Browsing by Author "Ryan, Elizabeth R."

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    From Passive Gatekeeper to Quarterback: Evolving Perceptions of Primary Care Among Medical Students in Longitudinal Outpatient Clerkships
    (Springer, 2022) Henschen, Bruce L.; Shaunfield, Sara; Golden, Blair P.; Gard, Lauren A.; Bierman, Jennifer; Evans, Daniel B.; Wayne, Diane B.; Ryan, Elizabeth R.; Yang, Monica; Cameron, Kenzie A.; Medicine, School of Medicine
    Background: Longitudinal clerkships provide students with meaningful clinical care roles that promote learning and professional development. It remains unclear how longitudinal primary care clerkships inform students' perceptions of primary care. Objective: To explore perceptions of primary care among medical students enrolled in longitudinal primary care clerkships. Design: Qualitative, semi-structured interviews with medical students over 4 years. Participants: Thirty-eight medical students participated at baseline; 35 participated in a 2-year follow-up interview; 24 participated at 4 years. Each student was enrolled in one of two longitudinal primary care clerkships: a team-based Education-Centered Medical Home (ECMH) or a one-on-one individual preceptorship (IP). Approach: De-identified interview transcripts were analyzed using a process of open and axial coding, followed by elaborative coding for longitudinal analysis. Codes were compiled into a set of themes and compared across time periods and between clerkships. Key results: Students reported that primary care serves as a first point of contact, emphasizing longitudinal care with a wide scope of practice and approaching patient care with a biopsychosocial perspective. Student perceptions of primary care greatly expanded over the course of 4 years: for instance, initial perceptions of primary care physicians evolved from "passive gatekeeper" to a more nuanced "quarterback." Students in ECMH, whose clerkship provided more opportunity for patient continuity, further reflected on the relationships they themselves developed with patients. Conclusions: Regardless of their eventual specialty choice, longitudinal experiences may aid all students in fostering a sense of the broad scope and importance of primary care. However, without numerous opportunities to witness continuity of care, students may perceive primary care as having limited scope and importance. Longitudinal clerkships, emphasizing continuity with patients and preceptors, may foster in students a broad and nuanced perspective of the scope of primary care as a field.
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    Medical School Without Walls: 50 Years of Regional Campuses at Indiana University School of Medicine
    (Wolters Kluwer, 2022-12) Wallach, Paul M.; Birnbaum, Deborah R.; Ryan, Elizabeth R.; Pieczko, Brandon T.; Hess, Jay L.
    The history of Indiana University School of Medicine (IUSM) dates to 1871, when Indiana Medical College entered into an affiliation with Indiana University in Bloomington to offer medical education. In 1971, the Indiana General Assembly passed a bill to create and fund a distributed model for medical education for which IUSM was responsible, an innovative approach to implementing a statewide medical education program. IUSM became one of the first U.S. medical schools to implement what is today known as a regional medical campus model. This regional medical campus system has permitted IUSM to expand enrollment based on national and local concerns about physician shortages, increase access to care locally, support expansion of graduate medical education, and provide opportunities for research and scholarship by faculty and students statewide. This effort was made possible by partnerships with other universities and health care systems across the state and the support of local community and state leaders. The model is a forward-thinking and cost-effective way to educate physicians for service in the state of Indiana and is applicable to others. This article highlights milestones in IUSM’s 50-year history of regional medical education, describes the development of the regional medical campus model, recognizes significant achievements over the years, shares lessons learned, and discusses considerations for the future of medical education.
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    Regional Medical Campuses: Leveraging our Structure
    (2020-03-06) Birnbaum, Deborah R.; Walvoord, Emily; Ryan, Elizabeth R.
    The focus of this session presentation at the 2020 IU School of Medicine Education Day is on how the School is leveraging its regional campus model. The School is the nation’s largest by enrollment, with nine campuses, eight of which are considered regional campuses. After a review of various regional campus models, an example of scholarship that reports on how IU School of Medicine regional campus students perform in the Match compared to main (Indianapolis) campus students is shared. The session presentation also examines the unique way IU School of Medicine is leveraging a Scholarly Concentrations Program for educational enhancement, reputational focus for regional campuses, deeper community engagement, and increased student and faculty scholarship.
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    The Impacts of the COVID-19 Pandemic on Youth Violence: Insights from Professional Key Informants
    (University of Minnesota Libraries Publishing, 2023-06-14) Aldallal, Mohamed; Omari, Deeb; Muvuka, Baraka; Ryan, Elizabeth R.
    Introduction: The COVID-19 pandemic has had drastic effects on youth violence protective and risk factors by isolating many at risk youth. While youth violence is a growing global health problem, there are limited studies exploring youth violence during the COVID-19 pandemic. Lake County in Northwest Indiana presents an opportunity for youth violence research and prevention given its socio-demographic context and its limited youth violence data. This study explored the COVID-19 pandemic’s impacts on youth violence and its risk and protective factors from the perspectives of professional key informants in Lake County, Indiana. Methods: This study utilized a descriptive qualitative design inspired by the constructivist grounded theory. We recruited professional key informants through purposive and snowball sampling. Data collection consisted of virtual semi-structured key informant interviews that were audio-recorded and transcribed verbatim. Data analysis consisted of inductive thematic analysis with open line-by-line coding, focused coding in Dedoose, and theme identification. Results: A total of six key informants were interviewed, representing diverse youth-serving occupations. These interviews revealed five general themes portraying the impacts of the COVID-19 pandemic on youth violence: mental health impacts on youth; socialization of youth; youth as victims, perpetrators, or witnesses; shifting of learning environments; and parent-child relationships. Key informants observed an increase in less visible types of youth violence, underlying pandemic-induced or-exacerbated youth mental and behavioral health issues, strained parent-child relationships, and the educational marginalization of youth in underserved communities during online learning transitions. Conclusions: This study highlighted underserved youth’s vulnerability to the COVID-19 pandemic’s adverse impacts on youth violence experiences, risk, and protective factors. Our findings support the need to prioritize youth during and after crises, to utilize innovative strategies to better reach underserved youth, and to develop ethical and integrated youth violence data systems. Future research should explore youth’s lived experiences with violence throughout the pandemic.
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    “Vets Restoring Vets”: An Innovative Peer Support Program
    (University of Minnesota Libraries Publishing, 2023-06-14) Stewart, Cody C.; Muvuka, Baraka; Hutwagner, Will; McCollum, Hunter; Dyer, William K.; Ryan, Elizabeth R.
    Introduction: Military Veterans disproportionately experience mental health issues due to unique service-related experiences. Peer and social support interventions have shown promise in improving Veterans’ mental health alongside clinical mental health interventions yet there are limited studies on Veteran-designed and Veteran–led peer or social support interventions. This study explored the perceptions and experiences of Veterans participating in an innovative Veteran-designed and Veteran-led peer and social support program. It was a preliminary study in a long-term Community Based Participatory Research partnership between Indiana University School of Medicine-Northwest regional campus and Operation Combat Bikesaver (OCB). Methods : This mixed methods study utilized a limited dataset from pre-and-post-session surveys collected by OCB between September 2019 and August 2021. We examined pre-post differences in participants’ self-rated “feelings” (i.e., emotional state) with the following independent variables through Linear Mixed Models in SPSS: OCB location, OCB event attended, day of the week, time of day, duration of attendance, frequency of attendance, and social assistance. We analyzed participants’ qualitative OCB experiences using inductive thematic analysis in Dedoose.  This study was reviewed and exempted by The Indiana University Human Research Protection Program (Protocol # 12499) on August 16, 2021. Results: A total of 128 participants completed pre-post surveys for 746 OCB sessions. There was a statistically significant pre-post session increase in participants’ feelings (mean=34.6; SD=21.7; p<0.001), with increasing effects by duration (p=0.002) in an OCB session. There was no linear trend in individual pre-and-post session changes in feelings over time. The following themes describe participants’ OCB experiences: sense of purpose and meaning, regaining comradery and brotherhood, “Vets restoring Vets,” satisfaction with OCB structure and processes, and experiencing OCB impacts. Conclusions: Convening Veterans with shared experiences around innovative and supportive social activities may develop their perceived sense of purpose, belonging, and mutual support and produce improvements in perceived mental health. Future research within this community-regional medical campus research partnership will explore jointly determined research questions to follow-up on the main findings and limitations of the current study.