2025 IUSM Education Day

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A Novel Approach to Point-of-Care Ultrasound (POCUS) Education: One-page Documents with Embedded E-Curriculum
(2025-04-25) Markus, Nathan; Brenner, Daniel; Duncan, Francesca; Sanjuan, Adriano; Osborn, Eric; Carlos, Grahm; Jackson; Rishi, Muhammed; Jackson, Edwin
Background: Point-of-care ultrasound (POCUS) has proven to be a valuable adjunct to the modern physical exam. The gold-standard approach of 1-on-1 learning image acquisition from sonographers and interpretation from clinician-experts is resource intensive, highlighting a need for alternative methods of teaching POCUS. Methods: This educational project utilized iterative development with the help of established POCUS educators and learner feedback in the form of surveys. Pre- and post- 30-day rotation surveys were administered and collected in Microsoft Forms. The survey questions comprised several categories including interest in learning POCUS, technical skill/image acquisition, and confidence in image interpretation. Learners were asked to rate their confidence in image acquisition and interpretation on a 5-level scale from “no skill” to “expert skill” as defined in the figures. Results: Preliminary survey data (n = 14) have been collected. Detailed results available in figures 2 and 3. In summary, 60% of learners were likely/very likely to use POCUS in clinical practice and 40% of learners were unlikely/very unlikely. Pre-intervention, 10% of learners rated their proficiency at image acquisition/probe placement at “no skill”, which decreased to 0% post-intervention. Sufficient skill in image acquisition increased from 20% pre-intervention to 50% post-intervention. Regarding image interpretation, 30% of learners rated skill in identifying anatomy as “no skill” or “little skill”. After the intervention, these groups decreased to 0%. Lastly, all participants felt that they were more confident in identifying cardiac anatomy after engaging with this project. All participants also reported that they would continue to use this resource this to learn POCUS. Conclusions: Learners perceive both value and effectiveness of this educational module. More work must be done to improve objectivity of results including engagement data, competency-based assessments, and randomization against the current standard education model.
Accommodating a Student with Hearing Loss in the Medical Curriculum: A Case Study
(2025-04-25) Martin, Angelika; Hoffman, Leslie; Russell, Abigail
Despite legislative advancements like the Americans with Disabilities Act (ADA)1, Deaf and Hard of Hearing (DHH) individuals remain underrepresented in medical education2 as many institutions lack adequate support systems to accommodate their needs.3 This case study documents the comprehensive support strategies implemented to address the challenges faced by a DHH learner throughout the entirety of undergraduate medical education, spanning both didactic and clinical settings. The student, with severe hearing loss in one ear and profound loss in the other, utilized a combination of oral communication, lip-reading, a Bluetooth-enabled hearing aid, and a cochlear implant. The student successfully navigated both foundational and clinical phases of medical education, overcoming barriers such as poor acoustics, overlapping communications, background noise, and the need for clear visual cues. Key strategies included the use of speech-to-text services such as Communication Access Real-Time Translation (CART) services, assistive listening devices such as microphones and amplifying stethoscopes, minimizing background noise, strategic positioning in classrooms or patient rooms, and utilizing the teach-back strategy. The study spans from pre-matriculation disclosure and accommodation planning, classroom teaching of foundational sciences to the completion of clinical clerkships and individualized career exploration electives. By detailing our approach and the successful integration of tailored and proactive accommodations, we provide valuable insights for educators aiming to support DHH students. This case study contributes to the literature by being the first to document such extensive accommodations across both didactic and clinical curricula. Our experience underscores the importance of creating an equitable and accessible environment, paving the way for a more diverse physician workforce and enhancing healthcare for the DHH community. The student's successful completion of the program and subsequent residency match underscores the potential for DHH individuals to thrive in medical education with appropriate support.
Acute compartment syndrome: A case report for pre-clinical students’ learning & associated small group worksheet
(2025-04-25) Callahan, Kyle; Mast, Aaron
Introduction: Acute compartment syndrome is a limb-threatening, orthopedic surgical emergency that is often a result of trauma with associated edema and increased pressure that has limited room for expansion due to the compartments of a limb. During pre-clinical years of medical school, the emphasis on musculoskeletal (MSK) ailments, including acute compartment syndrome, can be limited. It is therefore important to provide case reports that highlight even routine cases of traumatic MSK problems to the learning mind, as repetition is the key to learning. Small group worksheets were utilized during pre-clinical learning sessions, which further play a role in the learning process by forcing students to brainstorm solutions before answers are revealed, and can thus also be utilized to better understand MSK disease. Case Description: A male patient in their teens presented to the emergency department following an open fracture of his tibia and fibula after getting his leg stuck between a lawn mower and tree. On the day of injury, surgery was done for intramedullary fixation and distal tibia nailing. Post-op day one, early in the morning, the patient began complaining of mild pain and paresthesia of his toes and plantar foot, however had preserved motor function and brisk capillary refill. Compartments of the lower leg were swollen but not tense. A few hours later, the patient had increased pain with passive stretch, paresthesia up to his knee, and tense anterior compartment. The decision was made to do an emergent fasciotomy. The surgery was uncomplicated, but the post-op course was complicated by incision site infection. The patient has been progressing well and undergoing physical therapy with no gross motor or sensory deficits. Discussion: Acute compartment syndrome can be a rapidly progressing injury, and it is therefore vital to keep it high on the differential in patients complaining of pain with passive stretch and paresthesia. Serial physical exams with this patient ensured the fasciotomy was not delayed. While this report is a classic example of acute compartment syndrome, it can aid in the education of preclinical students. Next steps include incorporating this case and worksheet into MSK curriculum to determine if it leads to improved scores on standardized MSK exams.
Assessment and Implementation of Preconception Training for Internal Medicine Residents
(2025-04-25) Knoedler, Allison; Swanson, Erica
Background: Graduates of General Internal Medicine programs are expected to be able to provide quality women’s health (WH) care. Studies have revealed the overall weakness of this topic outside of Obstetrics and Gynecology. To our knowledge, other studies have not specifically assessed preconception counseling with Internal Medicine (IM) residents. Our objective was to assess resident’s understanding of the general internist’s role related to preconception counseling and to explore if providing curriculum on the topic could improve translation of this counseling into practice. Methods: An ambulatory half-day interactive lecture reviewed topical information and case study. IU residents in any year of training in IM or Medicine-Pediatrics programs who were on their ambulatory rotation from September through November, 2024 were eligible to participate. Pre and post surveys were distributed, assessing residents’ understanding of preconception counseling within IM scope of practice, their comfort with the material, and their anticipated likelihood of utilizing preconception counseling. Results: 26 residents responded to the pre-survey and 31 responded to the post-survey. Prior to intervention, 46% of residents felt that preconception counseling was within general internist’s practice compared to 100% in the post-survey. 46% of residents felt comfortable with preconception counseling in the pre-survey compared to 97% in the post-survey. 73% felt they would engage in preconception counseling with their patients over the next 12 months in the pre-survey compared to 87% in the post-survey. Unpaired t-tests found statistical significance in attitude toward the role of internists in preconception counseling (p-value <0.0001) as well as confidence in doing it (p-value <0.0001), while likelihood to engage in preconception counseling did not achieve significance (p-value 0.0602). Conclusions: Residents deepened understanding of preconception counseling and felt more comfortable with the material following topical curriculum integration into an ambulatory rotation.
Association of Socio-Demographic Factors and Social Determinants of Health with Physical Activity Level in Patients with Disabilities
(2025-04-25) Clark, Austin; Mangum, Joshua; Muvuka, Baraka; Guerrero, Jonathan
Background: Regular exercise has been shown to improve health outcomes and an important component of preventative medicine. The CDC has shown that patients with disabilities get less regular exercise than patients without disabilities. Identifying groups with low physical activity levels, such as patients with disabilities, and the barriers to physical activity can guide policy and decision making to improve health outcomes. This study examined associations between social determinants of health (SDOH) and physical activity levels. Methods: This retrospective study focused on patients with disabilities admitted at 3 urban hospitals in Northwest Indiana between January 2021 and April 2024. SDOH were screened and participants were selected based on CDC’s disability categories (Cognitive, Mobility, Vision, Hearing, Independent Living, and Self Care). Physical activity level was based on exercise minutes per week: Inactive (IA)=0 minutes, Insufficiently Active (ISA)=<150 minutes, and Sufficiently Active (SA)=150+ minutes. Results: 705 patients with disabilities with recorded physical activity levels were identified. No significant differences were found in physical activity levels between disability categories. The IA group differed significantly from both SA and ISA groups in Age Group, Social Connections Risk, and Length of Stay (p=<0.01). The SA and ISA groups showed significant difference in Financial Resource Risk (p=.045). Regression Analysis showed an increased risk for physical inactivity as Age increased (p=<.001), as well as patients with public insurance compared to private (p=0.02). Conclusion: Age is a common risk factor for reduced physical and the association of lower physical activity with Financial Resource Risk and Social Connections Risk is not novel, but further studies using larger samples may offer insight for future interventions. Future research would benefit from more specific physical activity data from patients with disabilities that may also give insight into adaptive interventions to improve exercise levels in this population.
Best Practices for Balancing Inquiry and Efficiency on a Gastroenterology Consult Service: Outcomes of a Delphi Survey
(2025-04-25) Bailey, Natashay; Dilly, Christen
INTRODUCTION AND BACKGROUND: Gastroenterology fellowship training is a time of development where fellows cultivate new clinical and endoscopic. On busy consultation services, there are unique challenges that put intellectual curiosity, clinical efficiency, and timely delivery of patient care at odds. STUDY OBJECTIVE: We seek to develop a list of best practice advisories (BPAs) aimed at balancing efficiency and inquiry on the GI fellowship consult experiences at Indiana University. METHODS: A literature review of established models for clinical teaching in graduate medical education (GME) was conducted to formulate draft statements. Two rounds of modified Delphi survey cycles were conducted from October to December 2024. For our purposes, the “experts” working to reach consensus were the GI fellows and the faculty members on the clinical competency committee. In round one, experts rated draft statements as essential for, compatible with, or not important for balancing inquiry and efficiency. The minimum threshold of agreement was set at 70% and comments were used to revise or suggest new statements after round one. In round two, respondents were asked to re-rate statements, using the aggregate data from round one, as essential or not essential. RESULTS: 12 fellows and 10 faculty members participated. We identified eight statements that were essential to balancing clinical efficiency and inquiry. Our panels found that because each service had unique pressures, it was difficult to identify practices that could be recommended universally. CONCLUSION: A panel of expert GI fellows and faculty identified best practice statements that can be used to promote clinical efficiency, inquiry for learners on busy GI consult services at IU. The discussions around our proposed BPAs revealed interesting differences in our values and a better understanding of the role of faculty and fellows.
Building a Culture of Growth and Safety: A Workshop on Positive Reinforcement, Mistreatment, and Psychological Safety
(2025-04-25) Sanjuan, Adriano; Akolkar Kishor, Jay; Duncan, Francesca
Introduction/Background. Medical training environments play a critical role in shaping the professional development and well-being of trainees. However, challenges such as ineffective feedback, mistreatment, and the absence of psychological safety can hinder learning and contribute to burnout and disengagement. This workshop integrates evidence-based strategies to foster positive reinforcement, address mistreatment, and promote psychological safety within educational and clinical settings. Study Objective/Hypothesis. We hypothesize that participants will report improved knowledge, skills, and confidence in: Recognizing, addressing, and reporting mistreatment effectively; providing feedback that promotes growth and motivation; creating environments that foster psychological safety. Objective: We aim to improve participants’ knowledge, skills, and confidence in: 1. Recognizing, addressing, and reporting mistreatment effectively. 2. Learn motivation techniques such as Self-Determination Theory, Growth-mindset and how to praise trainees, Effective Feedback, that fosters growth and motivation. 3. Creating psychologically safe environments conducive to learning and collaboration. Methods. This workshop was first delivered in March 2025 and will be repeated for a new group of participants. It consists of two parts: • Part I: Motivation Science and Learning Culture – This segment covers growth mindset, self-determination theory, psychological safety, and feedback strategies such as the Feedback Sandwich and Pendleton Model. It is followed by an interactive small-group scenario in which participants apply these concepts in a practical discussion. • Part II: Mistreatment Awareness and Response – This portion uses storytelling, video reflection, and case-based dialogue to explore mistreatment in clinical training. Participants are then introduced to the STAND-UP mnemonic, a novel tool created for this workshop, which consists of: Spot the situation. Think about intent. Acknowledge emotions. Name the situation. Document: Report events. Uplift yourself/others. Prevent future events). Results. Survey data will be collected for this workshop. Conclusions. This workshop aims to enhance learners’ ability to foster motivation, deliver effective feedback, and respond constructively to mistreatment. It offers a replicable model for improving educational climates and aligns with institutional goals of promoting inclusion and well-being in residency training.
Celiac Disease in Medical Curriculum
(2025-04-25) Kerns, Elizabeth; Husmann, Polly
Introduction/Background: Students attending US medical schools are often turning to commercial resources as a primary learning tool during their preclinical years. However, the quality and content of the material presented within these sources has not been widely studied. This study sought to compare sources of preclinical medical education using celiac disease, a common autoimmune illness. Celiac disease has an exceedingly variable range of presentations across many body systems, including subclinical symptoms. Despite accessible testing and treatment, most individuals with celiac have not been diagnosed, imposing significant disease burden. Study objective/Hypothesis: This study sought to evaluate and compare the IUSM preclinical curriculum and popular commercial resources regarding their presentation of celiac disease. Methods: After conducting a literature review, an evidence-based rubric was created to evaluate information about celiac disease. The rubric was applied to the IUSM preclinical curriculum and USMLE World, First Aid for the USMLE Step 1, and Boards and Beyond, commercial resources widely used by preclinical medical students. Results: The IUSM curriculum scored higher overall and higher in all but one category than all the commercial resources. USMLE World had the highest score of the commercial resources. All sources showed deficits in two or more categories. Conclusions: All sources assessed exhibit opportunities for improvement. However, the IUSM curriculum presented more thorough information regarding celiac disease. Although the commercial resources included within this study are used by students to prepare for standardized exams, they may be more concerned with improving test scores than providing students with the information needed to become effective physicians. Students may gain more complete information regarding celiac disease from the IUSM curriculum.
Continuing Education in Healthcare Professions (CEHP) Program-Based Analysis of Accreditation Evaluation Criteria
(2025-04-25) Denny, Kim M.; Lawley, Jeff; Schwartz, Jennifer E.
Introduction/Background: As a Jointly Accredited Provider of Interprofessional Continuing Education, IUSM Office of Continuing Education in Healthcare Professions (CEHP) follows accreditation Criteria to evaluate both activities and our program overall. Our CEHP Mission is: As the preeminent provider and accrediting body of comprehensive and innovative lifelong learning opportunities through educational activities for healthcare teams, it is our mission to enhance healthcare outcomes through educational activities that foster innovation and excellence in knowledge, practice, and change in strategy and/or performance of the healthcare team in the state of Indiana and beyond. Study Objective: The purpose of this study is to conduct a program-based analysis on the degree to which our CE mission has been met through conducting CME/CE activities as expected in Joint Accreditation Criteria (JAC) 2. This is specifically as it relates to changes in skills/strategy, or performance of the healthcare team, and/or patient outcomes. The sampling of CME/CE activities used for this study are the activity type of Regularly Scheduled Series (RSS) occurring in academic year 2024. Methods: We conduct this study by gathering data as expected in JAC 11 at the CME/CE activity level regarding changes in the healthcare team (skills/strategy, performance) and/or patient outcomes. We then aggregate the individual activity level evaluation results from Qualtrics into one overall program level analysis being tabulated in Microsoft Excel. Results: Preliminary analysis of this data set reveals that 80.27% of CME/CE learners anticipate enhancing their skills and strategies as healthcare team members after participating in our accredited activities. Additionally, 77.94% of these learners expect to improve patient-level outcomes based on their participation in these activities. Conclusions: Based on the preliminary analysis, our organization is significantly meeting its mission. Overall, these metrics suggest that our accredited activities are successfully contributing to the mission of fostering innovation and excellence in healthcare teams, both within Indiana and beyond.
Decreased racial disparities in sepsis mortality after an order set-driven initiative: An analysis of 8151 patients
(Academic Emergency Medicine, 2025-04-25) Fernandez Olivera, Maria; Pafford, Carl; Lardaro, Thomas; Roumpf, Steven; Saysana, Michele; Hunter, Benton
Background: Sepsis is a leading cause of hospital mortality and there is evidence that outcomes vary by patient demographics including race and gender. Our objectives were to determine whether the introduction of a standardized sepsis order set was associated with (1) changes in overall mortality or early antibiotic administration or (2) changes in outcome disparities based on race or gender. Methods: Patients seen in the emergency department and admitted to the hospital with a diagnosis code of sepsis were identified and divided into a preintervention co- hort seen during the 18 months prior to the initiation of a new sepsis order set and an intervention cohort seen during the 18 months after a quality initiative driven by in- troducing the order set. Associations between time period, race, gender, and mortality were assessed using univariate and multivariate logistic regression models. Other outcomes included early antibiotic administration (<3 h from arrival). Results: Overall mortality was unchanged during the intervention period (7.8% vs. 7.2%) in both univariate (relative risk [RR] 1.08, 95% confidence interval [CI] 0.93–1.26) and multivariate logistic regression (RR 1.11, 95% CI 0.93–1.28) models. Although male gender tended to have higher mortality, there was no statistically significant association between gender and mortality in either cohort. In the multivariable model, Black race was associated with increased risk of death in the preintervention period (RR 1.41, 95% CI 1.02–1.94), but this association was not present in the intervention period. Patients of color also saw significantly more improvement in early antibiotic administration during the intervention period than White patients. Conclusions: An order set–driven sepsis initiative was not associated with overall improved mortality but was associated with decreased racial disparities in sepsis mortality and early antibiotics.

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