Browsing by Subject "Medical education"

Now showing 1 - 10 of 60
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    Adaptability in Medical Education: 2nd Annual Indiana University School of Medicine Education Day Program
    (IUSM, 2021-04-22) Kochhar, Komal
    Program for the 5th annual Indiana University School of Medicine Education Day held virtually on April 22, 2021. An inherent challenge of operating a large multi-campus educational system is being able to provide professional development opportunities for all our medical educators across the state. To address this need, we implemented an annual “Education Day” at Indiana University School of Medicine to promote educational scholarship across our nine-campus system. Held each spring, 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 in educational research.
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    Assessment of Hypertension Management and Outcomes at an Indianapolis Student-Run Free Clinic
    (Johns Hopkins University Press, 2017) Wahle, Benjamin; Meyer, Kathryn; Faller, Meredith; Kochhar, Komal; Sevilla, Javier
    Purpose. To characterize the quality of health care at student-run free clinics (SRFCs) by analyzing hypertension management and outcomes at the Indiana University Student Outreach Clinic (IUSOC). Methods. A retrospective review of medical records was conducted for hypertensive patients managed at IUSOC over 15 months (N = 64). Indiana University Student Outreach Clinic’s hypertension control rate was compared with National Health and Nutrition Examination Survey (NHANES) data. Results. Blood pressure control rates increased significantly over the study period. Indiana University Student Outreach Clinic’s control rate did not differ significantly with the NHANES national average, but was significantly greater than the NHANES group with no usual source of care. Similarly, IUSOC patients without insurance or with unknown insurance status had greater control rates than an uninsured NHANES group, but did not differ significantly from an insured NHANES group. Conclusions. Despite unfavorable demographic characteristics, records for patients with hypertension who used IUSOC as a regular provider of primary care compared favorably with national data.
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    Balancing Demands: Determinants of Burnout Reported by Fellows in Pulmonary and Critical Care Medicine
    (American Thoracic Society, 2021-01-29) O’Toole, Jacqueline; Zaeh, Sandra; Eakin, Michelle N.; Adelman, Mark H.; Ashton, Rendell W.; Daugherty Biddison, Lee; Bosslet, Gabriel T.; Burkart, Kristin M.; Doyle, Stephen T.; Khan, Malik M. Khurram S.; Lenz, Peter H.; McCallister, Jennifer W.; Rand, Cynthia S.; Riekert, Kristin A.; Soffler, Morgan I.; Winter, Gretchen R.; Sharp, Michelle; Medicine, School of Medicine
    Background: Burnout is common among physicians who care for critically ill patients and is known to contribute to worse patient outcomes. Fellows training in pulmonary and critical care medicine (PCCM) have risk factors that make them susceptible to burnout; for example, clinical environments that require increased intellectual and emotional demands with long hours. The Accreditation Council for Graduate Medical Education has recognized the increasing importance of trainee burnout and encourages training programs to address burnout. Objective: To assess factors related to training and practice that posed a threat to the well-being among fellows training in PCCM and to obtain suggestions regarding how programs can improve fellow well-being. Methods: We conducted a qualitative content analysis of data collected from a prior cross-sectional electronic survey with free-response questions of fellows enrolled in pulmonary, PCCM, and critical care medicine training programs in the United States. Fellows were asked what factors posed a threat to their well-being and what changes their training program could implement. Responses were qualitatively coded and categorized into themes using thematic analysis. Results: A total of 427 fellows (44% of survey respondents) completed at least one free-response question. The majority of respondents (60%) identified as male and white/non-Hispanic (59%). The threats to well-being and burnout were grouped into five themes: clinical burden, individual factors, team culture, limited autonomy, and program resources. Clinical burden was the most common threat discussed by fellows. Fellows highlighted factors contributing to burnout that specifically pertained to trainees including challenging interpersonal relationships with attending physicians and limited protected educational time. Fellows proposed solutions addressing clinical care, changes at the program or institution level, and organizational culture changes to improve well-being. Conclusion: This study provides insight into factors fellows report as contributors to burnout and decreased well-being in addition to investigating fellow-driven solutions toward improving well-being. These solutions may help pulmonary, PCCM, and critical care medicine program directors better address fellow well-being in the future.
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    Build It and They Shall Come: Medical Education Communities of Practice
    (American Thoracic Society, 2023-05-01) Kelm, Diana J.; Neumeier, Anna; Hinkle, Laura J.; Adamson, Rosemary; Heath, Janae K.; Stewart, Nancy H.; Niroula, Abesh; Chiarchiaro, Jared; Denson, Joshua L.; Holden, Van K.; Soffler, Morgan; Carlos, W. Graham; Medicine, School of Medicine
    Background: Producing scholarship in education is essential to the career development of a clinician-educator. Challenges to scholarly production include a lack of resources, time, expertise, and collaborators. Objective: To develop communities of practice for education scholarship through an international society to increase community and academic productivity. Methods: We developed multi-institutional scholarship pods within the American Thoracic Society through the creation of a working group (2017-2019). Pods met virtually, and meetings were goal focused to advance education scholarship within their area of interest. To understand the impact of these scholarship pods, we surveyed pod leaders and members in 2021 and analyzed the academic productivity of each pod via a survey of pod leaders and a review of the PubMed index. Results: Nine pods were created, each with an assigned educational topic. The survey had a response rate of 76.6%. The perceived benefits were the opportunity to meet colleagues with similar interests at other institutions, production of scholarly work, and engagement in new experiences. The main challenges were difficulty finding times to meet because of competing clinical demands and aligning times among pod members. Regarding academic productivity, eight publications, four conference presentations, and one webinar/podcast were produced by six of the nine pods. Conclusion: The development of communities of practice resulted in increased multi-site collaboration, with boosted academic productivity as well as an enhanced sense of belonging. Multiple challenges remain but can likely be overcome with accountability, early discussion of roles and expectations, and clear delegation of tasks and authorship.
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    Build-A-Pelvis: a Low-cost Modeling Activity to Improve Medical Students’ Understanding of Perineal Anatomy
    (Springer, 2019-07-26) Smith, Theodore C.; Husmann, Polly; Medicine, School of Medicine
    Background: We demonstrate a low-cost, active learning module that provides medical students with a three-dimensional understanding of perineal anatomy. Activity: Student groups completed a perineal model and then reviewed another group's model of the opposite sex. Multiple pre- and post-module quizzes and correlated exam questions were analyzed. Self-reported understanding of perineal anatomy and usefulness of activity were reported. Results: Students showed significant increases between pre- and post-quiz scores and perceptions of understanding (p < 0.001). Outcomes on exam questions were significantly higher than non-participating counterparts (p = 0.011). Discussion: Thus, this low-cost modeling activity can benefit learning of perineal anatomy.
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    Communication Training in Adult and Pediatric Critical Care Medicine. A Systematic Review
    (American Thoracic Society, 2020-07-14) Mendez, Michael P.; Patel, Harin; Talan, Jordan; Doering, Michelle; Chiarchiaro, Jared; Sternschein, Rebecca M.; Steinbach, Trevor C.; O’Toole, Jacqueline; Sankari, Abdulghani; McCallister, Jennifer W.; Lee, May M.; Carlos, W. Graham; Lyons, Patrick G.; Medicine, School of Medicine
    Background: Interpersonal and communication skills are essential for physicians practicing in critical care settings. Accordingly, demonstration of these skills has been a core competency of the Accreditation Council for Graduate Medical Education since 2014. However, current practices regarding communication skills training in adult and pediatric critical care fellowships are not well described. Objective: To describe the current state of communication curricula and training methods in adult and pediatric critical care training programs as demonstrated by the published literature. Methods: We performed a systematic review of the published literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Three authors reviewed a comprehensive set of databases and independently selected articles on the basis of a predefined set of inclusion and exclusion criteria. Data were independently extracted from the selected articles. Results: The 23 publications meeting inclusion criteria fell into the following study classifications: intervention (n = 15), cross-sectional survey (n = 5), and instrument validation (n = 3). Most interventional studies assessed short-term and self-reported outcomes (e.g., learner attitudes and perspectives) only. Fifteen of 22 publications represented pediatric subspecialty programs. Conclusion: Opportunities exist to evaluate the influence of communication training programs on important outcomes, including measured learner behavior and patient and family outcomes, and the durability of skill retention.Background: Interpersonal and communication skills are essential for physicians practicing in critical care settings. Accordingly, demonstration of these skills has been a core competency of the Accreditation Council for Graduate Medical Education since 2014. However, current practices regarding communication skills training in adult and pediatric critical care fellowships are not well described. Objective: To describe the current state of communication curricula and training methods in adult and pediatric critical care training programs as demonstrated by the published literature. Methods: We performed a systematic review of the published literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Three authors reviewed a comprehensive set of databases and independently selected articles on the basis of a predefined set of inclusion and exclusion criteria. Data were independently extracted from the selected articles. Results: The 23 publications meeting inclusion criteria fell into the following study classifications: intervention (n = 15), cross-sectional survey (n = 5), and instrument validation (n = 3). Most interventional studies assessed short-term and self-reported outcomes (e.g., learner attitudes and perspectives) only. Fifteen of 22 publications represented pediatric subspecialty programs. Conclusion: Opportunities exist to evaluate the influence of communication training programs on important outcomes, including measured learner behavior and patient and family outcomes, and the durability of skill retention.
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    Community-based in situ simulation: bringing simulation to the masses
    (BMC, 2019-12-21) Walsh, Barbara M.; Auerbach, Marc A.; Gawel, Marcie N.; Brown, Linda L.; Byrne, Bobbi J.; Calhoun, Aaron; Katz-Nelson, Jessica; Tay, Khoon-Yen; Whitfill, Travis; Kessler, David; Dudas, Robert; Nishisaki, Akira; Nadkarni, Vinay; Hamilton, Melinda; Pediatrics, School of Medicine
    Simulation-based methods are regularly used to train inter-professional groups of healthcare providers at academic medical centers (AMC). These techniques are used less frequently in community hospitals. Bringing in-situ simulation (ISS) from AMCs to community sites is an approach that holds promise for addressing this disparity. This type of programming allows academic center faculty to freely share their expertise with community site providers. By creating meaningful partnerships community-based ISS facilitates the communication of best practices, distribution of up to date policies, and education/training. It also provides an opportunity for system testing at the community sites. In this article, we illustrate the process of implementing an outreach ISS program at community sites by presenting four exemplar programs. Using these exemplars as a springboard for discussion, we outline key lessons learned discuss barriers we encountered, and provide a framework that can be used to create similar simulation programs and partnerships. It is our hope that this discussion will serve as a foundation for those wishing to implement community-based, outreach ISS.
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    Comparing Eyesi Virtual Reality Simulator and Traditional Teaching Methods for Direct Ophthalmoscopy: Students’ Perspectives at Indiana University School of Medicine
    (Thieme, 2021-05-27) Tso, Hanna L.; Young, Jason; Yung, C. W.; Ophthalmology, School of Medicine
    Background: The fundus examination is an essential part of any ophthalmologic evaluation. However, medical students and primary care physicians often lack confidence with direct ophthalmoscopy. Virtual reality simulators are being employed in medical education to teach this technically challenging examination. Objective: To compare medical student ratings of the Eyesi Direct Ophthalmoscope Simulator and traditional small group teaching methods for learning direct ophthalmoscopy skills. Methods: All medical students at Indiana University School of Medicine traditionally learn direct ophthalmoscopy in their first 2 years during a small group session led by a physician instructor. Students who later enrolled in ophthalmology clinical electives during 2019 and 2020 were invited to additionally complete the Eyesi Direct Ophthalmoscope Simulator virtual reality curriculum. A voluntary, anonymous survey was sent between June and August 2020 to students who had completed both the traditional and Eyesi simulator sessions. Students were asked to rate their confidence in performing direct ophthalmoscopy following each session, and to indicate which teaching method was superior and why. Chi-square analysis was used to compare categorical variables. Results: Students' confidence ratings for performing direct ophthalmoscopy were significantly higher following completion of the Eyesi simulator session compared with the traditional small group session ( p  < 0.001). Four-fifths of respondents felt that the Eyesi simulator was superior to the traditional small group for learning the skills of direct ophthalmoscopy, while one-fifth felt that the two sessions were equally effective ( p  < 0.001). None of the students responded that the small group session was the superior teaching method. Conclusion: The Eyesi Direct Ophthalmoscope Simulator was rated highly among medical students and offers distinct learning advantages that could not be replicated in a traditional small group environment, such as providing numerous examples of pathological findings and allowing unlimited examination time without concern for patient's inconvenience or light exposure. The Eyesi simulator is a promising tool for teaching direct ophthalmoscopy to medical students. Ultimately, familiarity with the fundus examination will enable future physicians across specialties to better evaluate and appropriately refer patients with ocular fundus pathology.
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    Consensus Development of a Core Content for a Standardized Medical Toxicology Curriculum for Medical Students
    (Springer, 2022) Goldfine, Charlotte; Lung, Derrick; Beauchamp, Gillian; O’Connor, Ayrn; Stolbach, Andrew; Kao, Louise; Judge, Bryan; Wax, Paul; Patwari, Rahul; Kazzi, Ziad; Emergency Medicine, School of Medicine
    Background: Currently, no standardized core content in medical toxicology exists for medical students. The goals of this study were to (1) assess the current state and needs of medical toxicology clerkships and (2) develop a consensus-derived list of core topics that should be covered during a medical toxicology clerkship. Methods: We assembled a task force established by the American College of Medical Toxicology (ACMT) of nine experts in medical toxicology or emergency medicine. We developed a needs assessment survey that was sent to all medical student clerkship directors in medical toxicology. Based on their responses, we used a modified Delphi process to develop a consensus of core topics that should be covered during a medical student clerkship. Results: Nineteen out of 42 (45%) clerkship directors completed the survey; 18 met inclusion criteria. The majority of clerkships were 4 weeks in duration with an average of 15 students/year. The three most common teaching methods used were bedside teaching (n = 17/18), classroom teaching (n = 17/18), and journal club (n = 14/18). All the clerkship directors (n = 18/18) reported they would use a standardized curriculum as well as educational content developed by ACMT. There was overwhelming consensus on the core topics which included, but were not limited to, pharmacology/toxicology; drugs; drugs of abuse; natural products; pharmacological basis of antidote use; toxicologic syndromes; vital sign abnormalities; initial management; supportive and other care; withdrawal syndrome management; industrial, household, and environmental toxins; differential diagnosis by clinical findings; and ABCs-resuscitation. Conclusion: The ACMT task force developed a medical toxicology clerkship core content. The task force also identified a need for shared resources among clerkships.
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    Contemporary Neuroscience Core Curriculum for Medical Schools
    (Wolters Kluwer, 2021-10-04) Gelb, Douglas J.; Kraakevik, Jeff; Safdieh, Joseph E.; Agarwal, Sachin; Odia, Yazmin; Govindarajan, Raghav; Quick, Adam; Soni, Madhu; AAN Undergraduate Education Subcommittee (UES); Bickel, Jennifer; Gamaldo, Charlene; Hannon, Peter; Hatch, Hayden A. M.; Hernandez, Christian; Merlin, Lisa R.; Noble, James M.; Reyes-Iglesias, Yolanda; Salas, Rachel Marie E.; Sandness, David James; Treat, Lauren; AAN Education Committee; Benameur, Karima; Brown, Robert D., Jr.; DeLuca, Gabriele C.; Garg, Neeta; Goldstein, Larry B.; Gutmann, Laurie; Henchcliffe, Claire; Hessler, Amy; Jordan, Justin T.; Kilgore, Shannon M.; Khan, Jaffar; Levin, Kerry H.; Mohile, Nimish A.; Nevel, Kathryn S.; Roberts, Kirk; Said, Rana R.; Simpson, Ericka P.; Sirven, Joseph I.; Smith, A. Gordon; Southerland, Andrew Mebane; Wilson, Rujuta B.; Neurology, School of Medicine
    Medical students need to understand core neuroscience principles as a foundation for their required clinical experiences in neurology. In fact, they need a solid neuroscience foundation for their clinical experiences in all other medical disciplines also because the nervous system plays such a critical role in the function of every organ system. Because of the rapid pace of neuroscience discoveries, it is unrealistic to expect students to master the entire field. It is also unnecessary, as students can expect to have ready access to electronic reference sources no matter where they practice. In the preclerkship phase of medical school, the focus should be on providing students with the foundational knowledge to use those resources effectively and interpret them correctly. This article describes an organizational framework for teaching the essential neuroscience background needed by all physicians. This is particularly germane at a time when many medical schools are reassessing traditional practices and instituting curricular changes such as competency-based approaches, earlier clinical immersion, and increased emphasis on active learning. This article reviews factors that should be considered when developing the preclerkship neuroscience curriculum, including goals and objectives for the curriculum, the general topics to include, teaching and assessment methodology, who should direct the course, and the areas of expertise of faculty who might be enlisted as teachers or content experts. These guidelines were developed by a work group of experienced educators appointed by the Undergraduate Education Subcommittee (UES) of the American Academy of Neurology (AAN). They were then successively reviewed, edited, and approved by the entire UES, the AAN Education Committee, and the AAN Board of Directors.