2023 IUSM Education Day

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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.
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.
Deconstructing Professionalism
(2023-04-28) Schantz, Eli; Mansoori, Afsheen; Hicks, Clayton; Harris, Jonathan
The notion of professionalism informs policy-making at all levels of medical practice, from national organizations and licensing boards to hospital disciplinary committees. The creation of policies to promote professionalism, however, is made all the more complex in the context of undergraduate medical education, where the notion of professionalism not only acts to govern behavior, but also to shape the professional identity of physicians-in-training. Given the importance of such policies, our goal here is to characterize, both descriptively and prescriptively, how the notion of professionalism manifests in the policies governing undergraduate medical education. First, we present a review of the professionalism policies currently in effect at Indiana University School of Medicine (IUSM). Following this review, we turn to argue that these policies suffer from two significant shortcomings: (i) the frequent use of circular definitions, giving rise to considerable ambiguity, and (ii) pronounced conflict between policies which seek justice and policies which maintain institutional power structures. We conclude that these conceptual inadequacies represent significant barriers which can both hinder the professional growth of medical students and hamper their ability to navigate their professional obligations, and we offer a number of recommendations for refining and reforming these policies.
Evaluating the Effectiveness and Perceived Benefit of a Breast Imaging Website as an Educational Tool for Radiology Residents
(2023-04-28) Friel, Rylee; Miller, Elise; Niemeyer, Kathryn
BACKGROUND: The use of social media by medical professionals has grown exponentially over the last decade. Residents are using social media and educational content more frequently as they provide information easily accessible on their personal devices. Reading articles has been shown to help improve residents scores on post-test evaluations. However, how does a resident know which articles are reliable and are appropriate for their level of training? Guided educational materials provided during residency rotations can help lead trainees to the most accurate sources and steer them toward what they need to know. PURPOSE: To evaluate the effectiveness and perceived benefit of an educational website as an adjunctive teaching tool for radiology residents during their breast imaging rotations. METHODS AND MATERIALS: An educational website was created on Wix.com with teaching content organized by appropriateness for level of training. Educational tools included PowerPoint presentations designed for different training levels as well as links to important journal articles and other online resources Links to the department’s YouTube channel, Instagram account, and Twitter account were provided on the website as well. Residents were provided the link to the website at the beginning of their breast imaging rotations. They were given a 20-question multiple self-assessment at the end of their rotation and given an anonymous survey determining level of training and their use of the website over the rotation. Two years later, after the website had been utilized for several years, residents were later sent a survey of 9 questions related to their perceived benefit of the website. RESULTS: There were 21 eligible residents who completed the breast imaging rotation over the 7-months the self-assessment was administered. Of these, 16 residents completed the post-breast imaging rotation quiz for a total participation rate of 76%. 4 of these residents were first years, 7 were second years, and 5 were third years. The average first year score was 52%, average second year score was 64%, and average third year score was 65%. Only 2 residents indicated that they did not use the website. Overall, residents who used the website scored higher on the exam than those who did not (63% vs 52%). On follow-up survey three years later, 19 residents completed the survey. 78.95% stated use of website once per week and 21.05% stated use multiple times per week. Regarding website use outside of breast imaging rotations, 36.84% of residents reported use for board examination and related conferences, while 63.16% reported no use outside of studying for breast imaging rotations. When asked on a scale from 1-10 how useful the curriculum website was, the average was 7.11 with 73.7% recording a 7 or an 8. Overall, 89.47% expressed interest in having similar websites for other rotations. CONCLUSIONS: Online curriculum tools can be used as successful adjunctive teaching tools for radiology residents on their breast imaging rotations. Residents who utilize this tool perform both better on the post-procedure self-assessment had seen a perceived benefit in this educational tool.
Evaluating the Medical Leadership Reading Elective
(2023-04-28) Weller, Robert; Mitchell, Sally; Tsai, Mitchell; Yu, Corinna
Education in leadership is an essential skill in the development of an effective physician.1 The Medical Leadership Reading Elective at Indiana University School of Medicine was created in partnership with Dr. Mitchell Tsai at University of Vermont2 to provide medical students with a mental framework on leadership and management, discuss physician burnout and resilience, and to create a vision statement as future physician leaders. The curriculum included 3 trade books and 4-8 articles weekly with a weekly 2-3 page essay assignment answering, “What does leadership mean?” and ”How will you create effective/Agile medical teams?” Although research has been done on medical student reading rate capabilities for medical textbooks,3 it is unknown how quickly medical students can read trade books and business articles. The goal of this project was to assess whether the elective reading and writing assignments were reasonable and evaluate the effectiveness of the curriculum in developing a greater understanding of medical leadership and providing tools to be an effective physician leader.
Examining Visiting Student Evaluation Forms
(2023-04-28) Rigueiro, Gabriel; Dammann, Erin; Guillaud, Daniel; Packiasabapathy, Senthil; Mitchell, Sally; Yu, Corinna
Background: Each medical school has clinical evaluation forms with competencies that align with their institutional and course learning objectives. The differences between evaluation forms and the items being assessed presents a challenge for elective course directors to evaluate and complete forms for visiting students. The aim of this project was to compare common characteristics of visiting student evaluation forms presented to an elective course director on Anesthesiology & Perioperative Medicine (APM) in 2022-2023. Materials & Methods: Each medical school has clinical evaluation forms with competencies that align with their institutional and course learning objectives. The differences between evaluation forms and the items being assessed presents a challenge for elective course directors to evaluate and complete forms for visiting students. The aim of this project was to compare common characteristics of visiting student evaluation forms presented to an elective course director on Anesthesiology & Perioperative Medicine (APM) in 2022-2023. Results: Schools (n=33) included ACGME competencies for communication (94%, 31), professionalism (91%, 30), medical knowledge (79%, 26), practice-based improvement (79%, 26), patient care (76%, 25), and systems-based practice (61%, 20) in their evaluation forms. Clinical reasoning skills included history & physical (82%, 27), assessment & plan (79%, 26), differential diagnosis (64%, 21), and charting/note-taking (61%, 20). Additional categories included inter-professionalism (85%, 28), osteopathic principles and practices (64%, 21), self- awareness/receptiveness to feedback (48%, 16), and procedural skills (42%, 14). Formative and summative comments were requested from 94% (31) of schools. Discussion: While many competencies for visiting medical student evaluation forms align with IU School of Medicine evaluations, some subcategories of ACGME core competencies like charting/note-taking are not assessed in the APM elective. Visiting students do not obtain electronic medical record access due to time-prohibitive training requirements, and thus, do not chart during their rotation. Mock paper records for the preanesthetic evaluation history and physical, intraoperative anesthesia record, and postoperative notes and orders could be created as additional assignments to assess students in this skill. Formative/summative comments may or may not comment on the delivery of patient care. Comments frequently discuss teamwork, work ethic, and medical knowledge which are easily evaluated. The time-pressured environment of the OR can limit student opportunity to perform the preoperative anesthetic evaluation. A differential diagnosis during a preoperative history and physical is challenging on the APM elective because patients present to surgery after diagnostic workup. However, differential diagnoses for perioperative symptoms like tachycardia and hypertension could be assessed through Canvas case log discussions. Students currently share an abbreviated written patient presentation with a learning point. They could include perioperative differential diagnoses and treatment plans and share an article from the literature to demonstrate evidence-based learning with more specific questions about systems-based practice. The perioperative environment provides an excellent opportunity to evaluate students in their interprofessional and communication skills working with surgeons, nurses, technicians, assistants, and other learners. Additional questions could be included in the APM evaluation to capture these relationships more fully. Conclusion: Analyzing visiting student evaluations for competencies and skills provides insight into areas for improvement in the APM elective curriculum and clinical evaluation form.
Impact of Gabapentin and Pregabalin on Neurological Outcome After Ischemic Stroke
(2023-04-28) Weber, Michael; Morton, Caleb; Chang, Fen-Lei
Background: The purpose of this study is to determine whether patients taking either gabapentin or pregabalin at the time of their stroke injury tend to have better outcomes than patients with similar injuries who were not taking one of the two medications. Prior studies have shown potential neuro-protective effects of these two medications. Methods: A retrospective chart review of 115 ischemic stroke patients from 2016-2021 were assessed for patient outcomes using two tools, the NIH Stroke Scale (NIHSS) and the modified Rankin Scale (mRS), in addition to their hospital length of stay. The outcomes of patients taking either gabapentin or pregabalin with stroke diagnoses are compared to patients with stroke diagnoses who were not taking either medication. Kruskal-Wallis and X2 were used for statistical analysis. Results: There was a significantly larger proportion of gabapentin patients that improved compared to patients in the control group when using the mRS tool for patient outcomes (X2; p=0.015). The gabapentin group showed a significantly larger improvement in the NIHSS scores from admission to discharge (Kruskal-Wallis; p=0.0005). Patients on gabapentin had a longer hospital stay than those not taking the medication by 1.7 days (t-test; p=0.041). Discussion: Our data support the potential neuro-protective effect of gabapentin/pregabalin with improved outcomes after an ischemic stroke using two parallel outcome measures of NIHSS and mRS scores. Of interest, patient hospital stays were longer on gabapentin/pregabalin, which may contribute to the improved outcomes. We need larger patient groups to confirm and further study our findings. This often can be facilitated by studies involving larger medical practices, insurance, or payer databases. In addition, further investigation of potential confounders, other pharmaceuticals, other nervous system injury mechanisms, and impact of associated cost and care quality issues should occur.
Innovations in Medical Education: 4th Annual Indiana University School of Medicine Education Day Program
(2023-04-28) Indiana University School of Medicine
Program for the 4th annual Indiana University School of Medicine Education Day held at Hine Hall Conference Center on the IUPUI campus on April 28, 2023. The IUSM Education Day is an event for faculty, staff, students, residents, and fellows from all departments and campuses to showcase their medical education research through oral presentations, workshops, poster sessions, and small group discussions.
Inspired to Learn: Integrating Pre-Clinical Respiratory Educational Principles into Clinical Clerkship Practice
(2023-04-28) Sharpe, Shannen; Friel, Rylee; Barron, Emily; Shockley, Emily; Thamba, Aish; Bontrager, Erin; Ganapaneni, Sruthri; Stoll, Kennedy; Vellutini, Natalie; Roy, Lynn; Cooper, Shannon; Kochhar, Komal; Carlos, Graham
Introduction: IUSM students have reported on the Graduation Questionnaire (GQ) that there is a lack of pre-clinical content incorporated into clinical rotations. Student performance on respiratory/pulmonology questions on the USMLE Step 1 and 2 exams is similar to other medical disciplines at IUSM, despite feedback from students that the Pulmonary Grand Rounds (PGR) teaching method is very effective. Rather than presenting content via recorded didactic lectures, the PGR team, composed of a multidisciplinary physician panel, presents clinical vignettes in an interactive setting. Furthermore, according to student feedback, the current model lacks a sufficient content review of relevant Phase I material. Students have requested additional support with pre-clerkship study/review materials content. Through this study, we aim to empirically evaluate the impact of designing interactive pre-clerkship modules reviewing relevant Phase 1 PGR material on the medical knowledge and clinical competencies of Phase II students. Background: The American Medical Women’s Association organization called for scholarship pertaining to educational innovation. The PGR curriculum provides us with a unique opportunity to evaluate the impact of undergraduate medical education on student knowledge retention and engagement from a metacognition perspective. A diverse group of students and faculty was pulled together with the IUSM Research in Medical Education unit to creatively address the ability to quantify engagement and knowledge retention above in a scholarly project. PGR is a unique multi-modal teaching design built at a large medical school with nine campuses to increase student engagement via zoom, Top Hat, and a case-based teaching approach with a multidisciplinary panel. Study objective: Evaluate student engagement and knowledge retention through clerkship standardized examination performance, Step 2 performance, and GQ with the implementation of a spaced repetition learning model comprised of interactive pre-clerkship modules which reinforce session objectives introduced in pre-clinical education. Methods: In Phase I, PGR includes over 200 board-style questions throughout nine sessions. Students engage with the medical content by answering these questions on TopHat and discussing the reasoning for correct vs. Incorrect answers with the expert panel. Students are again tested over similar content during their local and NBME exams. We proposed the creation of an optional module for each clerkship for students to use prior to Phase II. The modules would include a question bank supplemented with videos to foster preparation and enhance performance on clinical clerkships and Step 2. This question bank would utilize the same questions students had originally seen in PGR months earlier to improve concept retention and memory. The instructional videos would connect physiology to the clinical scenarios the students expect to encounter during their clerkship. We would anonymously track student engagement through a pilot-tested survey and performance on the modules along with clerkship National Board of Medical Examiners exams, Step 2, and the GQ. Finally, we plan to assess knowledge gaps to supplement future grand rounds curriculum while providing clinically relevant information to improve patient care.
An Integrated Strategy: Preparing Future Biomedical Science Faculty for Teaching-Related Roles
(2023-04-28) Easterling, Lauren; Byram, Jessica; Seiden, Emily
In our biomedical science research PhD programs and postdoctoral training experiences, opportunities for these future faculty to learn about and gain experience related to teaching and learning in university settings is extremely limited. Our PhD students’ graduate appointments are limited to research assistantships, and our postdoctoral scholars are employed in research-focused roles. These factors limit their time and opportunities to participate in experiences related to how people learn and effective teaching strategies. The problem we attempted to solve was how to create and maximize teaching-related experiences in an environment where these opportunities are minimal. We created a multi-layered approach to providing graduate students and postdocs with opportunities to learn about and practice core skills related to teaching students through Division-developed programs, partnerships with existing programs and services, and fostering student/trainee-led programs. Division-developed programs and services that have been developed intentionally for the purpose of preparing trainees for teaching-related faculty roles include: - Designing and implementing an annual 1-2 week-long institute related to essentials of teaching and learning - A learning community with a journal club, networking opportunities, and workshops - Facilitating a process to find and screen potential volunteer teaching opportunities for students and postdocs - Providing specific, tailored, one-on-one and small group guidance and mentoring upon request These programs and services are co-curricular, non-academic experiences in which any PhD student or postdoctoral scholar at IU School of Medicine may participate and have been designed complement and not conflict with the primary biomedical science research training experiences of these trainees. We will also share how these Division-developed programs and services fit into existing School of Medicine and IUPUI programs, including the Academy of Teaching Scholars, CIRTL@IUPUI programming, IUPUI CTL programs and services, and IUPUI’s Preparing Future Faculty and Professionals program. The relationship between Division and school/campus/university-level program will also be discussed during our presentation in terms of the strategic importance of each to the other. Additionally, in partnership with the Department of Anatomy, Cell Biology and the IUPUI School of Education, the Division has developed a doctoral minor for graduate students in the life sciences that is an optional, curricular experience for graduate students who wish to include preparation and experience related to life science teaching and learning into their experience at IU School of Medicine. We will discuss how this doctoral minor complements the Division’s co-curricular programming and how the minor fits into a greater strategic framework for preparing future faculty in the biomedical sciences for teaching-related faculty roles. Finally, as part of a student-initiated and led initiative called Teaching, Learning, and Professor Support for Graduate Teaching Assistants (TLPS-GTA), we will discuss how a student-led, peer-to-peer program that overlaps in content with Division-level programming fits into our overall strategic framework. We will discuss how providing graduate student instructors with just-in-time knowledge and skills to current graduate teaching assistants complements the Division’s greater strategy for preparing future biomedical science faculty for teaching related roles while fulfilling a distinct part of our overall strategy for graduate student and postdoctoral scholar focused educational development.

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