Browsing by Author "Christman, Megan"

Now showing 1 - 6 of 6
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    The Case of the Vanishing Yoni Pearl
    (2022-03) Brown, Lucy; Heitz, Adaline; Cox, Natalie; Hulsman, Luci; Christman, Megan
    Case: A 41-year-old female presented to the Emergency Department (ED) with a retained vaginal foreign body (VFB). She reported inserting a detoxifying “yoni” pearl 36 hours prior. She was unable to remove it herself. She denied fever, vaginal pain, discharge, or dysuria. A gynecologist was consulted, and the VFB was removed manually without complications. Conclusions: The authors reviewed 29 case studies and series. Overall, tampons, condoms, menstrual cups, items used for sexual gratification, and unconventional items used for barrier contraception (e.g., aerosol caps) are among the most common VFBs in premenopausal adult women. Among postmenopausal adult women, medical devices such as pessaries can be neglected in the vagina leading to retained VFB. While most cases had no contributing risk factors, associated medical and social determinants include mental health disorders, history of sexual assault, and uninsured status. This is the first documented case of a detoxifying vaginal pearl VFB. Clinical Significance: VFB is a common presentation in the United States; from 2010 to 2014, 89,160 female patients presented to the ED with a vulvar/vaginal foreign body, many requiring gynecologic or urologic consultations and invasive procedures. Although this case was without complications, VFBs can have significant morbidity. Depending on the consistency of the foreign body, VFBs can serve as a nidus for infection with subsequent sepsis, most notably toxic shock syndrome. Other serious complications of VFBs are compression of tissue, which can lead to compromise of blood flow to that region, necrosis, perforation, and fistulas (i.e., rectovaginal or vesicovaginal). Fistula formation has also been reported as a direct result of the surgical trauma from removal of the VFB. Prevention efforts should be aimed at education about what can safely be placed in the vagina, and providers should focus on dispelling misinformation surrounding vaginal detoxification and cleanliness.
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    Fostering Interprofessional Education During Required Clerkships for Medical Students Across Regional Campuses
    (Journal of Regional Medical Campuses, 0024-12-15) Freed, Stephanie; Birnbaum, Deborah R.; Schwartz, Jennifer E.; Ko, Paul; Christman, Megan; Wallach, Paul M.
    It remains complex and challenging to deliver interprofessional education at medical schools with geographically distributed campuses. Indiana University School of Medicine (IUSM) expanded its interprofessional education directly into clinical training by implementing a simple exercise in required clerkships on all nine of its campuses and with various health system partners that achieves the goals of interprofessional education and in which students find value. Methods Between the academic years 2022-2023 and 2023-2024, IUSM medical students on every campus and across health systems, interviewed and reflected on the role of one healthcare professional involved in the care of a patient during each required clinical rotation. They interviewed different healthcare professionals and/or healthcare professions students to gain broad exposure and perspectives. Results All IUSM students on all its campuses interacted with a variety of healthcare professionals during their 3rd and 4th year clinical rotations statewide (n=6357 encounters). Across all campuses, 88% of interactions occurred with healthcare professionals rather than healthcare professions students. Statewide, between 84% and 95% of students reported that they ‘Strongly Agreed/Agreed’ that the experience contributed to the development of their interprofessional collaboration skills and knowledge, and that they found the assignment valuable. Conclusion Our interprofessional assignment offers medical schools with multiple campuses a promising solution to the challenges of delivering high-quality, and meaningful interprofessional education. It requires minimal to no resources, ensures comparability, and helps prepare students for real-world teamwork.
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    Impact of Dobbs Decision on Retention of Indiana Medical Students for Residency
    (Elsevier, 2023-10-08) Hulsman, Luci; Bradley, Paige K.; Caldwell, Amy; Christman, Megan; Rusk, Debra S.; Shanks, Anthony L.
    Background: As medical students consider residency training programs, access to comprehensive training in abortion care and the legal climate influencing abortion care provision are likely to affect their decision process. Objective: This study aimed to determine medical students' desire to stay in a state with an abortion ban for residency. Study design: A cross-sectional survey was distributed to all medical students at a large allopathic medical school. Anonymous survey questions investigated the likelihood of seeking residency training in states with abortion restrictions and the likelihood of considering obstetrics and gynecology as a specialty. Qualitative responses were also captured. Results: The survey was distributed to 1424 students, and 473 responses yielded a 33.2% completion rate; 66.8% of students were less likely to pursue residency training in Indiana following a proposed abortion ban. Moreover, 70.0% of students were less likely to pursue residency in a state with abortion restrictions. Approximately half of respondents (52.2%) were less likely to pursue obstetrics and gynecology as a specialty after proposed abortion restrictions. Qualitative remarks encompassed 6 themes: comprehensive health care access, frustration with the political climate, impact on health care providers, relocation, advocacy, and personal beliefs and ethical considerations. Conclusion: Most medical students expressed decreased likelihood of remaining in Indiana or in states with abortion restrictions for residency training. The field of obstetrics and gynecology has been negatively affected, with medical students indicating lower likelihood to pursue obstetrics and gynecology. Regardless of specialty, the physician shortage may be exacerbated in states with abortion restrictions. The overturn of Roe v Wade has the potential for significant effects on medical student plans for residency training location, thereby shaping the future of the physician workforce.
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    Integrating an interprofessional educational exercise into required medical student clerkships - a quantitative analysis
    (Springer Nature, 2025-02-01) Schwartz, Jennifer E.; Ko, Paul; Freed, Stephanie; Safdar, Neelum; Christman, Megan; Page, Renee; Birnbaum, Deborah R.; Wallach, Paul M.; Medicine, School of Medicine
    Purpose: Medical students are integrated into an interprofessional team to help them learn how to provide effective, patient-centered care. Indiana University School of Medicine (IUSM) introduced a unique, easy-to-implement interprofessional exercise into each clerkship to improve students' understanding of each professional's contribution to patient care. Methods: Between 2022 and 2023, IUSM medical students interviewed a variety of healthcare professionals engaged in the care of mutual patients using a template of questions; they wrote a brief report and evaluated the experience. Students interviewed a different professional in each clerkship to broaden their exposure. Results: 3088 encounters occurred, 68% at the Indianapolis campus and 32% at regional campuses. More than 82% of students agreed or strongly agreed to each of the following prompts regarding the exercise: aided their understanding of the benefits of an interprofessional team to patient care, better understood when participation of the specific healthcare professional would benefit their patient, the experience contributed to their understanding of the role of that profession within the healthcare team, their confidence in engaging other healthcare professionals on the health care team improved, and the experience aided in understanding of their own role as a member of the health care team. Conclusion: This exercise was easy to implement across a multi-campus system and improved student comprehension of the interprofessional team and indications for their engagement in patient care.
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    Integrating an interprofessional educational exercise into required medical student clerkships – a quantitative analysis
    (BMC Medical Education, 0025-02-01) Schwartz, Jennifer E.; Ko, Paul; Freed, Stephanie; Safdar, Neelum; Christman, Megan; Page, Renee; Birnbaum, Deborah R.; Wallach, Paul M.
    Purpose: Medical students are integrated into an interprofessional team to help them learn how to provide effective, patient-centered care. Indiana University School of Medicine (IUSM) introduced a unique, easy-to-implement interprofessional exercise into each clerkship to improve students’ understanding of each professional’s contribution to patient care. Methods: Between 2022 and 2023, IUSM medical students interviewed a variety of healthcare professionals engaged in the care of mutual patients using a template of questions; they wrote a brief report and evaluated the experience. Students interviewed a different professional in each clerkship to broaden their exposure. Results: 3088 encounters occurred, 68% at the Indianapolis campus and 32% at regional campuses. More than 82% of students agreed or strongly agreed to each of the following prompts regarding the exercise: aided their understanding of the benefits of an interprofessional team to patient care, better understood when participation of the specific healthcare professional would benefit their patient, the experience contributed to their understanding of the role of that profession within the healthcare team, their confidence in engaging other healthcare professionals on the health care team improved, and the experience aided in understanding of their own role as a member of the health care team. Conclusion: This exercise was easy to implement across a multi-campus system and improved student comprehension of the interprofessional team and indications for their engagement in patient care.