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Item A scoping review of librarian involvement in competency-based medical education(University Library System at the University of Pittsburgh, 2025) Cyrus, John W.; Zeigen, Laura; Knapp, Molly; Blevins, Amy E.; Patterson, Brandon; Ruth Lilly Medical Library, School of MedicineObjective: A scoping review was undertaken to understand the extent of literature on librarian involvement in competency-based medical education (CBME). Methods: We followed Joanna Briggs Institute methodology and PRISMA-ScR reporting guidelines. A search of peer-reviewed literature was conducted on December 31, 2022, in Medline, Embase, ERIC, CINAHL Complete, SCOPUS, LISS, LLIS, and LISTA. Studies were included if they described librarian involvement in the planning, delivery, or assessment of CBME in an LCME-accredited medical school and were published in English. Outcomes included characteristics of the inventions (duration, librarian role, content covered) and of the outcomes and measures (level on Kirkpatrick Model of Training Evaluation, direction of findings, measure used). Results: Fifty studies were included of 11,051 screened: 46 empirical studies or program evaluations and four literature reviews. Studies were published in eight journals with two-thirds published after 2010. Duration of the intervention ranged from 30 minutes to a semester long. Librarians served as collaborators, leaders, curriculum designers, and evaluators. Studies primarily covered asking clinical questions and finding information and most often assessed reaction or learning outcomes. Conclusions: A solid base of literature on librarian involvement in CBME exists; however, few studies measure user behavior or use validated outcomes measures. When librarians are communicating their value to stakeholders, having evidence for the contributions of librarians is essential. Existing publications may not capture the extent of work done in this area. Additional research is needed to quantify the impact of librarian involvement in competency-based medical education.Item Evaluating Shared Decision Making in Trial of Labor After Cesarean Counseling Using Objective Structured Clinical Examinations(Association of American Medical Colleges, 2020) Tucker Edmonds, Brownsyne; Hoffman, Shelley M.; Laitano, Tatiana; McKenzie, Fatima; Panoch, Janet; Litwiller, Abigail; Di Corcia, Mark J.; Obstetrics and Gynecology, School of MedicineIntroduction Although shared decision making (SDM) is optimal for trial of labor after cesarean (TOLAC) counseling, resources to assess residents' clinical competency and communication skills are lacking. We addressed this gap by developing and testing an objective structured clinical examination (OSCE) to evaluate whether learners were able to use SDM in TOLAC counseling. Methods We created three simulation scenarios with increasing complexity to assess the skills of residents in their first, second, or third postgraduate year in using SDM in TOLAC counseling. All cases involved a standardized patient requesting a TOLAC consultation. Residents were provided with a medical history and instructed to counsel and develop a care plan. A 10-item scoring rubric was used, and each item was rated 0 (absent), 1 (partial), or 2 (complete). Three coders independently rated the encounters; discrepancies were resolved by consensus. Results Over 3 years, 39 residents participated in 60 OSCE encounters. The majority provided complete discussions of the clinical issue (93%), chances of success (72%), and maternal and fetal risks (100% and 85%, respectively) but obtained partial assessments of understanding (78%). Discussions of benefits were typically absent, with the exception of the maternal benefits (47%). More than 40% of residents did not discuss the patient's goals, 53% lacked discussion of uncertainties related to TOLAC, and half failed to explore the patient's preference, with most deferring a decision to a future encounter. Discussion Residents consistently discussed diagnosis, prognosis, and maternal risks yet infrequently addressed goals and preferences—two critical elements of SDM.Item Integrated Case-Based Learning Session for Breast and Upper Limb Anatomy(Association of American Medical Colleges, 2024-05-10) Merritt, Emily; McNulty, Margaret A.; Byram, Jessica N.; Anatomy, Cell Biology and Physiology, School of MedicineIntroduction: Medical students are frequently introduced to medical school curricula through anatomy coursework, which often includes histology and embryology content. As medical education has increasingly emphasized integration of content areas, use of activities such as case-based learning (CBL) sessions has grown. Little published work has demonstrated the effectiveness of CBL sessions in integrating anatomy, embryology, and histology on first-year medical students' ability to improve content mastery and adapt their study techniques. Methods: We developed a CBL session that included anatomy, embryology, and histology content covering the upper extremity and breast pathology that was taught to incoming first-year medical students (N = 51) during a prematriculation program in the summers of 2022 and 2023. The session involved completion of an individual pre- and postsession quiz; group completion of clinical cases involving image interpretation, matching exercises, and construction of diagrams, flowcharts, or tables; and a postsession survey with Likert-style and free-response questions about preparation and session effectiveness. Results: Postsession quiz scores significantly improved (p < .001). On the postsession survey (response rate: 59%), students commented that they enjoyed the real-life application and integration of the cases and that the sessions improved their understanding of the connections between content areas. Other comments demonstrated that students were evaluating and adapting their study approach in preparation for the sessions, often using techniques introduced and practiced in the sessions. Discussion: CBL sessions can provide opportunities to incoming first-year medical students to practice, adapt, and evaluate study techniques while delivering integrated content.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 SBAR-LA: SBAR Brief Assessment Rubric for Learner Assessment(Association of American Medical Colleges, 2021-10-18) Davis, Beth P.; Mitchell, Sally A.; Weston, Jeannie; Dragon, Catherine; Luthra, Munish; Kim, James; Stoddard, Hugh A.; Ander, Douglas S.; Anesthesia, School of MedicineIntroduction: Structured communication tools are associated with improvement in information transfer and lead to improved patient safety. Situation, Background, Assessment, Recommendation (SBAR) is one such tool. Because there is a paucity of instruments to measure SBAR effectiveness, we developed and validated an assessment tool for use with prepractice health professions students. Methods: We developed the SBAR Brief Assessment Rubric for Learner Assessment (SBAR-LA) by starting with a preliminary list of items based on the SBAR framework. During an interprofessional team training event, students were trained in the use of SBAR. Subsequently, they were assigned to perform a simulated communication scenario demonstrating use of SBAR principles. We used 10 videos from these scenarios to refine the items and scales over two rounds. Finally, we applied the instrument on another subset of 10 students to conduct rater calibration and measure interrater reliability. Results: We used a total of 20 out of 225 videos of student performance to create the 10-item instrument. Interrater reliability was .672, and for eight items, the Fleiss' kappa was considered good or fair. Discussion: We developed a scoring rubric for teaching SBAR communication that met criteria for validity and demonstrated adequate interrater reliability. Our development process provided evidence of validity for the content, construct, and response process used. Additional evidence from the use of SBAR-LA in settings where communication skills can be directly observed, such as simulation and clinical environments, may further enhance the instrument's accuracy. The SBAR-LA is a valid and reliable instrument to assess student performance.