Browsing by Author "Byrne, Bobbi"

Now showing 1 - 6 of 6
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    Adolescent Interview With a Medical Interpreter: A Standardized Patient Encounter for Pediatric Residents
    (Springer Nature, 2023-10-18) Hudson, Tristin; Hecht, Shaina M.; Robbins, Cynthia; McHenry, Megan S.; Byrne, Bobbi; Pediatrics, School of Medicine
    Background: Pediatricians can cultivate a more trusting relationship with their non-English speaking patients by emphasizing the importance of upholding patient confidentiality in the presence of an interpreter. We designed a case for pediatric residents to increase comfort when conducting an adolescent interview using a medical interpreter, emphasizing the importance of upholding patient confidentiality, specifically when discussing sensitive health topics. Methods: We developed a standardized patient encounter (SPE) for pediatric residents at a large academic institution that focused on exploring sensitive health topics with an adolescent, non-English speaking female patient using an interpreter. A validated survey was administered upon completion of the case, prompting participants to reflect on their comfort and skills with specific activities before and after the case, and was analyzed using paired t-tests. Results: Eighty-nine residents participated; 66 were interns and 23 were in their second year of residency. The mean scores of all paired survey items significantly increased after the case (p<0.01), indicating perceived personal growth in all educational objective categories. The majority of the participants (97%, N=86) agreed that they built skills in understanding cultural humility and caring for future patients (mean Likert scores: 4.91 and 5.10, respectively). Conclusions: Upon completion of the case, residents reported increased comfort and skills using a medical interpreter for non-English speaking patients within the context of patient-centered care, discussing various sensitive health topics, emphasizing the importance of upholding patient confidentiality, and demonstrating skills in adolescent interviewing. Both medical confidentiality and cultural humility education can be integrated into simulation-based medical education to improve the quality of care for diverse patient populations.
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    Fetal Injury from Maternal Penetrating Abdominal Trauma in Pregnancy
    (2023-03-24) Barron, Emily; Jeffries, Alison; Pelton, Sarah; Vogel, Katherine; Byrne, Bobbi
    Relevant Background Information: Pregnant women are particularly vulnerable to abuse, and trauma during pregnancy is the leading cause of non-obstetric maternal mortality. Penetrating abdominal trauma, which is less common than blunt trauma, is associated with higher rates of fetal injury and mortality. Case Description: We report a rare case of penetrating abdominal trauma that resulted in fetal injury following child-to-parent violence. A male infant was born at 36+4 weeks gestation via emergent cesarean section following multiple maternal abdominal stab wounds, one of which penetrated the uterus. Upon arrival at the emergency department, fetal heart tracing displayed decelerations. The infant was delivered with Apgar scores of 7 and 8 at 1 and 5 minutes, respectively. Exam revealed a 1.5 cm laceration over his left buttock, 2 cm from the anus, penetrating 1-2 cm into his subcutaneous tissue. He was transferred to a nearby children’s hospital for surgical evaluation where his wound was inspected, irrigated with normal saline, and reapproximated with sutures. Barium enema study demonstrated no evidence of rectal perforation, and brain MRI was normal without evidence of head trauma. He was discharged at 4 days old and has remained well; no significant issues were noted by his pediatrician at 19 months of age. Conclusions: This case demonstrates the importance of immediate cesarean delivery in a penetrating injury to a gravid woman experiencing fetal distress. Following delivery, a thorough evaluation of the infant is imperative to identify and treat any non-obvious traumatic injuries. Clinical Significance: In addition to harming the mother, physical injury can potentially jeopardize the pregnancy and fetus’ health and may lead to separation during a critical period for mother-baby bonding. Healthcare providers should work to identify women during the antenatal period who are at risk of interpersonal violence and facilitate access to resources and interventions.
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    Fostering Cultural Humility in Caring for a Returning Traveler: A Pediatric Resident Simulation
    (2022) Hecht, Shaina; Westwater, Molly; Sui, Htayni; Byrne, Bobbi
    Introduction: International travel has become more frequent outside of the current worldwide pandemic. With increased international travel, there is also more opportunity for physicians to encounter illness associated with this travel, including in pediatric patients. Pediatric residents should be well versed in obtaining a detailed travel history, creating a differential diagnosis and launching a treatment plan with the family for management of illness after international travel. Additionally, the concepts of cultural humility and avoiding judgement while caring for families with different cultural backgrounds is an important skill for residents to foster during training. Study Design/Hypothesis: A simulated patient encounter focusing on a pediatric patient with recent international travel was designed as part of a large multi-scenario simulation education event that is held annually for all pediatric residents. We hypothesized that this simulation would increase pediatric resident knowledge in obtaining a travel history as well as improve the residents’ self-perceived cultural humility when caring for international travelers. Methods: We designed a simulation scenario for second year pediatric residents focused on a febrile child who recently returned from international travel. The child’s family originally presented to a local religious leader prior to having the medical assessment. Pre and post simulation, a survey with questions regarding medical knowledge in the preparation of a pediatric patient for international travel as well as assessment of these patients upon return from international travel were included. Additionally, the Multidimensional Cultural Humility Scale (MCHS) was administered to residents to assess their cultural humility pre- and post- simulation. Results: Twenty- seven residents participated in the simulation. Overall, the mean score of the MCHS did not significantly increase after the simulation. After completing the scenario, all participants did agree that they felt more comfortable caring for immigrant children, more prepared to take a travel history, and more comfortable caring for a child who has traveled or will travel internationally. Conclusions: While we did not find statistical significance in overall self- perceived cultural humility after completing the simulation, pediatric residents felt more prepared to care for children after international travel as a result of participating in this educational intervention. Further data is required to determine if statistical significance would be achieved with increased numbers of participants. Based on post-scenario feedback and observations from scenario facilitators, minor adjustments will be made in future iterations of the scenario to better meet the educational objectives outlined for the participating pediatric residents.
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    Implementation of an Annual “Education Day” to Foster Medical Education Scholarship in a Regional Campus System
    (University of Minnesota Libraries Publishing, 2024-06-24) Kochhar, Komal; Soleimani, Leila; Byrne, Bobbi; Stefanidis, Dimitrios; Pettit, Katie; Zakeri, Bita; Denny, Kim; Brokaw, James; Wallach, Paul
    We implemented an annual “Education Day” at Indiana University School of Medicine to promote educational scholarship across our nine-campus system. Held each spring from 2020 to 2023, Education Day showcased the educational scholarship of our faculty, staff, and learners, and provided a forum to share best educational practices and forge new collaborations.
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    Integrating Cultural Humility Into Infant Safe Sleep Counseling: A Pediatric Resident Simulation
    (Cureus, 2021-12-31) Moore, Chelsea; Hecht, Shaina M.; Sui, Htayni; Mayer, Lisa; Scott, Emily K.; Byrne, Bobbi; McHenry, Megan S.; Pediatrics, School of Medicine
    Introduction: Co-sleeping with infants is a common practice across cultures, but pediatricians may struggle to engage in patient-centered conversations about infant sleep practices with non-native English- speaking families. Cultural humility is a critical skill to utilize when engaging in cross-cultural conversations. We designed a simulation for pediatric residents to counsel on safe sleep and enhance skills in self-perceived cultural humility and preparedness when caring for diverse patient populations. Methods: We created a simulation for the second year and senior pediatric residents at a large academic institution focused on a co-sleeping parent and infant from the Burmese community. The Multidimensional Cultural Humility Scale (MCHS) was administered prior to and after the simulation. We also included additional questions regarding changes in knowledge and preparation in engaging in co-sleeping conversations across cultures. Results: Fifty-seven residents participated. Overall, the mean score of the MCHS significantly increased after the simulation, indicating an increase in self-perceived cultural humility. All participants felt more prepared to have conversations about co-sleeping and to engage in difficult conversations with diverse patient populations, and all learned valuable skills to improve care for future patients. Comments regarding the scenario noted an appreciation for learning more about the Burmese population and understanding new approaches to safe sleep counseling. Discussion: After this simulated scenario, residents reported increased self-perceived cultural humility, preparedness in counseling on co-sleeping, and skills to engage in difficult conversations with diverse patient populations. Topics such as cultural humility can be incorporated into simulation-based medical education to help improve the care of diverse patient populations.
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    Statewide Synergy: Showcasing Scholarship and Innovation in Medical Education at IUSM, 2020-2024
    (2024) Kochhar, Komal; Soleimani, Leila; Byrne, Bobbi; Stefanidis, Dimitrios; Pettit, Katie; Zakeri, Bita; Denny, Kim; McNulty , Margaret; Hoffman, Leslie; Brokaw, James; Wallach, Paul
    Background IUSM employs a large geographically distributed system of medical education composed of 8 regional medical campuses statewide with the main medical campus in Indianapolis. An inherent challenge of operating such a large multi-campus system is being able to provide relevant professional development opportunities for all our medical educators and staff from across the state, as well as to provide our learners with formative opportunities to engage with faculty and peers in a community of scholars. Study objective We planned and implemented a one-day event available to all faculty, staff, and learners from across our multi-campus system with a focus on medical education scholarship. Methods In March 2020, the first Education Day took place on the Indianapolis campus, orchestrated by a five-member Planning Committee from the Dean’s Office of Educational Affairs. Peer-reviewed proposals culminated in oral and poster presentations, workshops, and group discussions. Eight themed sessions included presentations about specific aspects of IUSM’s educational mission: Diversity, Equity & Inclusion, Wellness, Point-of-Care Ultrasound, Simulation, Undergraduate Medical Education, Graduate Medical Education, Regional Medical Campuses, and Biomedical (MS/PhD) Education. A lunchtime keynote address was given by a nationally recognized medical educator. The day-long event ended with an awards ceremony to recognize the “best” faculty, staff, and learner proposals. With minimal variation, a similar planning process and agenda were used for the subsequent Education Days held in late April 2021 (virtual), 2022, and 2023. About 40 faculty reviewers from across campuses reviewed submissions using a standard rubric. Each submission was reviewed by two reviewers with a third reviewer resolving any split decisions. Accepted proposals were archived in the University’s ScholarWorks Digital Repository to extend their reach. Results Over four years, an average of 132 proposals were reviewed annually, with attendance averaging 281, trending upwards each year. While most attendees were from Indianapolis campus (76%), participation from the RMCs (24%) increased each year. Attendees represented basic science departments (17%), clinical departments (61%), and other school units, e.g., library, Dean’s offices, etc. (22%). Education Day presenters included faculty (38%), staff (12%), and learners (50%). The “learners” included medical students, residents, fellows, and a few graduate students. Beginning in 2022, we included Scholarly Concentration projects from medical students statewide which were presented during a special poster session. Post-event survey data across the four years revealed high satisfaction, with 81% rating the event as “excellent” or “very good.” Majority “strongly agreed” or “agreed” that Education Day met their professional expectations and needs (88%); provided supporting material/tools helpful to their professional role (83%); and included opportunities to learn interactively (82%). As a result of this event, majority “strongly agreed” or “agreed” they will be better able to network and collaborate with other IUSM colleagues (87%), identify best practices in medical education (81%), learn to present and publish educational outcomes data (75%), and describe current approaches to evaluate learners (73%). Conclusions IUSM’s Annual Education Day has established itself as a successful venue to share educational best practices, forge new collaborations, and encourage participation from all IUSM campuses.