Browsing by Author "Agosto, Elizabeth R."

Now showing 1 - 5 of 5
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    Anatomy Preparedness in Medical Education: Determining and Building Sufficient Preparedness in Professional Anatomy Courses
    (2023-08) Balle, Megan C.; McNulty, Margaret A.; Agosto, Elizabeth R.; Byram, Jessica N.; Graunke, Steven S.; Magee, Paula A.; Williams, James C.
    Widely accepted as a foundational course within health professions education, anatomy is often taken at the beginning of the health professional curriculum and students are expected to be prepared for the rigors of the course. Anatomy preparedness, evaluated in this study, has been defined as matriculating into a graduate or professional anatomy course with an adequate foundation in basic anatomy knowledge. In a mixed-methods study, pre-requisite syllabi of physician assistant students were analyzed via deductive content analysis to explore common traits within each group. The top and bottom 10% performing students were invited to participate in semi-structured interviews, n=5 participated. Additionally, correlation analyses were used to determine whether performance on a basic anatomy pre-quiz could aid in identifying allied health students with the potential to struggle in a professional anatomy course. A post-course survey was given to determine in which anatomy topics students felt underprepared upon matriculation, prior anatomy experience, feelings of preparedness, and anatomy pre-requisite recommendation. Finally, a pre-matriculation program targeting under-represented in medicine (URiM) students and those at-risk for failure in the medical program was developed. Correlation analyses were used to determine if there was a relationship between performance in the pre-matriculation program and the medical anatomy course. The same post-course survey was administered and focus groups were conducted; transcripts were analyzed via deductive content analysis. Syllabi traits critical to student success included exposure to specimens/prosections, practical exams, and supply of study resources; interviewees also perceived these traits to be important. Twenty-question pre-quiz scores significantly and positively correlated with student performance in their professional anatomy course. Students reported feeling deficient in anatomicomedical terminology and the nervous system. The pre-matriculation program was a success, with students performing at or above average within their cohort and compared to other URiM students. Both allied health and pre-matriculation students recommended taking anatomy prior to professional school. As seen in this study, students are capable of success with the proper resources and support. Furthermore, allied health and medical students recognized the importance of anatomy preparedness for success in health professional anatomy coursework and their openness to resources aimed at supporting their success.
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    Evolvability and Constraint in the Primate Basicranium, Shoulder, and Hip and the Importance of Multi-trait Evolution
    (Springer, 2021-06) Agosto, Elizabeth R.; Auerbach, Benjamin M.; Anatomy and Cell Biology, School of Medicine
    The scapula shares developmental and functional relationships with traits of the basicranium, vertebral column, humerus, and clavicle. As a limb girdle, it also shares analogous characteristics with the pelvis. Despite these relationships, studies of primate shoulder evolution often focus on traits of the scapula in isolation. Such analyses may lead to spurious conclusions, as they implicitly model the scapula as evolving independent of other anatomical regions. Traits of the shoulder girdle share genetic covariances with each other, as well as potential covariances with dimensions of other skeletal elements. To create accurate models of shoulder evolution, it is imperative to account for the constraints imposed by these sources of covariance. Here, we use evolutionary quantitative methods to test a model in which shoulder morphological evolution is influenced by its developmental and functional covariances with the basicranium in the Colobus genus. This evolutionary relationship is also assessed with morphology of the pelvis to provide context to the evolutionary covariance among traits of the basicranium and shoulder girdle. Our results indicate potential evolutionary implications arising from covariances among the basicranium, shoulder, and pelvis. We further propose that the shoulder and basicranium may be examples of developmental, functional, and genetic covariances among traits that manifest an evolutionary suite of mutually constrained morphologies. We demonstrate novel evolutionary relationships among the shoulder girdle and basicranium that affect not only models of primate shoulder evolution but have broader implications for modeling trait evolution across the skeleton.
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    Experiences of Residency Program Directors in Their Roles: Exploring Well-Being Through Burnout and Engagement
    (2022-11) Robertson, Kyle A.; Byram, Jessica N.; Hayes, Cleveland; Agosto, Elizabeth R.; McNulty, Margaret A.; Organ, Jason M.
    Recent literature on well-being of physicians in general, and residency program directors (PD) specifically, has demonstrated those meeting the criteria of burnout reaching almost 50% in physicians, and 20-30% in PDs. However, few studies have explored engagement, or the positive or meaningful aspects, in physicians and no studies have explored engagement in the PD and Assistant PD community. Therefore, this study employed a qualitative approach to explore the experiences of PDs and APDs as they encountered burnout, engagement, and every combination in between through their multifaceted, roles, responsibilities, and tasks embedded in their institutional context and personal lives. Phase 1 participants (n=3) included two PDs and one APD from Indiana University School of Medicine (IUSM). Participants in Phase 1 took part in three semi-structured interviews at 6-month intervals, and direct observations in their clinical, administrative, and education roles. Phase 2 participants (n=5) were PDs from IUSM who completed a single semi-structured interview based on preliminary results and exploration of Phase 1 participants’ experiences. Interviews and field notes from observations were analyzed using inductive thematic analysis, followed by a deductive application of Job Demands-Resources (JD-R) theory. Document analysis was incorporated to add context, understanding, and a rich description of the participants’ experiences. This study found multiple sub-themes situated within four major themes: It Takes a Village, Integration of the “Hats” They Wear, Motivation and the Meaning of Their Career, and Coping. Exploring the sub-themes to JD-R theory allowed contextualization of how job demands, job resources, personal resources, absence of resources, job crafting, recovery, self-undermining, and strain, interact to add context, nuance, and broader conceptualization of how PD and APD experienced their multifaceted roles. This study provides a rich description of the experiences of PDs and APDs embedded in their social context of roles, tasks, and responsibilities. These results indicated that understanding how the individual experiences their job demands as they interact with their experiences of job and personal resources, and how the individual proactively engages with their environment through job crafting and recovery enables for a nuanced appreciation of engagement and burnout.
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    Morphological integration and evolutionary potential of the primate shoulder: Variation among taxa and implications for genetic covariances with the basicranium, pelvis, and arm
    (Elsevier, 2022) Agosto, Elizabeth R.; Benjamin M. , Auerbach; Anatomy, Cell Biology and Physiology, School of Medicine
    Within the primate order, the morphology of the shoulder girdle is immensely variable and has been shown to reflect the functional demands of the upper limb. The observed morphological variation among extant primate taxa consequently has been hypothesized to be driven by selection for different functional demands. Evolutionary analyses of the shoulder girdle often assess this anatomical region, and its traits, individually, therefore implicitly assuming independent evolution of the shoulder girdle. However, the primate shoulder girdle has developmental and functional covariances with the basicranium and pelvic girdle that have been shown to potentially influence its evolution. It is unknown whether these relationships are similar or even present across primate taxa, and how they may affect morphological variation among primates. This study evaluates the strength of covariance and evolutionary potential across four anatomical regions: shoulder girdle, basicranium, pelvis, and distal humerus. Measures of morphological integration and evolutionary potential (conditioned covariance and evolutionary flexibility) are assessed across eight anthropoid primate taxa. Results demonstrate a consistent pattern of morphological constraint within paired anatomical regions across primates. Differences in evolutionary flexibility are observed among primate genera, with humans having the highest evolutionary potential overall. This pattern does not follow functional differences, but rather a separation between monkeys and apes. Therefore, evolutionary hypotheses of primate shoulder girdle morphological variation that evaluate functional demands alone may not account for the effect of these relationships. Collectively, our findings suggest differences in genetic covariance among anatomical regions may have contributed to the observable morphological variation among taxa.
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    What's My Role Again? Cultivating Interprofessionalism, Role Knowlege, and Role Clarity Through Case-Based Learning
    (2024-03) Herriott, Hannah Laine; McNulty, Margaret A.; Byram, Jessica N.; Agosto, Elizabeth R.; Deane, Andrew S.; Rebman, Rebecca; Scheurich, Jim J.
    As healthcare has shifted away from physician-centered practice, in favor of a patient-centered model, the importance of interprofessional team-based practice was recognized. Early exposure, practice working through clinical cases in teams, and learning each profession’s roles are essential determinants of successful interprofessional collaboration (IPC). Although interprofessional role comprehension is widely accepted as one of four core competencies of interprofessional education (IPE) and lack of role comprehension is associated with medical errors; literature measuring said construct is lacking. Role knowledge and clarity are two crucial skills that encompass identifying the roles and limitations of various professions’ scopes of practice and discerning which professional is best equipped to undertake a task in a particular situation. The present study investigated a novel IPE intervention employing role centered, small group casebased learning (CBL) sessions, integrated throughout an anatomy course for firstsemester occupational therapy (OTD), physical therapy (DPT), and physician assistant (MPAS) students. Additionally, fourth-year medical (MD) students participated in the IPE intervention by serving as near-peer facilitators for each of the small groups. A sequential explanatory, mixed methods design was employed to examine participants’: 1) acquisition of role knowledge, 2) demonstration of role clarity, 3) views of IPC after engaging in CBL sessions, and 4) perceptions of the intervention itself. The present study addressed the previously mentioned gap in the literature by exploring a CBL intervention’s influence on role comprehension (a previously unquantified aspect of IPE), in addition to their IPE-related perceptions. The aforementioned CBL intervention effectively improved role knowledge and clarity when implemented in-person; however, no significant changes were demonstrated in the virtual cohort. While many positive perceptions of the intervention and IPE experience were found, some misconceptions about professions and inhibitory power dynamics were also identified. Despite the latter findings, the CBL intervention examined in this study can serve as an effective model for cultivating IPE through enhanced role knowledge and clarity among health professional students.