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Item Collaborating Across Borders VII (CAB VII): The Crossroads of Collaboration, Indianapolis, Indiana, USA - October 20–23, 2019(Elsevier, 2021) Binion, Kelsey; King, Sharla; Pfeifle, Andrea; Zakeri, Bita; Medicine, School of MedicineItem Development and implementation of a point of care ultrasound curriculum at a multi-site institution(Springer, 2021-02-21) Russell, Frances M.; Herbert, Audrey; Ferre, Robinson M.; Zakeri, Bita; Echeverria, Valerie; Peterson, Dina; Wallach, Paul; Emergency Medicine, School of MedicineIn 2014, over 60% of medical schools were incorporating point of care ultrasound (POCUS) into their curriculum. Today, over 6 years later, many more schools are teaching POCUS or are in the planning stages of implementing a POCUS curriculum. In 2019, the AAMC reported that 53 schools or over one-third of US medical schools have multi-site campuses for undergraduate medical education. Implementation of a POCUS educational initiative at a multi-site campus presents unique challenges for teaching a uniform curriculum statewide. This article will discuss the POCUS curriculum and implementation process at a large multi-site institution.Item 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, PaulWe 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.Item Piloting a Graduate Medical Education Point-of-Care Ultrasound Curriculum(Springer Nature, 2022-07-23) Ferre, Robinson M.; Russell, Frances M.; Peterson, Dina; Zakeri, Bita; Herbert, Audrey; Nti, Benjamin; Goldman, Mitchell; Wilcox, James G.; Wallach, Paul M.; Emergency Medicine, School of MedicineObjective: As point-of-care ultrasound (POCUS) use grows, training in graduate medical education (GME) is increasingly needed. We piloted a multispecialty GME POCUS curriculum and assessed feasibility, knowledge, and comfort with performing POCUS exams. Methods: Residents were selected from the following residency programs: internal medicine, family medicine, emergency medicine, and a combined internal medicine/pediatrics program. Didactics occurred through an online curriculum that consisted of five modules: physics and machine operation, cardiac, lung, soft tissue, and extended focused sonography in trauma applications. Residents completed a pre- and post-curriculum questionnaire, as well as knowledge assessments before and after each module. One-hour hands-on training sessions were held for each module. Differences between pre- and post-participation questionnaire responses were analyzed using the Wilcoxon rank sum. Results: Of the 24 residents selected, 21 (86%) were post-graduate year two or three, and 16 (65%) were from the internal medicine program. Eighteen (67%) residents reported limited prior POCUS experience. All pre- to post-knowledge assessment scores increased (p<0.05). Statistically significant increases pre- to post-curriculum were found for frequency of POCUS use (p = 0.003), comfort in using POCUS for assessing for abdominal aortic aneurysm, soft tissue abscess detection, undifferentiated hypotension and dyspnea, cardiac arrest and heart failure (p<0.025); and competency in machine use, acquiring and interpreting images and incorporating POCUS into clinical practice (p<0.001). All participants felt the skills learned during this curriculum were essential to their future practice. Conclusions: In this pilot, we found using a combination of online and hands-on training to be feasible, with improvement in residents’ knowledge, comfort, and use of POCUS.Item Piloting a Graduate Medical Education Point-of-Care Ultrasound Curriculum(Springer, 2022-07) Ferre, Robinson M.; Russell, Frances M.; Peterson, Dina; Zakeri, Bita; Herbert, Audrey; Nti, Benjamin; Goldman, Mitchell; Wilcox, James G.; Wallach, Paul M.; Radiology & Imaging Sciences, School of MedicineObjective As point-of-care ultrasound (POCUS) use grows, training in graduate medical education (GME) is increasingly needed. We piloted a multispecialty GME POCUS curriculum and assessed feasibility, knowledge, and comfort with performing POCUS exams. Methods Residents were selected from the following residency programs: internal medicine, family medicine, emergency medicine, and a combined internal medicine/pediatrics program. Didactics occurred through an online curriculum that consisted of five modules: physics and machine operation, cardiac, lung, soft tissue, and extended focused sonography in trauma applications. Residents completed a pre- and post-curriculum questionnaire, as well as knowledge assessments before and after each module. One-hour hands-on training sessions were held for each module. Differences between pre- and post-participation questionnaire responses were analyzed using the Wilcoxon rank sum. Results Of the 24 residents selected, 21 (86%) were post-graduate year two or three, and 16 (65%) were from the internal medicine program. Eighteen (67%) residents reported limited prior POCUS experience. All pre- to post-knowledge assessment scores increased (p<0.05). Statistically significant increases pre- to post-curriculum were found for frequency of POCUS use (p = 0.003), comfort in using POCUS for assessing for abdominal aortic aneurysm, soft tissue abscess detection, undifferentiated hypotension and dyspnea, cardiac arrest and heart failure (p<0.025); and competency in machine use, acquiring and interpreting images and incorporating POCUS into clinical practice (p<0.001). All participants felt the skills learned during this curriculum were essential to their future practice. Conclusions In this pilot, we found using a combination of online and hands-on training to be feasible, with improvement in residents' knowledge, comfort, and use of POCUS.Item Point-of-Care Ultrasound Education During a Pandemic: From Webinar to Progressive Dinner- Style Bedside Learning(Springer Nature, 2022-05-19) Herbert, Audrey; Russell, Frances M.; Zahn, Gregory; Zakeri, Bita; Motzkus, Christine; Wallach, Paul M.; Ferre, Robinson M.; Emergency Medicine, School of MedicineObjective: Point-of-care ultrasound (POCUS), traditionally, requires the proximity of learners and educators, making POCUS education challenging during the COVID-19 pandemic. We set out to evaluate three alternate approaches to teaching POCUS in UME. Sessions progressed from an online seminar to a remote, interactive simulation to a “progressive dinner” style session, as precautions evolved throughout the pandemic. Methods: This prospective study details a series of three POCUS workshops that were designed to align with prevailing social distancing precautions during the COVID-19 pandemic. Overall, 656 medical students were included. The first and second workshops used web-based conferencing technology with real-time ultrasound imaging, with the second workshop focusing on clinical integration through simulation. As distancing precautions were updated, a novel “progressive dinner” technique was used for the third workshop. Surveys were conducted after each session to obtain feedback on students’ attitudes toward alternative teaching techniques and quantitative and qualitative analyses were used. Results: The initial, remote POCUS workshop was performed for 180 medical students. Ninety-nine (177) percent of students felt the session was “intellectually challenging” and “stimulating.” Ninety-nine percent of students (340/344), after the second workshop, indicated the session was intellectually challenging, stimulating, and a positive learning experience. Students' ability to correctly identify pathologic images increased post-session evaluation from in-session polling. For workshop three, 99% (107/108) of students indicated that the session was “informative.” There was a significant improvement in pre- to post-workshop knowledge regarding image acquisition, interpretation, and clinical integration. Conclusion: While image acquisition skills are best conveyed at the bedside, these modified POCUS teaching techniques developed and delivered in alignment with COVID-19 pandemic restrictions during a series of three workshops were shown to be effective surrogates for traditional teaching approaches when social distancing requirements, a large learner pool, or lack of local expertise exist.Item The State of Point-of-Care Ultrasound Training in Undergraduate Medical Education: Findings From a National Survey(Wolters Kluwer, 2021-11) Russell, Frances M.; Zakeri, Bita; Herbert, Audrey; Ferre, Robinson M.; Leiser, Abraham; Wallach, Paul M.; Emergency Medicine, School of MedicinePurpose: The primary aim of this study was to evaluate the current state of point-of-care ultrasound (POCUS) integration in undergraduate medical education (UME) at MD-granting medical schools in the United States. Method: In 2020, 154 clinical ultrasound directors and curricular deans at MD-granting medical schools were surveyed. The 25-question survey collected data about school characteristics, barriers to POCUS training implementation, and POCUS curriculum details. Descriptive analysis was conducted using frequency and percentage distributions. Results: One hundred and twenty-two (79%) of 154 schools responded to the survey, of which 36 were multi-campus. Sixty-nine (57%) schools had an approved POCUS curriculum, with 10 (8%) offering a longitudinal 4-year curriculum. For a majority of schools POCUS instruction was required during the first (86%) and second year (68%). Forty-two (61%) schools were teaching fundamentals, diagnostic, and procedural ultrasound. One-hundred and fifteen (94%) schools identified barriers to implementing POCUS training in UME, which included lack of trained faculty (63%), lack of time in current curricula (54%), and lack of equipment (44%). Seven (6%) schools identified no barriers. Conclusions: Over half of the responding medical schools in the United States had integrated POCUS instruction into their UME curricula. Despite this, a very small portion had a longitudinal curriculum and multiple barriers existed for implementation, with the most common being lack of trained faculty. The data from this study can be used by schools planning to add or expand POCUS instruction within their current curricula.Item 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, PaulBackground 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.Item Training the Trainer: Faculty From Across Multiple Specialties Show Improved Confidence, Knowledge and Skill in Point of Care Ultrasound After a Short Intervention(Cureus, 2020-12) Russell, Frances M.; Herbert, Audrey; Zakeri, Bita; Blaha, Mary; Ferre, Robinson M.; Sarmiento, Elisa J.; Wallach, Paul M.; Emergency Medicine, School of MedicineObjectives: Lack of faculty skill and confidence in performing and teaching point-of-care ultrasound (POCUS) remains a significant barrier to implementation of a longitudinal ultrasound curriculum in undergraduate medical education. Our objective was to assess faculty comfort, knowledge and skill with performing and teaching POCUS before and after a focused workshop. Methods: This was a prospective study assessing faculty from multiple specialties. Faculty completed a pre- and post-workshop survey and ultrasound knowledge assessment, and a post-workshop objective structured clinical examination (OSCE) to assess ability to perform POCUS. Differences between pre- and post-workshop responses were analyzed using Fisher's Exact and Wilcoxon tests, and statistical significance was accepted for p<0.05. Results: We analyzed data on 78 faculty from multiple disciplines. Faculty had a median of 7.5 years of experience with medical student teaching. Sixty-eight percent of faculty had performed <25 prior ultrasound (US) examinations. Comparing pre- to post-workshop responses, we found significant reductions in barriers to using US, and improved confidence with using, obtaining and interpreting POCUS (p<0.01). Faculty felt significantly more comfortable with the idea of teaching medical students POCUS (p<0.01). POCUS knowledge improved from 50% to 86% (p<0.01). On the post-workshop OSCE, 90% of anatomic structures were correctly identified with a median image quality of 4 out of 5. Conclusion: After attending a six-hour workshop, faculty across multiple specialties had increased confidence with using and teaching POCUS, showed improved knowledge, and were able to correctly identify pertinent anatomic structures with ultrasound while obtaining good image quality.Item Two-week intensive medical student point-of-care ultrasound training impact on long term utilization(Springer Nature, 2024-08-16) Herbert, Audrey; Russell, Frances M.; Ferre, Robinson M.; Wilcox, James; Peterson, Dina; Davis, Jean; Zakeri, Bita; Hays, Matthew; Wallach, Paul M.; Emergency Medicine, School of MedicineBackground: There is little to no data evaluating long term usage of point of care ultrasound (POCUS) after a training intervention for medical students. The purpose of this study was to examine the impact of an intensive POCUS training program on medical student's usage at 9-months post-program. Methods: This was a prospective cross-sectional study of rising second year medical students who participated in a 2-week summer POCUS training program. Instruction consisted of 8 h of asynchronous online didactic material, 2-4 h of daily hands-on instructor-led and independent scanning, and instruction on how to teach POCUS. Students were assessed pre- and post-program, and again at 9 months post-program to evaluate POCUS usage. Results: A total of 56 students participated in the program over 2 summers; 52 (92.9%) responded to the 9-month post-program survey. At 9 months, 49 (94.2%) of students taught POCUS after the program to peers or faculty. Students reported serving as a POCUS instructor in 283 subsequent teaching sessions accounting for 849 h of POCUS instruction time. Six (11.5%) students were involved in the creation of a POCUS interest group on their regional campus, 7 (13%) created a POCUS curriculum for their student interest group, and 4 (7.7%) created an opt-in co-curricular POCUS program for students at their regional campus. Three (5.8%) students did not serve as educators after the program and only one student reported not using POCUS again after the program. Conclusion: After a 2-week intensive POCUS training program for medical students, the majority of students demonstrated continued involvement in POCUS learning and education at 9-month follow-up including serving as peer instructors and assisting with limitations in financial resources and trained faculty.