News

Join Your IAMSE Colleagues for #IAMSECafe Virtual Chats!

As we all forge ahead building online classrooms and serving remote student bodies, IAMSE is here to keep you connected with your colleagues around the globe. We invite you to join us over the next few weeks for IAMSE Cafe, a virtual round table discussion where you control the conversations. Have you transitioned seamlessly online and into your home office, or do you still have some questions? Do you struggle to help your students through cancellations and postponements, or did your team find an ingenious way to move forward remotely?

Join our moderator, Dr. Kelly Quesnelle from Western Michigan University Homer Stryker M.D. School of Medicine beginning Tuesday, March 31 at 10AM EST  for a series of conversations focused on how to help us all have the most successful instruction and transition possible.

Tuesday, March 31, 2020 at 10AM EST – MedEd Mailbag: The Virtual Teacher. Join Kelly as she takes member questions and opens the floor for discussion about how IAMSE members are dealing with and making the best of online teaching.

Thursday, April 2, 2020 at 10AM EST – Leading by Example: Practicing Self-care in a Time of Crisis. Adi Haramati of Georgetown University School of Medicine will lead a discussion about the importance of utilizing a number of mind-body techniques to reduce stress and promote resilience. We will also share how many of us have incorporated simple tools into our virtual reality with peers and learners.

April 7, 2020 at 10AM EST – MedEd Mailbag: Being Productive in Your Own Space. Join Kelly as she takes your questions about transitioning and adapting to an online learning environment while in your natural habitat. This open discussion will be led by the audience.

April 9, 2020 at 10AM EST – How Re-thinking and Re-designing Anatomy Instruction Into the Online Space Can Lead to Better Classroom and Cadaver Lab Learning Experiences. Join Jon Wisco from Boston University School of Medicine in a discussion about how the paradigm shift of what and when anatomy content can be taught, and how it contributes to classroom and lab learning experiences.

Join any of these webinars by clicking: https://zoom.us/j/237132753

We look forward to hearing from you next week!

A special message from our partners at AAMC

We hope this message finds you doing well!  We want to share your great work and support the broad learning community with new or adapted clinically relevant learning experiences.

Our medical and health professions’ educators are responding to this pandemic with new or adapted learning experiences that can be done without patient contact during COVID-19. The AAMC is creating a new free and open resource repository that will allow for the agile sharing and disseminating of these educational approaches.

We are particularly interested in submissions of learning experiences that support patient care, but may not necessarily involve direct patient contact. Examples of appropriate resources may include a description with or without supplements, such as: checklists, worksheets, lesson plans, cases, or lecture outlines. Existing electives on diverse topics that have or can be adapted for online or remote completion are also welcome.

If you have exemplars to share, please send email to curricularinnovation@aamc.org

Our specific inclusion criteria for this collection, includes:

  • Describes experiences or activities that represent a structured learning experience (or can be readily designed as such)
  • Does not involve physical contact with patients
  • Can be offered virtually in real time and/or asynchronously
  • Can be offered with or without peers and/or facilitation
  • Objectives are focused on skills with clinical relevance in broad competency areas
  • Adhere to the Creative Commons License Attribution – Non Commercial

We will be reviewing those submissions and, as needed, reaching out for more information. Again, our intent is to curate and disseminate this information for the broader med ed community.

Thank you for all you are doing to support learners and the clinical learning environment during this unprecedented time!

On behalf of
Lisa Howley, PhD, MEd
Sr Director of Strategic Initiatives & Partnerships in Medical Education
Association of American Medical Colleges

A Review from Medical Science Educator from Dr. Dani McBeth

Each month the IAMSE Publications Committee reviews published articles from Medical Science Educator. This month’s review, written by Dr. Dani McBeth, is taken from the article titled Factors Predictive of Performance on USMLE Step 1: Do Commercial Study Aids Improve Scores? (doi:10.1007/s40670-019-00722-4) published in Medical Science Educator, Volume 29, (pages 667–672), 2019 by Parry, S., Pachunka, J. & Beck Dallaghan, G.L.

I read with great interest an article in Medical Science Educator, Factors Predictive of Performance on USMLE Step 1: Do Commercial Study Aids Improve Scores?, Parry et al. The Step 1 exam has obtained such outsize importance, that it drives the way our students approach their studies. While this may be abhorrent to many of us, it is reality. Therefore, I found this article and the associated references to be of great interest. In my school, I plan to use the article in our Step 1 coaching program.

The study sought to correlate the results of Step 1 performance in 2 cohorts of students from a single medical school with academic performance in the curriculum and the use of commercially available study aids. While some of the results may not be too surprising, there were others that may be helpful in advising students about their approach to the exam. Not surprisingly, the strongest correlation to Step 1 scores was academic performance in the curriculum. The consistent use of the UWorld Qbank and the numbers of questions completed in the Qbank were also strongly correlated with Step 1 scores. Those students completing the entire Qbank twice had the highest Step 1 performance. There was no correlation between Step 1 scores and the numbers of practice exams completed, either the UWorld provided exams or the NBME CBSSA’s. This result does not negate the importance of self-assessment during the dedicated study process but may offer some advice as to the numbers of such self-assessment exams that are useful. It is my experience that too frequent self-assessment in many students may serve to increase anxiety levels. Perhaps surprisingly given the numbers of students who religiously rely on it, the extent to which First Aid was read and re-read did not correlate with increased Step 1 performance. Finally, there was a negative correlation to increased preparation time. In our school, we have seen an increasing number of students delaying their exams with the certitude that this will result in their desired score. Anecdotally, I have heard that this is an increasing issue at other schools as well.  The authors correctly point out the limitations of their study; a single medical school over only a to year period. Despite that, the article is useful in provoking thought about approaching how to help students think about their exam preparation. Similar studies with a larger sample of schools and expanding to include other commercially available resources including full prep courses would be of interest to many.

Respectfully submitted by
Dani L McBeth, PhD
Publications Committee member

Early Bird Deadline for #IAMSE20 Suspended

In light of the sudden shift in working and teaching conditions, as well as the sweeping global restrictions on travel and mass gatherings, we understand the uncertainties regarding the IAMSE 2020 meeting. Educators all over the world are dealing with event cancelations, postponements and format changes. Given the current climate and uncertainty facing most of us as we try to plan our future educational activities, IAMSE is suspending the April 1 Early Bird registration deadline. We will reassess the situation in mid-to-late April and provide guidance by May 1, 2020.

ScholarRx offers free access to Rx Bricks online curricular system to schools affected by COVID-19

In response to a request for assistance from a partner medical school impacted by COVID-19, ScholarRx has agreed to make its Rx Bricks program available at no cost to M2 students for the remainder of the 2019-20 academic year. This comprehensive, online resource can assist schools implementing contingency plans necessitated by the COVID-19 outbreak.

In this specific case, Rx Bricks will support the Infectious Disease course where the school has lost access to teaching faculty due to the public health emergency. ScholarRx will provide the students with access to Rx Bricks and further assist the school with curricular implementation and mapping support.

ScholarRx wishes to extend this offer of free access to Rx Bricks to you and your school. Please let us know if we can help you support the education process during this challenging period.

For more information or to request assistance, go to: https://scholarrx.com/covid-19-assistance-offer/

Rx Bricks is an innovative digital learning system designed to help students easily learn the foundations of medicine. 

Rx Bricks offers a repository of preclinical curricular materials and learning frameworks that can be rapidly deployed and customized to suit your unique curriculum needs and goals.

Rx Bricks uses short, high-yield, interactive lessons called “bricks.” Content is broken down into the smallest cohesive learning units, or “bricks”, and organized around basic science topics (e.g., pressure-volume loops) or clinical concepts (e.g., ischemic heart disease). Each brick uses clear language to explain and contextualize key topics, many in less than 20 minutes. Then it offers built-in review tools to test understanding of the content right away.

Currently, ScholarRx offers more than 600 Rx Bricks covering 12 preclinical disciplines and organ systems.

To learn more, go to: https://scholarrx.com/covid-19-assistance-offer/

Have an Announcement? Share it in Medical Science Educator!

In every issue of Medical Science Educator, we publish an announcements section. In this section, we share information that is of interest to the readership of the journal. Individual IAMSE members wishing to post medical education related announcements in the Journal are invited to send their requests to the Editorial Assistant at journal@iamse.org. Announcements may be IAMSE-related, announcements from other medical education organizations, medical education conference information or international issues affecting medical education. Announcements will be published at the Editors discretion.

Deadline for inclusion in the next issue: April 5, 2020

Thank you,
Peter GM de Jong, PhD
Editor-in-Chief

#IAMSE20 Faculty Development Course Highlight

The 24th Annual IAMSE Meeting will feature a host of new workshops throughout the entire conference. One of our first-time workshops is Designing VR-Enhanced Educational Activities: A Backward Design Approach. This afternoon workshop will be given on Saturday, June 13 and will be led by Yerko Berrocal, Wen Cheng (Mark) Huang, Daniel Salcedo and James Thomas.

Workshop: From Theory to Practice: How to Apply Best Practices to Create Effective Video Microlectures
Time: Saturday, June 13 from 12:15 PM – 3:15 PM
Speakers: Yerko Berrocal – University of Illinois College of Medicine
Wen Cheng (Mark) Huang – Municipal WangFang Hospital, Taipei Medical University
Daniel Salcedo – Taipei Medical University, Center for Education in Medical Simulation
James Thomas – Lecturer

Virtual reality (VR) use for health professions education has been rapidly growing during the past few years. This educational technology offers great potential benefits, including better learner engagement, ability to provide learner-centred adaptive content, with a strong focus on experiential learning.  Unfortunately, there is still a lack of evidence-based best practices in VR-education, and poor implementation strategies can lead to limited educational outcomes and unnecessary costs. Proper design of VR-enhanced educational interventions based on proven educational frameworks with appropriate assessment strategies is essential to take full advantage of this technology. This interactive workshop aims to introduce the principles of backward design for VR-enhanced learning activities to improve educational outcomes and reduce unnecessary costs associated with deficient implementation, through the careful integration of educational objectives and assessment methods. Selecting the right tools for the job is essential in the successful utilization of any educational technology, and gaining the necessary knowledge of how to optimize VR in health professions education is critical to establishing a successful program. This workshop has been successfully conducted in Taiwan and Hong Kong, and this is the first opportunity to hold it in North America.

Objectives

  • Understanding the full potential of VR as an educational tool
  • Identifying different types of VR tools commonly used in health professions education
  • Understanding the backwards design approach to developing educational activities with VR
  • Analyzing a VR-enhanced educational activity through a case study
  • Identifying common VR implementation errors and their impact on educational outcomes
  • Identifying strategies to improve educational transfer using VR
  • Designing a sample educational intervention using the backward design approach

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

IAMSE to Host Virtual Roundtable Discussions

IAMSE wants to hear how you are doing and how you are adapting to the new challenges at your institution. Have you had to cancel student research, deliver online exams or revamp your curriculum to more easily be shared online? What questions or words of advice would you give to fellow medical educators? Let us know during an upcoming #IAMSEchat.

We will soon be facilitating online discussions for our members to come together and chat about what works, what doesn’t, and how we can all be learning from and leaning on each other in this tumultuous time. Thus, to assist each other and help maintain our sense of community, we invite you to join in the conversation with your fellow educators in IAMSE by submitting your discussion topics here.

We will share information on these upcoming virtual roundtables in the next few days as it becomes available.

Subscribe to Medical Science Educator Table of Contents

Be alerted every time a new issue of Medical Science Educator is published by signing up for Table of Content alerts!

Springer offers MSE journal subscribers a first look at the newest articles as soon as they are available, so you never miss a breakthrough. To subscribe, visit Springer online here. In the right column, four headings down, you will see “Alerts for this journal.” Simply enter your email address to receive the table of contents for Medical Science Educator by email every time a new issue is published.

I hope you will enjoy reading our journal Medical Science Educator. If you have any questions, please contact journal@iamse.org .

Thank you,
Peter GM de Jong, PhD
Editor-in-Chief

Call for Reviewers – Medical Science Educator

Medical Science Educators Needs Reviewers Like You!
As editor-in-chief of the IAMSE journal Medical Science Educator, I would like to invite you to join us a manuscript reviewer. Medical Science Educator publishes articles which focus on teaching the sciences that are fundamental to modern medicine and health. Coverage includes basic science education, clinical teaching and the incorporation of modern educational technologies. Our journal is experiencing an increasing interest from educators from all over the world to publish with us.

Our reviewers are expected to have a broad interest in medical education. We will try to match the manuscript topic to your field of interest or expertise, but this is not always possible. Although expertise in the field is always helpful, the most important goal of our peer review is to judge the manuscript for its quality and appropriateness to be published in our journal and to provide the authors useful feedback. This is done using a standardized review form, and reviews must be returned within three weeks. We invite you to review at least four manuscripts per year, but of course more is always appreciated.

For the professional development of our reviewers, we offer a review workshop during the IAMSE annual meeting, free of charge. This year this workshop will be organized on Saturday June 13, 2020 at the meeting in Denver, CO, USA. Our reviewers are expected to be IAMSE members in good standing, so we hope that you maintain your active membership.

If you are interested in becoming a reviewer, or if you have any questions, please contact me at journal@iamse.org. I look forward to working with you.

Peter GM de Jong, PhD
Editor-in-Chief

#IAMSE20 Faculty Development Course Highlight

The 24th Annual IAMSE Meeting will feature a host of new workshops throughout the entire meeting. One of our first-time workshops is From Theory to Practice: How to Apply Best Practices to Create Effective Video Microlectures. This morning workshop will be given on Saturday, June 13 and will be led by Yerko Berrocal, Jonathan Fisher, Leslie Hammersmith and Andrew Darr.

Workshop: From Theory to Practice: How to Apply Best Practices to Create Effective Video Microlectures
Time: Saturday, June 13 from 8:30 AM – 11:30 AM
Speakers: Yerko Berrocal – University of Illinois College of Medicine
Jonathan Fisher – University of Illinois College of Medicine Peoria
Leslie Hammersmith – University of Illinois at Chicago
Andrew Darr – U of I College of Medicine at Peoria

Well-designed microlecture videos are an effective and efficient method for conveying core knowledge and key concepts.  Locally-produced video microlectures enable a faculty member to customize content delivery specific to session learning objectives and curricular context.  Faculty-generated video microlectures give students confidence that materials are relevant and personalized and also allow students to develop and maintain a sense of familiarity with faculty members.  However, sub-optimal design of video microlectures undermines learning effectiveness and detracts from student engagement.  Therefore, it is critical to control the quality of materials presented to our students.   In this interactive workshop, the science of learning and evidence-based multimedia principles will be applied as participants work in small groups to design, create, and refine their own video microlectures.

Objectives
At the conclusion of this workshop, participants will be familiar with a research-based theory of how people learn (i.e. the science of learning) and evidence-based principles on how to design effective and engaging video microlectures.  Participants will gain knowledge and practice in microlecture video production using low-cost and user-friendly resources that can be easily utilized at their home institutions.  Furthermore, participants will learn how to effectively use an established peer-review rubric to improve the overall quality of content produced both within the session and in the future.

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

IAMSE Spring 2020 WAS Session 2 Highlights

[The following notes were generated by Rebecca Rowe, PhD.]

IAMSE Webinar Series, Spring 2020

Speakers: Anna Change, MD, Director, Clinical Microsystems Clerkship, University of San Francisco School of Medicine; Adrienne Green, MD, Chief Medical Officer and Vice President for Patient Safety and Accreditation, University of San Francisco Health System and Edgar Pierluissi, MD, Director, Health Systems Improvement, University of San Francisco School of Medicine.
Title: “Health Systems Sciences: The Pre-Clinical Years in Medical Education”
Series: Evolution and Revolution in Medical Education: Health Systems Sciences

Objectives for the Session:
1. Identify the importance of health systems science in medical student education
2. Describe one sample strategy for integrating health system science with basic and clinical sciences in pre-clinical undergraduate medical education
3. List benefits of value-added student roles from the perspective of health system

During the session the following sections will be addressed:
1. What is health systems science and why is it important to medical education? Presented by Dr. Edgar Pierluissi.
2. How do we teach HSS in the pre-clerkship years? Presented by Dr. Anna Chang
3. Why do academic health centers want HSS education? Presented by Dr. Adrienne Green

Dr. Pierluissi started by reminding us the definition of HSS.
HSS is defined as “the study of how health care is delivered. It seeks to improve the quality of health care for patients and populations”. American Medical Association

1. Why is HSS important to Medical Education?
• Quality
• Patient Complexity
• Cost

Quality (JAMA, 2018; 319 (10); 1024-1039)
• There are many areas where American medicine doesn’t deliver care that we know can be achieved, although there are some areas of excellence.
• When comparing to the other wealthy countries, the USA ranked highly in Clinical Outcomes (1st), but did not do as well in other domains such as Access (6th), Perception of care (10th) and Disparities in Health Care (11th).
• There are significant gaps in health care quality across the US such as either overuse of diagnostic imaging or underuse of cancer screening.
• Basically, the quality of care in the US is not what is should be.
• The inclusion of HSS in medical education is a response to this problem.

Patient Complexity
• As patients age, the number of patients with complex medical and psychosocial factors is increasing.
• Patients that present with 4 or more co-morbidities increases with age.
• This population of patients disproportionately account for poor health outcomes and health care costs. ( J Amer Board of Fam Med 2018)
• In summary, “as the number of patients with multimorbid, complex, and medical and psychosocial factors increase, health outcomes will depend more on teams and systems of care than the individual physician.”

Cost
• The US spends more, by far, on health care than other wealthy countries.
• The cost of health care has consequences.
• Data shows that at least 25% of Americans, or a family member, delayed care for a serious health medical condition owing to the cost of care. (The Washington Post 2019)
• One-third of people that filed for bankruptcy confirmed the cost of health care was a contributing factor.
• Adhering to evidence, aligning care with patient’s values, increasing collaboration and care has the potential to reduce waste.
• Much of the cost of health care is due to waste.
• The aim of HSS in medical education is to reduce waste and to increase the value of care.

This concludes this section on the Drivers for HSS in Medical Student Education. By incorporating HSS in medical education, future physicians will be better equipped to participate in and lead systems change that addresses these issues, not alone, but part of a larger solution.

2. How do we teach HSS in pre-clerkship years? Presented by Anna Chang
Concerns for integrating HSS: (Gonzalo et al. Academic Medicine 2018 and 2019)
• Pre-clerkship medical students…is it too early?
o Feel it is not too early as students bring in a fresh perspective and motivation to make the world a better place.
• The medical student curriculum is already packed. Where do we put this?
o Through a process of re-envisioning, integration, and thoughtful change management are strategies that make this important transformation feasible.
• Clinical Faculty never learned this. Who will teach it?
o Through the strategy of co-learning and expansion of the definition of “educator” has helped to address this gap.
• Health systems are still working to improve. How can they partner to teach students?
o Invited the students to join the faculty to improve this together!

In addition to lectures and small classroom learning, there are a number of ways medicals in the US, Canada and the UK, have engaged medical students in experiential learning of HSS.
HS Experiential Learning Models
• Students can act as Patient navigators for individual patients
• Students can serve as Medical scribes for individual clinicians
• Engages students in Patient population health managers for groups of patients
• Medical Students serve as Quality improvement team members for health systems

The remaining of this section will explain how UCSF School of Medicine uses Medical Students as Quality improvement team members for health systems.

UCSF School of Medicine and PharmD program starts the New Bridges Curriculum in 2016.
The rest of this section will focus on foundation 1, which is the phase that encompasses the first and second years of medical school.

For UCSF School of Medicine, HSS is taught in multiple places with the focus being in the Clinical Microsystems Clerkship, which is a longitudinal element that combines direct patient care with health systems improvements. This is where experiential learning focus on quality improvement occurs.

Therefore, the goals of Clinical Microsystems Clerkship is to help early learners to learn:
• Health Systems Improvement
• Interprofessional Collaboration
• Direct Patient Care

Components critical to this curriculum:
• Faculty development
• Lectures and small groups
• Projects applying learn

3. Do academic health centers want HSS education presented by Dr. Adrienne Green.

Dr. Green shared with the audience why academic medical centers like UCSF want to collaborate with educational leaders to develop these types of programs.

Dr. Green presented Why HSS? From a Chief Medical Officer Perspective.
• Formal experiential training is far more effective than learning by doing on the job and I wish I’d had this kind of training in medical school.
• Students enter medical school eager to contribute to positive change, and for exposure to improvement strategies and policy implications.
• Early introduction and engagement in local health care value (quality/cost) work is key.
• Systems based practice is a core competency for students, residents, fellows, and practicing physicians, so there is a need to build these skills for the long term, regardless of their site or their type of practice.

• For UCSF, alignment of student quality improvement projects with UCSF Health True North priorities and Lean strategies is the key.
• Health systems and educational leaders collaborate and iterate each year.
• Training for physicians coaches and students includes:
o Health systems priorities to guide project selection and design
o Lean improvement methodology (same as health system)
• Students integrate into existing improvement teams and ongoing work.
• Students are seen as unique contributors to teams and expand the improvement workforce.

What is meant by Lean tool?
• Dr. Green discussed an example called “A3 Thinking” as a way of problem-solving and documenting their project work than contains the following parts:
o Problem
o Current state
o Target
o Gap analysis
o Experiments
o Action plan
o reflection
• This forces then to fully work through the problem they are trying to solve, at the current state in that particular area to determine the root cause of the problem, before developing their intervention and action plans.

The last part of Dr. Green’s session took us through one of the UCSF student presentations illustrating the work they are doing.

Take-home points by:
Dr. Pierluissi: Because of the gaps in our health care systems, today’s medical educators need to add HSS early in undergraduate medical education.

Dr. Chang: There are models to integrate HSS into the classroom and experiential learning in the first two years of medical school for early students.

Dr. Green: Academic health system leaders perceive an alignment and value in having early medical students engaged in health systems improvement.