Office of Educational Affairs, IU School of Medicine

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    A Taste of Agile to Create Change in Medical Education
    (2024 AAMC Group on Regional Medical Campus Conference, 0024-06-03) Birnbaum, Deborah R.; Sipes-Fears, Debra; Rohr-Kirchgraber, Theresa; Breffle, Kelly
    A Taste of Agile provides an introduction to developing an agile mindset and will model and dive into two agile tools. Participants will get an overview of agile science and participate in an Innovation Forum, an agile tool used for idea generation and problem solving, to help solve a problem specific to regional campuses. Participants will also use a reflection tool to generate timely, actionable, nonjudgmental feedback. In addition to learning how to use these tools, participants will get tips on how to apply these tools back at their jobs, and other resources to learn agile change that can be applied in medical education and health care.
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    A Taste of Agile to Create Change in Medical Education
    (2024 AAMC Staff Track Conference, 0024-09) Birnbaum, Deborah R.; Sipes-Fears, Debra; Rohr-Kirchgraber, Theresa; Breffle, Kelly
    Change is difficult. It is frequently stated that it takes an average of 17 years for research evidence to reach clinical practice. Over the past decade, an interdisciplinary team of scientists at Indiana University developed agile methods to design, implement, and diffuse evidence-based behavioral and social science interventions. Such methods incorporate rapid, iterative, and adaptive problem-solving techniques that are based on insights from agile science. Agile science integrates findings from behavioral economics, complexity science, and network science to understand, predict, and nudge the behavior of both an individual human and that of a social organization of humans such as a healthcare delivery system or medical school. While earning a graduate certificate in Innovation and Implementation Science, I became curious about the use of agile science in education, in general, and medical education and interprofessional education, in particular. A literature search indicated that little of agile science has found its way into traditional education, medical education or interprofessional education. In working with classmates also engaged in educating the next generation of health care providers, we believe this approach holds great promise, is completely feasible for medical education and is transferable to any institution. A Taste of Agile provides an introduction to developing an agile mindset and will model and dive into two agile tools. Participants will get an overview of agile science and participate in an Innovation Forum, an agile tool used for idea generation and problem solving, to help solve a problem specific to staff. Participants will also use a reflection tool to generate timely, actionable, nonjudgmental feedback. In addition to learning how to use these tools, participants will get tips on how to apply these tools back at their jobs, and other resources to learn agile change that can applied in medical education and health care.
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    Fostering Interprofessional Education During Required Clerkships for Medical Students Across Regional Campuses
    (Journal of Regional Medical Campuses, 0024-12-15) Freed, Stephanie; Birnbaum, Deborah R.; Schwartz, Jennifer E.; Ko, Paul; Christman, Megan; Wallach, Paul M.
    It remains complex and challenging to deliver interprofessional education at medical schools with geographically distributed campuses. Indiana University School of Medicine (IUSM) expanded its interprofessional education directly into clinical training by implementing a simple exercise in required clerkships on all nine of its campuses and with various health system partners that achieves the goals of interprofessional education and in which students find value. Methods Between the academic years 2022-2023 and 2023-2024, IUSM medical students on every campus and across health systems, interviewed and reflected on the role of one healthcare professional involved in the care of a patient during each required clinical rotation. They interviewed different healthcare professionals and/or healthcare professions students to gain broad exposure and perspectives. Results All IUSM students on all its campuses interacted with a variety of healthcare professionals during their 3rd and 4th year clinical rotations statewide (n=6357 encounters). Across all campuses, 88% of interactions occurred with healthcare professionals rather than healthcare professions students. Statewide, between 84% and 95% of students reported that they ‘Strongly Agreed/Agreed’ that the experience contributed to the development of their interprofessional collaboration skills and knowledge, and that they found the assignment valuable. Conclusion Our interprofessional assignment offers medical schools with multiple campuses a promising solution to the challenges of delivering high-quality, and meaningful interprofessional education. It requires minimal to no resources, ensures comparability, and helps prepare students for real-world teamwork.
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    Integrating an interprofessional educational exercise into required medical student clerkships – a quantitative analysis
    (BMC Medical Education, 0025-02-01) Schwartz, Jennifer E.; Ko, Paul; Freed, Stephanie; Safdar, Neelum; Christman, Megan; Page, Renee; Birnbaum, Deborah R.; Wallach, Paul M.
    Purpose: Medical students are integrated into an interprofessional team to help them learn how to provide effective, patient-centered care. Indiana University School of Medicine (IUSM) introduced a unique, easy-to-implement interprofessional exercise into each clerkship to improve students’ understanding of each professional’s contribution to patient care. Methods: Between 2022 and 2023, IUSM medical students interviewed a variety of healthcare professionals engaged in the care of mutual patients using a template of questions; they wrote a brief report and evaluated the experience. Students interviewed a different professional in each clerkship to broaden their exposure. Results: 3088 encounters occurred, 68% at the Indianapolis campus and 32% at regional campuses. More than 82% of students agreed or strongly agreed to each of the following prompts regarding the exercise: aided their understanding of the benefits of an interprofessional team to patient care, better understood when participation of the specific healthcare professional would benefit their patient, the experience contributed to their understanding of the role of that profession within the healthcare team, their confidence in engaging other healthcare professionals on the health care team improved, and the experience aided in understanding of their own role as a member of the health care team. Conclusion: This exercise was easy to implement across a multi-campus system and improved student comprehension of the interprofessional team and indications for their engagement in patient care.
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    Development of Cancer-Related Protease Assay Using DNA-Encoded Proteomic Probes
    (2015-05) Ivaturi, Samantha; Jetson, Rachael; Krusemark, Casey
    Proteases function by breaking the peptide bonds within proteins that hold amino acids together. This action, proteolysis, is essential for the proper functioning of numerous biological processes. The activity of this vast group of enzymes is held in a delicate balance in normal living systems, however tumor growth and metastasis can develop as a result of irregular protease activity. A number of protease activities are well known to be misrelated in cancerous cells. The objective of the project is to develop DNA-encoded probes to use as a tool for protease assays that will enable low-cost, high-throughput profiling of enzymatic activity in samples by DNA sequence analysis for the early detection, characterization, and prevention of cancer. The encoding of functional proteomic information in DNA sequence promises to have significant benefits over traditional methods, including highly sensitive detection and capabilities for extensive multiplexing. Model proteases used in this experiment will include caspase 3 and prostate specific antigen (PSA).
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    Influenza Group 2 HA Stem-Only Nanoparticles Induce Heterotypic Immune Response
    (2017-08) Asdell, Stephanie M.; Moin, Syed M.; Corbett, Kizzmekia; Boyington, Jeffrey; Graham, Barney S.
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    Endocannabinoids Regulate Cerebellar Granule Cell Differentiation
    (2017-09) Essex, Amanda; Black, Kylie; Baygani, Shawyon; Mier, Tristan; Martinez, Ricardo; Mackie, Ken; Kalinovsky, Anna
    The cerebellum plays a crucial role in learning and execution of complex automated behaviors, including fine motor skills, language, and emotional regulation. Cerebellar development continues throughout an extended postnatal period. The most numerous neurons in the cerebellum, as well as the entire brain, are the cerebellar granule cells (GCs), which are generated in a dedicated secondary proliferative zone, the external granule cell layer (EGL), during the first three postnatal weeks in mice, and over a year in humans. The robust expansion of granule cells during early development is responsible for the majority of cerebellar expansion. Morphological and molecular changes that drive GC proliferation and differentiation have been extensively characterized, starting from the developmental studies by Santiago Ramón y Cajal. GC progenitors (GCPs) proliferate in the outer EGL (oEGL). As they are pushed into the inner EGL (iEGL) by the newly generated GCPs, they exit the cell cycle and begin differentiation, first extending bipolar neurites, followed by tangential migration, and eventually radial migration to the inner granule cell layer (IGL), their target territory. Deregulation of GCPs expansion, proliferation to differentiation switch, or the rate of migration could contribute to abnormal cerebellar size and compartmentalization and disrupt cerebellar circuits’ wiring and function. Endocannabinoids (eCBs) have been identified as key players regulating neuron proliferation and migration in the fore- and mid-brain development, however their role in cerebellar development has not yet been explored in detail. Our preliminary results show robust expression of cannabinoid receptor 1 (CB1) in iEGL GCs, concomitant with expression diacylglycerol lipase α (DGLα) a major enzyme required for the synthesis of eCB 2-arachidonoylglycerol (2-AG), in PCs. Furthermore, our preliminary results show that cerebellar size is reduced in CB1 KOs. In this study we investigate the mechanisms through which eCB signaling may regulate GC proliferation and differentiation, focusing on the GCPs cycle length, rate of differentiation and migration.
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    Human Antibody-Dependent Cellular Cytotoxicity-Mediating Antibodies Do Not Recruit Non-Human Primate CD20+ NK Cells
    (2018-04) Asdell, Stephanie M.; Edwards, R. Whitney; Jha, Shalini; Ferrari, Guido
    The antibody-dependent cell-mediated cytotoxicity (ADCC) response represents one of mechanisms through which the immune system destroys tumor or infected cells. During the ADCC response to HIV-1, natural killer (NK) cells are recruited by natural infection- or vaccine-induced antibodies (Abs) bound to the HIV-1 envelope glycoproteins expressed on infected CD4+ T cells via Fc-gamma Receptor IIIA (Fc-R IIIA). The NK cells’ Ab-mediated recognition of the infected cells leads to the release of granzymes and perforin by degranulation, triggering apoptotic signal pathways in the infected cells and ultimately leading to their elimination. We have optimized an assay to investigate the degranulation of non-human primate (NHP) NK cells from five different NHP donors by measuring levels of CD107a, a marker present on the inner membranes of NK lysosomes. Using one NHP and two human monoclonal antibodies (mAbs), we compared degranulation of NK in NHP splenocytes, NHP peripheral blood mononuclear cells (PBMC), and human PBMC. We observed that both NHP and human mAbs recruited NHP and human NK effector cells. Of note, we examined the activity of CD20+ and CD20- NK cells, with the former being NK cells from a unique subset of NHP NK splenocytes. Our analysis suggests that CD20+ cells likely do not play a role in the NHP ADCC response. In conclusion, we can identify the cellular populations responsible for the Ab-mediated killing of HIV-1 infected cells, and we will be able to further analyze their full functional profile at the level of messenger RNA expression, i.e. their transcriptomic profile.
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    WHI3 Regulation of CDK in S. cerevisiae.
    (2018-04-10) Brown, Lucy; Gihana, Gabriel; Lacefield, Soni
    There are many diseases associated with malfunc4ons in the cell cycle. For instance, aneuploidy—when daughter cells have the abnormal number of chromosomes—results from improper cell division. Diseases that arise from chromosomal abnormali4es range from Down Syndrome to Turner Syndrome to Patau Syndrome, all extremely debilita4ng afflic4ons. Another serious consequence of unregulated cell division is the development of cancers. One of the hallmarks of cancer cells is cell prolifera4on, which is a result of unregulated cell division. Studying cell cycle regula4on in yeast, par4cularly budding yeast, Saccharomyces cerevisiae, allows for a beFer understanding of the human cell cycle. Many of the genes studied in my lab are conserved in humans, meaning that those yeast cell proteins also func4on in human cells. Mito4c cell division—the type of division in which a mother cell produces two iden4cal daughter cells—is regulated by a protein complex called cyclin-dependent kinase (CDK). This protein complex has been intensely studied by cell biologists, yet there is s4ll much that is unknown about how it is controlled. CDK—which must be ac4ve in order for cell division to occur—is regulated by a protein in yeast called Swe1. Swe1 inhibits CDK when the cell is perturbed, thereby hal4ng cell division. One way that the cell can be perturbed is by the dele4on of the protein ELM1. When present, ELM1 regulates the cytoskeleton of the cell. However, when ELM1 is deleted, Swe1 is ac4vated, which results in a delayed cell division and irregularly long buds. These long buds are also the result of sep4n perturba4on. When func4oning properly, sep4n proteins form a ring around the bud neck. We recently found that the dele4on of another protein called WHI3 rescues the ELM1 dele4on-induced cell division delay and long buds. By u4lizing fluorescent microscopy, we have been able to visualize cells lacking both WHI3 and ELM1. Our hypothesis is that WHI3 is somehow involved in regula4on of CDK. In order to test this hypothesis, we are working on experiments to see what happens to CDK and other regulators of cell division when ELM1 is deleted, WHI3 is deleted, and when both WHI3 and ELM1 are deleted. I will be conduc4ng other molecular biology experiments to measure the level of CDK ac4vity in both the cytoplasm and the nucleus. My work will help to elucidate another mechanism by which CDK is regulated, which will contribute to our overall understanding of proper progression through the cell cycle.