year’s event will be even more successful than before.

How you can help: Please consider donating items that would be appealing to our members. Even if you are unable to attend the meeting this year in Roanoke, you can still participate! Pleasecontact our office regarding the items you would like to donate.  

Silent Auction

Examples of past contributions include (but are not limited to) the following: functional equipment, computer hardware (older versions of the iPad), software – educational programs or applications, signed artwork / photographic images, jewelry, books, textbooks, video or
graphic supplies, lab supplies, lab or service bureau gift certificates, retail gift certificates, medical or photographic antiques, collectibles, handcrafted items, promotional items from suppliers, mugs, t-shirts, caps, etc. from your institution/state/country, food, wine, or specialties of your state/region/country, vacation homes to be used for a week, and airline miles.
 Please let us know which item(s) you would like to donate by emailing support@iamse.org.
 Thank you for considering your contributions to this important endeavor. We look forward to seeing you in Roanoke!

A Review from Medical Science Educator from Dr. John Szarek

Each month the IAMSE Publications Committee reviews published articles from Medical Science Educator. This month’s review, written by Dr. John L. Szarek, is taken from the article titledDesign and Implementation of the Interprofessional Education Passport Curriculum in a Multi-campus University with Distance Learners, published in the Medical Science Educator, Volume 28, (pages 749–755), 2018 by K. Packard, J. Doll, K. Beran-Shepler, N.H. Stewart, and A. Maio.


 For many of us, IPE is a grassroots effort led by faculty champions who take on the responsibility of developing and leading sessions on top of their regular responsibilities. Encouraging the participation of others, and the development and implementation of effective IPE are paramount in developing a sustainable program. In the December 2018 issue of Medical Science Educator, Kathleen Packard and colleagues at the School of Pharmacy and Health Professions, and the School of Medicine at Creighton University describe a curricular model of IPE, The IPE Passport.

 The IPE Passport is maintained through an established IPE Center and an IPE Curriculum Committee. A 0.5 credit (8 contact hours) introductory IPE course is the first component of the IPE curriculum. The course is an online, self-paced course that provides a basic introduction to the concepts of IPE and interprofessional collaborative practice for health professions students. After completing the introductory IPE course, students then complete a minimum of three IPE passport activities prior to graduation. Each profession dictates how these activities are achieved. For example, embedding all three activities within the curriculum, using a menu approach or a combination of embedded and menu approaches. IPE Passport activities are developed through an application process which must meet specified rubric criteria and be approved by the IPE Curriculum Committee. All members of the academic community including learners can submit a proposal. The IPE Passport activities are centralized within the IPE Center which facilitates students’ selection of activities, and ensures a quality and paired experience among all the health professions programs. As with any new educational activity, faculty development is critical. For an IPE activity to be approved, at least one faculty facilitator must have taken the faculty development version of the introductory IPE course. Students are assessed longitudinally using The Interdisciplinary Education Perception Scale and each IPE Passport activity has its own assessment plan. Thus, the IPE Passport supports grassroots IPE, leverages IPE beyond core champions and promotes IPE innovation. Best practices include a standardized rubric for evaluating proposals, dissemination of information, and centralization of Passport activities.

Many of us involved in IPE bear the burden of creating activities, logistics, etc. The IPE Passport program is a promising educational curriculum which not only helps programs meet profession-specific IPE accreditation requirements but, importantly, it also encourages other members of the academic community who may not have been involved in the past to take an active role in IPE which helps promote a culture change.

John L. Szarek, BPharm, PhD, CHSE
Professor and Director of Clinical Pharmacology
Education Director for Simulation
Geisinger Commonwealth School of Medicine
Member, IAMSE Publications Committee

IAMSE Spring 2019 WAS Session 3 Highlights

[The following notes were generated by Mark Slivkoff, PhD]

IAMSE Webinar Series, Spring 2019

Speakers: Kim Dahlman, PhD
Assistant Professor of Medicine Co-leader, Integrated Science Courses Vanderbilt University School of Medicine Nashville, TN USA

Title: Role of Foundational Sciences in Clinical Years
Series:
The Role of Basic Science in 21st Century Medical Education

During last week’s webinar, we learned of the unique curriculum of Boonshoft School of Medicine at Wright State University. This week’s presentation by Dr. Kim Dahlman also focused on a non-traditional approach to medical education, specifically on the curriculum at her U.S. medical school, the School of Medicine at Vanderbilt University in Nashville, Tennessee. Most medical schools have clear course distinctions between the basic foundational sciences and clinical sciences; first- and second-year students usually spend their time studying the former while “post-board-exam” students in the third and fourth years usually are in clinical rotations and out of the classroom. At Vanderbilt, however, as Dr. Dahlman explained, third and fourth year students are required to take classroom-based courses which are heavily grounded in the foundational sciences.

Dr. Dahlman laid out her agenda for her presentation and subsequently discussed the rationale for foundational science integration, the specifics of the Vanderbilt Medical curriculum (C2.0), the details of the Integrated Science Courses (ISCs), and then the challenges and solutions behind their curriculum.

There is growing evidence that a deep understanding of complex foundational science plays a crucial role in effective clinical decision making.

References:
• Dahlman et al. (2018). Integrating foundational science in a clinical context in the post-clerkship curriculum. Med Sci Edu, 28(1): 145-154.
• Baghdady et al. (2013). Integration of basic sciences and clinical sciences in oral radiology education for dental students. J Dent Educ, 77(6): 757-763.
• Bandiera et al. (2018). Back from basics: integration of science and practice in medical education. Medical Education, 52: 78-85.
• Goldman and Schroth (2012). Deconstructing integration: A framework for the rational application of integration as a guiding curricular strategy. Acad Med, 87: 729-734.
• Kulasegaram et al. (2013). Cognition before curriculum: Rethinking the Integration of Basic Science and Clinical Learning. Acad Med, 88: 1578-1585.
• Kulasegaram et al. (2015). Cause and effect: Testing a mechanism and method for the cognitive integration of basic science. Acad Med, 90: S63-S69.
• Kulasegaram et al. (2015). The mediating effect of context variation in mixed practice for transfer of basic science. Adv in Health Sci Edu, 20: 953-968.
• Mylopoulos and Woods. (2014). Preparing medical students for future learning using basic science instruction. Medical Education, 48: 667-673.
• Mylopoulos et al. (2018). Twelve tips for designing curricula that support the development of adaptive expertise. Medical Teacher, 40:8, 850-854.

IAMSE to visit AACOM 2019 Conference in Washington, DC

The 2019 American Association of Colleges of Osteopathic Medicine Educating Leaders Conference will be taking place in Washington, DC, USA from April 10 – 12, 2019. The IAMSE booth will be present at the conference to exhibit, so if you plan on attending this meeting, do not forget to swing by and say hello!  

AACOM 2019

 There will also be an IAMSE-sponsored Symposium titled “The Role of Data in Health Sciences Education and the Impact on Faculty Development” led by Peter GM de Jong, Frank J Papa andElizabeth K McClain. The session will be held Wednesday, April 10 from 3:15pm – 4:15pm. For more information on the AACOM Meeting, please click here.

#IAMSE19 Faculty Development Course Highlight: “Not Everything That Counts Can be Counted:” Introduction to Qualitative Research

The 23rd Annual IAMSE Meeting is just around the corner, and we would like to showcase one of our many new Faculty Development Workshops: “Not Everything that Counts can be Counted:” Introduction to Qualitative Research. This full-day workshop will be given on Saturday, June 8 and will be led by Stefanie Attardi, Stephen Loftus, Valerie O’Loughlin and Jason Wasserman.

Workshop: “Not Everything that Counts can be Counted” Introduction to Qualitative Research
Time: Saturday, June 8 from 8:30 AM – 3:15 PM
Speakers: Stefanie Attardi – Oakland University William Beaumont School of Medicine
Stephen Loftus – Oakland University William Beaumont School of Medicine
Valerie O’Loughlin – Indiana University School of Medicine – Bloomington
Jason Wasserman – Oakland University William Beaumont School of Medicine
Additional Cost: $275.00 USD

Educators often want to know about how people understand or perceive aspects of their educational experience or professions. Qualitative research represents a systematic approach to narrative (spoken or written) or visual data that leaves intact the robust experiences of people, thereby representing an important way of interrogating education and improving health professions education.
 
Through short, interactive didactic presentations, small group discussions, practice activities, and peer presentation, the speakers will introduce participants to several aspects of qualitative research. Working from the attendee’s own research interests, during the workshop the participant will write a qualitative purpose statement, synthesize usable qualitative research questions, select an appropriate study design, and plan methods for data collection and analysis.

Additional details about this and our other Faculty Development Workshops, as well as registration information, can be found at http://www.iamseconference.org.