Session Details: 23rd Annual IAMSE Meeting

Presentation 1 - Breaking with tradition: Implementing active learning into Grand Rounds
Jennifer M. Keller

The George Washington University

PURPOSE Active learning has been demonstrated in multiple studies to improve retention in Education. This project describes one department's (Obstetrics and Gynecology) integration of active learning into weekly Grand Rounds at our urban, academic medical center. This abstract includes preliminary data from this integration. METHODS Information on active learning techniques was provided to all speakers. Data was collected on the implementation of active learning techniques in each session. Evaluations of each session were collected. Two weeks later, attendees were asked to recall information from the prior sessions and if they had used what they learned in clinical practice. RESULTS 60% of speakers fully implemented active learning into their talks. 20% did not implement any active learning techniques. The remaining 20% utilized some active learning techniques. 24% of attendees were students, 34% residents and 41% faculty (MD, CNM, NP). 83% of those completing evaluations were < 40 years old. Active learning techniques used by speakers included: Audience response, think-pair-share, and case discussions. The sessions were all rated very highly by the attendees. The mean evaluation score was 4.9/5. The evaluation forms contained positive comments about the format of the sessions. Attendees named case-based teaching, the interactive nature of the sessions, group discussions and the engaging nature of talks in their evaluations. We will continue to collect data weekly through the rest of the academic year. We plan to look at correlations between age and evaluation scores, use of active learning and recall and use of active learning and evaluation scores. CONCLUSION Use of active learning techniques during Grand Rounds at an academic center is viewed favorably by those attending. Active learning has been demonstrated in other studies to improve retention and we plan to look at this as an outcome as additional sessions are completed.

Presentation 2 - LEVERAGING E-LEARNING TO RESPOND TO THE OPIOID CRISIS
Jacqueline S. Barnett

Duke University School of Medicine PA Program

PURPOSE As part of a federal grant aimed to improve health professions education to address the opioid crisis, the Duke Physician Assistant (PA) Program developed three online modules that are available without cost to health profession students and clinicians across the country. This abstract describes the project and its early outcomes. METHODS The Duke PA Program convened an interprofessional team and developed educational modules related to opioid use disorders. The interactive web-based modules include pre and post-tests that assess knowledge, skills, and attitudes. We made the modules available to students and practitioners at Duke and across the country in July 2018. The three modules, Safe Opioid Prescribing, Recognizing and Treating Opioid Misuse and Abuse, and Opioids and Pain Management have been incorporated into the Duke PA Program curriculum, and efforts are underway to include them in other clinical education training programs. The modules were designed to meet the continuing medical education and licensure/certification requirements for providers who order or administer control substances in NC and other states. Individuals can access the modules without cost through Duke or at www.aheconnect.com/pcte, making them accessible across NC, the US, and beyond. RESULTS After three months, we have recorded 190 module completions. Initial results indicate that as students and clinicians complete the modules, they are increasing their knowledge and skills around diagnosing and treating opioid use disorders and developing attitudes that take away the stigma of addiction. CONCLUSION There are more individuals with an opioid use disorder than there are clinicians trained to care for them. This innovative education project will assist in efforts to better prepare current and future clinicians to participate in the care of those with an opioid use disorder and fill a much-needed gap in communities.

Presentation 3 - DIGITAL BADGES IN MEDICAL EDUCATION: A SYSTEMATIC REVIEW
Patrick Welch

Ethos Veterinary Health

PURPOSE A challenge to the competency-based model of medical education is verification of skill acquisition. Digital badges represent an innovative strategy for credentialing competencies. Despite the growing interest in digital badges, there is currently no synthesis of the medical education literature regarding this credentialing strategy. The purpose of this research was to conduct the first systematic review of digital badges in medical education by comprehensively identifying, critically appraising, and meticulously synthesizing the literature base. METHODS A rigorous systematic search of major databases (PubMed, Web of Science, CAB Abstracts), key journals, and previous reviews from 2008 to 2018 was conducted and reported via Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies were appraised and methodological scoring was conducted with the Medical Education Research Study Quality Instrument (MERSQI) and the Newcastle-Ottawa Scale (NOS). RESULTS A corpus of 201 records was identified and assessed for eligibility resulting in 26 independent publications for analysis. Twenty-two sources were journal articles (84%) with 1 dissertation (4%), 2 book chapters (8%) and 1 conference proceeding (4%). All papers were published since 2013 with 70% after 2016. There were 17 review resources, 6 descriptive studies and 3 quasi-experiments. Content areas included medicine (18), nursing (6), pharmacy (1) and veterinary medicine (1). The mean (SD) quality scores were 9.0 (2.2) for MERSQI (maximum 18) and 3.5 for NOS (maximum 6). Theoretical frameworks focused on motivation theories and components of social cognitive theory such as self-regulation and goal-setting. Badges were described as extrinsic motivators implemented within a gamification context. Studies focused on subjective and self-reported outcomes, however, validated instruments were utilized. CONCLUSION The results of the research synthesis indicate a growing momentum towards utilizing digital badges as an innovative credentialing strategy to disrupt higher education and strive towards a new model of learner-centered, competency-based medical education.

Presentation 4 - INTEGRATION OF SIMULATION-BASED AND AUTHENTIC LEARNING EXPERIENCES TO IMPROVE VETERINARY CLINICAL ANESTHESIA SKILLS
Julie Noyes

Washington State University

PURPOSE Simulation training can prepare students for high risk clinical procedures while protecting patient welfare. Multiple meta-analyses have revealed gaps in simulation-based research such as a paucity of instruction integrating simulation-based and authentic clinical experiences that are designed according to pedagogical frameworks and implemented directly into curricula. We sought to address these gaps by designing a multimodal veterinary clinical anesthesia course based on deliberate practice, implementing it into the curriculum, and evaluating student outcomes with live patients. METHODS A stratified random sampling method was used to select 16 second year veterinary students for a 6-week course that integrated simulation-based and authentic learning experiences and a matched control group (n = 32). A simulated operating room environment was constructed using a canine manikin, an anesthesia machine and monitoring equipment, and an interactive patient monitoring computer simulation that depicted changes in multi-parameter vital signs based on student decision-making. Authentic learning experiences were interspersed with simulation training. Clinical performance was recorded using head-mounted GoPro cameras during the first live patient anesthesia and surgery experience and evaluated by two blinded, boarded anesthesiologists from separate institutions using a standardized rubric assessed for content validity. RESULTS Results demonstrated the simulation group performed significantly better on clinical tasks, F(1,30) = 5.95, p = .02, (d = 0.86) and professional skills, F(1,30) = 4.01, p = .04 (d = 0.72). According to the rubric, the control group, which represented training in the traditional curriculum, average performance rating was "Marginal: requires further training" (M =2.73, SD = 0.75) while the simulation group average performance rating was "Satisfactory: performance meets expectations for this level of training" (M = 3.35, SD = 0.69). CONCLUSION Multimodal simulation-based training adequately prepared students for clinical anesthesia management versus the control group. This suggests that multimodal courses have value in preparing students for clinical practice.