2020 IUSM Education Day

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https://hdl.handle.net/1805/22622
Scholarly works presented at the first annual IUSM Education Day conference on March 6, 2020.

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    Regional Medical Campuses: Leveraging our Structure
    (2020-03-06) Birnbaum, Deborah R.; Walvoord, Emily; Ryan, Elizabeth R.
    The focus of this session presentation at the 2020 IU School of Medicine Education Day is on how the School is leveraging its regional campus model. The School is the nation’s largest by enrollment, with nine campuses, eight of which are considered regional campuses. After a review of various regional campus models, an example of scholarship that reports on how IU School of Medicine regional campus students perform in the Match compared to main (Indianapolis) campus students is shared. The session presentation also examines the unique way IU School of Medicine is leveraging a Scholarly Concentrations Program for educational enhancement, reputational focus for regional campuses, deeper community engagement, and increased student and faculty scholarship.
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    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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    Use of a Structured Early Intervention to Improve Student Success
    (2020-03-06) Howley, Liam; Klemsz, Abigail; Matthews, Kelly; Mehta, Rakesh
    Indiana University School of Medicine has a competency-based curriculum with defined milestones that students must achieve to graduate. Early identification of students with challenges in these competencies enables educators to quickly intervene to help ensure these students achieve those competency specific milestones. Area of Concern (AOC) was developed to allow faculty to recognize and identify “low level” concerns in a course/clerkship/elective and to facilitate the opportunity for additional coaching by the Lead Advisor before these behaviors lead to a significant impact on grades.
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    "A Whole New Perspective on How the Body Fits Together" - An Evaluation of a Cadaver Lab Experience for High School and Undergraduate Students
    (2020-03-06) Cale, Andrew; Byram, Jessica; Schmalz, Naomi
    IUPUI Anatomy Lab Tour Project Abstract “A Whole New Perspective on How the Body Fits Together” – An Evaluation of a Cadaver Lab Experience for High School and Undergraduate Students Andrew Cale MS1, Jessica Byram PhD1, Naomi Schmalz MS1,2 1Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA 2Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, IN, USA Background: Since 2014, the Center for Anatomy and Physiology Education at Indiana University School of Medicine – Indianapolis has hosted interactive human cadaver lab tours for local high school and undergraduate students. During these graduate student-led tours, touring students observe human anatomy on prosections and with isolated organs. Similar educational outreach initiatives have been shown to benefit adolescents by improving health literacy and encouraging interests in healthcare careers. Aim: To evaluate students’ perceptions of the anatomy lab tours and their impact on students’ interests in healthcare careers. Methods: Between April and December 2018, touring students (n=261) were invited to complete pre- and post-tour surveys evaluating their past experiences with cadaver labs, tour expectations, career interests, and additional thoughts and feelings regarding the tour. Pre-surveys were paper-based and completed in-person, while post-surveys were administered online via REDCap and completed within one week of the tour. Responses were aggregated into pre- and post-tour groups and analyzed using thematic analysis. This study was granted exempt status from the IRB at Indiana University (#1802755251). Results: Of the 261 students who completed pre-tour surveys, 204 (78%) completed the post-tour survey. Before the tour, students anticipated learning about human anatomy (52%) and expected to only be able to see (and not feel) a cadaver (66%). Most students expressed excitement (80%) or nervousness (45%). A few students viewed the lab tour as an opportunity to test if they could see themselves in a healthcare career (4%). After the tour, most students indicated that the tour either met (77%) or exceeded (22%) their expectations. Students found the lab tour to be educational and interesting. They were surprised by the opportunity to interact with the cadaver (23%) and by the pre-dissected appearance of the cadaver (26%). Numerous students (41%) also expressed an increased interest in healthcare careers after the lab tour. Conclusion: Overall, students perceived the lab tours as engaging, educational experiences that not only improved their anatomical knowledge, but also reinforced or increased their interest in healthcare careers. Academic institutions interested in positively impacting their local students can implement a cadaver lab tour program by sharing access to their in-house human cadaver lab and recruiting instructors to share their time and anatomy expertise.
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    The IUSM Scholarly Concentrations Program: Strategic Collaborative Education Across Schools and Departments
    (2020-03-06) Birnbaum, Deborah R.; Rojas, Michelle; Corson-Knowles, Daniel; Wallach, Paul M.
    A changing healthcare landscape calls for innovation and expansion of expertise in medical education. How does a medical school better prepare medical students to thrive in a changing profession? Through its Scholarly Concentrations Program, Indiana University School of Medicine is collaborating with non-physician experts from schools with expertise in topics that are medically relevant and of interest to medical students. Scholarly Concentrations are longitudinal experiences that enhance the medical education program through coursework and scholarly work. In addition to enhancing students’ education, it offers the opportunity to enhance campus reputation and develop research focus for students and faculty. Partnerships were created in both directions. IU School of Medicine sought out schools and departments with unique expertise on different medical campuses. Schools and departments also approached IU School of Medicine about its Scholarly Concentrations program as momentum built. These partnerships are creating mutual benefits for IUSM, partners, faculty and students. Benefits for partner organizations include mentoring opportunities, reputational enhancement, having an impact on healthcare system, and pathways to certificates and advanced degrees. For IUSM and its students, the partnerships enhance professional development through Scholarly Concentrations in areas of clinical, teaching, research, advocacy and administration.
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    The Effect of Identity Dissonance and Consonance on Professional Identity Formation in Medical Students
    (2020-03-06) Byram, Jessica N.
    Professional identity formation (PIF) in medical students is often considered a straightforward process of professional socialization where students adopt the norms, values, knowledge, and skills required of physicians. However, no studies have examined the processes through which medical students’ identities are transformed during the professionalization process and how their developing professional identities blend with their existing identities. Nine medical students from Indiana University School of Medicine completed this study spanning the second (MS2) and third (MS3) years of medical school. Participants completed three semi-structured interviews at the start of MS2, end of MS2, and end of MS3, and submitted 10 audio diaries at two-month intervals between interviews. In audio diary recordings, participants discussed who they wanted to be as physicians and how their experiences transformed their developing professional identities. A thematic analysis of interviews and audio diaries were used to create a framework of PIF.This study found several processes of PIF that related to how consonant one considered his/her personal identity to be to the identity of a ‘typical’ medical student and physician, and the degree to which one’s experiences fulfilled his/her expectations and conceptions of medicine, medical students, and physicians. Medical students experiencing identity consonance utilized processes to adapt their personalities and found their experiences to confirm their commitment to medicine. Those experiencing positive identity dissonance used processes to accommodate their personality and had experiences that challenged their connection to medicine. While they found medical professionalization to be arduous, their negative experiences were often seen as necessary processes. Finally, several participants experienced negative identity dissonance, in which they refused to modify their personality to match that of the "typical" medical student and doubted their ability to make it through medical education. This study identified identity dissonance in medical students and the processes they used to cope with it. Doubt has only recently been described in medical students but this study established the impact doubt has on PIF in that it prevents medical students from seeing themselves as future physicians. Dissonance was also experienced by participants who felt they did not have the identity of a typical medical student or physician (e.g., they are female, non-white, lower socioeconomic status, or introverted) and they had experiences with patients and faculty that confirmed they did not meet this stereotyped identity. Students experiencing identity dissonance, particularly those with negative experiences, are at greatest risk of internalizing a professional identity that is inconsistent with members of the profession and may even leave professional education. Medical educators need to recognize and address identity dissonance and the sources that are creating it to assist the medical students in becoming the physicians they aspire to be.
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    A Comprehensive Anatomical Characterization and Radiographic Study of Stage III Testicular Cancer in a 31-Year-Old Male Patient
    (2020-03-06) Mas, Jose L.; Talarico, Ernest F.; Jones, Jonathan A.
    The purpose of this investigation was to characterize an unusual case of stage III testicular germ cell tumor (TGCT) in a 31-year-old male with metastases to nodes, bone, viscera and brain, and to understand all possible routes of metastatic disease. Testicular cancer (TC) has an increasing incidence worldwide, and its etiology, risk factors and pathogenesis are not completely understood. Medical records were reviewed, and the cadaveric specimen evaluated by physical examination and gross dissection. Paraffin embedded tissue sections of the primary tumor were stained with Hematoxylin and Eosin (H&E) for histological study. To examine metastatic spread, pre- and post-mortem digital radiologic image acquisition was done using x-ray films, and high-resolution CT Scans and MRI Scans. Image analysis, multi-planar reformatting, and three-dimensional (3-D) reconstruction were done on radiographic series. Dissection showed masses bilaterally from the apex through the lung base; masses on the internal thoracic wall, and hepatomegaly and splenomegaly with multiple tumor masses. Testicular parenchyma was composed of primitive germ cells that formed glomeruloid or embryonal-like structures, as well as areas with a micro-cystic histologic pattern and areas of fibrous dysplasia. Medical imaging 3-D video radiographic dissection was notable for a 38.45 mm diameter, mid-brain tumor; extreme hepatomegaly with numerous tumors, a large penetrating tumor of the left ilium, and multiple tumors throughout both lungs and the thoracolumbar spine (T5-S1). This study provides insight into the histology and metastatic spread of TGCT that is essential for clinicians to understand in the evaluation and treatment of TC patients.
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    Attitudes towards Nutrition Education among Pediatricians and Guardians
    (2020-03-06) DeGoey, Madison; Kubascik, Erica; Uzelac, Biljana; Simpson, Steve; Kostrominova, Tatiana
    Childhood obesity rates in the United States are at historic highs. In Lake County, Indiana, the obesity rates of WIC children ages 2-5 years old is 12.1%. While the causes of obesity are well known within the scientific community, there appears to be a disconnect when relaying this information to patients. One cause of this disconnect is the inadequate nutrition education that physicians receive during medical school and residency. A survey found that the average medical school devotes less than 20 hours to nutrition education. Additionally, the biochemical nutrition education that students receive in medical school cannot be easily translated to patient intervention. Since 62% of patients believe that their physicians can help them lose weight, having physicians who do not have adequate education on nutrition leaves patients without the help they need. Our surveys were developed to assess the level of nutrition counseling provided by pediatricians and how patients/guardians prefer to be educated. Our hypothesis is that pediatricians will benefit from further nutrition education in medical school, and that guardians will desire in person instructions in pediatric offices as well as easy and accessible online sources. Two surveys were created, one for physicians and another for parents/guardians of children ages 1-12 years old residing in Lake County. The physician survey contained 15 items that evaluated attitudes toward nutrition and obesity education. Topics included level of nutrition counseling education received in medical school and residency, how much time physicians spend educating patients/parents on nutrition, what nutrition education resources they currently provide, opinion on whose responsibility it is to provide nutrition education, and what approach they think would be best to educate patients and parents. The guardian survey contained 21 items that evaluated dietary behaviors. The dietary behaviors included family dynamics (who typically feds the children, if food is prepared in the home, and how much is spent on food each week) and child eating habits (how many snacks per day, how often the child eats fast food, and how often the child consumes sweetened beverages). The surveys will be utilized for future research, and the results will help determine the approach for educating physicians and guardians. A booklet of healthy recipes was also developed to educate on healthy eating and as a participation benefit. The goal of the booklet was to choose easy, child friendly recipes that the family could cook together. To gain background on nutrition education, we observed the different education methods of local pediatricians and reviewed the literature. Intervention at both the clinical and community levels will be important for improving long-term health outcomes in pediatric patients. The knowledge gained from these surveys will aide in the development of programs needed to provide physicians, guardians,and patients with proper nutrition education.