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Item The Case of Ty Jackson: An Interactive Module on LGBT Health Employing Introspective Techniques and Video-Based Case Discussion(Association of American Medical Colleges, 2019-06-04) Gavzy, Samuel J.; Berenson, Marc G.; Decker, Jilyan; Domogauer, Jason; Alexander, Andreia; Pulaski, Matthew; Soto-Greene, Maria; Sánchez, Nelson; Sánchez, John Paul; Emergency Medicine, School of MedicineIntroduction: The Institute of Medicine's 2011 report on lesbian, gay, bisexual, and transgender (LGBT) health and the legalization of same-sex marriage are just two of the numerous milestones that have hastened medical schools' efforts to prepare trainees to address the needs of LGBT community members. Early awareness of sexual diversity through self- and peer introspection and video-based education can help trainees build a foundation towards providing affirming care to LGBT patients. Methods: The Kern model was used to develop, implement, and evaluate an interactive multimodal workshop to provide first-year medical students with a formative introduction to LGBT health. Learning objectives focused on comprehending the spectrum of human sexuality, health issues for LGBT patients, and better practices for promoting affirming care. The module consisted of a PowerPoint presentation, sexuality survey, videos of provider-patient encounters, and community-based resources. Results: The workshop was implemented among 178 first-year medical students in September 2018, with 93% completing the pre-/postworkshop evaluations. Comparison of evaluations showed an increase in confidence in addressing each of the three learning objectives. Over 85% rated the PowerPoint and videos as very good or excellent. Discussion: This workshop was effective in helping first-year medical students appreciate the spectrum of sexual diversity, health issues facing LGBT individuals, and better practices to promote affirming care. The real-time sexuality survey helped trainees appreciate sexual diversity through self-reflection and near-peer sharing. The videos and accompanying discussion provided real-life encounters, along with common pitfalls in and pearls for communicating with LGBT patients.Item Drug-Induced Liver Injury Module for Medical Students(Association of American Medical Colleges, 2020-07-15) Dilly, Christen K.; Craven, Hannah J.; Molleston, Jean P.; Medicine, School of MedicineIntroduction No published curricula exist to introduce medical students to drug-induced liver injury (DILI). However, DILI is the most common cause of acute liver failure in the US, and drug-drug interactions are tested on the USMLE Step 1. Methods We developed an independent study module to introduce students to DILI. This module consisted of a narrated PowerPoint introduction, a journal article, and four example cases. Students completed the module independently. To evaluate the effectiveness of the activity, exam data and responses to the cases were reviewed, and end-of-course survey data were used. These responses were used to modify questions for clarity and to develop a feedback rubric. Results Mean scores on case-related questions in the module ranged from 44% to 73%. However, mean scores on test questions related to DILI ranged from 61% to 98%. It is possible that students learned from receiving feedback in the form of correct answers to the cases. On course evaluations, 52.4% of students agreed or strongly agreed that the online modules as a group (which included the DILI module) were an effective teaching method. Discussion This module introduces students to DILI and enables them to interact with valuable resources. We hope that modifications will improve the learning experience and effectiveness of the module. Going forward, we plan to collect validity evidence for the feedback rubric and develop an advanced version of the module for gastroenterology fellows.Item Genetic Testing and Counseling in Metabolic Liver Disease: An Interactive Lecture for Medical Students(Association of American Medical Colleges, 2020-10-19) McPheron, Molly A.; Craven, Hannah J.; Molleston, Jean P.; Dilly, Christen K.; Medical and Molecular Genetics, School of MedicineIntroduction Medical students have limited opportunities to learn about current genetic testing. This session provided exposure to different types of testing and the complex issues that physicians may encounter when counseling patients on proper testing and interpreting results. Methods We designed a 1-hour interactive lecture for second-year medical students. We presented an overview of the topic, then applied the concepts to specific disorders and cases. Students were asked to answer questions regarding cases using an audience response system, and we used their responses as the basis for our in-class discussion. This session has been held twice, with 25 students attending in 2018 and 31 students in 2019. The session was also recorded so that additional students not in attendance could watch, and was available to 151 students in 2018 and 333 students in 2019. Results Students answered questions via audience response system. There was a range of 47%–100% of students giving the correct answers in 2018, and 55%–93% in 2019. Exam questions covering genetic counseling issues were answered correctly by 66% and 77% of students in 2018, and 70% and 68% of students in 2019. Discussion This session provided an opportunity for medical students to be exposed to some of the complex ethical and psychosocial issues that may arise with genetic testing for liver disease and to consider how to navigate them. Using an audience response system during the lecture made the session more interactive and allowed the teacher to correct errors and teach based on the responses.Item “I Didn't Know What to Say”: Responding to Racism, Discrimination, and Microaggressions With the OWTFD Approach(Association of American Medical Colleges, 2020-07-31) Sotto-Santiago, Sylk; Mac, Jacqueline; Duncan, Francesca; Smith, Joseph; Medicine, School of MedicineIntroduction Academic medicine has long faced the challenge of addressing health inequities, reflecting on how these contribute to structural racism, and perpetuating negative social determinants of health. Most recently, we have constructed opportunities for dialogues about racism, discrimination, and microaggressions (RDM). As such, we created a professional development program that encouraged participants to (1) openly discuss RDM and the impact they have in academia, (2) learn about tools to address and respond to RDM, and (3) move towards the creation of inclusive environments. The target audience included institutional leaders, faculty, trainees, professional staff, and health care teams. Methods We sought to meet workshop goals by integrating anti-racist dramaturgical teaching, introducing concepts knowledge, and practicing communication tools. To assess learning and evaluate our workshops, participants completed a pre- and postsurvey. Results Results showed that 30 participants were more comfortable with discussing issues related to race/ethnicity, gender identity/expression, sexual orientation, and spirituality after participating in the workshops. Prior to the two workshops, the percentage of learners who felt confident initiating conversations ranged from 29% to 54%. After the workshops, the percentage of learners who felt confident ranged from 58% to 92%. The greatest increase, 100%, was observed in the levels of confidence in initiating conversations related to race/ethnicity. Discussion Despite medical education's commitment to cultural competence and institutional mission statements that value diversity, equity, inclusion, and justice, professional development opportunities are limited. Participants strongly agreed their participation in such a workshop was relevant and important to their professional work.Item Improving CPAP Adherence for Obstructive Sleep Apnea: A Practical Application Primer on CPAP Desensitization(2020) Chernyak, YelenaIntroduction: Obstructive sleep apnea (OSA) is a common medical condition with well-established morbidity and mortality. Continuous positive airway pressure (CPAP) is a highly effective treatment prescribed to most individuals with OSA that has documented poor adherence rate for a variety of reasons including claustrophobia and discomfort. CPAP desensitization is an effective, simple, and brief treatment shown to improve adherence rates to CPAP. Methods: A psychologist specializing in behavioral sleep medicine developed this module focused on teaching medical residents the techniques of CPAP desensitization. The educational activity was an interactive 45-minute seminar which included a didactic component followed by a case presentation and interactive role-play. A post-seminar survey was used to evaluate the content of the workshop, as well as growth in awareness and perception of knowledge and skills with a pre- to post-workshop evaluation. Results: In a survey of 25 primary care and psychiatry residents and sleep medicine fellows, 92% of respondents indicated that the topic of CPAP barriers and CPAP desensitization was important. Ratings of self-reported knowledge and skills improved nearly one-third following the workshop. Qualitative feedback indicated the utility and enthusiasm learners had for this topic. Discussion: The workshop on CPAP desensitization was a valuable tool that should be disseminated more widely to improve treatment adherence in the significant portion of the population that suffers from OSA which does not use adherence to positive airway pressure therapy. The workshop is applicable to other health professionals including medical students and nursing, social work, or psychology trainees.Item Integrated Case-Based Learning Sessions in Anatomy are an Effective Teaching Method for Pre-Matriculating Medical Students(2023-04-19) Merritt, Emily; McNulty, Margaret; Neal, Chemen; Deane, Andrew; Haywood, Antwione; Byram, JessicaObjective or Purpose of Innovation: To assess the effectiveness of case-based learning (CBL) sessions in promoting study techniques for integrated anatomy content. Background: Medical students are frequently introduced to medical school curricula through anatomy coursework, which often includes histology and embryology content. The LEAD Scholars pre-matriculation program introduces anatomy content and study skills to facilitate adjustments to medical school and reduce existing achievement gaps for under-represented students. Recent changes in medical education emphasize integration of content areas, resulting in greater use of activities such as CBL sessions. Little work has demonstrated the effectiveness of CBL sessions integrating anatomy, embryology, and histology on first year medical students’ ability to improve content mastery and adapt their study techniques. Innovation Design- Methods and Measures: Three CBL sessions that each included anatomy, embryology, and histology content covering the upper extremity and thorax were written and taught to LEAD Scholars (n=18). Each session involved: completion of an individual pre- and post-quiz, group completion of clinical cases involving image interpretation, matching exercises, and construction of diagrams, flow charts, or tables, and a post-session survey with Likert-style and free response questions about preparation and session effectiveness. Quiz scores were compared using Wilcoxon signed-rank tests and free responses evaluated using content analysis. Outcomes: Post-quiz scores were significantly improved for all CBLs (p < 0.01). Innovation Strengths and Limitations: Students enjoyed the real-life application and integration of the cases and commented that the sessions improved their understanding of the connections between content areas. Other comments demonstrated that students evaluated and adapted their study approach in preparation for the sessions, often using techniques included in the sessions. Limitations include the low-stakes nature of this summer program, which likely influenced students’ study outside of scheduled program time. Feasibility and Transferability: CBL sessions can be tailored to an individual medical school’s curriculum to provide opportunities to incoming first-year medical students to practice, adapt, and evaluate study techniques while delivering integrated content.Item Integrated Case-Based Learning Sessions in Anatomy are an Effective Teaching Method for Pre-Matriculating Medical Students(2022-07-21) Merritt, Emily; McNulty, Margaret; Neal, Chemen; Deane, Andrew; Haywood, Antwione; Byram, JessicaIntroduction: Medical students are often first introduced to fast-paced, high-volume curricula through anatomy coursework. The LEAD Scholars pre-matriculation program introduces incoming students to anatomy content and study skills to facilitate adjustments to medical school and reduce existing achievement gaps for under-represented students. Little work has demonstrated the effectiveness of case-based learning (CBL) sessions integrating anatomy, embryology, and histology on first year medical students’ ability to problem solve and improve content mastery. To address the lack of research, the goal of this study was to implement such CBL sessions to assess their effectiveness in promoting study techniques while integrating anatomy content Methods: Four fully integrated CBL sessions that each included anatomy, embryology, and histology content covering the upper extremity and thorax were written. For each session, LEAD Scholars (n = 25) completed an individual pre- and post-quiz and worked in groups through cases consisting of clinical scenarios and questions that required students to interpret images, complete matching exercises, and make diagrams, flow charts, or tables. Students completed a post-session survey with Likert-style and free response questions about preparation and session effectiveness. Pre- and post-quiz scores were compared using Wilcoxon signed rank tests. Free responses were analyzed using thematic analysis. Results: Analyses revealed significant improvements on post-quiz scores for all CBLs (p < 0.01). In the post-session survey, students strongly agreed the sessions effectively improved their understanding of course material and appropriately connected anatomy, embryology, and histology content. Students commented that they enjoyed the real-life application of the material and that the sessions encouraged them to keep up with the content, were helpful for making connections between the topic areas, and helped illustrate whether their study habits were effective or needed to be changed. They suggested additional cases and more pre-work to guide preparations as ways to improve the sessions. Conclusion: These results suggest that CBL sessions are a viable means for providing opportunities to practice and adapt study techniques while delivering integrated medical anatomy content to first year medical students. Session modifications will focus on expanding the sessions to provide more opportunities to practice the content and study techniques and including specific pre-work activities to guide preparation.Item Investigating the Effectiveness of Case-Based Learning Sessions for Integrating Anatomy Content(2022-04-28) Merritt, Emily R.; McNulty, Margaret A.; Neal, Chemen M.; Deane, Andrew S.; Haywood, Antwion A.; Byram, Jessica N.Introduction: Adjusting to medical school can be challenging as students learn to adapt to the curriculum’s fast pace and content volume. Gross anatomy, embryology, and histology are increasingly integrated into medical curricula, with the responsibility placed on students to find and understand the relationships between these content areas. Case-based learning (CBL) is an effective and commonly used means of teaching in medical education, and its application of problem-solving skills to clinical cases make it a useful method for integrating content. Study Objective: Therefore, the goal of this research was to assess the effectiveness and value of CBL sessions in integrating gross anatomy, embryology, and histology and promoting effective study techniques. Methods: In 2021, Indiana University School of Medicine implemented a pre-matriculation program (termed “Leadership and Academic Development”, or LEAD, Scholars) targeted toward under-represented students in medicine. The program included content from the first block of the medical anatomy course and four fully integrated CBL sessions that each included anatomy, embryology, and histology content from the upper extremity and thorax. LEAD Scholars (n = 25) were divided into groups of six or seven; for each session, they completed an individual pre- and post-quiz and worked as a group to answer case questions. Cases consisted of one or more clinical scenarios and questions that required students to interpret images, complete matching exercises, and make diagrams or flow charts. Students completed a post-session survey with Likert-style questions and free responses about preparation and session effectiveness. Pre- and post-quiz scores were compared using Wilcoxon signed rank tests. Free responses were analyzed using thematic analysis. Results: Analyses revealed a significant improvement on post-quiz scores for all CBLs (p≤0.002). In the post-session survey, students strongly agreed the sessions were effective at improving their understanding of course content and appropriately connecting anatomy, embryology, and histology content. Students commented that they enjoyed the real-life application of the material, found the sessions helpful for making connections between the topic areas, and encouraged them to keep up with the material. They noted that adding more cases and providing more pre-work to guide preparations would improve the sessions. Students also discussed needing to change their study habits as the sessions progressed and noted difficulty in keeping up with the embryology and histology content in light of the volume of gross anatomy material. Conclusion: These results suggest that CBL sessions are a viable means for delivering integrated medical anatomy content to medical students and providing opportunities to practice and adapt study techniques. Session modifications will focus on expanding the sessions to provide more opportunities to practice the content and study techniques and including specific pre-work activities to guide preparation.