Browsing by Author "Hoffman, Leslie A."
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Item Empowering Youth: Examining Health Literacy Gains in High School Students(2024-04-26) Grischke, Tyra; Tannir, Shadia; Bohn, Camden; Hoffman, Leslie A.Research Statement/ResearchQuestion This study assesses the health literacy of high school students’ before and after an educational presentation about hypertension, a health condition more prevalent in underserved communities. Background Low health literacy is associated with worse health outcomes, particularly within underserved communities. Improving health literacy among high school students can empower them to take action to improve health and well-being within their communities. Methods In spring 2023, medical students from IUSM visited four high schools to educate students on health literacy and hypertension. Participants completed a 15-item test prior to and immediately following the presentation. Demographic data (grade level, race, ethnicity, and gender) was collected. Data was collected anonymously, using assigned codes to match pre- and post-tests. Data was analyzed using paired samples t-tests and ANOVA. Results A total of 104 high school students completed pre- and post-tests. There was a significant improvement in quiz scores from pre- (7.95±1.74) to post-test (9.41±2.01; p<.001). One-way ANOVA found significant differences in pre- and post-test performance based on race, with Black students scoring lower than White students on both pre-test (7.28±1.28 vs. 8.31±1.70; p<.05) and post-test (8.55±2.21 vs. 9.85±1.76; p<.05). There was also a significant interaction between students’ gender and their pre- and post-test scores with female students showing greater improvements in test scores than male students. Limitations This study was conducted in a single school district in a small midwestern city and may not be generalizable to larger urban or rural populations. The presentation was given during a science class and may have been biased by students’ prior knowledge. Differences among presenters may also impact students’ comprehension. Conclusion High school students’ health literacy improved after an educational presentation on hypertension. This study revealed racial disparities in health literacy, highlighting the need for more health education in schools that have more students from underserved racial and ethnic groups.Item Experiences of Female and Male Medical Students With Death, Dying, and Palliative Care: One Size Does Not Fit All(Sage, 2018-06) Hoffman, Leslie A.; Mehta, Rakesh; Vu, T. Robert; Frankel, Richard M.; Anatomy and Cell Biology, School of MedicineBackground: Medical students learn about death, dying, and palliative care (DDPC) through formal curricular offerings and informal clinical experiences; however, the lessons learned in the clinic may be at odds with the formal curriculum. Reflective writing is a means for students to “bracket” their DDPC experiences and reconcile conflicts between the formal and informal curriculum. Objectives: The aim of this study is to compare the level of reflection demonstrated in medical students’ narratives on DDPC with other experiences and to examine the domains of professionalism that students perceive to be prevalent in their DDPC experiences. Methods: Third-year medical students submitted professionalism narratives during their internal medicine clerkship. We identified a subset of narratives related to DDPC (n = 388) and randomly selected control narratives (n = 153). We assessed the level of reflection demonstrated in the narratives using a validated rubric and analyzed the professionalism domains that students identified as relevant to their experience. Results: There was no difference in reflective level between DDPC and control narratives. Within the DDPC group, female students demonstrated higher reflection (2.24 ± 0.71) than male students (2.01 ± 0.77; P < .001). Caring, compassion and communication, and honor and integrity were prominent among DDPC narratives. More females identified caring, compassion, and communication as relevant to their DDPC experiences, whereas more males identified altruism. Conclusion: Males and females have different perceptions of DDPC experiences, and female students appear to be more deeply impacted. These findings can help clinical faculty engage students more effectively with this challenging topic.Item Investigating the Long-Term Outcomes of Service-Learning(2022-10) Schmalz, Naomi Alexandra; Byram, Jessica N.; Hoffman, Leslie A.; Organ, Jason M.; Palmer, Megan M.; Wisco, Jonathan J.Anatomy Academy (AA) is a service-learning program in which pre- and current health professional students (Mentors) work in pairs to teach anatomy, physiology, and nutrition to children in the community. The purpose of this study was to investigate the short- and long-term Mentor outcomes in personal, social, civic, academic, and professional domains. Former Mentors were invited to complete a survey of Likert-style and free response questions evaluating the perceived impact of their AA experience on: teaching skills, personal and interpersonal development, civic engagement, and academic and professional development. Follow-up interviews with a subset of survey respondents were performed. The survey was completed by 219 Mentors and 17 survey respondents were interviewed. Over 50% of former Mentors reported moderate or major impact of AA participation on elements of personal and interpersonal development (e.g., selfesteem [57.6%], altruism [67.9%], communication skills [60.1%], and ability to work with others [72.6%]) and community service participation (54.2%) that endures in the years after the program. Mentors who worked with low-income or Special needs populations reported unique impacts in personal, interpersonal, and civic domains. A majority of former Mentors agreed that AA participation helped them learn practical skills (76.3%) and factual knowledge (65.4%) relevant to the their careers, with several current health professionals reported that they regularly employ teaching and interpersonal skills learned while Mentors in their roles as physicians, nurses, or physician’s assistants. A majority of former Mentors reported that AA validated their choice to either pursue a healthcare career or not (59.7%), increased their confidence in performing professional tasks (64.7%), and helped shape their professional identity (58.9%). These results indicate that a health education-based service-learning program offers undergraduate, graduate, and professional students interested in or actively pursuing a healthcare career benefits across personal, interpersonal, civic, and professional domains that support their academic progress and preparation for professional practice. This study contributes much-needed evidence of the long-term student outcomes of service-learning to the literature, with a particular focus on how the pedagogy can supplement the education and professional development of pre- and current health professional students.Item Metacognition in Anatomical Sciences Education(2023-06) Cale, Andrew Stephen; McNulty, Margaret A.; Byram, Jessica N.; Hoffman, Leslie A.; Longtin, Krista; Palmer, Megan; Williams, James C.Metacognition, the ability to self-regulate one’s learning and performance, is well-known to provide numerous academic and professional benefits for students, educators, and clinicians. However, few studies have studied metacognition specifically in the context of anatomical sciences education. Therefore, the overarching purpose of this dissertation was to explore the metacognition of students and educators who are learning and teaching the anatomical sciences. This dissertation investigated the metacognition of allied health students (physical therapy, physician assistant, and occupational therapy; n=109), first-year medical students (n=1802), and anatomy educators (faculty, associate instructors, and teaching assistants; n=13) in anatomy courses through three multiple-methods studies. Quantitative data were collected using assessment data and either the Metacognition Awareness Inventory (MAI), Practice-Based Learning and Improvement (PBLI) assignments, or Teacher Metacognition Inventory (TMI). These data were then analyzed using the appropriate descriptive and inferential statistics. Qualitative data were also collected through reflective writing activities (e.g., online discussion boards or reflective journals) and analyzed using thematic or framework analysis. Overall, both students and educators improved their metacognition across a semester of either learning or teaching anatomy, with certain subgroups demonstrating greater metacognitive ability or growth than others. Higher performing allied health and medical students were both more accurate at predicting their exam performances compared to their lower performing peers. Faculty also demonstrated the greatest teaching-specific metacognition, though teaching assistants exhibited the greatest growth in their teaching-specific metacognition. These improvements were primarily in their reflective ability and awareness of personal strengths and weaknesses as teachers. Several notable themes relating to metacognition were also identified such as student willingness to monitor learning diminishing over time due to competing academic or professional commitments. Additionally, novice educators were more inwardly-focused on personal traits and content mastery, whereas experienced educators were more outwardly-focused on interpersonal factors (e.g., student rapport and inclusive language). These insights into the metacognition of both students and educators can inform how to best support and improve teaching and learning in the anatomical sciences. Given the significance of metacognition, it may be beneficial to incorporate educational activities that can support the metacognition of both students and educators, simultaneously.Item A Novel Resident-as-Teacher Curriculum to Improve Residents’ Integration Into the Clinic(STFM, 2019-03-11) Hoffman, Leslie A.; Furman, David; Waterson, Zachry; Henriksen, Brian; Anatomy and Cell Biology, School of MedicineIntroduction Graduate medical education depends on senior residents to facilitate peer education. Previous studies have described the benefits of resident-as-teacher (RaT) curricula; however, means of assessing these interventions have proven difficult. The purpose of this study was to provide meaningful evaluation of a novel RaT curriculum and scribing activity. Methods Didactic sessions on teaching skills were presented in July, 2017. First- and third-year residents then alternated scribing for each other for 4 weeks within the outpatient clinic to allow for near-peer educational exchange. Residents’ attitudes toward teaching and perceptions of teaching abilities were assessed using preand postintervention surveys. Independent reviewers reviewed charts completed by PGY-1 residents during the scribing activity, and compared them to charts from the previous academic year. Results All first-year (n=12; 100%) and third-year (n=10; 100%) residents participated in the study. After participating in the RaT curriculum, residents were more comfortable giving feedback to other residents and felt better prepared to teach and assess the effectiveness of their teaching. Although there was no significant difference in ratings between the 2016 and 2017 charts, reviewers noted that the 2017 charts contained fewer obvious omissions, and third-year residents felt the charts were completed in a timelier manner. First-year residents saw 16% more patients in 2017 than they had in 2016, which expedited integration into the clinic. Conclusion This innovative RaT curriculum with scribing activity improved residents’ teaching and communication skills and provided first-year residents with a more efficient and meaningful orientation into the outpatient clinic.Item Overcoming Barriers to Providing Narrative Feedback in Pre-clinical Medical Education: Design and Implementation of a Comment Builder Tool(2023-04-28) Hoffman, Leslie A.; Shere, Helen; Bauer, Erich; Vargo-Gogola, TracyFormative feedback is an essential component of competency based medical education1. This feedback should be individualized, reinforce effective behaviors, and provide actionable strategies for improvement. In the first year Human Structure course at Indiana University School of Medicine (IUSM), students complete a two-part assignment to assess the Practice-Based Learning and Improvement competency. Faculty are expected to provide narrative feedback to students on the assignment; however, narrative feedback was not consistently provided to all students in prior years. To lower the barriers to providing feedback, a narrative comment builder tool was developed and implemented. Here we report our experiences with developing and implementing the tool and evaluating ongoing barriers to providing narrative feedback to students.Item The professionalization of medical students : a longitudinal analysis of professional identity formation and professionalism perceptions in second and third year medical students(2017-12) Byram, Jessica Nichole; Scheurich, James J.; Brokaw, James J.; Hoffman, Leslie A.; Seifert, Mark F.; Hoffmann-Longtin, KristaBackground: Recent literature on professional identity formation (PIF) conceptualizes the developmental process into stage theories that remove critical context. This study employed a longitudinal approach to PIF that explored the processes through which professional identity is formed in second (MS2) and third (MS3) year medical students and how their perceptions of professionalism transformed and influenced their PIF. Methods: Nine medical students (n=9) from Indiana University School of Medicine completed this study spanning MS2 and MS3. Participants completed three semi-structured interviews and submitted 10 audio diaries at two-month intervals between interviews. Participants also completed the Professionalism Assessment Tool (PAT) at the beginning of MS2 (PAT1) and end of MS3 (PAT2). Interviews and audio diaries were analyzed using the constant comparative approach and a Wilcoxon signed-rank test was used to determine significant differences between mean domain scores of PAT1 and PAT2. Results: This study found several processes of PIF within five themes: Exploring Self in Medicine, Connecting to Image of Medicine, Embodying Role, Internalizing Values, and Exploring Specialty Choice. Processes of participating in patient care and selecting a specialty have the most profound impact on PIF and resulted in medical students feeling like members of the medical community. Analyses revealed participants’ perceptions of professionalism became more complex with clinical experiences and their perceptions of their ability to enact those behaviors transformed across the study period. Furthermore, the participants’ perceptions of professionalism set the foundation for the values they desired to demonstrate as part of their professional identities. Conclusions: This study presents a cohesive picture of how PIF occurs across MS2 and MS3 and how professionalism influences this important developmental process. These results indicate PIF is best cultivated within a medical curriculum where students are able to utilize processes to foster its development. Since professionalism serves as an important foundation to professional identity and a comprehensive understanding is needed for medical students to appreciate a physician’s role in society, the curriculum must be structured in a way to promote a complex, reflective understanding of professionalism that is based on values, actions, and who one wants to be as a physician.Item Promoting metacognition in an allied health anatomy course(Wiley, 2023-05) Cale, Andrew S.; Hoffman, Leslie A.; McNulty, Margaret A.; Anatomy, Cell Biology and Physiology, School of MedicineMetacognition, the ability to self-regulate one's learning and performance, has been shown to improve student outcomes. Anatomy is recognized as one of the toughest courses in allied health curricula, and students could benefit from metacognitive activities. The purpose of this study was to explore the changes in metacognition of allied health students in an anatomy course and identify which groups need support with this skill. First-year physician assistant (MPAS), physical therapy (DPT), and occupational therapy (OTD) students (n = 129) were invited to participate. At the beginning and end of the course, students completed a questionnaire including the metacognitive awareness inventory (MAI) that assesses metacognition. Students were also asked to reflect on their examination performances using a modified Likert scale and participated in reflective discussion boards to encourage development of metacognitive skills, which were thematically analyzed. Paired metacognition scores had increased significantly by the end of the course. However, middle-performers anticipated high grades and were less satisfied with their grade, indicating a disconnect in their metacognition compared to high- and low-performers. Students' receptiveness to modifying study strategies to improve performance declined throughout the course; by mid-way through, they relied more on existing strategies. Increasing time constraints were frequently cited as a major factor when considering study strategies and modification of such strategies. To maximize the effectiveness of metacognitive activities, they should be positioned early in the course when students are most receptive. In addition, middle performers may benefit from additional support to improve metacognition.