Presentation 1 - Utilizing a Mock Ethics Committee Meeting as an Interprofessional Module to Teach Ethical Principles while Solving an Ethical Dilemma
Janet Lieto
UNTHSC-TCOM

PURPOSE Teaching medical ethical principles to first year medical students includes memorization and understanding definitions of ethical concepts and principles.  These students have the ability to study and understand concepts but are rarely given the chance to apply this knowledge.  A module was developed to apply ethical problem solving skills utilizing the "Four Topic" approach incorporating osteopathic medical students, physician assistant students and pharmacy students.  This abstract describes the project and its outcomes.   METHODS The module was developed as an interprofessional education (IPE) session for each of the colleges.  Faculty from each of these colleges as well as the director of IPE and an ethicist helped develop 12 "scripts" representing all parties present at the Mock Ethics Committee meeting.  Each of the scripts represented a different perspective such as the patients' husband and sister, physician, physician assistant, pharmacist, nurse, hospital administrator, chaplain, social worker, lay person, committee chairperson, and recorder.  Student leaders were chosen by the faculty and trained to be the committee chairperson.  Each person's script revealed different information about the patient.  At the end of the 2 hour session, the ethics committee needed to come to consensus and decide the outcome for a brain dead patient on a ventilator. RESULTS 423 students participated in the 2 hour module.  Pre and post session survey questions were collected regarding ethical content and working as part of an interprofessional committee.   The data demonstrated that students were more confident after the module in their ability to apply ethical principles to problem solve an ethical dilemma.  In addition they also realized the importance of an interprofessional team in helping to come to a committee recommendation.   CONCLUSION A Mock IPE Ethics Committee meeting module increased student's confidence in problem solving an ethical dilemma while valuing the importance of the interprofessional team in making difficult ethical decisions.
 

Phillip Carpenter

McGovern Medical School

 

PURPOSE:  Traditional lecturing has generated student apathy marked by poor classroom attendance. To circumvent this we coupled a flipped classroom with a Think-Pair-Share (TPS) teaching strategy and demonstrated knowledge gain and value for attending class. This abstract describes the project and its outcomes. METHODS: Multiple biochemistry-oriented pre-clerkship lectures were flipped where students viewed pre-recorded content before class. During class, students answered clinically relevant, application-based questions using the Poll Everywhere (PollEv) audience response system, in conjunction with a TPS activity. Students initially answered the questions individually without discussion. They then answered the same questions a second time after discussion with their peers. A satisfaction survey regarding their flipped-TPS experience was conducted after the sessions. RESULTS: This study demonstrates that our flipped-TPS classroom attracted students to attend class as evidenced by up to 90% participation. Further, we found, on average, up to 50% knowledge improvement on PollEv questions after peer discussion. Survey results indicate that 75% of the students found the flipped-TPS classroom conducive to learning,  54% of students preferred a flipped classroom to 28% who preferred streaming lectures, and 86% of students perceived attending class to be worth their time (n =213). CONCLUSION:  Using a flipped-TPS model not only increases student enthusiasm to attend lectures, but more importantly, also allows for increased learning and higher level thinking through social construction.

 

Sateesh Babu Arja

Avalon University School of Medicine, Curacao

Purpose The two popular methods of clinical skills teaching are "Peyton's four-step approach" and "Gagne's theory of instructional design". A hybrid method, a combination of both methods was developed and implemented in Clinical Skills during the first two years of undergraduate medical education at Avalon University. The reasons for developing the hybrid method are to provide more opportunities for demonstration, practice by students, and immediate feedback. The hybrid method includes explaining the learning objectives, discussions based on the knowledge of basic sciences, demonstration with audiovisual aids, demonstration with commentary but no audiovisual aids, practice by students in groups, and students demonstrating in front of the instructor. Feedback was provided, followed by assessment, and feedback given again after the assessment. This study aims to evaluate the hybrid method of clinical skills teaching. Methods This is a quasi-experimental study; the new teaching method was evaluated after its implementation. Data were gathered for the control group and three study groups in 2017 and 2018. An end-of-course evaluation was issued to collect both quantitative and qualitative feedback from students. It included 17 questions on a five-point Likert scale. Quantitative data also include students' performance in assessments. Results Student feedback (end-of-course evaluations) responses for the control group were n=26, and n=22, n=14, and n=10 for three study groups, respectively. The student responses for all 17 questions revealed an increased satisfaction with improved median and mode. Differences in class performance were analyzed using the Kruskal-Wallis test. The average class performance on end-of-course examination showed a statistically significant improvement (p<0.01). Conclusion The hybrid method of teaching in clinical skills improved the students' satisfaction and academic performance. This hybrid method of clinical skills teaching can be easily implemented, regardless of class size.   In the future, we plan to continue evaluating this model with a larger sample size.

 

Douglas B. Spicer

University of New England College of Osteopathic Medicine

 

PURPOSE The concept of cognitive integration refers to the value of understanding the basic science connections to clinical signs and symptoms. Practicing clinicians are often not aware of using these connections in clinical reasoning, however many studies indicate the importance of integrating the basic and clinical sciences for learning diagnostic reasoning. Recent studies have suggested that cognitive integration is achieved when the relationships between the basic science and clinical domains are explicitly demonstrated to learners. Our initial studies exploring this suggested that enhancement of clinical reasoning required that the students build these connections themselves. To assess this, we designed a study to test the hypothesis that taking integrated notes while studying improves the ability of students to diagnostically discriminate between multiple endocrinopathies. METHODS Students were presented with a learning resource on the dysregulation of the hypothalamic-pituitary-adrenal axis that explained the causal links between the basic science and clinical features of each of the disorders. One piece of blank paper was included for note-taking. Students were told that they had one hour to study the material before they would take two tests; one measuring recall and one measuring diagnostic reasoning. The intervention group was also instructed to specifically take integrated notes using basic science concepts to explain the clinical signs, symptoms, and laboratory values. Retention was measured one week later using  similar tests. RESULTS Thirty-four first-year medical students completed the study. No significant difference between groups was found on the initial recall test. However, the group that was instructed to take integrated notes did significantly better on the initial diagnostic test and on both tests a week later. CONCLUSIONS The results suggest that the act of writing integrated notes improves clinical reasoning and retention. This supports the value of giving students strategies to actively integrate and synthesize information.