Browsing by Author "Brokaw, James J."

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    Beneath the Scalpel: Exploring the Dark Chapters in the History of Body Procurement
    (2023-10-03) Brokaw, James J.
    Presentation slides for lecture delivered by James J. Brokaw, PhD, MPH (Professor Emeritus of Anatomy & Cell Biology, IU School of Medicine) on October 3, 2023. Uncovering the controversial and often grim history of acquiring bodies for anatomical study, from the shadowy days of grave robbing and body snatching to the emergence of ethical standards and regulations, this presentation shines a light on the evolution of practices that have shaped the field of dissection, prompting reflection on the delicate balance between scientific progress and ethical considerations. Presentation recording available online: https://purl.dlib.indiana.edu/iudl/media/692t156n7d
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    Conducting admissions interviews at regional campuses influences applicants’ preferred campus assignment in a statewide system of distributed medical education
    (2016-04-08) Brokaw, James J.; O'Neal, Jonathon P.; West, Karen W.; Smartt, Karen A.
    There was a strong statistical association between interviewing at the Northwest campus and matriculating at the Northwest campus. This was accompanied by a 22% increase in the number of matriculants who ranked the Northwest campus as their 1st or 2nd choice, as compared to previous years when everyone interviewed at the Indianapolis campus. This suggests that interviewing onsite may have fostered positive attitudes about the Northwest campus. The evidence for Muncie is less compelling. Although there was a statistical association between interviewing and matriculating at the Muncie campus, the percentage of matriculants who highly-ranked the Muncie campus actually dropped by 11% compared to previous years (but not statistically significant).
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    Developing an Anatomy Education PhD Program: Key Lessons and National Trends
    (2022-07-14) Brokaw, James J.
    PRESENTATION OUTLINE Brief history of the Education Track PhD Program What was our rationale for the Education Track PhD program? How did we develop our program and gain university approval? What are some of the key lessons we learned? What does our Education Track curriculum look like? Where do our Education Track graduates go? How do we pay for our program? Have other schools developed similar programs?
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    "Do I really have to complete another evaluation?" exploring relationships among physicians' evaluative load, evaluative strain, and the quality of clinical clerkship evaluations
    (2017-06) Traser, Courtney Jo; Brokaw, James J.
    Background. Despite widespread criticism of physician-performed evaluations of medical students’ clinical skills, clinical clerkship evaluations (CCEs) remain the foremost means by which to assess trainees’ clinical prowess. Efforts undertaken to improve the quality of feedback students receive have ostensibly led to higher assessment demands on physician faculty; the consequences of which remain unknown. Accordingly, this study investigated the extent to which physicians’ evaluative responsibilities influenced the quality of CCEs and qualitatively explored physicians’ perceptions of these evaluations. Methods. A questionnaire was delivered to physicians (n = 93) at Indiana University School of Medicine to gauge their perceived evaluative responsibilities. Evaluation records of each participant were obtained and were used to calculate one’s measurable quantity of CCEs, the timeliness of CCE submissions, and the quality of the Likert-scale and written feedback data included in each evaluation. A path analysis estimated the extent to which one’s evaluative responsibilities affected the timeliness of CCE submissions and CCE quality. Semi-structured interviews with a subset of participants (n = 8) gathered perceptions of the evaluations and the evaluative process. Results. One’s measurable quantity of evaluations did not influence one’s perceptions of the evaluative task, but did directly influence the quality of the Likert-scale items. Moreover, one’s perceptions of the evaluative task directly influenced the timeliness of CCE submissions and indirectly influenced the quality of the closed-ended CCE items. Tardiness in the submission of CCEs had a positive effect on the amount of score differentiation among the Likert-scale data. Neither evaluative responsibilities nor the timeliness of CCE submissions influenced the quality of written feedback. Qualitative analysis revealed mixed opinions on the utility of CCEs and highlighted the temporal burden and practical limitations of completing CCEs. Conclusions. These findings suggest physicians’ perceptions of CCEs are independent of their assigned evaluative quantity, yet influence both the timeliness of evaluation submissions and evaluative quality. Further elucidation of the mechanisms underlying the positive influence of evaluation quantity and timely CCE submissions on CCE quality are needed to fully rationalize these findings and improve the evaluative process. Continued research is needed to pinpoint which factors influence the quality of written feedback.
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    Do the benefits continue? Long term impacts of the Anatomy Education Research Institute (AERI) 2017
    (BMC, 2022-11-24) Husmann, Polly R.; Brokaw, James J.; O’Loughlin, Valerie Dean; Anatomy, Cell Biology and Physiology, School of Medicine
    Background: The Anatomy Education Research Institute (AERI) was held in Bloomington, Indiana in July of 2017. Previous research has shown that AERI was successful in meeting Kirkpatrick's first two levels of evaluation via positive initial reactions and learning gains identified at the end of AERI. This manuscript demonstrates continued success in Kirkpatrick levels two and three via six-month and thirty-month follow-up surveys and nine-month follow-up focus groups and interviews. Methods: Quantitative analyses were completed using Microsoft Excel (2019) and SPSS version 26 while qualitative analyses were completed for both survey responses and focus groups/interviews using thematic analyses. Results: Results demonstrate that the learning gains seen immediately post-AERI 2017 were sustained for all participants (accepted applicants and invited speakers). Qualitative results continued to demonstrate positive reactions to AERI 2017. Both quantitative and qualitative results demonstrated that the main obstacle to educational research for most participants is time, while collaboration, IRB, institutional roadblocks, and devaluing of educational research were also identified as obstacles. Conclusions: The research presented here indicates positive outcomes to Kirkpatrick Levels 1, 2, & 3 of evaluation following AERI 2017. However, substantial obstacles still exist for researchers in medical education. The need for a sustained community of practice for educational researchers was suggested as a potential buffer against these obstacles and multiple options for providing that community are discussed.
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    Does Attending a Regional Medical Campus Influence the Training Outcomes of Family Medicine Residents?
    (University of Minnesota Libraries, 2019-07) Kochhar, Komal; Fancher, Laurie M.; Brokaw, James J.; Nalin, Peter M.; Family Medicine, School of Medicine
    Introduction: Indiana University School of Medicine (IUSM) is the largest medical school in the nation, with its main campus located in Indianapolis and eight regional medical campuses (RMC) distributed across the state. In this study, we compared the survey responses of family medicine residents who had attended medical school at the main campus in Indianapolis versus an RMC to see if there were any noticeable differences in their residency training outcomes. Methods: From 2012 to 2017, in the spring of each year, a cross-sectional survey was administered to all final-year family medicine residents graduating from the eleven family medicine residency programs in Indiana. A total of 519 out of 520 residents completed the survey. Of whom, 132 respondents indicated they had graduated from IUSM; 45 reported they had attended the Indianapolis campus and 87 had attended one of the RMCs in the state. Our dataset for this study was comprised of these 132 respondents. Chi-square test or Fisher’s exact test were used to compare responses between groups. P-values ≤ 0.05 were considered statistically significant. Results: In the ACGME competency areas, the residents who attended an RMC versus the Indianapolis campus were significantly more likely to report being fully competent in Medical Knowledge (90% vs. 76%, p = 0.032) and Systems-Based Practice (83% vs. 64%, p = 0.019). Additionally, the residents who attended an RMC compared to their Indianapolis counterparts reported significantly higher rates of being trained to serve rural populations (73% vs. 52%, p = 0.017) as well as being fully competent to serve rural populations (69% vs. 42%, p = 0.003). However, the residents who attended an RMC were no more likely to establish a practice in a rural area than were the residents who attended Indianapolis (18% vs. 17%, p = 0.845). Conclusions: Based on these self-reported data, the family medicine residents who attended an RMC may perceive themselves to be better-prepared in a few core competency areas, as well as in serving rural populations, compared to those who attended the Indianapolis campus. These findings suggest that IUSM’s complex statewide system of medical education may offer some unique advantages in preparing students for residency, especially in family medicine.
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    The Education Track PhD Program in Anatomy at Indiana University School of Medicine: A Decade Producing Anatomy Educator-Scholars
    (2018) Brokaw, James J.; Husmann, Polly R.; O'Loughlin, Valerie D.
    In 2008, the Indiana University School of Medicine (IUSM) admitted its first student to a newly approved PhD program focusing on anatomical education rather than biomedical research. The goal of the Education Track PhD program is twofold: (1) to provide students with extensive training in all of the anatomical sub-disciplines coupled with sufficient teaching experience to be fully prepared to assume major educational responsibilities upon graduation and (2) to train students to conduct rigorous, medical education research and other educational scholarship necessary for promotion and tenure. The 90-credit hour curriculum includes coursework in anatomy and other biomedical subjects, education, statistics, and electives. For their dissertation work, the students complete a research project about some aspect of medical education. As of December 2017, the Education Track program had admitted 23 students and produced 10 graduates. Two more students are anticipated to graduate by June 2018. All of the graduates were offered faculty appointments (8 tenure track and 2 nontenure track) immediately upon graduation at major universities and medical schools. Four of the graduates were offered positions at IUSM. Eight graduates have appointments in medical school anatomy departments, 1 in a physical therapy department, and 1 in a physician assistant department. None of the graduates have been in their faculty positions long enough yet to have achieved tenure. During the period from 2009 through 2017, the students and graduates of the program gave 84 conference presentations and authored 47 peer-reviewed publications about anatomy or other aspects of medical education. Thus, in the 10 years since its inception, the Education Track program has successfully produced a small but stable supply of doctoral-level anatomy educator-scholars for a growing academic market.
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    The Efficacy of Team-Based Learning in Histology
    (2010) Brokaw, James J.; Condon, Keith W.
    Team-Based Learning (TBL) is an instructional strategy in which traditional lectures are replaced with in-class activities that promote group discussion and active learning. Students are expected to master the basic facts and concepts of the subject matter prior to coming to class. We sought to determine whether the knowledge obtained using TBL is comparable to that obtained using traditional lectures, and whether students have a preference for either instructional method. From 2006-2008, the students in a graduate histology course were taught the structure and function of the basic tissues using TBL. Other topics in the course were taught using lectures, so the students experienced both instructional methods. Using the same 59 multiple-choice questions, we tested the students’ knowledge about the basic tissues, and compared the results to those obtained in 2005, when the basic tissue material was taught using lectures. In 2006-2008, the mean ± SD exam performance after TBL (87.5 ± 7.5, n = 32; 83.9 ± 11.1, n = 36; 78.9 ± 13.2, n = 24) was similar to that observed in 2005 after lectures (82.7 ± 12.0, n = 39). When asked to respond to the statement, “I prefer TBL sessions rather than traditional lectures”, 40.4% of the students agreed or strongly agreed, 23.4% disagreed or strongly disagreed, and 36.0% had no opinion (89 of 92 students responding). These results suggest that TBL and lectures produce comparable learning outcomes, at least as measured on a multiple-choice exam, and that students have a mild preference for the TBL format.
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    Essentials of Complementary and Alternative Medicine for Medical Students and Residents: A Web-Based Course for Self-Instruction
    (2003) Brokaw, James J.; McConnell, Elizabeth J.; Raess, Beat U.
    Because physicians are increasingly seeing patients who use CAM therapies, they need to be aware of the potential harm some of these therapies pose. The objective of this project was to develop brief, self-contained lessons that teach the fundamental concepts of CAM and the use of herbal medicines. Each PowerPoint® lesson presents basic information about major aspects of CAM, which can usually be completed in less than 30 minutes. The course will be made available via ANGEL, an internet-based course presentation and management system. To assess understanding of the material, students have the option of taking a brief online quiz at the conclusion of each lesson. The first six lessons comprise a general overview of CAM that exposes the student to a broad variety of “popular” CAM topics: Introduction, Alternative Medical Systems, Mind-Body Interventions, Manipulative Therapies, Energy Therapies and Biologically-Based Therapies. The last four lessons focus on herbal remedies, their uses, actions, and precautions: Pharmacological and Clinical Aspects of Botanicals, Botanical and Herbal Medicines, Herbal Medicines and Drug Interactions, and Patient Education and Advising. This course simply presents information and neither promotes nor condemns the use of CAM. The intent is to expose physicians-in-training to CAM information in a self-paced, time-efficient manner that will enable them to practice safe and effective medicine in a population that typically uses one or more forms of CAM.
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    An exploration of reflective writing and self-assessments to explain professionalism lapses among medical students
    (2014-07) Hoffman, Leslie Ann; Frankel, Richard M.; Brokaw, James J.; Pike, Gary R. (Gary Robert), 1952-; Shew, Ronald L.; Vu, T. Robert
    Background: Recent literature on medical professionalism claims that self-awareness and the ability to reflect upon one’s experiences is a critical component of professionalism; however there is a paucity of empirical evidence to support this claim. This study employed a mixed methods approach to explore the utility of reflective writing and self- and peer assessments in explaining professionalism lapses among medical students. Methods: A retrospective case-control study was conducted using students from Indiana University School of Medicine (IUSM) who had been disciplined for unprofessional behavior between 2006-2013 (case group; n=70). A randomly selected control group (n=230) was used for comparison. Reflective ability was assessed using a validated rubric to score students’ professionalism journals. Mean reflection scores and assessment scores were compared using t-tests. Logistic regression analysis was used to determine the impact of reflection scores and self- and peer assessment scores on the likelihood of having been disciplined for unprofessional behavior. Subsequent qualitative analysis further explored when and how students learned professionalism during their clinical experiences. Results: The study found that students in the case group exhibited lower reflective ability than control students. Furthermore, reflective ability was a significant factor in explaining the odds that a student had been cited for professionalism lapses. There were no differences in self-assessment scores between the two groups, but students in the case group had significantly lower peer assessment scores than control students. Peer assessment scores also had the greatest influence on the odds that a student had been cited for professionalism deficiencies during medical school. Qualitative analysis revealed that students learn professionalism from role models who demonstrated altruism and respect (or lack thereof). Conclusions: These findings suggest that students should be provided with guidance and feedback on their reflective writing to promote higher levels of reflection, which may reduce the number of students who are cited for professionalism lapses. These findings also indicate that peer assessments can be used to provide students with insightful feedback regarding their professional development. Finally, role models have a strong influence on students’ professional development, and therefore must be cognizant of the implicit messages their behaviors convey.