Browsing by Author "Stout, Julianne"
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Item Change in Medical Students’ Attitudes Towards Family Planning after a Pregnancy Options Counseling Panel(2024-04-26) Peipert, Leah J.; Brown, Lucy; King, Carli; Bhamidipalli, Surya Sruthi; Stout, Julianne; Peipert, Jeffrey F.; Caldwell, AmyINTRODUCTION: Abortion is one of the most commonly performed procedures in the U.S., but abortion education is lacking in medical curricula. Previous studies have shown that clinical exposure to abortion care in medical school can change students’ attitudes about abortion, yet few medical schools incorporate abortion education during students’ preclinical years. STUDY OBJECTIVE: This study evaluates changes in medical students’ attitudes after a virtual pregnancy counseling panel intervention during pre-clinical medical education at Indiana University School of Medicine. We hypothesized that students would feel more comfortable counseling and treating patients for unplanned pregnancy after attending the virtual panel. METHODS: Students participated in a “Pregnancy Options Panel” during their second-year course covering reproductive health. The panel consisted of OBGYNs, a pediatrician, and a social worker. Using a case study format, panelists guided discussion of appropriate care for a patient diagnosed with an unintended pregnancy. Two identical 19-item surveys consisting of multiple-choice and open-ended questions were electronically disseminated before and after the panel to assess students’ comfort and beliefs about family planning counseling and treatment. Statistical analyses were performed using non-parametric statistics (Wilcoxon signed rank and McNemar’s test) to compare before and after responses of participants. The study was IRB exempt. RESULTS: The second-year medical school class enrolled in the reproductive health course at Indiana University was composed of 366 students with 189 students (51.6%) identifying as female. Of the 366 students, 171 students (46.7%) completed surveys before and after the panel. Demographics were as follows: 60.6% female, 37.6% male, 64.9% white, 2.9% black, 84.6% non-Hispanic, and 10.7% Hispanic. After the pregnancy panel, students reported increased comfort when contemplating referral to an abortion provider, prescribing a medication abortion, and performing a surgical abortion compared to prior to the panel (p<0.01, all comparisons). Students were more likely to withhold disclosing their personal beliefs about abortion when counseling a pregnant patient (64.6% vs 42.3%, p<0.01), felt more capable of approaching the conversation about pregnancy options in a genuinely neutral manner (86.4% vs 71.6%, p<0.01), and had a significant increase in preparedness to counsel on continuing pregnancy, abortion, and adoption (p<0.01). CONCLUSIONS: Our pregnancy options counseling panel effectively guided students through a common reproductive health scenario counseling a patient with unintended pregnancy. Second year preclinical medical students felt more prepared to counsel patients neutrally and without influence of their own beliefs after attending the educational event. Students additionally felt more comfortable referring to an abortion provider, prescribing a medical abortion, and performing a surgical abortion after the panel, emphasizing how exposure to family planning scenarios can influence future physicians’ comfort providing non-judgmental counseling and abortion care. Expert panels comprised of health professionals with diverse clinical and social perspectives on pregnancy options can serve as an instructional model for preparing medical students for their obstetric and gynecological clinical clerkship and improving pre-clinical medical curriculum on the often-neglected topic of abortion.Item Development and Implementation of Pregnancy Options Counseling Curriculum in Preclinical Medical Education(2022-04-28) Komanapalli, Sarah; Brown, Lucy; Swiezy, Sarah; McKinzie, Alexandra; Stout, JulianneINTRODUCTION: Pre-clinical education during medical school is an opportunity to lay a strong foundation for clinical skill development. Options counseling for pregnancy is one such topic that is essential for students to learn early in their education. The most recent estimates from the CDC report that 102.1 per 1,000 women aged 15–44 will be pregnant. Teaching medical students the skills for pregnancy options counseling centers patient goals and prevents significant adverse outcomes, particularly those that come from being denied appropriate abortion counseling. In a previous assessment of student preparedness and interest, we found that Indiana University School of Medicine (IUSM) adequately covers family planning topics, but has gaps in abortion counseling during preclinical education. Our survey definitively showed that IUSM medical students are interested in learning about options counseling and feel unprepared to counsel about abortion; additionally, abortion counseling preparedness did not improve in our sample even after completing the OBGYN clerkship. Based on these findings, we sought to implement curriculum change in the form of a panel-based discussion that would improve student education and comfort with this crucial healthcare topic. STUDY OBJECTIVE: 1) Introduce options counseling education into IUSM preclinical reproductive education and 2) evaluate changes in student preparedness and 3) satisfaction with the panel discussion METHODS: We used data from prior surveys that demonstrated high student interest and poor preparedness regarding complete options counseling to approach faculty regarding adding options counseling to preclinical curriculum. We subsequently collaborated with pre clinical education course faculty to design and implement a panel discussion about options counseling for the preclinical reproductive coure. We then developed a survey in Qualtrics to distribute to students following the panel. The survey has 17 questions including 3 free response prompts. The survey evaluates whether students feel prepared to provide options counseling after the panel, how well topics were covered, and satisfaction overall. RESULTS: The panel will take place on February 7, 2022 and the survey will be open for weeks after the panel, at which point we will analyze student responses. We expect that our post-panel survey will demonstrate increased preparedness to counsel patients about options during pregnancy. CONCLUSIONS/IMPLICATIONS: Future panels and additional course development will fill gaps in preclinical education regarding options counseling, while expanding the skills of medical students. In addition, being prepared to offer patient centered care could better prepare students for clerkships and clinical experiences. This is a promising start to enhance preclinical education regarding women’s health.Item Investigating Leadership Beliefs Among Medical Students Before and After Women's Physician Panel(2023-04-28) Jeffries, Alison; Ayub, Jinan; Jauregui, Alexa; Kendrick, Sara; Stout, JulianneBACKGROUND While the number of female medical student graduates and residents continues to rise, women still hold a minority of visible leadership positions in medicine. Many factors are at play such as personal values, time commitment, and experience, which influence applying for and obtaining such positions. STUDY OBJECTIVE Our goal was to investigate the ways students can serve as leaders and learn from women physician role models who have held a variety of formal and informal positions. This study was designed to understand medical students’ perspectives of leadership and how beliefs may change after attending a women’s physician panel. METHODS Phase 1 medical students completed anonymous surveys before and after attending a one-hour “Women in Leadership” panel featuring three women physicians at different career stages. During the event, two audience participation activities were performed. The first involved students generating a digital word cloud using words they selected to describe characteristics of good leaders, and the second was ranking values they deemed important based on results from Barrett's Personal Value Assessment. The pre-survey collected demographic information and asked participants to define leadership. The post-survey asked them to define leadership again, questioned how the panel altered their views on women in leadership, and for one main takeaway from the panel. Both surveys asked participants to indicate the extent to which they agreed with seven statements regarding their opinions about leadership positions, their own leadership abilities, leadership opportunities, and how their values affect their career goals. RESULTS There were 15 attendees at the panel, and thirteen individuals completed both the pre- and post-surveys with 85% identifying as female and 15% identifying as male. In both surveys, all respondents agreed or strongly agreed that it is important for women to be in visible leadership roles. When defining leadership after the panel, there was greater emphasis on confidence, active listening, and integrity. Five out of 13 participants reported feeling more confident in being in a leadership role after the panel, while eight reported no increase or no change in confidence. Additionally, when comparing post-survey to pre-survey results, six out of 13 respondents reported an increase in how often they think about how their values impact their career goals, while six respondents reported no change, and one respondent reported a decrease. Key takeaways from the panel included giving oneself more grace, how leadership is a skill that can be developed, advocating for oneself and others, and “I can be a leader.” These results aligned with common themes shared by the panelists, including maintaining a growth mindset, becoming comfortable with managing conflicts, and manifesting leadership qualities without an official title. CONCLUSION This study emphasizes the importance of women physicians serving as leaders and sharing their experiences with medical students. Discussing qualities of leadership, reflecting on one’s personal values, and listening to women physicians share their stories can help students develop a better understanding of how they can serve as leaders, with or without a title, throughout all stages of their medical training.Item Musculoskeletal Clinical Online Cases With a Focus on Anatomy for Preclinical Learners(Association of American Medical Colleges, 2024-11-01) Robertson, Kyle; McNulty, Margaret A.; Natoli, Roman M.; Stout, Julianne; Ulrich, Gary; Anatomy, Cell Biology and Physiology, School of MedicineIntroduction: While musculoskeletal disorders are leading causes of medical visits, musculoskeletal education is underrepresented in US medical curricula. Previous studies have demonstrated that undergraduate medical students often fail to demonstrate competency surrounding musculoskeletal disorders. More educational content is needed to support musculoskeletal knowledge in learners. Methods: We developed an online, case-based musculoskeletal module for second-year medical students alongside their standard course material and presented clinical cases with multiple-choice question quizzes regarding the presentation, diagnosis, and anatomic correlation of musculoskeletal conditions. Cases, under 10 minutes each, targeted common, medically important areas of musculoskeletal health. Results: Grades in the required musculoskeletal course were significantly and positively correlated with online module quiz performance. 258 (73%) of 354 students completed at least one quiz, and students completed an average of 14 out of 15 quizzes. Learners who completed more than 50% of the quizzes performed significantly better in the course than those who completed fewer quizzes; this was true for a formative internal course exam (p = .035), an NBME customized assessment (p = .008), and the course overall (p = .021). Additional analyses of students' perceptions revealed that students valued the self-directed online learning environment. The high completion rate (73%) for the online module also signaled student value in the content and format. Discussion: This module represents educational material that has been demonstrated to improve medical student musculoskeletal learning. Additionally, the module could be expanded to address inadequacies in orthopedic education among other students, such as allied health learners.Item Obesity and exercise training alter inflammatory pathway skeletal muscle small extracellular vesicle microRNAs(Wiley, 2022) Sullivan, Brian P.; Nie, Yaohui; Evans, Sheelagh; Kargl, Chris K.; Hettinger, Zach R.; Garner, Ron T.; Hubal, Monica J.; Kuang, Shihuan; Stout, Julianne; Gavin, Timothy P.; Kinesiology, School of Health and Human SciencesObesity is associated with chronic inflammation characterized by increased levels of inflammatory cytokines, whereas exercise training reduces inflammation. Small extracellular vesicles (EVs; 30–150 nm) participate in cell‐to‐cell communication in part through microRNA (miRNA) post‐transcriptional regulation of mRNA. We examined whether obesity and concurrent aerobic and resistance exercise training alter skeletal muscle EV miRNA content and inflammatory signalling. Vastus lateralis biopsies were obtained from sedentary individuals with (OB) and without obesity (LN). Before and after 7 days of concurrent aerobic and resistance training, muscle‐derived small EV miRNAs and whole‐muscle mRNAs were measured. Pathway analysis revealed that obesity alters small EV miRNAs that target inflammatory (SERPINF1, death receptor and Gαi) and growth pathways (Wnt/β‐catenin, PTEN, PI3K/AKT and IGF‐1). In addition, exercise training alters small EV miRNAs in an anti‐inflammatory manner, targeting the IL‐10, IL‐8, Toll‐like receptor and nuclear factor‐κB signalling pathways. In whole muscle, IL‐8 mRNA was reduced by 50% and Jun mRNA by 25% after exercise training, consistent with the anti‐inflammatory effects of exercise on skeletal muscle. Obesity and 7 days of concurrent exercise training differentially alter skeletal muscle‐derived small EV miRNA contents targeting inflammatory and anabolic pathways.Item Trauma-Informed Care in the Classroom: Our Experience with a Content Warning in a Medical School Course(Springer, 2022-04-28) Stout, Julianne; Martin, Angelika I.; Pharmacology and Toxicology, School of MedicineTrauma is now recognized as a common human experience that has consequences, including adverse effects on learning outcomes. Principles of trauma-informed care include awareness of the impact of trauma and use of strategies to prevent retraumatization. While well-described in medical and mental health care, these principles have been inconsistently applied in the medical education classroom. Content warnings can be part of a trauma-informed classroom approach that notifies learners about potentially distressing topics, allows individuals to employ self-care, and seeks to resist retraumatization. This article describes our experience integrating a content warning about reproductive topics in a second-year medical school course.