2024 IUSM Education Day

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Strategies and Challenges to Diversifying Standardized Patients at a Rural Regional Campus
(2024-04-26) Menez, Olwen; Zagales, Ruth; Colleton, Taylor; Rodriguez Artze, Claudia; Cordero, Laura
Background: The use of standardized patients (SPs) has been a longstanding norm in medical education, with 94% of U.S. medical schools employing this instructional approach. Research shows that experiences with diverse SPs can increase students’ transcultural self-efficacy perceptions, and that all students benefit from formal cultural competency instruction. However, diversity initiatives surrounding SPs seem to be lacking in terms of recruitment and training. The purpose of this study is to expand on current recruiting practices that aim to racially/ethnically diversify the SP population. Methods: Recruitment of SPs was conducted over a five month period at local wellness fairs, cultural festivals, engagements with diversity officers, and collaborations with minority health coalitions via distribution of 500 pre-approved flyers. Interested individuals contacted the simulations facilitator for an invite to a scheduled information session. Afterwards, participants completed background checks, and following eligibility, completed vendor packets to begin working. Results: The original pool of SPs included 25 individuals. Of these, 22 (88%) were White non-Hispanic individuals. Resulting from recruitment efforts, 22 individuals responded to the flyer. Seventeen respondents were invited to an information session and ten attended. Of the ten present, five were people of color. Out of these, three filled out the background check information. From these, only one person completed the vendor packet and could thus work as an SP. Future Directions: Diversifying the SP population plays a crucial role in medical education by giving students the ability to engage with diverse patients while practicing cultural sensitivity. Medical education should continue longitudinal recruitment of diverse SPs using multifaceted approaches.
Ethical Boundaries in AI-Driven Medical Education: Safeguarding Patient Data
(2024-04-26) Karki, Sabin; Stephanian, Brooke; Schantz, Eli
Advancing AI in Medical Education: Understanding the Malpractice Landscape
(2024-04-26) Stephanian, Brooke; Karki, Sabin; Schantz, Eli
An Assessment of ChatGPT’s Performance as a Patient Counseling Tool: Exploring the Potential Integration of Large Language Model-based ChatBots into Online Patient Portals
(2024-04-26) Price, Charles; Brougham, Albert; Burton, Kyle; Dexter, Paul
BACKGROUND: With the advancement of online patient portals, patients now have unprecedented access to their healthcare providers. This has led to increased physician burden associated with electronic inbox overload [1]. Recent developments in artificial intelligence, specifically in Large Language Model-based chatbots (i.e. ChatGPT), may prove to be useful tools in reducing such burden. Can ChatGPT reliably be utilized as a patient counseling tool? ChatGPT can be described as “an advanced language model that uses deep learning techniques to produce human-like responses to natural language inputs” [5]. Despite concerns surrounding this technology (i.e. spreading of misinformation, inconsistent reproducibility, “hallucination” phenomena), several studies have demonstrated ChatGPT’s clinical savviness. One study examined ChatGPT’s ability to answer frequently asked fertility-related questions, finding the model’s responses to be comparable to the CDC’s published answers in respect to length, factual content, and sentiment [6]. Additionally, ChatGPT was found capable of achieving a passing score on the STEP 1 licensing exam, a benchmark set for third year medical students [7]. OBJECTIVE: This study aims to further evaluate the clinical decision making of ChatGPT, specifically the ability for ChatGPT to provide accurate medical counseling in response to frequently asked patient questions within the field of cardiology. METHODS: 35 frequently asked cardiovascular questions (FAQs) published by the OHSU Knight Cardiovascular Institute were processed through ChatGPT 4 (Classic Version) by OpenAI. ChatGPT’s answers and the provided answers by the OHSU Knight Cardiovascular Institute were assessed in respect to length, factual content, sentiment analysis, and the presence of incorrect/false statements. RESULTS: When comparing ChatGPT’s responses to the 35 FAQs against the published responses by OHSU, Chat GPT’s responses were significantly longer in length (295.4 vs 112.5 (words/response)) and included more factual statements per response (7.2 vs 3.5). Chat GPT was able to produce responses of similar sentiment polarity (0.10 vs 0.11 on a scale of -1 (negative) to 1 (positive)) and subjectivity (0.46 vs 0.43 on a scale from 0 (objective) to 1 (subjective)). 0% of ChatGPT’s factual statements were found to be false or harmful. CONCLUSIONS: The results of this study provide valuable insight into the clinical “knowledge” and fluency of ChatGPT, demonstrating its ability to produce accurate and effective responses to frequently asked cardiovascular questions. Larger scale studies with an additional focus on ChatGPT’s reproducibility/consistency may provide important implications for the future of patient education. Implementation of AI-based chatbots into online patient portals may prove to be assistive to physicians, alleviating the growing burden of electronic inbox volume.
Characteristics associated with access to kidney transplantation services in the Ohio River Valley
(2024-04-26) Kelty, Catherine; Buford, Jade; Drewry, Kelsey; Adebiyi, Oluwafisayo; Sharfuddin, Asif; Fridell, Jonathan; Sher, Jawad; Huml, Anne; Moe, Sharon; Patzer, Rachel
“I’m supposed to be a helper”: Spiritual distress of abortion providers after Dobbs v. Jackson
(2024-04-26) Bode, Leah; Kumar, Komal; McQuillan, Josie; Scott, Nicole; Bernard, Caitlin
INTRO On June 24, 2022, the U.S. Supreme Court voted to overturn Roe v. Wade, the 1970 landmark case protecting abortion rights in America, in Dobbs v. Jackson Women’s Health Organization. The decision has the potential to affect the way that abortion providers practice their specialty by interacting with patients and making meaning from their work. Meaning making in one’s work has been shown to be integral in fostering spiritual well-being and preventing burnout in medicine. We sought to demonstrate the spectrum of spirituality of abortion providers and their subsequent spiritual distress in the aftermath of Dobbs. METHODS We conducted thirty-minute interviews on Zoom with 26 abortion providers from 17 states from November 2022 to February 2023. Demographics collected included age, racial identity, location of practice (by state), years in practice, fellowship training, and practice setting (community, academic, hybrid). States were then classified according to the Guttmacher Institute classifications of Most restrictive, Restrictive, Some restrictions/protections, Protective, and Very protective as of December 2022. Interviews consisted of questions such as "What are the major tenants of your spiritual beliefs (if none, how you make meaning)?” and “Tell me about any spiritual distress or alienation from your religious or spiritual community as a result of the Dobbs decision.” Interviews were analyzed using NVivo 14. RESULTS Providers were equally distributed amongst community (34.6%), academic (34.6%), and hybrid (30.8%) settings. Location of practice (state) was well-distributed across the restrictive-protective spectrum: 7.7% Most restrictive, 30.8% Restrictive, 15.4% Some restrictions/protections, 30.8% Protective, and 15.4% Very protective. The majority of participants identified a personal spirituality, while less than half were tied to an organized religion. Sixteen participants (61.5%) cited ethical principles of justice, non-maleficence, respect for human life, or autonomy as major tenets of their spirituality. Ten subjects (38.5%) felt spiritually called to provide abortion care, 11 others (42.3%) perceived abortion care as a spiritual obligation, and 12 participants (46.2%) noted the act of providing an abortion as a spiritual act, for provider and/or patient. Most participants experienced spiritual distress relating to the Dobbs decision. Those who did not experience spiritual distress (26%) noted location and the alignment of their work with spiritual values as protective factors. Of note, 92% of participants described their spirituality as helpful in coping with the fall of Roe v. Wade. Sources of strength included advocacy, agency (e.g., “I feel strength knowing that I’m still able to do this job”), legislative work, and community; 57.7% specifically cited the abortion provider community. CONCLUSION The decision to be an abortion provider is often motivated by one’s spiritual identity. Many abortion providers endorsed feelings of spiritual distress related to not being able to comply with their moral and/or spiritual obligation of providing abortions secondary to new restrictions. Location factored heavily into whether providers were experiencing this distress, suggesting that state restrictions on abortions have directly impacted the spiritual well-being of abortion providers. As many laws pertaining to abortion are influenced by religious beliefs, it is important to recognize that abortion providers themselves are overwhelming spiritual.
Psychiatry Teacher’s Guide: A Web-Based Resource for Faculty Development
(2024-04-26) Upshaw, Landon; Smith, Alyssa; Giust, Julianne
Developing effective faculty development resources for community-based preceptors is often limited by cost, adoption, and administrative pitfalls. With the community-based preceptor model being adopted by medical schools nationally, effective faculty development initiatives must be efficient and worthy of preceptors’ time. Studies have shown that preceptors value convenience, flexibility, and timely content. Avenues utilized by medical school administrations in distributing faculty development include podcasts, online modules/quizzes, instructional videos, and online discussion boards. Given the size of Indiana University School of Medicine (IUSoM) and its training sites across the state, flexibility, cohesion, and efficiency are especially prioritized for faculty development. With these characteristics in mind, the IUSoM psychiatry clerkship team developed the Psychiatry Teacher’s Guide in a PDF book format and interactive Canvas webpage. The Psychiatry Teacher’s Guide aims to improve three main areas: increase active learning in the clinical setting, increase NBME engagement and preparation for shelf exams, and ensure quality summative and formative evaluation of clerkship students. The Psychiatry Teacher’s Guide was distributed via email to all preceptors who oversee third-year medical students during their psychiatry clerkship rotation, including faculty, residents, and fellows. The Psychiatry Teacher’s Guide content was synthesized into four chapters: clerkship updates, teaching pearls, final clinical evaluations, and mentoring/letters of recommendation. Following the distribution of the Psychiatry Teacher’s Guide, a post survey was sent to preceptors. The survey consisted of multiple choice (including Likert-scale questions) and open-ended questions. Participation in the survey was anonymous and voluntary. Results from the survey were analyzed as part of our quality improvement efforts and in the analysis of the Guide’s usefulness. This study was approved by the institution’s IRB under exempt status. The Teacher’s Guide was distributed to 270 psychiatry preceptors at IUSoM in September 2023, and the survey link was distributed to those actively serving as preceptors (n=255) in October 2023. Results (n=28) are promising and show that 90% of respondents are “Somewhat Likely” or “Extremely Likely” to implement concepts learned in the Teacher’s Guide into their teaching practices. Additionally, 75% of respondents “Somewhat Agree” or “Strongly Agree” that the Teacher’s Guide has helped them identify gaps in their teachings and methods they can use to improve. We aim to discuss the design, development, implementation, and distribution of the Psychiatry Teacher’s Guide in the psychiatry clerkship at IUSoM. We will share results from our survey and data collected by Canvas to highlight the most valued resources shared in our form of faculty development. We will also discuss the next steps in the improvement of the Psychiatry Teacher’s Guide and the ways in which it can be a sustainable piece of faculty development and valuable reference tool for preceptors.
Tips to Leverage Your ORCID
(2024-04-26) Dolan, Levi; Craven, Hannah J.; Ramirez, Mirian; Whipple, Elizabeth C.
Introduction/Background: An effective scholarly presence means not only publishing research, but also connecting research outputs to an online professional identity. ORCID (Open Research and Contributor ID) is a not-for-profit organization that allows researchers to create a unique persistent identifier to organize their bibliography, datasets, grants, and other works. An ORCID is affiliation-agnostic and keeps researchers with similar names distinct, increasing attribution accuracy. Workshop Objectives: By connecting their ORCID profile to existing systems, researchers can benefit from automated updates that support validation and efficient presentation of their scholarly outputs. After introducing how to create an ORCID profile, this workshop will move beyond ORCID basics and walk through how to maximize the benefits of a centralized online presence for a researcher’s works. Methods: This workshop will focus on the steps for setting up connections with three major systems for populating ORCID profiles: CrossRef (an aggregator of metadata for scholarly literature publication outlets), DataCite (similar to CrossRef, but focused on data repositories), and Scopus (one of the most powerful scholarly publishing databases for managing author affiliation information). Attendees will participate in the hands-on processes needed to set up their ORCID profiles if needed, and to open these connections so that in the future they will not need to manually enter data for their profiles to be updated, minimizing maintenance time needed to maintain their scholarly presence. Learning Goals: Attendees can expect to leave this workshop with a robust persistent record of their research outputs. This will increase the findability and reusability of their research, which will provide avenues for greater scholarly impact. An ORCID profile is not a prerequisite for attending.
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, Amy
INTRODUCTION: 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.
A Roadmap to Surgical Education: A Scoping Review of Educational Needs in Surgery
(2024-04-26) Yan, Yichuan; Krusing, Madeline; Awad, MIchael; Stefanidis, Dimitrios
Purpose: Understanding the educational needs can help organizations like the Association for Surgical Education to develop relevant solutions. However, relevant literature is limited to know the needs. Thus, the aim of this study was to identify the educational needs in surgical education literature. Methods: Following the PRISMA Statement guideline, we performed a scoping review with three search terms in two databases in tandem with three inclusion criteria to identify the literature pertinent to educational needs in surgery. Through content analysis of the abstracts of the identified literature, we inquired about the objectives, methods, data sources, and conclusions in each identified article to tease out the trends, specialties, participants, and topics of educational needs in surgical education literature. Descriptive statistics of frequency were used to present the data. Results: The PRISMA article selection procedures resulted in 212 peer-reviewed journal articles in the scoping review. The content analysis identified the trends of the needs in four areas including the trends of educational needs, surgical specialties, participants, and topics of educational needs. To synthesize the results of the data analysis, a heat map was created with the cross-section of the trends and topics of educational needs showing the hot topics and potential gaps in surgical education literature. Conclusions: The scoping review provides surgical educators and trainees an overview of the educational needs in the literature that can serve as a roadmap of educational needs to be taken into consideration by organizations like the ASE to help address the needs and advance the field.

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