IUSM Education Day

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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.
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.
Adoption and Attitudes of AI Large Language Models in Academic Settings and Beyond
(2024-04-26) Gomez, Victoria; Balle, Megan; McNulty, Margaret
Introduction and Objective: Large Language Models (LLMs) such as ChatGPT are artificial intelligence tools that have received significant attention regarding use in educational settings. The purpose of this study was to begin to obtain a clearer picture regarding how students and instructors are currently using LLMs so educational policies and practices can be modified appropriately to incorporate the quickly advancing technology. Materials and Methods: In an IRB-approved study, current students and instructors in health professional programs were asked to complete a survey that collected demographics, perceptions, and use of LLMs through Likert and free response questions. Descriptive statistics were performed on Likert items and free responses were analyzed using a thematic analysis framework. Results: The survey received 38 viable student responses and 21 from instructors. Overall, there was limited adoption of LLMs among students. ChatGPT was the most commonly used LLM. Of student respondents, 39.5% reported never using LLMs in their academic career. Of those not currently using an LLM, 35% did not plan to start, citing a lack of understanding. Students were more likely to perceive using LLMs as “lazy” and “cutting corners,” and primarily used it to create practice questions and/or as a search engine. Similarly, 22% of instructors never used LLMs in their academic career, though compared to students they felt there was more opportunity for LLMs in an academic setting. Indeed, 29% of students reported instructors spending time discussing the use of LLMs, while 21% of students reported instructors implementing the use of LLMs on assignments. The most common way instructors used LLMs themselves was for writing assistance such as cover letters and emails. Conclusion: These preliminary results indicate students and instructors are not yet extensively using LLMs in an academic setting, but instructors indicate there is potential for AI in higher education. With increased use and frequent updates, the possibilities of LLMs are likely not yet fully realized. Should current trajectories hold, LLMs could lead to substantial reform in medicine and medical education. Differences between how students and instructors perceive LLMs indicate a need for more discussion regarding how the technology can be practically integrated in educational settings, including clearer ethical guidelines. Significance/Implication: With AI and LLMs’ rising popularity and frequent improvements, it is vital to consider its use within and implications on the ever-changing medical school curriculum, including ongoing monitoring of use and application of LLMs by both students and educators.
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.
An Analysis of Indiana Youth Group Demographics
(Proceedings of IMPRS, 2023-01-26) Gross, Rachel; Abraham, Olivia; Messmore, Niki
This study examines the demographics of the youth attending Indiana Youth Group (IYG) programs and how the demographics of the IYG attendees compare to youth in Marion County, Indiana at large. Indiana Youth Group is a center based in Indianapolis that serves LGBTQ+ youth ages 12-24 that creates safer spaces to build community and offers harm-reduction programs that empower youth to build confidence, explore their identities, and foster friendships. IYG provides a wide array of programs free of charge, including basic needs, support groups, arts and crafts, sexual health education, STI/HIV testing, case management, mental health counseling, and affinity groups to lessen the impact of stressors most faced by LGBTQ+ youth and increase self-efficacy. Based on our analysis of demographic data from the 2020 IYG Annual Report and the 2020 Indiana Youth Institute (IYI) County Snapshots, we found that IYG attendees are less diverse than the greater Marion County youth population in terms of race in 2020. IYG serves a higher proportion of white youth and a lower proportion of Black and Hispanic/Latinx compared to the Marion County population. Our study proposes the following strategies to broaden outreach to racially minoritized populations: identify and build relationships with trusted community-based organizations (CBOs) within Black, Indigenous, and People of Color (BIPOC) communities, invest in health education and health literacy, and increase language access by conveying program information through trusted community messengers. Organizational changes could include cultural competency and social justice training for staff that specifically focuses on the intersection between systemic racism and LGBTQ+ oppression.
Applying Cyclical Loading Parameters for In-Vitro Neo-Tendon Development
(2024-04-26) Darden, Faith; Jenkins, Thomas; Little, Dianne
INTRODUCTION: Annually, over 545,000 rotator cuff tear repairs occur in the USA. Current surgical methods have varied success, due to factors including tear size and patient age. The fibrotic tissue that results from repair is susceptible to re-tear: retear rate following repair is up to 94% for large tears. There is a need for better treatment. Tissue engineering is a potential solution. Poly(lactic acid) meltblown scaffolds produce neotendon but cannot withstand physiological strains. Here, we evaluate how cyclical tensile loading of poly(ε-caprolactone) (PCL) meltblown scaffolds affects neo-tendon development. METHODS: We seeded PCL with human adipose stem cells and cultured for 28 days with cyclic loading to 6% strain three times per week for 0, 125, 5,000, and 10,000 cycles/day using a tensile bioreactor. We characterized the viscoelastic mechanical properties using this protocol: preconditioning, hysteresis loops and 10 min stress relaxations at 1, 3, 5, and 7% strain, each followed by frequency sweeps at 0.1, 1, and 5 Hz, and a ramp-to-failure. We determined various parameters using custom MATLAB code. Data were evaluated for effect of loading using ANOVA with Tukey HSD post-hoc tests (n=3-5, α=0.05). RESULTS: Loading at 5,000 cycles (Fig. 1) improved sample linear modulus and yield stress compared to other loading groups, while increased loading led to decreased yield stretch. Samples loaded at 5,000 cycles had higher phase shifts at lower frequencies, suggesting greater stress dissipation. Stress relaxation decreased from 3% strain to 5% and 7% strain. There was no effect of loading on stress relaxation. Loading up to 5,000 cycles tended to increase energy storage and secant stiffness but dropped when increased to 10,000 cycles. CONCLUSION: Tendon viscoelastic properties are essential for their mechanical stability and function; scaffolds with similar mechanical function could improve repair. Tensile loading during culture improves mechanical function up to 5,000 cycles/day but loading at 10,000 cycles/day seems to cause damage to the fibers, reducing modulus, yield stretch, yield stress, stiffness, and energy storage at higher strains. Our data will establish if meltblown scaffolds are viable for preclinical studies and could inform rehabilitation protocols for engineered tendon development.
Asian American Experience in the Largest Allopathic Medical School
(2023-04-28) Chen, Steven X.; Wang, Manda Y.; Padgett, Craig M.; Kochhar, Komal; Ko, Paul
Asians generally comprise around 20% of medical professionals but make up about 7% of the United States population. They are considered an overrepresented minority within the field of medicine. We studied the Pan- Asian diaspora at the only allopathic medical school in Indiana by identifying relationships and trends of medical students. The percentage of the Asian population in the state of Indiana is approximately 2.7%. The Indiana University School of Medicine possesses two unique qualities that make it stand out among its counterparts and suitable for a study regarding representation across Indiana and comparable midwestern schools: 1) It has nine statewide campuses covering the entire state, and 2) it is largest medical school in the nation. In this cross-sectional study, we obtained matriculation and graduation data from classes entering IUSM between 2013-2022. Data were de-identified per protocols within IUSM’s Business Intelligence office. IRB review not required due to a determination of not human research. The racial category of Asian was determined by self- identification on one or more application and/or onboarding forms. It includes, but is not limited to, Chinese, Filipino, Indian, Korea, Indian, Japanese, Vietnamese. The category may also include those who identify as two or more races. Excluded are American Indian, Alaska Native, Native Hawaiian, Pacific Islander. Asian representation at IUSM were comparable to the overall representation of Asians in medicine. While regional variation differed among each of the nine statewide campuses, the population of Asian students were overrepresented compared to their respective campus’s county population. There was also no significant difference between Asians and non-Asians matching outside of Indiana for residency nor was there any selection for a specific specialty (e.g. primary care, surgery). Our work stands to highlight the importance of quantifying the Asian experience and to benefit future work in diversity, equity, and inclusion. The Asian experience is unique when considering the group’s underrepresentation in society but overrepresentation in the medical field. Given the “model minority” myth surrounding Asians at large, more data and studies are needed to examine and understand the experience of medical students as they interface with the hidden curriculum and patient care.
Assessing a Longitudinal Educational Experience for Continuous Quality Improvement
(Indiana University School of Medicine Education Day, 2024-04-26) Masseria, Anthony; Birnbaum, Deborah R.
This presentation explores the use of assessment tools to promote adaptability and continuous quality improvement (CQI) in a large educational program. The Scholarly Concentrations Program is a statewide program complementing the core medical school curriculum and empowering students to delve into topics of personal interest. The pilot was launched with a “CQI” mindset, and after three years, a robust assessment plan is gathering feedback. While “building the plane as we fly it”, the program has grown from 100 students in its first year to over 400 in its third. A robust, longitudinal evaluation plan is critical. The intended goal is to use this program example to replicate it with other large educational programs anywhere.
Assessment Of Need For Trauma Education For Pediatric Residents In The Emergency Department, And Creation Of A Video Module In Response
(2020-03-06) Whitehead, Anne; Phillips, Brian; Haut, Lindsey
Introduction: Over 200 learners rotate through our pediatric emergency department yearly, and roughly 130 of them are residents in a pediatrics (categorical or combined) residency program. For many of these residents, the pediatric emergency medicine rotation is one of the only opportunities for experience with pediatric trauma resuscitation. Consistently, residents have identified pediatric trauma as an area of discomfort within their practice. Trauma resuscitations in the emergency department are relatively infrequent, and high stakes, so are not ideal opportunities for novice learners. Simulation exists as part of the curriculum, but scheduling challenges make increasing this portion of the curriculum impractical. We sought to further explore resident experience with trauma resuscitation education, and to create a new approach to trauma education that would supplement the existing curriculum. Methods: We distributed 2 different surveys to all pediatric residents on their pediatric emergency medicine rotation: one prior to the start of the rotation, and one after completion. Survey data were collected anonymously and voluntarily, over the course of 1 year. Based on preliminary survey data and informal discussions with residents and education leadership, we conceived of the idea of a video as a novel educational tool to supplement our existing pediatric trauma curriculum. This would be viewed online, asynchronously, circumventing many of the practical challenges associated with increasing simulation or patient care time. We developed a script with an emphasis on a practical approach to running a pediatric trauma resuscitation. Results: Our survey data found that residents started their pediatric emergency medicine rotations with low confidence in leading trauma resuscitation, rating their confidence an average of 25.1 on a visual analog scale (VAS) from 1 to 100. There was a modest improvement after the rotation to 43.7. Anxiety about trauma resuscitation, however, remained high with a rating of 63.2 on a VAS of 1 to 100 before the rotation, and 62.5 after. At the end of their rotations, residents reported that patient care and simulation sessions both contributed a moderate amount (63.2 and 56.5 respectively on a VAS from 1 to 100), while self study only contributed a little (33.1). In response to these data, we created a trauma education video for residents rotating through the pediatric emergency department. The video was filmed in one of our own trauma resuscitation rooms in the Riley Pediatric Emergency Department with our own nurses and Emergency Medicine/Pediatrics residents, with technical support from IU Collaboration Technologies and Classroom Support. Conclusions: Our survey data confirmed the need for improvement in education on pediatric trauma resuscitation. Results suggest residents find that more “hands on” opportunities contribute more to their education, but there remain significant challenges to increasing these opportunities. We are hopeful that the practical emphasis of our pediatric trauma education video will improve the effectiveness over other self-study modalities already in existence. In the coming months, we intend to incorporate the video into the online education modules and investigate its impact on resident confidence and comfort with pediatric trauma resuscitation.

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