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Item Leadership and Mentorship in Medical Education: 6th Annual Indiana University School of Medicine Education Day Program(2025-04-25) Kochhar, Komal; Hoffman, Leslie; Rodgers, David; Stefanidis, Dimitrios; Allen, BradleyProgram for the 6th annual Indiana University School of Medicine Education Day held at Hine Hall Conference Center on the IU Indianapolis campus on April 25, 2025. 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, the Indiana University School of Medicine implemented an annual “Education Day”to promote educational scholarship across our nine-campus system. Held each spring, Education Day showcases the educational scholarship of IUSM faculty, staff, and learners, and provides a forum to share best educational practices and forge new collaborations in educational research.Item Accommodating a Student with Hearing Loss in the Medical Curriculum: A Case Study(2025-04-25) Martin, Angelika; Hoffman, Leslie; Russell, AbigailDespite 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.Item Assessment and Implementation of Preconception Training for Internal Medicine Residents(2025-04-25) Knoedler, Allison; Swanson, EricaBackground: 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.Item 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, EdwinBackground: 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.Item Point-of-Care Ultrasound and the Pediatric Patient-Family Experience: A Randomized Control Study(2025-04-25) Gutierrez, Samuel; Pamela, Soriano; Matthew , Hays; Benjamin , NtiBackground: Existing literature indicates that patients respond positively to point-of-care ultrasound (POCUS) across various clinical settings. However, limited research explores how patient families perceive its use in pediatric emergency department (ED) care. Our study aims to evaluate POCUS’s impact on patient experience, stress, and anxiety in the pediatric ED. Methods: We conducted a randomized study (1:1) of pediatric patients (<17 years) presenting with a clinical indication for POCUS (lung, FAST, cardiac, or soft tissue applications). Patients were assigned to either a POCUS or non-POCUS group, excluding those who were unstable or had prior POCUS evaluations. Patient families completed pre- and post-surveys (5-point Likert scale) at triage and ED disposition. Demographic data were obtained from the electronic medical record. Statistical analyses included Chi-Square, Fisher’s Exact, Wilcoxon, and sign tests (α=0.05) to compare group responses and assess for changes in responses over time. Results: A total of 200 patient-families were enrolled. The cohort was primarily English-speaking, non-Hispanic white males, with an average age of 5.16 years (SEM ±0.37). Common chief complaints included cough (34%), fever (15%), abdominal pain (14%), and shortness of breath (13%). No significant differences were observed in patient experience or ED length of stay. However, sign tests indicated significant reductions in stress and anxiety within both groups from pre- to post-survey assessments [Anxiety: p<0.0001 (POCUS), p=0.0003 (non-POCUS); Stress: p<0.0001 (POCUS), p<0.0001 (non-POCUS)]. POCUS patient-families reported a significantly greater perceived importance of imaging and stated that POCUS directly alleviated their stress and anxiety. Conclusion: POCUS was associated with a positive patient-family experience in the pediatric ED, reducing perceived stress and anxiety. While overall experience and length of stay remained unchanged, most families in the POCUS group strongly supported its use, highlighting its potential to enhance patient-centered care and need for further research into its broader clinical integration.Item Social Determinants of Health and Their Effects on Readmission and 30-Day Readmission in Patients with a History of Cardiovascular Interventions(2025-04-25) Delos Reyes, Mark; Muvuka , Baraka; Guerrero , JonathanSocial Determinants of Health and Their Effects on Readmission and 30-Day Readmission in Patients with a History of Cardiovascular Interventions Mark Delos Reyes, Baraka Muvuka, Jonathan Guerrero Indiana University School of Medicine- Northwest (IUSM-NW) Background: 30-day readmission is a quality indicator impacting patients and healthcare systems. Medicare patients accounted for 2.3 million 30-day readmissions, costing $35.7 billion 4 years following the 2012 Hospital Readmission Reduction Program (HRRP) launch . Three of six HRRP measures are cardiovascular: myocardial infarction, Heart Failure, and Coronary Artery Bypass Graft Surgery. This study examined relationships between social determinants of health (SDOH), demographics, and behavioral factors on readmission and 30-day readmission among patients with a cardiovascular intervention history in partnership with an urban Northwest Indiana (NWI)-based health system. Methods: This retrospective study analyzed de-identified data from inpatient SDOH screenings in Epic using the Protocol for Responding to and Assessing Patients Assets, Risks and Experiences (PRAPARE) at 3 urban hospitals between January 2021 and April 2024. Data analysis included descriptive, bivariate (Chi-Square, Mann-Whitney U, Kruskal Wallis; p<0.05), and multivariate (binary logistic regression; p<0.05) analyses in SPSS 29.0. This study was exempted by the Indiana University Human Research Protection Program (IRB #14040). Results: The sample comprised 3717 patients, majority White (70.2%), publicly insured (87.4%), and older adults (73+17). Readmissions represented 43.5% of admissions, 19.8% being 30-day readmissions. Bivariate analysis revealed significant associations between readmission and age (p<0.001), ethnicity (p=0.001), race (p<0.001), sex (p<0.001), sexual orientation (p=0.007), insurance type (p<0.001), financial resource risk (<0.001), housing risk (p=0.05), smoking status (p=0.041), BMI (p<0.001), hospital (p<0.001), and comorbidities (p=0.027). Sex, insurance type, sexual orientation, BMI, and hospital were also associated with 30-day readmission. Multivariate analysis revealed significantly higher odds of readmission with prolonged hospital stay (OR=1.051; p<0.001), former smoking (OR=1.759; p=0.039), and patients at a small, lower SES-serving hospital (OR=1.473; p<0.001). Conclusions: Social-behavioral factors were associated with readmissions and 30-day readmissions among patients with a history of cardiovascular interventions. Integrating SDOH and behavioral screenings and interventions into hospital readmission reduction initiatives could strengthen these programs.Item Know Before You Go: Evaluating the Utility of Pre-Departure Training for Internal Medicine Residents Prior to an International Elective(2025-04-25) Arias, Grace; Goble, Gretchen; Thornton, Corinne; Baenziger, JenniferA needs assessment at Indiana University revealed that a large majority of internal medicine residents desired formal pre-departure training for their international elective in Kenya. In response, a two-hour orientation covering cultural context and site-specific clinical cases was developed and led by residents with prior experience in Eldoret. Pre- and post-curriculum surveys showed that participants, 75% of whom had minimal to moderate prior LMIC experience, reported increased familiarity with clinical challenges, improved preparedness, and reduced anxiety.Item Leveraging Advanced Cardiac POCUS in the Diagnosis of Infective Endocarditis with Negative Conventional Imaging: A Case Report(2025-04) Sanjuan, Adriano; Andrade, Heather; Bundy, Alyson; Clapham, Philip; Markus, Nathan; Brenner, Daniel; Hariri, Irina; Jackson, EdwinIntroduction. Infective endocarditis (IE) is a life-threatening condition that includes bacteremia and echocardiographic findings. However, many cases yield inconclusive results with transthoracic (TTE) or transesophageal echocardiography (TEE), creating diagnostic challenges. This report highlights the role of advanced cardiac point-of-care ultrasound (POCUS) in addressing these limitations, using daily POCUS exams to address these limitations. Case report. A 68-year-old male with methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia and recurrent fevers underwent multiple conventional TTEs and a TEE, that failed to detect valvular vegetations. Advanced cardiac POCUS, including parasternal long-axis (PLAX), parasternal short-axis (PSAX), right ventricular (RV) inflow/outflow, and apical four-chamber views, was performed daily at the bedside. The PLAX view enabled visualization of new onset of aortic regurgitation, and Color Doppler imaging was applied to assess the severity of the valve disfunction. A vegetation in the aortic valve was identified, later confirmed by a consultative TTE and TEE, leading to a change in management. Discussion. This case highlights the utility of advanced cardiac POCUS in diagnosing IE when conventional imaging is inconclusive. Advanced cardiac POCUS offers immediate, bedside diagnostic insights, making it a valuable tool for critically ill patients. Compared to basic cardiac POCUS, the advanced cardiac POCUS includes the RV inflow/outflow (that can be achieved through tilting or fanning of the probe), and use of color Doppler. A study by Hellmann et al. demonstrated that medical residents could achieve significant proficiency with color Doppler, with minimal formal training, aligning with our experience. Despite limitations such as operator dependency and patient characteristics, the integration of advanced cardiac POCUS into diagnostic workflows has the potential to improve diagnostic accuracy and outcomes. Additionally, the case emphasizes the need for advanced cardiac POCUS education among trainees, expanding their ability to address complex clinical scenarios.Item 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, FrancescaIntroduction/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.Item Objective Assessment and Scoring of Parkinsonian Tremors using Wrist Sensor Technology(2025-04-25) Sullivan, Megan E.; Shanghavi, Aditya A.; Rentley, Oliwia; Zauber, Sarah Elizabeth; Sereno, Anne B.Background: Parkinson’s Disease (PD) is the second leading cause of neurodegenerative disease in humans. The gold standard for assessing disease progression is the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Neurologists score motor symptoms from 0-4 and determine medication adjustments based on score variation between the OFF and ON medication states. Numerous studies have noted inter-rater variability due to the subjectivity of the visual-based MDS-UPDRS rating scale complicating treatment plans. Objective: This clinical study evaluated the use of wrist-worn inertial sensors as a more objective and reliable method for measuring the severity of Parkinsonian rest and postural tremors, in comparison to the current gold standard, the MDS-UPDRS. Methods: 30 PD patients and 30 age-matched healthy controls performed the rest and postural tasks. Shimmer3 IMU sensors, sampling at 100Hz, were attached to both wrists to record angular velocity and linear acceleration. Tremor Severity Score (TSS), a novel objective tremor scoring algorithm based on sensor signals, was developed to measure tremor severity. Results: In a subset of controls and PD patients tested only ON medication, the mean scores for rest and postural tremor showed significant differences using both MDS-UPDRS (0.53 vs 0.46) and TSS (0.53 vs 0.39) rating scales, with TSS showing a marginally greater effect size (0.07 vs 0.06). When comparing OFF/ON states in a subset of 7 PD patients, the MDS-UPDRS showed no significant difference between scores, while the TSS showed significantly lower scores in the ON vs OFF state for both postural (0.44 vs 1.1) and rest tremor (0.91 vs 1.97). Conclusion: Results suggest TSS is more sensitive to changes in tasks (rest, postural) and medication effects (OFF vs ON). The ability to more objectively assess tremor severity and progression has implications for early diagnosis, medication dose adjustments, and more accurate assessment of patients in the telehealth setting.
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