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102 - Administration Of Formative Assessments In A Proctored Setting Is Associated With Improved Summative Assessment Performance In Undergraduate Medical Education
Yerko Berrocal | Andrew Darr | Jonathan Fisher | Jenna Regan | Amy Lin | Richard Tapping
Health Sciences Education Department, University of Illinois College of Medicine Peoria | University of Illinois College of Medicine Chicago

PURPOSE:Despite significant evidence supporting the use of formative exams in undergraduate medical education, the potential impact of the setting in which they are administered has not been previously explored. The purpose of this study was to examine whether administering formative assessment in a proctored versus non-proctored setting influences student performance on final summative exams.  

METHODS:During the seven weeks of the Block 1 curriculum at the University of Illinois College of Medicine at Peoria (UICOMP) we administered weekly multiple-choice question (MCQ) formative assessments in either a proctored or non-proctored setting to 58 Year 1 medical students. At the end of the block, a cumulative summative 100 MCQ exam was administered to all Year 1 medical students. All MCQs were linked to United States Medical Licensing Examination (USMLE) topics and learning objectives (LOs) prior to both formative and summative exam administration. Student performance on summative exam MCQs with LOs that were previously assessed in the proctored formative was compared to summative assessment performance on LOs that were previously assessed in non-proctored formative assessments.  

RESULTS:The percentage correct on the final summative assessment was 0.90 ± 0.07 SD for items whose LOs were formatively assessed in a proctored setting compared to 0.80 ± 0.17 SD for items whose LOs were assessed in a non-proctored setting.  

CONCLUSION:The present study suggests that participation in proctored formative assessments may correlate with greater success on final summative exams, as demonstrated by an 11% increase in correct responses on questions with identical LOs previously assessed in proctored formative setting. 


103 - Analysis Of Lifelong Learning Behaviors And Attitudes And Academic Performance: A Four-Year Study
Linda Adkison | Frances E Jack-Edwards
Trinity Medical Sciences University | Trinity Medical Sciences University
No Poster Provided

PURPOSE: The purpose of this study was to investigate attitudes and behaviors among students toward lifelong learning.  The Jefferson Scale for Physician Lifelong Learning (JeffSPL) provides the most consistent measure of lifelong learning among physicians. This study assessed learning beliefs and motivation, attention to learning, and technical skills in seeking information. 

METHODS:  The JeffSPLL-MS, a 14-item survey tool adapted for medical students, was administered to students at the beginning of years 1-3 and during year 4.  Students self-identified for purposes of tracking outcomes.  Items on the survey described activities and attitudes in individuals motivated to learn including the ability to recognize learning needs. The descriptors were linked to Likert response anchors of agreement to provide information about each item.  Scores ranged between 14 and 56.  Analyses were performed with SPSS and Excel.  

RESULTS:  The validity and reliability of the JeffSPLL-MS instrument demonstrated the Cronbach alpha as 0.83 with a test-retest reliability of 0.67. These compared favorably with the published results for the JeffSPLL and JeffSPLL-MS.  Response rates were 87.6%, 72.3%, 85.6%, and 87.1% for students in years 1-4, respectively.  Analysis of variance demonstrated no difference between different cohorts in the same year of study.  The weakest items in years 1-3 were those requiring and activity.  When cohorts were analyzed using the cumulative grade point average, there was significance between high and low performers (p<0.05).   Students' attitudes about lifelong learning are stronger than the behaviors they engage in.  There were differences in learning beliefs and motivation and skills in seeking information among the four cohorts.  Within cohorts, the strongest performances were associated with higher academic performance (p<0.01). 

CONCLUSIONS:  Results in this study support prior findings and help to explain differences between these studies and that of Wetzel et al.  It also suggests improvements in student behaviors may foster better academic performances.


107 - Motives And Methods For Differentiating Student Confidence And Certainty In Knowledge Assessments
Ethan Snow | Megan Brown | Sarah McBrien
University of Nebraska Medical Center, College of Medicine |University of Nebraska Medical Center, College of Allied Health Professions

PURPOSE:Knowledge is learned information that is true and justified; it is multidimensional. Knowledge assessments that evaluate response trueness (i.e., correctness) and justification can accurately detect all knowledge levels. Evaluating response justification involves comparing what students think they know to what they actually know. Despite their distinctions, student confidence and certainty have been used interchangeably as response justifications. The objective of the present study is to investigate whether there are critical differences between student confidence and certainty in knowledge assessment. 

METHODS:A literature review was conducted to ensure comprehensive analysis, substantiate working postulations, assemble best fit term meanings, and compare student confidence and certainty. A customized questionnaire will be administered to students to survey and compare their interpretations of confidence and certainty. 

RESULTS:Confidence refers to a student's degree of belief in their ability to provide a correct response to an assessment item (given some frame of reference for what the item will concern and entail), and certainty refers to a student's degree of belief in that their response to an assessment item is correct. Both are examples of student metacognition assessed by prompts for self-reflection but evaluated at considerably different times (before vs. during assessment item presentation). Accordingly, confidence contributes to determining the likelihood of students applying learned information to skills and decision-making, whereas certainty validates information acquisition and correctness by illustrating whether correct and incorrect responses are the result of complete, partial, absent, or flawed knowledge. 

CONCLUSIONS: This study reveals that student confidence and certainty share similar metacognitive origins and assessment formats but exhibit critically different, independent roles in assessing knowledge and timings of evaluation. Certainty is proper for justifying assessment item responses in knowledge assessments. Differentiating student confidence and certainty may improve knowledge assessment efficacy, inform other strategies for enhancing knowledge assessments, and benefit student learning and long-term knowledge retention.

108 - Pharmacology Exam Flashcards: Friend or Foe? Exam performance & student opinions.

Rupa Lalchandani Tuan | Marieke Kruidering-Hall
University of California, San Francisco, School of Medicine 

PURPOSE:To evaluate the impact of flashcards on students' open-ended question (OEQ) exam performance and to explore attitudes around resource-enhanced exams. Background The UCSF Bridges curriculum is an integrated, organ systems-based curriculum. Students learn via multiple modalities including live lectures, small groups, online videos, click-through online PowerPoints and interactive case-based wrap-up sessions. Summative assessments for each block are entirely OEQ and require application of knowledge. Pharmacology-specific OEQ scores were gathered from all blocks that taught and assessed pharmacology: Ground School (GS), Airways, Blood, Circulation (ABC), Renal, Endocrine, GI, and Nutrition (REGN), Pathogens & Host Defense (PHD), and Brain, Movement, & Behavior (BMB). We provided flashcards to study from in all blocks, but exam-flashcards were only made available during 4 out of 9 exams (REGN & PHD).  

METHODS: We collected pharmacology OEQ scores from medical students in the 2017-2018 academic year. OEQs were scored by trained faculty on a scale of 1-6 using a holistic rubric: "meets expectations" (5,6), "borderline" (3,4) or "does not meet expectations" (1,2). OEQ scores were averaged and results were analyzed using repeated measures analysis of variance in SPSS software. Three students who did not complete all blocks were removed from analysis. Student survey data are being collected using Qualtrics and we will calculate descriptive statistics and analyze comments for emerging themes.  

RESULTS: Mean performance on pharmacology OEQs was significantly different across all blocks. Mean performance on exams with flashcards (REGN & PHD) was the lowest.   (GS: 5.56±0.03; ABC: 5.21±0.03; REGN: 5.07±0.03; PHD: 4.99±0.03; BMB: 5.45±0.03; ± SEM, n=149).   

CONCLUSIONS & LESSONS LEARNED: Providing flashcards does not increase exam performance, suggesting the exam favors application over recall. We postulate that resource-enhanced examinations may better mimic the clinic, in which data is directly accessible during patient encounters. We acknowledge the potential confounding effects of different teaching methods used in each block.


109 - Predictive Differences of Medical Student Emotional Intelligence on Perspective-Taking at Three-Year Medical Degree Programs
Robert Treat | Molly Falk-Steinmetz | Jeff Fritz | Amy Prunuske | William J. Hueston | Kristina Kaljo | Craig Hanke
Medical College of Wisconsin 

PURPOSE: Conceptual perspective-taking is the empathic ability to take on the viewpoint of another person's thoughts, feelings and attitudes which is essential for successful social interactions.¹ As future healthcare providers, medical students need high levels of perspective-taking for understanding their patients feelings, which can be assisted by high levels of emotional intelligence.² Limitations in available student time can compromise emotional intelligence and therefore perspective-taking. Three-year medical degree programs are excellent locations for comparing student perspective-taking under severe restrictions in time. Three-year programs with distinctive institutional cultures may encourage students to use varying facets of emotional intelligence to impact perspective-taking.  The purpose of this study is to analyze the predictive relationship of emotional intelligence on perspective-taking between students at two different three-year medical degree programs.  

METHODS: In 2017/18, 205/500 M-1/M-2 medical students from two different three-year medical degree programs at the same medical school voluntarily completed these surveys: Interpersonal Reactivity Index to measure perspective-taking and Trait-Emotional Intelligence Questionnaire. Mean score differences analyzed with univariate ANOVA and Cohen's d effect sizes. Stepwise multivariate linear regressions used for predicting perspective-taking scores from emotional intelligence. IBM® SPSS® 24.0 generated statistical analysis. This research approved by the institution's IRB.  

RESULTS: Perspective-taking (alpha=0.7) mean scores were significantly different between (d=0.8, p<.001) the two three-year medical degree programs (mean(sd)=28.6(4.3) vs. 25.1(4.8)), but not compared to a single four-year program (26.7(4.6)).  Linear regression results for the three-year program with higher perspective-taking scores was predicted (R²=0.60, p<.001) by optimism (beta=0.5), motivation (beta=0.3) and assertiveness (beta=-0.6). The second three-year program perspective-taking was predicted (R²=0.35, p<.001) by social awareness (beta=0.5) and emotion-regulation (beta=0.3). At a four-year program perspective-taking was predicted (R²=0.40, p<.001) by self-esteem (beta=0.4) and relationships (beta=0.4).  

CONCLUSIONS: Medical students using "more positive" emotional intelligence facets such as optimism and motivation will yield higher perspective-taking scores.


110 - Predictive Differences of Medical Student Personal and Social Values on Authenticity across Time
Robert Treat | William J. Hueston | Amy Prunuske | Jeff Fritz | Kristina Kaljo | Craig Hanke | Molly Falk-Steinmetz
Medical College of Wisconsin 

PURPOSE: Remaining true to ourselves is the hallmark of authenticity.¹ Life experiences can challenge our ability to remain true to ourselves,² and the influence of our personal and social values on remaining authentic can shift with the passage of time.³ Can the impact of values on authenticity shift from the challenges of medical school? The social value of benevolence is rated highest by medical students in the USA, but personal values such as achievement and self-direction are important as well. The purpose of this study is to analyze the predictive relationship of medical student values on authenticity across their first two years of medical school. 

METHODS: In 2017/18, 205/500 M-1/M-2 medical students voluntarily completed self-reported surveys using the following validated instruments: (1) 25-Item RS-25 Resilience Scale (scale: 1=strongly disagree/7=strongly agree) to yield authenticity scores; and 56-Item Schwartz's Value Inventory (0=not important/7=supreme importance). Stepwise multivariate linear regressions used for predicting authenticity scores from values. IBM® SPSS® 24.0 generated statistical analysis. This research approved by the institution's IRB. 

RESULTS: The empirical range of authenticity scores was 17 - 35 with a mean (sd)=28.3 (3.3) and were significantly (p<.001) above the instrument's midline score=20. Ninety-nine percent (99%) had authenticity scores above midline. Linear regression results for the first-year student's authenticity was predicted (R²=0.41, p<.001) by inner harmony (beta=0.5), and meaning-in-life (beta=0.3). The second-year student's authenticity was predicted (R²=0.57, p<.001) by social power (beta=0.4), health (0.4), politeness (0.4), cleanliness (0.3), creativity (-0.4), and sense of belonging (-0.5). 

CONCLUSIONS: Medical student authenticity was impacted by a wider array of values after their first year in school. Values shift from a solely social focus for first-year students to include values with a personal focus. Furthermore, values transition from primarily self-expansion to self-protection. Second-year students' direct values that promote gains and prevent loss towards their authentic selves. 


111 - Program Assessment via Novel Use of CDC Framework: Evaluation of an Interprofessional Leadership Development Intervention
Madeline Aulisio | Sarah Wackerbarth
University of Kentucky 
PURPOSE:Employers expect health professions program graduates to possess both the capability to participate in teams and lead. However, formal teamwork and leadership skill development is largely absent from curricula. Leadership Legacy, a course embedded within eight health professions programs at UK, was created in 2009 to address this need. After ten years, an evaluation of Leadership Legacy with a trusted framework was timely. The six-step CDC Framework prioritizes the values of utility, feasibility, propriety, and accuracy and is typically used to evaluate public health programs at the federal, state, and local levels. However, the framework's broad applicability can extend to many types of programs that impact health. 

METHODS:Stakeholders (here, encompassing faculty, staff, and students) are first engaged to create a descriptive logic model to direct the evaluation's focus. For Leadership Legacy, two priority questions then emerged: whether students better understood their own roles and others' roles (crucial for teamwork) and whether they graduated with enhanced leadership capabilities. After identification of the evaluation's focus, the framework guides the user through gathering credible evidence and reporting conclusions. The framework also provides direction for ensuring that priority areas utility, feasibility, propriety, and accuracy guide completion of the framework's six steps. 

RESULTS:The CDC Framework has proven to be informative and effective and has generated continued discussion of its adaptability to other educational interventions and program evaluations. Data collection continues, but information yielded by course evaluations and stakeholder interviews indicates that Leadership Legacy may be positively impacting skill development. However, opportunities have emerged to modify evaluations to better capture the potential impact of the experience on quality of care provided following graduation. 

CONCLUSIONS: The CDC Framework provides an intelligible process to stakeholders and is easy to adapt to a variety of programs. It demonstrates promise with regards to evaluation of educational interventions.


112 - Retention of Biochemistry Knowledge in the First Year of Medical School Predicts LCME Step 1 Performance
Anna Blenda | Carrie Bailes | Mary Caldwell | Renee Chosed | Matthew Tucker
University of South Carolina School of Medicine Greenville 

PURPOSE: Medical students are tasked with absorbing a vast amount of medical knowledge. But how much of that knowledge is retained (and how deeply), and how does retention predict performance on high stakes exams such as USMLE Step1? Here we retested students on biochemistry summative exam items 10.5 months after first sitting for the exam. We used the original multiple choice format (cued recall), but also had students generate answers without seeing the answer choices (free recall), as a measure of depth of learning. We also examined whether knowledge retention predicts Step1 performance.   

METHODS: Second year medical students (N=45, 24 Females) reported to the same location of the original exam and used the same testing software. Students were tested (cued and free recall) on 50 of 104 questions from the original summative exam. The question stem was displayed with a text box below it to allow for free recall of an answer. After an answer was entered, the original multiple choice answers were shown, and students selected the best answer (cued recall).   

RESULTS: The original exam average for our sample was 87.2±5.5%. 10.5 months later the average was 53.9±9.6%, 62% of their original scores. Free recall rates were considerably lower (15.8±9.2% correct). Higher scores on the original exam predicted better retention of the material 10.5 months later (r=.289, p=0.057) and increased Step 1 (r=0.491, p=0. 001) scores. Higher retention rates were associated with better Biochemistry MCAT performance (r=0.318, p=0. 038) and with higher Step1 scores (r=0.422, p=0.006). Class rank + memory retention explained 55% of the variance in Step1 scores.   

CONCLUSIONS: Our findings suggest that differences in free vs. cued recall may provide insights about how deeply information is memorized, and they also highlight the importance of retention (not just overall performance or class rank) for predicting high-stakes test performance.


113 - The Quality Of Integrated Illness Scripts Developed By Senior Medical Students In A Medical Pharmacology Elective
Khiet D. Ngo, D.O., M.S. | Reed Nerness | Dan Rogstad, M.D. Ph.D.
Loma Linda University School of Medicine 

PURPOSE:Cognitive integration is increasingly recognized as an essential component of optimal learning and clinical decision-making. Integrated illness scripts (IIS) are a practical cognitive integration tool that have recently been introduced. Traditional illness scripts include the clinical presentation, risk factors, and/or pathophysiological insult for a given condition. IIS expand the framework of traditional scripts by integrating basic science causal explanations for each of the most common clinical features associated with the condition. This study evaluated the quality of IIS developed by senior students as part of a medical pharmacology elective. 

METHODS:Fourteen unedited IIS created by 14 senior students were scored using a Likert-scale rubric(1=lowest to 5 = highest). IIS were assessed for overall clarity, clear clinical definition of key clinical features, and adequate description of relevant causal mechanisms. A final question assessed the level detail of causal explanations. 

RESULTS:Mean score for each question: 1) "Was the integrated illness script easy to understand?" (3.0/5.0); 2) "Did the description of each clinical feature adequately explain the feature from a basic science perspective?" (2.9/5.0); 3) "When appropriate, did the clinical features include a definition of the feature?" (1.9/5.0); 4) "Was the definition and conceptual overview statement clear and easy to understand?"= (3.5/5.0); 5) "Assess the level detail of the causal explanations"(Just the right amount =3; Too little details =11). 

CONCLUSIONS:Senior medical students struggled to demonstrate sufficient understanding of the relationship between basic science and clinical knowledge for common conditions. These findings suggest much opportunity exists for improving the quality of integrated teaching and learning within the four year curriculum. Earlier practice in the creation and use of IIS should be considered to optimize the development of cognitive integration.


114 - Use Of Sedlacek Non-Cognitive Variables For Assessment Of Medical School Applicants
Bernadette Scott | Frances E Jack-Edwards | Keshab R Paudel | Frank E Fitzpatrick | Kathryn A Murray | Linda R Adkison
Trinity Medical Sciences University 
No Poster Provided

PURPOSE:  In 2017, Trinity School of Medicine implemented a new evaluation form for the admissions process.  The purpose of this change was to better quantify non-cognitive variables among applicants. In 2018, an increase in the number of transfer applicants occurred following the impact of tropical disasters and the non-cognitive variables were used to assess transfer applicants compared to new matriculating students. 
METHODS: The Admissions Committee selected the Sedlacek non-cognitive variables that had been tested in the US for an assessment instrument.  Interviewers were instructed to assess applicants in eight areas and provide written evidence for each: Positive self-concept, realistic self-appraisal, understanding how to navigate the system, long-range goals, strong support person, leadership, community service, and nontraditional learning. Each applicant also self-assessed themselves. The written assessment reviewed by the committee also included the typical academic metrics, personal statements, and recommendations. Data were collected for two years.  
RESULTS:  Data were analyzed between new student matriculants and transfer students.  Scores between the interviewer and applicant were also compared.  There were no differences in mean undergraduate GPAs but the transfer students had significantly lower mean MCAT scores than the new students. Data were significant between new students and transfer students with transfer students scoring significantly lower in positive self-concept, realistic self-appraisal, strong support person, and leadership.  There was no significance between the interviewer and applicant in any of the eight areas. Both groups of students scored themselves with more confidence than the interviewer: 6/8 and 8/8 categories by new and transfer students, respectively.  

CONCLUSIONS:  A variable in the use of this tool is the interviewers' use of a narrow scale when assessing applicants. However, they could easily discern between a new applicant and a transfer student.  These data parallel performances in the medical curriculum.


115 - Conception Of Learning And Teaching For Faculty That Teaches Basic Science
Helena Carvalho | Francis C Dane | Shari A. Whicker
Department of Basic Science Education, Virginia Tech Carilion School of Medicine | Department of Arts & Sciences, Jefferson College of Health Sciences | Office of Continuing Professional Development, Carilion Clinic and Virginia Tech Carilion School of Medicine

PURPOSE: Approaches to teaching can be placed on a continuum that ranges from teacher-centric to student-centric. The educator's conception of learning and teaching (COLT) affects the way in which faculty teach and, ultimately, how students learn. Our goal was to research the COLT for Basic Science faculty at a medical school and how it is relate to time dedicated to teaching and their choice of teaching methodologies. 

METHODS: It was a cross-sectional study using survey methodology. Quantitative data were anonymously surveyed 130 faculty members who taught Basic Sciences in the 2018 at Virginia Tech Carilion School of Medicine. We used 2 scales of the COLT survey (Jacobs et al., 2012): 1)Teacher Centeredness (TC) and 2)Appreciation of Active Learning (AL). We also collected information on teaching experience and teaching methodologies. Reliability for the survey was assessed with Cronbach's alpha test. Correlation and Chi Square were used to examine relationships between variables. Analysis of Variance was used to examine group differences. 

RESULTS: The response rate was 38%. Overall, BS faculty scored higher on AL (4.06±0.41) and lower in TC (3.12±0.6) regardless of gender and degree. 17 disciplines were listed and 21 teaching modalities reported. Most faculty lecture (80%), and laboratory (20%) were used by faculty who scored high on TC (F= 8.69;p=.005). Younger faculty (30-39y.o.) score lower than older (50-59 y.o.) on TC (F=3.29;p=.027). More variety of teaching styles was reported among faculty with a lower score in TC (r=-.323,p=.022), a higher academic rank (r=.401; p=0.006), and more time teaching (r=.483;p=0.001). 

CONCLUSIONS: Faculty overall appreciated active learning to a greater extent than teacher centered but a majority faculty lecture. Diverse teaching methods are observed with faculty with a lower score on teacher centered, high rank and more time teaching. The data suggested that experienced faculty would prefer active learning approaches.


116 - Integrated assessment in a competency-based didactic curriculum

Lise Johnson | Cathy Ruff
Rocky Vista University 

PURPOSE: The Physician Assistant (PA) program at Rocky Vista University is the first competency-by-design PA program in the United States. One of the novel features of this program is the fully competency-based didactic curriculum.  Assessment is a challenging feature of all competency-based programs which becomes even more difficult in the context of classroom education. Requirements for a competency-based assessment include: an objective standard of performance, an opportunity for students to demonstrate different levels of mastery, integration of subject material across different courses, and the ability to identify and provided targeted interventions for struggling learners. 

METHODS: To satisfy these requirements a novel assessment model was developed for the RVU PA didactic curriculum. The major features of this assessment are: It is integrated across all of the didactic courses. The faculty choose a common presentation and each course director writes questions relating to that presentation. The questions are broad and open-ended, answered by students in a short answer or essay style. Grading is not based on points but on the students' demonstration of knowledge at a benchmarked milestone. Students who do not achieve the expected milestone on one or more questions are asked to retake that question within a short time frame. 

RESULTS: These integrated assignments were implemented in the PA 2019-2020 academic year, interleaved with more traditional multiple-choice block exams. Student and faculty survey responses are reported. 

CONCLUSION: Integrated assignments are a novel tool for assessing student competence. This assessment format allows faculty to identify and correct any learning deficiencies early and provides a mechanism for tracking learner development.


117 - Implementation Of Entrustable Professional Attributes For Student Evaluations And Medical Student Performance Evaluations
Linda R Adksion | Marc T Zubrow
Trinity Medical Sciences University 

PURPOSE: Trinity School of Medicine adopted Entrustable Professional Attributes (EPAs) in 2016.  Five EPAs were adopted for pre-clerkship students and thirteen were adopted for core clerkship and elective students.  Described here is implementation of EPAs in 2019.  

METHODS: EPAs were introduced to faculty at all sites and a new assessment tool was developed.  The thirteen EPAs were distributed in six cores clerkships so that each EPA was assessed at least three times during the third year. For electives, preceptors were provided all thirteen and asked to assess those appropriate for the particular elective. Cumulative outcomes for each student were included in the Medical Student Performance Evaluation (MSPE). Students and faculty provided feedback on the process.  

RESULTS:  Though faculty development sessions occurred in twice a year in 2017-2018, implementation of the new assessment tool in clerkships resulted in slow completion of evaluation forms through the first few months.  This delay was less prevalent in the pre-clerkship setting.  Those students who completed graduation requirements in May had fewer evaluations than those who continued cores and electives through August when MSPEs were being completed.  Students with more elective assessments had more EPAs assessed than those in cores in which only a sub-set of EPAs were completed per clerkship. Students were pleased with these assessments being included in the MSPE. Faculty found the information very helpful for residency letters of recommendation.  Debriefings provided suggestions to improve the process. 

CONCLUSION:  The implementation of EPA assessments was an important step towards addressing entrustment of graduates. While no entrustment level was determined for students, a cumulative report was developed to provide a guide to program directors regarding the level of performance in the EPAs, along with other information, for residency applicants. 


118 - Developing a Model to Rapidly Assess the Mechanism of Disease Map
Raleigh Ems | Leslie H. Fall, MD | Davis Harris PhD | Khiet Ngo DO, MS | Amy Wilson-Delfosse PhD
Case Western Reserve University School of Medicine | Giesel School of Medicine at Dartmouth, Aquifer | University of Central Florida | Loma Linda University School of Medicine 

PURPOSE: Concept maps are a graphical representation of knowledge structures that rely on hierarchical organization and links.  The Mechanism of Disease (MOD) map is a special type of concept map that represents the integration of causal mechanisms that describe any given clinical condition within an Integrated Illness Script (an integration tool developed by the Aquifer Sciences initiative). Distinguishing characteristics of the MOD map include lack of a true hierarchy, initiation at an inciting event and propagation toward an endpoint of clinical features.  The degree of a point is the number of connections incident to it. Network analysis, and graph theory, consider features of networks, such as degree, to glean the importance of different points in the network. We propose using the principle of degree to assess quality of student generated MOD maps. This model will permit rapid assessment of student performance in the creation of maps and enable monitoring of learner progress of the learner over time.  

METHODS:  MOD maps generated by medical students at Case Western Reserve University were graded by a formula summing the three highest-degree nodes in a map. These scores were then compared to a previously-described rubric-based scoring system, applied by one expert grader, to assess concept maps. Twelve maps representing two different disease processes were used.  

RESULTS:  The correlation between the degree and expert graded model was 0.30.  

CONCLUSION:  A small correlation was found when a mathematical scoring method was compared to rubric grading of MOD maps. Modification of the mathematical model or including a greater number of maps and more expert rubric graders may improve this correlation. This work will be expanded to include MOD maps from four US medical schools, each using the maps for different purposes with different stages of learners.


119 - Estimating Usmle Step 1 Scores From Comlex Usa Level 1 Scores In An Osteopathic Medical Student Population
Fernando Gomez | Lielt Bedilu
Rocky Vista University School of Osteopathic Medicine

PURPOSE:With the onset of a single accreditation system and a single main residency match, residency directors will need to consider the comparability of the USMLE Step 1 scores and the COMLEX USA Level 1 scores submitted by their applicants. This study investigates whether a relationship between the scores on the two examinations exists within a population of students at Rocky Vista University College of Osteopathic Medicine (RVUCOM). 

METHODS:De-identified COMLEX-USA Level 1 and USMLE Step 1 scores of 298 students who took both examinations was provided by the RVUCOM Office of the Registrar. The USMLE Step 1 and COMLEX-USA Level 1 scores were analyzed.  Simplified equations were examined for ease of use in estimating how a student could potentially score on the USMLE Step 1 examination knowing their COMLEX-USA Level 1 result. 

RESULTS:The simplified equation USMLE = 0.2(COMLEX) + 110 gives a reasonable estimate of potential student score on the USMLE Step 1 examination for the cohort in our study. 

CONCLUSION:This study shows that for our examined cohort of osteopathic medicine students, who are educated on materials tested on both examinations, a simplified equation could be utilized to estimate expected USMLE Step 1 scores from the COMLEX-USA Level 1 scores.  However, one must consider that there could be a considerable margin of error in the estimate for an individual student.  All available information should be examined in evaluating residency applications and no applicants should be accepted or rejected based on this single examination score estimate.


120 - Filling The Gap In Musculoskeletal Medicine: Assessing Musculoskeletal Knowledge In Physician Assistant Students Prior To Graduation

Diane Visich
University of New England, Physician Assistant Program

PURPOSE:Physician assistants (PAs) are increasingly being called upon to fill gaps in Musculoskeletal (MSK) medicine. Numerous studies have examined future physicians' MSK clinical knowledge, but only one published study has examined the MSK knowledge of graduating PAs. The purpose of this study is to evaluate graduating PA students' MSK knowledge, explore methods to identify knowledge gaps, and examine the knowledge impact of orthopedic rotations. 

METHODS:MSK components of the PA Clinical Knowledge Rating and Assessment Tool (PACKRAT), Physician Assistant National Certification Examination (PANCE), and University of Pennsylvania Basic Competency Examination in Musculoskeletal Medicine (UP BCEMM) were utilized to assess 227 graduating PA student MSK knowledge. Pass rates, mean scores, and individual question performance were used to assess MSK knowledge and identify knowledge gaps.  The impact of elective orthopedic rotations on MSK knowledge was examined. 

RESULTS:Pass rates for UP BCEMM, PACKRAT, and PANCE were 63%, 38%, and 83% respectively with mean respective exam scores of 74.5%, 68.9% and 79%. Knowledge gaps were identified in neurology, anatomy, fracture care, and "red flag" case scenarios. Orthopedic rotations had a significant impact on MSK PANCE performance. 

CONCLUSIONS:UP BCEMM performance was higher than reported in previous studies with medical students, residents, and PA students, but may fall below current PA program benchmarks. PACKRAT was useful in identifying knowledge gaps, likely enhancing PANCE performance. Although MSK PANCE performance was favorable, it can only be used to identify gaps post-graduation, after PA program intervention is no longer possible.  Since PAs are increasingly being called upon to fill gaps in MSK medicine, further MSK knowledge studies triangulating data from both current widely accepted tools and new assessment tools should be undertaken to assess knowledge and identify gaps prior to graduation. Required orthopedic rotations should be considered to enhance MSK knowledge.


121 - Evaluation Of Osce As An Assessment Tool For Clinical Skills By Students' Feedback    
Assessment   Nataliya Haliyash | Nataliia Petrenko | Nadiia Pasyaka   
I.Horbachevsky Ternopil National Medical University 

PURPOSE OSCE was used for evaluation of 3rd-5th year students' progress at the Faculty of Medicine, I.Horbachevsky Ternopil National Medical University (TNMU). The aim of the study was to analyze students' feedback about the OSCE as an assessment tool for their clinical skills.

METHODS This study has a cross sectional descriptive design. 346 randomly selected students were involved in the survey: 121 of 3rd year (Group 1), 138 of 4th year (G2) and 87 of 5th year students (G3). The questionnaire developed by Pierre et al (2004) was adapted and translated into Ukrainian in this study. It assesses students' evaluation of the OSCE attributes, the quality of OSCE performance, and OSCE scoring and objectivity. OSCE stations covered skills on interviewing and physical examination, clinical procedures and clinical management.

RESULTS The majority of the students accepted OSCE as a good evaluation tool for their clinical performance. Most of them provided positive feedback about the OSCE attributes and agreed that OSCE was fair (G1 87.6%, G2 80.4%, G3 86.2%), covered a wide range of knowledge (G1 91.7%, G2 86.2%, G3 88.5%), felt that OSCE stations were well structured and sequenced (G1 93.4%, G2 89.8%, G3 91.9%). They reported that such type of OSCE minimized the chance of failing and highlighted areas of weaknesses. Going through the OSCE was a useful practical experience for most students. However, several students felt that OSCE was very stressful.

CONCLUSION The implementation of OSCE at Faculty of Medicine TNMU was a useful experience for students, and was considered a valuable and worthy for further development. The received feedback proved that OSCE is an acceptable, useful assessment tool for students' clinical performance.    

202 - A Narrative Review Of Interventions To Teach Medical Students How To Break Bad News
Vaishnavi Warrier | Dr. Archana Pradhan
Rutgers Robert Wood Johnson Medical School 

PURPOSE: Breaking bad news (BBN) is a key advanced communication skill that physicians must learn. We conducted a 15-year review of articles on BBN interventions in undergraduate medical education. We used these findings to present recommendations to medical educators on best practices for teaching medical students how to deliver bad news. 

Methods:Relevant literature was identified using the following databases: PubMed, Web of Science, ERIC, and CINAHL. A search for full-text articles in English that had been published in or after 2004 and met the criteria for testing an intervention focused on teaching medical students how to break bad news to patients was conducted. In the process, the authors reviewed 179 abstracts in 118 academic journals. The 16 studies that met the inclusion criteria of the literature review then underwent an appraisal using MERSQI, a tool used to evaluate the methodological quality of medical education research published by Cook and Reed in 2018. After appraisal of the 16 studies, 15 with MERSQI scores greater than 11.3 were included in the final analysis and summarized in the paper. 

RESULTS:The studies in this literature review have shown that the three-pronged approach of didactics-role play-student assessment can be effective. Future interventions should focus on providing longitudinal training in order to ensure retention of knowledge and encourage its incorporation into clinical practice. Along with training in BBN, students should receive feedback on nonverbal behavior, perceived empathetic responses, and the use of explicit and implicit language. Assessments should evaluate global communication skills, delivery of bad news, and empathy separately. 

CONCLUSION:The review reveals 1) standard components which should be included in an undergraduate BBN curriculum 2) a pressing need for utilizing a teaching and evaluation tool that incorporates nonverbal communication and 3) further need to test long-term curriculum retention.


203 - A Survey of Medical Educator Perceptions of Active Learning

Amber J. Heck | Veronica Y. Tatum | Courtney Cross | Amanda J. Chase
TCU and UNTHSC School of Medicine | Nova Southeastern University College of Allopathic Medicine

PURPOSE:Active learning is generally defined as an instructional method that engages students in the learning process by using meaningful learning activities in the classroom. Ample evidence in educational literature suggests that active learning improves student's comprehension and problem-solving. However, it is widely believed that many educators are reluctant to adopt it. The goal of this study was to explore medical educators' perceptions of active learning and identify potential barriers to implementation. 

METHODS:We developed a 25-question Qualtrics survey based on the Miller and Metz "perceptions of active learning" survey. We added 12 single response demographics questions to the 13 original survey questions. We launched the survey in August of 2019 and disseminated to over 2,800 subscribers via the DR-ED listserv. 

RESULTS:We collected 137 responses between August and November of 2019 from respondents from 49 states, who were primarily full-time PhDs, MDs, and DOs at MD and DO programs. 95.3% of respondents were familiar with the term active learning, and 91.5% had observed it in the classroom. Of those who observed it, 88.7% felt it was used effectively. 55.1% reported using active learning 20-50% of the time, however, 78.7% expressed the desire to use it more than 50% of the time. The most commonly cited reasons for not incorporating it included being lecture accustomed, lack of administrative support, and insufficient time to develop. 58% strongly agreed that students learn better from active learning than didactic lecture, and 62% agreed it improves long-term retention. 

CONCLUSIONS:We found overwhelming knowledge of and support for active learning among medical educators. The barriers perceived were related to institutional support for resource intensive active learning. Despite positive perceptions of active learning and medical educators' desires to incorporate more, a gap remains between institutional and medical educators' support of active learning.


215 - Unique Exposure To Ultrasound In Pre-Clinical Undergraduate Medical Education
Zarah Rosen | Doris Chan | Rachel Kelly | Lauren Hollifield | Diane Han | Nora Doyle, MD, MPH, MSc.
UNLV School of Medicine 

PURPOSE: Point-of-Care Ultrasound (POCUS) is increasingly valued across medical disciplines. As benefits of ultrasound are recognized, so too is the need to integrate ultrasound into undergraduate medical education (UME). Early exposure contributes to ease of use during clinical rotations. Our objective is to describe integration of POCUS before clinical immersion and how efforts were perceived. 

METHODS: 58 medical students participated in a hands-on training session before initiation of clerkship duties. A brief didactic introduction for ultrasound techniques began each session. Students were divided into duos and rotated through 6 stations designed to provide training in ultrasound of the abdomen, head/neck, and cardiac. Each station consisted of a clinical scenario, ultrasound machine, standardized patient/model, and instructor. Student feedback was collected via 6-point questionnaire at the end of the session. 

RESULTS: 58/58 students completed the survey, positively evaluating clinical relevance and student satisfaction. 58/58 students answered "yes" that "the session met the stated learning objectives," 57/58 answered "yes" that "the learning environment was conducive to my acquiring new skills." Comments were entered in an optional field with the descriptors "great" and "helpful" trending throughout feedback, indicating high student satisfaction. 

CONCLUSIONS: UME is changing, with new challenges to preparing students for clinical years including the incorporation of POCUS. The overwhelmingly positive feedback for our session indicates integrating POCUS as an educational tool with hands-on ultrasound practice can provide engaging and applicable skills for medical students.


216 - University-wide assessment of healthcare programs for readiness of team-based interprofessional education

Cassie Jackson
Medical Student at USD SSOM

PURPOSE: Modern healthcare occurs in a dynamic and complex environment that requires providers to work together, collaborate, and quickly adapt to the continuously changing work environment. To prepare providers to meet these demands, practical healthcare and academia establish inter-professional education (IPE) opportunities for healthcare professions. According to constructivist theory of learning, readiness to accept or reject given concepts determines the learning outcome. The USD SSOM research group has performed an institution-wide assessment of readiness of healthcare students to participate in IPE activities.  

METHODS: Using a 29-item survey, the researchers assessed healthcare students' attitudes toward IPE, readiness to learn, readiness to teach and degree of development of professional identity.  

RESULTS: Students from all programs felt that their readiness to teach and to learn increases through the curriculum. Medical students' professional identity increased through the curriculum, rapidly inclined during clinical rotations. Nursing and PT/OT students' professional identity started high then rapidly declined early within the program's curriculum and increased toward the graduation. Knowledge of the professional roles of the other professions was uniformly high across all the professions, then decreased at the middle to ¾ of the programs' curricula and increased toward the end of the corresponding curricula. At the time of graduation, nursing students' knowledge of the professional roles of the other healthcare providers was lowest. Overall IPE attitude scores were high at the beginning of the curricula, declined toward the middle to ¾ of the curricula, and increased toward the graduation time. At the time of graduation, nursing students had the highest interest toward IPE among tested specialties.  

CONCLUSION: Obtained results were used in establishing the optimal time in the medical and health sciences school curricula to institute IPE, identify its content, sequence of activities, number of professions involved in a single activity, as well as other attributes of the IPE curricula.


217 - Study of the Feasibility of an Elective in Clinical Nutrition with Culinary Medicine Workshops
Lindsey Leggett | Kareem Ahmed | Cheryl Vanier | Amina Sadik
Touro University Nevada College of Osteopathic Medicine 

PURPOSE: This study aimed to determine current satisfaction with the nutrition curriculum offered to students of Touro University Nevada, College of Osteopathic Medicine (TUNCOM) and assess interest in and the feasibility of an elective comprised of clinical nutrition supplemented with culinary medicine workshops as a means to fulfill this potential gap in the curriculum. 

METHODS: The study design consisted of two surveys, one for the first and second-year cohorts (n=310) and one for the third and fourth-year cohorts (n=240). Results were utilized in the formation of a pilot course consisting of two culinary medicine sessions. After the completion of the two pilot sessions, a survey was sent to all participants (n=16) to evaluate the course with changes implemented accordingly. 

RESULTS: First and second-year students agreed that nutrition counseling is an important component of patient care and that physicians are not adequately trained in nutrition. Third and fourth-year students indicated that they should have had more time devoted to nutrition and that they do not currently feel prepared to counsel patients regarding nutrition-linked diseases. Overall, 84% of students reported being interested in the proposed elective. The most popular method of instruction depended on the year of the student, preclinical year students preferred the in-class setting, third-year students preferred online lectures and fourth-year students preferred online PowerPoints. All levels of students preferred the culinary sessions to occur once every two weeks. 

CONCLUSIONS: The results of the surveys demonstrated that students view nutrition counseling as an important component of patient care, but currently feel unprepared and are not satisfied with the nutrition curriculum offered at TUNCOM. Students are very interested in a clinical nutrition with culinary medicine workshops elective. The overall results of the surveys and the success of the pilot sessions strongly demonstrate the need for the proposed elective. 


218 - The first team: Using anatomy lab groups to teach teamwork in medicine
Valerie J Lang | Michelle Prong
University of Rochester School of Medicine & Dentistry

PURPOSE: With the emphasis on team-based care in medicine, there is an intensifying need to teach medical students teamwork principles. Gross anatomy lab groups are typically the first "teams" students experience during medical school.  We created serial workshops to introduce teamwork principles and develop students' awareness of their own and their teammates' personality preferences, and the impact on team functioning. 

METHODS: First year medical students in their Human Structure and Function course participated in 3-hour workshops at months 1 and 3. In workshop 1, students completed personality inventories based on Myers-Briggs personality types, then reviewed their reports.  A didactic introduced the strengths and limitations of categorizations and importance of diverse teams.  Students with similar results discussed their preferences, including characteristics of people they find more or less challenging to work with, and feelings about constructive feedback.  Then students reorganized into their anatomy lab groups, where they discussed their preferences, how these preferences could support or challenge the group, and how to address these challenges, and completed written reflections.  In workshop 2a clinician introduced principles of interdisicplinary teamwork and their impact on patients. Students shared their own narratives about dissecting a donor and reflected on how they handled a teamwork challenge and experienced giving and receiving constructive feedback with their lab groups.  Reflections and narrative evaluations were reviewed. 

RESULTS: 102 students participated in each session. Reflections described a range of scenarios among lab groups that parallel issues common among clinical teams.  Evaluations reflected a spectrum of opinion ranging from highly valuing structured time to address lab group team dynamics and personal experiences dissecting a donor, to concern about the validity of personality inventories.  

CONCLUSION: Anatomy lab groups are appropriate for introducing principles of teamwork. Future sessions will emphasize the relative validity of personality inventories for reflection versus research.


219 - Innovative Approaches in Creating LGBT-Inclusive Undergraduate Medical Education

Douglas J. Koch | Marcine Pickron-Davis, PhD
Philadelphia College of Osteopathic Medicine 

PURPOSE: In the US, those who identify as lesbian, gay, bisexual, or transgender (LGBT) represent an estimated 4.7% of the total adult population. Studies reveal that this population experiences health disparities resulting in higher rates of substance abuse, mental illness, increased risk of sexually transmitted infections, delayed health screenings, and suicide. There are numerous barriers to health care for LGBT individuals with the largest barrier reported as the paucity of knowledgeable LGBT-inclusive healthcare providers.  Organizations such as AAMC, The Institute of Medicine, The Joint Commission, and the United States Department of Health and Human Services have all identified increased training and education as a strategy to eliminate this health crisis. In this poster session, we introduce one medical school's approach to preparing clinicians to be culturally competent and responsive healthcare providers for this vulnerable population. 

METHODS: Through a multi-pronged approach, Philadelphia College of Osteopathic Medical Education has supported an LGBT-inclusive medical education by focusing on campus programming, curriculum, and faculty/staff professional development. 

RESULTS: Outcomes to our efforts include: Transgender in Medicine Lecture Series; mandatory Gender and Sexuality IPE; the incorporation of trans standardized patients in the Clinical Learning and Assessment Center; partnerships with local LGBT-serving healthcare centers for clinical rotations;  the development of a Diversity and Inclusion Strategic Plan; partnerships with graduates who are experts in the field of trans-medicine (need a better term); and offering an in-house developed training in the area of LGBT competencies to faculty, staff, and students. 

CONCLUSION: Capitalizing on existing internal relationships and partnering with community resources, PCOM is a leader in educating future clinicians well equipped to meet the unique needs of the LGBT community.


220 - Inspiring Wonder In A Neuroscience Curriculum
Mario Loomis
Sam Houston State University College of Osteopathic Medicine

PURPOSE: To design a neuroscience curriculum that improves retention by shifting the focus from "what, where, and how," to "why." 

METHODS: Each subject in the curriculum was framed with a question designed to inspire wonder and reflection, mental retrieval of previously learned information, incorporation of new information, and consolidation with multiple association cortices, all of which facilitate and improve long-term learning.

RESULTS: While some framing questions in the curriculum have identifiable answers, such as "why is there an optic chiasm?" others do not. Asked the question, "Why do touch and pain fibers cross at different CNS levels?" a student retrieves information regarding the spinal sensory tracts and consolidates that information with multiple association cortices to propose a reason why. Suffering a blow on one side of the spine, one would lose touch, but not pain sense on that side, which would better maintain self-defense. Likewise, while teaching the subject of retinal cones, the following is asked: as the primary colors red (564nm) and blue (437nm) combine to form violet, why is the wavelength of violet (410nm) even shorter than that of blue, and how do our cones detect it, since blue cones (S-cones) are the shortest wavelength cones? Retrieving information regarding the EM spectrum, a student proposes a circular model, rather than the traditional linear one, with an asymptote between blue and red. Thus violet light could stimulate both blue cones (S-cones) and red cones (L-cones) and the color violet be perceived. Even if such proposals prove to be inaccurate, the process will have still served its purpose by increasing long-term memory of the details. 

CONCLUSION: We have designed a neuroscience curriculum to inspire wonder through reflective questioning, optimizing retention through mental retrieval and consolidation. 


221 - Integrating Hands-on Culinary Education in Medical School Curricula
Hany Ibrahim | Krista Lund | Michael A. Conte | Leslie D. Catron
College of Osteopathic Medicine, California Health Sciences University 

PURPOSE:While it is expected that nutrition will be a central focus for healthcare in the future, many healthcare providers find it difficult to confidently counsel their patients on healthy eating habits. This is primarily due to a lack of adequate nutritional training, which often results in the provider electing to defer to costly or unavailable specialists instead of taking the lead in providing nutrition counseling. As a result, a fertile opportunity is missed to prevent and mitigate diseases, to improve healthcare outcomes and reduce rising health care costs. Medical school provides a favorable environment to incorporate culinary and nutrition education prior to practice. This highlights the need to discuss the obstacles to integrate nutrition education into medical school curricula and develop effective strategies to improve nutrition education for health care professionals. 

METHODS: The College of Osteopathic Medicine at California Health Sciences University assessed and recognized the need for developing strategies to allow for hands-on culinary education to be incorporated in its curriculum for a smoother transition of nutrition science to clinical practice. 

RESULTS: The leadership of the College of Osteopathic Medicine took ownership of the challenge and solution by collaborating with other stakeholders in the College of Pharmacy, the university, and other community leaders to overcome the obstacles to nutrition education. 

CONCLUSIONS:  Securing adequate resources to build an on-campus teaching and demonstration kitchen and effectively integrating nutrition into medical school curriculum is critical for promoting the well-being of students and empowering them with tools to truly embrace the osteopathic philosophy by holistically evaluating and treating their future patients. The teaching kitchen is to be utilized for offering hands-on experiences in culinary medical courses and community seminars to provide evidence-based recommendations to a wide range of audiences including students, faculty, patients, and interested community members. 


222 - Interprofessional Education and Practice - Clinical Laboratory Sciences and Medical Students
Norman Farr | Janet Enderle
University of Texas Medical Branch, Galveston, TX 

PURPOSE: An interprofessional educational activity to increase medical students' understanding of diagnostic lab testing and to prepare students for future collaborative practice with Clinical Laboratory Scientists (CLS). As the field of laboratory medicine has exploded, it is increasingly important for physicians to work with CLS in the shared care of patients. The importance of this collaboration and opportunity for interprofessional education is under-recognized in the literature and practice. 

METHODS: Medical students worked with CLS students in 2 clinical-skills workshops, phlebotomy and diagnostic testing. Teams of medical students rotated through a series of diagnostic testing stations led by a CLS student, receiving and interpreting results on simulated patients to make clinical diagnoses, an innovative approach to teaching this content. Medical students evaluated the sessions on multiple domains. 

RESULTS: 91% (210) of students completed the evaluations, 90% agree or strongly agree that the workshops provided helpful feedback and preparation for clerkships. On a pre(224) and post(154) workshop survey, the answers of strongly disagree and disagree decreased while the response of strongly agree increased in the post-survey: 1) I understand the role of CLS professionals within an interprofessional team -- increased by 8% (p = .03), 2) I have an understanding of how I will work with CLS professionals -- increased by 8% (p = .03), 3) I have an understanding of the role CLS professionals play in patient care -- increased by 6% (p = .04). 

CONCLUSIONS: This novel interprofessional educational activity increased understanding of diagnostic lab testing, how students will work with CLS, how CLS contribute to patient care and prepared students for future collaborative practice. This activity is easily adaptable both in content of the workshop and in working in an interprofessional team with CLS colleagues. 


223 - Lessons to integrate preclinical sciences in an Ecuadorian medical school: a quasi-experimental study. 
Ana Maria Gomez Jaramillo
Universidad Europea de Madrid
No poster provided

PURPOSE: This study aims to evaluate the impact of a curricular change in the preclinical track implemented during 2011 in the School of Medicine of San Francisco University of Quito (USFQ) in Ecuador. 

METHODS: USFQ School of Medicine offers a 6-year education program that leads to an MD degree. Before 2011 its curriculum was arranged with the first 2 years focused on basic sciences and the next 4 years dedicated to clinical science training. During 2011 USFQ implemented a brand new third-year to strengthen the basic and preclinical sciences. In order to evaluate this curriculum change, we used the scores of the NBME-CBSE exams as the outcome variable. The sample consisted of a total number of 506 medical students, cohort before 2011 (199 students) and cohort after 2011 (307 students). We perform ANOVA to assess variation in the performance of the NBME-CBSE exams between cohorts. In addition, to evaluate the correlation between scores, time and the number of exams attempts we conducted correlation and linear regression analysis. 

RESULTS: Before 2011, the NBME-CBSE score was 44,6  8,9 and after the curricular change it was 49,32  9,5. Overall, we observed a significant increment between the NBME-CSBE score over time. The largest difference in scores (9.4%) were between the years before 2011  and 2018-2019 (p-value:<0.001); 44,6 vs. 48.8, respectively. The correlation analysis shown a positive trend between the scores and time after the curriculum change. Further, the regression analysis shows that for every additional attempt in the NBME-CBSE the overall score decrease in ~0.6 point. 


224 - Medical Student Perspectives On A Structured Medical Student Leadership Curriculum
Sarah Meeuwsen | Michael Sobin | Robert Treat | Kurt Pfeifer | Jeffery Fritz
Medical College of Wisconsin 

PURPOSE: U.S. medical schools have responded to the call to include leadership development in undergraduate medical school curriculums. Structured leadership programs have developed skills that increase the probability of future success. However, only 55 % of U.S. medical schools provide leadership education for their students. We assessed medical students at a private, Midwestern medical school on the importance of and desire to pursue leadership training.  

METHODS: In 2019 an electronic survey was developed to incorporate aspects of demographics, previous and current leadership experience, and perspectives on importance and delivery style of a medical student leadership curriculum and distributed electronically (e-mail/social media). The importance of leadership skills used a 10-point scale (10=high). Dependent t-tests and Spearman rho correlations generated with IBM® SPSS® 24.0.  

RESULTS: One hundred fifty-five (20%) medical students completed the survey. Fifty-six percent reported formal leadership education as an important part of a medical school curriculum. Students were willing to take time to learn leadership skills by replacing a current class session (39%) or via one-day conference (32%).  The importance of faculty leadership skills (8.5(+/-2.0) was rated significantly higher (p<0.001) than student leadership skills (7.0(+/-2.0) and were significantly correlated (rho=0.5, p<0.001). The importance of student leadership skills was significantly correlated (all p<0.050) with pathway activities (rho=0.5), wellness activities (rho=0.4), extracurricular activities (rho=0.3), clinical skill courses (rho=0.2).  

CONCLUSIONS: Our findings report that medical students view leadership education at the same level of importance as electives, wellness activities, and clinical didactics.  Students reported that leadership skills were important for themselves and faculty but had higher expectations as learners developed professionally. The primary barriers to student interest in a leadership curriculum include a full course schedule and perceived difficulty teaching leadership skills. Future studies will examine the impact of formal medical student leadership curriculum and identify optimal modes of leadership training delivery. 


225 - Missing Piece Of The Health Disparity Puzzle: Transgender Education
Janice Schwartz
Michigan State University College of Osteopathic Medicine
No poster provided

PURPOSE: Trans health content is often lacking in core courses and residency programs yet the number of individuals identifying as transgender is growing. Delivering high quality healthcare to this segment of the population has become a National priority. Various efforts are being put forth to address this issue. In this abstract we describe the design of an educational approach involving the development of realistic clinical cases and discuss our expectations for improvements in learning outcomes for the future. 

METHODS: As a first step in this process we set out to evaluate the prior curricular exposure and clinical training levels of medical students at a single college of osteopathic medicine, in years I though IV, and residents in the Statewide Campus System, at all levels of training. In order to accomplish this, we conducted a cross-sectional, institutional board reviewed, internet-based survey between November 2018 and February 2019 which produced 116 completed responses. Findings from these surveys, which included 12 rating items and responses in an open-ended comments section, overwhelmingly pointed to a need to expand the transgender health content of pre-clerkship courses and provide more training opportunities during clerkship and residency rotations. We used video technology as a versatile and realistic means of designing transgender teaching cases reflecting the specific and general health care presentations of individuals in this population. 

RESULTS: Twelve transgender teaching cases have been developed -- four for each of three major competencies in medical education: Cultural Competency, Medical Knowledge, and Inter-professional Health Care. Representative cases are undergoing pilot testing to evaluate the alignment of case content with 1) accompanying assessments; 2) the content of core courses; and 3) current standards of care. 

CONCLUSIONS: Lesson learned: For quality assurance each case will be designed with learning outcomes, questions, and answers that correspond to best practices for healthcare and national board competencies. 


226 - Promotion Of Wellness On Us Medical School Websites
Gabi N Waite | Tanya J Giuliani | Mary P Pelkowski | David B Averill
Geisinger Commonwealth School of Medicine 

PURPOSE: During the past 5 years, physician burnout has been 60-75% greater than the general population. Burnout of medical students is also a concern because this cohort presents with emotional exhaustion and a low sense of personal satisfaction. This study examined how US medical schools have addressed wellness and resilience on their publicly accessible webpages. 

METHODS: We accessed the websites of 191 medical schools listed by the American Associations of Medical Colleges (AAMC) and of Colleges of Osteopathic Medicine (AACOM). During the summer of 2019, these websites were searched for wellness and resilience programs using a list of defined keywords. The location of these programs in curriculum and student services or affairs was of further interest. Ease of locating information was rated as 1-easy, 2-moderate, or 3-difficult. We used PubMed to determine how many schools had published findings on the efficacy of their wellness programs. 

RESULTS: Approximately 70% of medical schools (64% allopathic; 74% osteopathic schools) provided information about wellness programs on their websites. Only 22% of schools (30% allopathic; 14% osteopathic) identified enhancement of student resilience as a specific goal. The ease of finding this data averaged 1.6. Approximately 2% of medical schools reported findings on the effectiveness of their wellness or resilience programs. 

CONCLUSION: A majority of medical schools highlighted wellness programs on their websites. This finding aligns with initiatives of the AAMC and AACOM to enhance the wellness and resilience of medical students. The ease of finding detailed information on wellness and resilience as part of curricula or activities of student affairs suggests that medical schools have identified student burnout as an issue requiring attention. Further, scholarly assessment of these programs is small. We recommend that more systematic approaches should be used to understand the success of medical schools in combatting student burnout. 


227 - Service Learning: A Framework For Enhancing Learning Opportunity At A Caribbean Medical School
Samal Nauhria | Amitabha Basu | Irene Derksen
St.Matthews University 

PURPOSE: Liaison Committee on Medical Education recommends that medical program provides sufficient opportunities for participation in service-learning and community activities to students. We attempted to appraise the framework that provides an opportunity for students to learn priority health conditions, local culture, and health practices in the community, incorporate or upscale these conditions in the curriculum. Additionally, we wanted to recognize competencies students comprehend from this activity. 

METHODS: Students volunteer at the yearly health fair organized by our university and local health agencies. A qualitative methodology is used to learn these student's perceptions about their activities at the health fairs. Two focus groups of 7 and 8 students, who participated in the fair in the past 2 years, were interviewed using a set of open-ended questions. Response audio were recorded, transcribed, hand-coded and categorized based on common themes. 

RESULTS: Reportedly, students valued this activity as they learned to collect blood samples from a finger prick, using the instruments and interviewing skills. They got a chance to apply their patient-examination skills learned at the university. Adult-onset diabetes, hypertension, and nutritional imbalance appear to be a common occurrence in the community. The students gained an enhanced understanding of the following competencies: Communication skills ("learned how to explain it to the patients, interacted with them"); Professionalism and Teamwork ("Was working with a nurse, I think her name was Nancy"); Social responsibility ("To educate the community on their health, without them a community may seem under served"). 

CONCLUSION: This existing framework promotes student's participation in community activities, learning actively, identifying common diseases and emphasizing these diseases in the curriculum. We are working on a proposal for incorporating service-learning as an optional 1-credit course in the Basic Science curriculum.


228 - How do pre-clinical medical students define self-directed learning?

Alexandra Csortan | Lauren Pomerantz | Jason Pollock | Jonathan Kibble | Christine Kauffman
University of Central Florida College of Medicine 

PURPOSE: The Liaison Committee on Medical Education (LCME) requires allotment of unscheduled time for self-directed learning to facilitate the development of lifelong learning skills. The LCME's definition of self-directed learning includes an educational needs self-assessment, individual mastery of information, resource credibility assessment, and subsequent feedback. The purpose of this study was to determine the medical student perspective and understanding of self-directed learning during the pre-clinical curriculum. 

METHODS: Focus groups were performed using nominal group technique to assess second-year, first-year, and newly matriculated medical student's understanding by asking them to identify the meaning of self-directed learning. Two separate focus groups were performed for each class. The resulting qualitative answers with their numerical scores were then compared within and between each class. Self-regulated learning theory was used as a model incorporating overarching themes of planning, learning, assessment, and adjustment. 

RESULTS: The second-year medical students predominantly emphasized definitions within the scope of learning including learning strategies, styles, and methods used to accomplish provided objectives. First-year medical students emphasized planning including goal setting, self-efficacy, and motivation in the context of an expected curriculum and cumulatively ranked the learning theme lower. Conversely, newly matriculated medical students predominantly accentuated the theme of planning with only some mention of learning style to learn necessary information. Themes of assessment and adjustment were neglected by each cohort in the top ranked definitions. 

CONCLUSIONS: The results from initial matriculation to the second year evince a gradient of transition from planning goals of education to using learning strategies. Students interpreted self-directed learning in the context of achieving faculty-defined objectives rather than defining their own learning outcomes. To encourage unified understanding of self-directed learning and development of lifelong learning skills, the pre-clinical curriculum can better underscore the purpose and components of self-directed learning in addition to allotting sufficient time for achievement.


229 - Implementation Of Skills Competencies Across A Medical Curriculum
Jamil Ibrahim | Linda Adkison | Mignonette Sotto | Frances Jack-Edwards | Bernadette Scott | Amrie Morris-Patterson
Trinity Medical Sciences University School of Medicine

PURPOSE:  To further define the curriculum map for the Trinity Medical Sciences University School of Medicine (TMSU-SOM) and to better document the development of students' clinical skills, the faculty developed a clear expectations for the introduction of skills and level of mastery.  At the end of four clinical terms, student skills were assessed in an objective structured clinical examination and a summary report was provided to the clinical chair of the first clerkship. 

METHODS:  A review of the clinical skills curriculum provided a list of skills introduced and assessed either as formative or summative assessments.  Students documented practice of these skills during pre-clerkship terms in a skills log.  Skills were mapped as "introduced/practiced" and "expected to perform."  Clinical clerkship chairs participated in mapping expectations for clerkships.  The map was reviewed annually.   An Individual Clinical Skills Assessment form was developed to provide information to clinical chairs as students entered clerkship training. 

RESULTS:  The Skills Map provided a clear expectation for students and was included in each course's master syllabi.  Students acknowledged increased transparency on expectations. Among pre-clerkship clinical faculty, the map provided improved reproducibility of expectations during terms and for the two year evaluation of students.  The Clinical Skills Assessments provided clinical chair with insight into each starting student and led to better alignment of students with preceptors.  Assessment outcomes could also be used in letters of reference and the assessments used for the Medical Student Performance Evaluation. 

CONCLUSION: Developing a clear and progressive expectation of skills development provides repetitiveness needed leading to competency.  The benchmarks provided transparency for assessment which students appreciated.  The Clinical Skills Assessments were well received by clinical faculty. 


230 - Enriching Medical Student Learning Experiences

K James Kallail | Pam Shaw | Tyler Hughes | Benito Berardo
KU School of Medicine-Wichita | KU School of Medicine-Kansas City | KU School of Medicine-Salina 

PURPOSE: Medical students must develop skills in assessing their own learning needs and developing strategies to meet those needs. Medical curricula should be designed to provide active and enriching ways to explore medicine beyond the classroom. The program should enhance the elements of motivation, discovery, innovation, social services, cultural exploration, and personal development. 

METHODS: The University of Kansas School of Medicine instituted a new curriculum in 2017 called ACE (Active, Competency-based, and Excellence-driven). Eight one-week courses of enrichment experiences are embedded within the first two years of the curriculum. After each of eight medical content blocks, students are required to participate in a one-week, non-graded enrichment experience according to their own learning needs and interests. Students choose the type of enrichment activities including clinical experiences, professional development, leadership development, research and scholarly activity, and community engagement. 

RESULTS: A total of 196 enrichment activities at three campuses were developed for 211 students during the first two years of medical school. Most students selected clinical experiences with enrichments available in most medical specialties and sub-specialties. Students also use enrichment weeks to conduct research/scholarly activity, particularly those students pursuing the Honors Track. A total of 2071 enrichment experiences were completed in the first two years. 

CONCLUSIONS: An administrative burden exists to provide so many different experiences to 211 students during each enrichment week. Most enrichments involved clinical experiences, although research/scholarly activity and professional development enrichments also were popular. Evaluations from students and antidotal data suggested enrichments are popular among students and a good change of pace from the usual rigorous activities of the curriculum. Because of the large number of experiences required to conduct the enrichment weeks, a continuous process of evaluation is required to maintain a robust program.


231 - First Year Medical Students' Perceptions Of A Classroom Activity On Entrustable Professional Activity (Epa) 4: Enter And Discuss Orders And Prescriptions
Kin S. Ly | Barbara Winterson
University of New England College of Osteopathic Medicine | University of New England College of Osteopathic Medicine

PURPOSE: All medical students should be able to perform the Core Entrustable Professional Activities (EPAs) upon entering residency. While some medical schools focus on the EPAs during the 3rd and 4th years, there is limited data on preparing students for the EPAs during the 1st and 2nd years of undergraduate medical education. This abstract describes a classroom activity introducing first year medical students to EPA 4. 

METHODS: In a 2 hour session of a Year 1 Osteopathic Medical Knowledge course, students were introduced to all thirteen EPAs, with a focus on prescription writing, a component of EPA 4. Information on state legal requirements for a prescription order, use of an electronic database to find medication selection/dosing information, and how to write a prescription order was provided. Afterwards, students were each given a clinical case, expected to write a prescription order, and encouraged to discuss their assigned case with their team members. 164 first year medical students were surveyed pre- and post-classroom activity for self-assessment of their knowledge and comfort with EPA 4. 

RESULTS: Pre-class survey results showed a majority of students never heard of EPAs prior to the activity. Students showed a large improvement in their understanding of state law requirements for prescriptions, felt more comfortable in choosing and dosing the appropriate medication, and writing a prescription after the activity. Open-ended survey questions allowed for qualitative data regarding how the students felt about the activity and ways in which it could be improved. 

CONCLUSIONS: Implementing an active classroom session on EPA 4 in the first year of medical school is a novel and engaging way to introduce medical students to EPAs. Students gain valuable team-working skills, have an opportunity to apply what they learned in microbiology and pharmacology, and become more comfortable with their future roles as physicians. 


232 - Challenge based learning: On how students opinion helps the faculty
Arturo Lajud | Oscar Gutierrez | Aniela Méndez-Reguera | Salma Armendariz-de-la-Fuente | Omar Ortega | Belinda Carrión
Tecnologico de Monterrey

PURPOSE: It is fundamental that Gen Z students take control of their own learning, teaching techniques, and adapt to their changing necessities. Hence our aim was to evaluate our student's knowledge regarding the first-semester curriculum with Challenge-based Learning (CBL) and obtain feedback on the difficulties they might encounter throughout it. 

METHODS: On an 18 week semester, divided in 5 week periods interspersed by an entrepreneur week, three questionnaires were sent to 109 health career students in 3 different times, with the aim of inquiring about the students' knowledge on CBL, opportunity areas in the curriculum design as well as them to recognize the skills needed to successfully achieve in the CBL model.  

RESULTS: Out of 109 students, 55 answered the survey. Only 26.7% had a clear understanding of the CBL curriculum, and 36.2% had previous CBL experience high school. When asked, 75% of them thought there wasn't a proper introduction to the new model. During the course of the semester students were asked about their main learning barrier, "adaptation to the new model" and "transition to a college education" were the most answered. Nonetheless, after the first two months, 70% considered their learning skills improved considerably (e.g. resilience, time management, critical thinking, and collaborative work) and by the end of the semester, 55.5% thought the challenge helped them incorporate the knowledge reviewed in the classroom. 

CONCLUSIONS: The implementation of a new curriculum is challenging for both (students and faculty). The results showed difficulties at beginning regarding the adaptation and adjustment to the model, and the need for the institution to consider the students' experience to improve the curriculum. 


233 - Daily Exposure To Electrocardiogram (Ecg)-Related Problems During Cardiovascular (Cv) Course Improved Second Year Medical (M2) Student Confidence And Performance In Ecg Interpretation
Sandra Pfister | Heidi Ludtke | Kimberly Dunisch | Kris Scheel | Marcie Berger
Medical College of Wisconsin, Milwaukee, WI 

PURPOSE: Accurate ECG interpretation is an essential proficiency for students to develop in their medical education. Yet most medical students lack confidence in these skills. M2 students enrolled in the CV course at MCW reported that there was not enough classroom time to learn ECGs and felt inadequately prepared. Starting in 2015, the CV unit provided daily take-home ECG problems for students to answer and submit for credit. 

METHODS: Students received ECG introductory lectures and then problems were posted to learning platform. Questions were multiple-choice format and first covered basic skills (e.g. calculate HR). The number of questions asked per day varied and more difficult concepts were progressively tested (e.g, identify left anterior fascicular block). Students had until midnight of the day the questions were posted to submit answers. Students were permitted to work independently or collaboratively on questions and were told the most important purpose of the ECG problems was to provide more experience in understanding difficult concepts. 

RESULTS: Approximately 30 questions were used and percent correct rate was typically between 85 and 100%. Participation was voluntary but the number of students that answered questions was similar each year (2015-2019) with close to 100% participation. Prior to 2015, scores on ECG-related exam questions averaged 81 ± 14% (2013-14). Since implementation of take-home ECG problems, the exam scores averaged 91 ± 7%. The upward trend in exam scores suggested that extra exposure to ECG interpretation was beneficial. Importantly, student comments reflected a greater confidence in understanding difficult ECGs and appreciation for having more practice. 

CONCLUSION: The addition of ECG problems that students could do outside of classroom time in a collaborative manner enhanced student confidence in ECG interpretation. This was reflected by student comments on end-of-course evaluations and better performance on ECG-related exam questions. 


234 - Design And Implementation Of Case-Based Collaboravie Learning (Cbcl) Teaching Communities At The University Of Kansas School Of Medicine
Melissa Quearry | Joseph Fontes | Gary C Doolittle | Giulia Bonaminio
University of Kansas School of Medicine 

PURPOSE: In 2017, the University of Kansas School of Medicine implemented an Active, Competency-Based, Excellence driven (ACE) curriculum.  A unique active learning activity of ACE is case-based collaborative learning (CBCL), where students work collaboratively in small groups, applying previously acquired scientific and clinical knowledge to address clinical cases.  Facilitation of CBCLs by non-content-expert faculty led to the creation of CBCL teaching communities.  This poster describes the process of developing and measuring the success of the communities. 

METHODS: Initial facilitator recruitment was by outreach to basic science and clinical departments by members of the planning committee for the new curriculum. Recruitment in subsequent years has been by email solicitation. Small groups of 7-8 students align with 29 facilitator groups (teaching communities).  With a total of 49 CBCLs in the first year, each faculty member facilitates 7 CBCLs. Second year is similar.  Faculty were intentionally placed into groups to achieve a mix of both basic scientists and clinicians as well as a diversity of disciplines and specialties.  Faculty assess student competencies, evaluate each case they facilitate and are evaluated by students at the end of each course. 

RESULTS: Facilitator attrition is low, with more than 80% remaining in the program since its implementation in 2017.  More than 82% of CBCL faculty facilitate cases in both years 1 and 2, representing 10 basic science and 19 clinical departments.  Faculty interest in joining communities is high, often from encouragement by current facilitators.  Survey results show high student and faculty satisfaction with CBCL.  Faculty participation in CBCL faculty development opportunities is high. 

CONCLUSION: Participation in CBCL teaching communities has produced a large and committed cadre of faculty invested in the ACE curriculum and CBCL.  Faculty satisfaction with CBCL has increased interest in facilitation and in the curriculum as a whole. 


235 - Development and Implementation of a Longitudinal, Research Curriculum for Osteopathic Medical Students
Jillian Lucas Baker | Susan Muller-Weeks | Jennifer Fischer | Adarsh Gupta | Magdala Chery | Raul DeLa Cadena | Rachel Shmuts | Millicent King Channell
Rowan University School of Osteopathic Medicine
No poster provided

PURPOSE: More medical students are engaging in research during medical school, however, some are lacking formal research training. Further, residency programs (which are becoming more competitive to secure) are now requiring residents to participate in research. To prepare students to be able to effectively engage in research, the new curriculum at RowanSOM now includes a longitudinal, research course, Medical Scholarship (MS), for all medical students. This abstract describes the curriculum development, implementation, and outcomes to date. 

METHODS: A multi-disciplinary advisory board with faculty and staff from RowanSOM was created to assist with the development of the MS course, selecting research educational sessions, sequencing of sessions, and course assignments. Course sessions included didactics on biostatistics, clinical informatics, developing research questions, epidemiology, health equity, research ethics, searching research databases, and writing literature reviews. Content was delivered through in-person lectures, small group assignments, and media presentations. 

RESULTS: The MS course has just completed its first semester. All students (N=210) participated in a one week, research introductory course. Before the course started, all students were assigned into a research working group. Each group was assigned to complete the following sections of a literature review: (1) a clinical research question (2) an annotated bibliography and an (3) introduction section. Student groups will complete the full literature reviews in the upcoming semester, conduct scientific, oral presentations on their clinical topics, and go through mock IRB submission process.   Course lecturers included faculty and staff members (N=12) from RowanSOM and Rowan University. 

CONCLUSIONS: It is vital for medical students to receive formal research straining to appreciate medical literature as well as understand the evidence behind medical care better. This research experience can lessen the burden of health disparities for the communities. This course could potentially serve as a model for research training for other medical school programs.


236 - Developing A Novel Multi-System Integrated Course For Osteopathic Medical School Curriculum
Yuan Zhao | Mary Manis | Hatem Elshabrawy
Sam Houston State University College of Osteopathic Medicine

PURPOSE: Sam Houston State University College of Osteopathic Medicine is developing the curriculum for its inaugural class. The first two years of didactic education will consist of a series of system-based courses that discuss different body systems in health and disease. In contrast to traditional system courses in which body systems are taught independently, we are proposing a course model that fully integrates two body systems by concurrently presenting them in the context of clinical cases. 

METHODS: We are applying our model to the Immune System and HEENT (head, eyes, ears, nose and throat) course. To tie together concepts and applications related to these two systems, we deliberately reviewed topics from the content outlines for the medical licensing examinations. Fundamental topics of the immune system will be covered and tied to their manifestations in the HEENT system including trauma, inflammation, infection and cancer. Concepts will be delivered through various active learning and problem-solving processes, and further consolidated in weekly case-based small group learning sessions. To assess the effectiveness of this model, exams, quizzes, and reflective writing will be employed. Course evaluations will be carefully reviewed to create a course improvement action plan. At the end of the course, a focus group qualitative study will be conducted to gain deeper understanding of students' perspectives on this new learning model. 

RESULTS: We believe that our new course model will provide the opportunity for our students to enhance their abilities to critically analyze multi-organ/system diseases and better retain the knowledge and skills necessary for success in clinical rotations and medical licensure examinations. 

CONCLUSION: This project has the potential to enhance motivation, curriculum satisfaction, and academic success of medical students. It may also provide insights into the development of similar courses in health care professional programs.


237 - Tackling Scientific Frontiers During Undergraduate Medical Education: Thinking Outside The Steps    
Curriculum   Jessica Chacon | Houriya Ayoubieh | Cynthia Perry | Maureen Francis | Curt Pfarr | Jorge Cervantes  
Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine

PURPOSE Despite efforts to introduce emerging biomedical advances into the curriculum at some medical schools, only a small percentage of students feel that their education has prepared them for an era of personalized medicine. As coursework introducing cutting-edge scientific discoveries is underrepresented in undergraduate training, we are developing a new horizontal curriculum thread to introduce students to these important advances, with a focus on evidence-based clinical utility.

METHODS As a first step toward developing a robust curriculum thread, the Paul L. Foster School of Medicine implemented a 2-hour session given to a hundred 1st year medical students entitled "Therapeutic Use of Stem Cells." In addition, we piloted a teaching strategy for 3rd year medical students focusing on "Scientific Hot Topics and New Discoveries" that included material on CRISPR/CAS-9 technology and cancer immunotherapy.

RESULTS Based on preliminary results of these pilot sessions, we are implementing a horizontal teaching strategy throughout the undergraduate curriculum that tackles scientific developments in genomic and precision medicine by presenting and discussing related basic science principles and potential clinical uses across various disciplines. Contextualized teaching using clinical cases will be used to demonstrate the potential utility and drawbacks of new technologies, such as sequencing technology, gene editing, and adoptive cell therapy. To evaluate the efficacy of our strategy, electronic surveys will be administered to determine students' attitudes regarding these sessions and their perspectives on engaging in scientific advances as they progress in their training and practice.

CONCLUSIONS We plan to undertake an educational strategy to promote core competencies regarding scientific frontiers in medicine to empower medical students to utilize scientific advances in the future. Strengthened with a deeper understanding of these technologies, students will have a greater appreciation of their use in modern medicine.    

302 - Can what students need also be what students want? Building integrated e-learning modules in a flipped classroom curriculum
Haviva M. Goldman
Drexel University College of Medicine
No poster provided

PURPOSE: E-learning modules play a central role in flipped classroom curricula, allowing students to access and learn required material prior to utilizing the information in an active-learning classroom setting.  E-modules can provide for more efficient delivery of content, as well as increased interactivity and integration.  As e-learning modules need to appeal to a diverse population of learners, creating a delivery method that meets the needs of both faculty and students can be a challenge. Here we report on the development of e-learning modules in our integrated, flipped classroom curriculum. 

METHODS: We experimented with a variety of commercial e-learning content creation programs and web design software with the goal of creating e-learning content that meets the perceived needs of both faculty and students. Specifically, faculty sought a platform that was easy to use, with resulting content being simple to navigate, accessible from any device, multimedia rich including video and images, and with quizzing/self-assessment capability with feedback. Students emphasized the need for modules to be downloadable for off-line use in note taking programs in a searchable, PDF format. 

RESULTS: E-learning content was created using commercial programs (Adobe Captivate, SoftChalk, Rapidweaver), as well as interactive PDF editors. Student feedback and lessons learned will be presented along with the resulting hybrid, modular format that incorporates the best aspects of each program while providing students with the downloadable materials they desire. 

CONCLUSIONS: Density of content and fast pace of delivery poses particular challenges in creating e-learning materials in Medical Education.  Faculty needs, student preferences and the nature of the curriculum all need to be considered in determining the best delivery mechanisms for e-learning materials. Balancing these demands can result in flexible formats that can appeal to a wide variety of users and curricular designs. 


303 - DDx: An evidence-based process for building online educational resources
Kendra Oliver
Vanderbilt University
No poster provided

PURPOSE: Vanderbilt University School of Medicine is a world leader in the areas of pharmacology, drug discovery, and drug development. Drug Discovery Online is a new program focused on the design and construction of online programs for students interested in the pharmaceutical industry. We sought to apply the latest approaches and state-of-the-art practices in online learning to develop these courses. The Drug Discovery Online program's goal is to increase the digital literacy of current students, showcase the rich research expertise within the Basic Sciences, School of Medicine, and reach additional students through creating online resources. 

METHODS: First, we aimed to create DDx courses, which stands for Discovery Diagnosis, and are short courses meant to serve as quick guides into exploring drug discovery and pharmacology topics. The goal of these mini-courses was to offer quick, to the point, lessons on drug discovery topics. An approach was developed that applies the science of learning and best practices in online education to develop the courses. After using this process, the courses were assessed using Quality Matters rubric and also student/faculty feedback. All aspects of the online course were assessed including the registration process, the online learning management system, and the individual course materials. 

RESULTS: Here, I present the approach, the assessment strategies, and the future direction for online course creation that we plan to use for Drug Discovery Online. Overall, we have iteratively improved the delivery, content, and methods used in our online educational resource approaches using evidence-based methods. 

CONCLUSIONS: The goal of this work was to streamline the online course development process. In doing so, I believe that we have develop an approach that could serve as a case study for the larger medical educator community and help direct future online resource development endeavors. 


304 - Development of a Case-Based Podcast Series to Improve Spaced Learning for USMLE STEP 1
Isheeta Madeka | Sydney Thomas | Marina Girgis | Timothy Peters
Wake Forest School of Medicine 

PURPOSE: Research in adult education has demonstrated the efficacy of spaced learning in improving acquisition and retention of learning compared to bolus education, or massed distribution of educational encounters. The Wake Forest School of Medicine (WFSOM) pre-clinical M.D. curriculum teaches general principles prior to organ system blocks. We believe better integration of general principles within organ system blocks via spaced learning will better prepare medical students for USMLE Step 1. Given the growing popularity of podcast learning as an adjunct study tool, we have created a case-based podcast to facilitate spaced learning of high-yield, board-relevant microbiology topics throughout the organ system blocks at WFSOM and assess its utility as a learning modality. 

METHODS: A podcast developed by the investigators will be distributed to first year medical students during their Neurology block. Students will be surveyed after the podcast release to assess the podcasts' effectiveness at illustrating high-yield, board-relevant concepts and to evaluate students' perceptions of the podcast as an educational tool. 

RESULTS: Results will be available after the Neurology block is completed, approximately February 2020. 

CONCLUSION: We hypothesize that this will be a worthwhile learning modality to incorporate in to pre-clinical education to facilitate spaced learning. 


305 - Development Of Mini-Preparatory Course Using Online Resources
Hye Yoon | Kathryn Propst | Kristen Ashley Horner | Thomas Hope | Jaehwa Choi
Mercer University School of Medicine 

PURPOSE: Students frequently have difficulties learning the anatomy of the nervous system. To help students' learning in neuroanatomy, a mini-preparatory course was developed and its usage was evaluated. The goal of offering the mini-preparatory course was to encourage students' self-directed learning during a time when their course load was reduced. 

METHODS: A review of a commercially available lecture series purchased by MUSM's library was performed. Sets of video lectures were selected and grouped into important neuroanatomy topics: introduction, ascending and descending pathways, brain stem, and cranial nerves. Freely available online resources were also reviewed and selected. Relevant textbook readings were provided for students who preferred to read rather than listen to lectures. This course was offered as a voluntary, non-credit earning mini-course. After the final exam, students were asked to complete a course survey that asked about their course grades and the use of the learning resources in the mini-course. 

RESULTS: Fifty-four out of 122 students (44%) participated in the course survey. The majority of students who responded indicated that they preferred short lecture videos (< 20 min) and the interactive learning modules freely available from the University of British Columbia compared to hour-plus long lecture videos. Most students used 58 ± 39% of the learning materials before the neurology module began and 64 ± 38% during the course. The correlation between the number of activities the student did and their exam scores were very weak and negative: -0.11 for the mid-module exam and -0.16 for the end-of-module exam. 

CONCLUSIONS: In conclusion, a self-paced mini-preparatory course was developed to aid students in learning neuroanatomy. The role of the preparatory course on students' performance on the summative exam was inconclusive. The interpretation of the course survey is limited because it focused on the number of activities rather than the quality of self-directed learning.

402 - Assessing Students' Spatial Abilities In Neuroanatomy Education
Joanna Appel
Medical College of Georgia at Augusta University
No poster provided

PURPOSE: Neuroanatomy is a challenging subject -- it requires students to acquire, assimilate, and apply knowledge of complex neuroanatomical structures, and is highly reliant upon spatial processes. Three-dimensional (3D) physical models and computer-aided digital models are effective in promoting the development of neuroanatomical spatial representations. However, what remains unclear is exactly which tools benefit students the most. This pilot study investigates whether there is a relationship between individuals' spatial abilities and their neuro-spatial knowledge, and to determine whether learning neuroanatomy is enhanced using one of three instructional tools. 

METHODS: The spatial aptitude of undergraduate medical students enrolled in neuroanatomy was measured by tests previously validated as predictors of visual-spatial abilities, and a spatial aptitude profile was generated for each student. Students were given a pretest designed to assess critical spatial skills within the context of applied-neuroanatomy. Following the pretest, students attended a learning session where they interacted with one of three learning tools: a) 3D printed neuroanatomical models, b) computer-based 3D virtual neuroanatomical models, or c) a hands-on deep-brain dissection. Effectiveness of each tool on student learning was evaluated by posttest. One-way ANOVA was used to assess the most effective tool. 

RESULTS: Preliminarily, students who scored high on the spatial abilities battery scored high on the pretest as well. All three instructional tools proved effective when assessing percentage change in pretest:posttest scores. Data is currently under analysis to determine if there exists an interplay between individual students' spatial abilities and the effectiveness of each learning tool. 

CONCLUSION:Identifying specific tools to assist students in strengthening their spatial skills could help medical educators better identify which learning tool/s would be the most effective for teaching and learning in pre-clerkship courses that require high levels of spatial ability. Potential applications include individualized support for students to reduce cognitive load. 


403 - Blended Learning for Larynx & Pharynx Anatomy
Teresa Patitucci
Medical College of Wisconsin

PURPOSE: Larynx and pharynx are complex areas of the body anatomically. Blended learning has been shown to help reduce achievement gaps1, improve exam performance 2, and increase student satisfaction and engagement 2,3.  Our institution has three sites with need to engage learners at each location. The aim of this study is to evaluate student comprehension and satisfaction of a blended learning module on the topic of larynx and pharynx.  

METHODS: In 2018-19, students on one MCW campus (n=21) completed a blended learning module using customized digital pre-work and an in-class problem set, while the other two sites attended a didactic lecture. Aggregate performance on relevant exam questions was compared and students completed a satisfaction survey via Qualtrics.  This paradigm will be expanded in AY2019-20 to students on all campuses using a custom video for pre-work and problem sets run by local facilitators. Average exam performance and student satisfaction will be assessed. This project was approved by the Medical College of Wisconsin Institutional Review Board.  

RESULTS: 85.7% of students completed the pre-work and 95.2% attended the in-class session. 50% of survey respondents preferred blended learning, 22.2% preferred didactic lecture and 27.8% had no preference. 76% of participants were satisfied or very satisfied with the blended learning session, 18% were neutral, and only 6% were dissatisfied or very dissatisfied. Importantly, there was no significant difference in exam performance. The AY2019-20 session will take place in January 2020.  

CONCLUSION: Learner engagement at a multi-site institution can be difficult. This study shows that a blended learning approach where all students complete the same pre-work and then get to engage with faculty at their own site does not adversely affect learner comprehension or experience, demonstrating a viable model for instruction at multi-site institutions. 


404 - Can basic science faculty be instrumental in designing clinical reasoning sessions?
Marta Ambrozewicz
No poster provided

PURPOSE: Clinical reasoning is the ability to integrate and apply different types of knowledge, to weigh evidence, critically think about arguments and to reflect upon the process used to arrive at a diagnosis.  If at all, this skill is formally taught within clinical skills or during clerkships.  However, clinical reasoning requires not only an accumulation of knowledge but also a level of experience, which only comes with time and practice. Therefore, we propose it should be taught earlier in the curriculum in combination with the basic sciences within the pre-clerkship years.  

METHODS: Four clinical reasoning sessions were designed and used in the Heart Lung and Kidney module, which occurs as the first class of the second year of medical education. Each session lasted 50 minutes in a small group format (8-10 students) with one facilitator (faculty member or senior student). Using publically available material, clinical cases were used to create discussion material.   The role of basic science faculty was to create illness scripts, which simply stated, is compare, and contrast format of different diseases.  

RESULTS: The sessions and processes will be described in detail to serve as a guide for other basic scientists.  All students going through the module participated. Based on their weekly feedback and module evaluations these sessions received the highest rating as students greatly appreciated building their clinical reasoning skills.  

CONCLUSIONS: It is possible for basic science faculty to take an active part or even initiative to start teaching clinical reasoning skills to preclinical students. While this might require stepping out of one's comfort zone, there are significant benefits to the students and to the faculty as well. Please contact regarding any questions you may have regarding this submission


405 - Can learning from cadavers teach students about wellness, personal development, and professional identity formation? An exploration of first-year medical students' reflections on the cadaver dissection experience

Matthew Abrams
UCF College of Medicine

PURPOSE: There is growing evidence that activities centered around the human cadaveric experience, such as memorial services and reflective writing, promote psychological and professional development, protect against burnout and foster a sense of connection. Our study's qualitative approach integrates grounded theory and narrative medicine movements to explore the question: "What is the impact of the first-year cadaver dissection anatomy experience on the personal and professional development of medical students?" 

METHODS: This cross-sectional study was conducted at the conclusion of the first-year anatomy module. Participants consisted of 117 first-year United States allopathic medical students. A questionnaire was designed to elicit the students' experiences and provide them an opportunity for introspection. The exercise consisted of four reflection questions which were provided to 20 groups of six first-year students. Grounded theory analysis was used to explore themes in students' responses at the conclusion of their dissection module. 

RESULTS: Participants exhibited several common reactions to the cadaver dissection anatomy experience. Identified themes included: gratitude, awareness of one's own mortality, appreciation for health and lifestyle, career development, and the benefit of learning the intricate anatomical details using a tangible method. After analyzing all team responses, a total of 266 unique open codes were identified for all four interview questions. These open codes were sorted into ten distinct broader axial codes/primary themes, some with 2-3 sub-themes. 

CONLUSIONS:The aims of our study were to identify themes that emerged as students reflected on the impact of their dissection experience, and to examine the benefits of reflective writing for students' wellbeing and professional identity formation. The researchers observed that the educational effects of reflective writing resembled those found in other areas of medical education, with the following novel themes emerging: empathy, humanism, and compassion. These novel themes are being increasingly recognized as vital components of medical student wellness.


406 - Demystifying Action Potentials: Making Sense Of Neuroscience For All Educational Backgrounds
Kristofer Rau
Virginia Tech Carilion School of Medicine

PURPOSE: Neuroscience is a challenging topic to teach due to the abundance of neuroanatomical structures and molecular components that are involved, as well as the breadth of neurophysiological functions that play important roles in just about every system of the human body. The purpose of this project was: 1) to facilitate neurophysiology instruction to first year medical students at the Virginia Tech-Carilion School of Medicine (VTCSOM); 2) to provide an opportunity for the students to gain experience in effectively communicating complex medical concepts; and 3) to introduce neuroscience to elementary school students in the Roanoke community. 

METHODS: First year medical students participated in an hands-on, two-hour session that focused on neurophysiology. Afterward, students had the opportunity to demonstrate their knowledge during a community STEM outreach event at a local elementary school that included an interactive discussion on the functions of the brain, followed by hands-on neurophysiology activities, and a concluding wrap-up session focused on how we can keep our brains healthy. 

RESULTS: After their introductory session, VTCSOM students introduced basic neuroscience to 150 third, fourth, and fifth graders at Grandin Court Elementary School (Roanoke, VA). For the medical students, the activities were a welcomed addition to the didactic lectures that typically cover these topics. Those who participated in the outreach event  "felt personal satisfaction having had the experience", and felt that they "understood neurophysiology better after having to teach it to children". The activities kept the children engaged for the duration of the event, and they learned about several important topics related to their bodies. The elementary school teachers also enjoyed the experience, and have already invited us back for next year. Thanks to word-of-mouth, the success of this project has also opened up new opportunities with additional community partners. 

CONCLUSION: Community outreach is a valuable tool that may improve medical student education and student communication skills.



407 - Examination Of Students' Motivational Styles And Their Experience Of A Gamified Exercise In Histology

Jayme R Gallegos | Steve Taliaferro | Leslie Takaki
University of Western States 

PURPOSE: Professional students typically experience a high-stress environment detrimental to learning and performance. Gamification is the use of game elements to enhance learning. Gamifying class exercises has been shown to create a less stressful and threatening environment encouraging learning among professional students. The participants in gaming exercises can fall into one of several motivational categories. We used a novel game -- "the marble game" -- and examined students' motivation as well as their stress levels and learning in a histology class. 

METHODS: Two different cohorts were surveyed following 10 weeks of participation in the marble game (Spring '19 and Summer '19). Following the completion of the marble game, the students were given a 30-question survey including their motivations for playing the marble game, perceptions of their learning and stress levels regarding course material. There were 111 responses in the Spring '19 group and 45 responses in the Summer '19 group. Each participant responded to 30 questions that were tallied and correlations between lower stress and higher learning and others were examined. 

RESULTS: Many of the students identified competition and increase of social interaction with classmates as being their prime motivator for game participation. Students reported an increase in class engagement, enjoyment of the exercise, the instant feedback, decrease of stress and an increase of feelings of competence. Positive correlations between a risk-free environment and feeling of competence elicited by the game (P = 0.041 and P = 0.01) were also reported. 

CONCLUSIONS: The marble game lowered stress, and increased feelings of interest, engagement and confidence in histology. The feeling of a risk-free environment during the game correlated positively with feelings of competence about the course material. Competition and social interaction were the highest motivators. This exercise demonstrates that gaming can be a useful learning tool for students in higher education.


408 - Exploring First Year Medical Student Learning Experiences In An Interdisciplinary Therapeutic Enzyme Design Lab Integrating Basic Sciences And Engineering
Jaya G. Yodh | Kaustubh Bhalerao | Robert C. Wallon
Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign

PURPOSE: The Foundational Elements Course at Carle Illinois College of Medicine developed a therapeutic enzyme design lab for its inaugural student class as a way to implement its engineering-integrated curriculum at the basic science level. For the lab's second run, the engineer-biochemist instructor team piloted a mixed-methods research study to evaluate student learning experiences and outcomes from this integrative activity. 

METHODS: The two-hour enzyme-engineering lab had five six-student teams work towards three learning goals:  1) utilize informatics databases to research enzyme genetics, kinetics, and structure-function for the commercial thrombolytic enzyme Alteplase, and then 2) propose a new product formulation and 3) value proposition for stakeholders.  A learning rubric was applied to documents submitted by each team to assess attainment of the learning goals.   A post-lab focus group with five student volunteers enabled exploration of student perceptions of the activity with respect to learning of enzyme basics, product marketing and innovation, usefulness of informatics databases and impact of teamwork. 

RESULTS: Document analysis showed that work produced by each student team was at an acceptable level with respect to the learning rubric goals. Inductive coding analysis of the focus group results resulted in themes focused on how the activity structure promoted both creativity and teamwork between students with different training backgrounds.  These, in turn, positively impacted students' motivation and their ability to apply foundational concepts to medical innovation. 

CONCLUSION: A mixed-method evaluation demonstrated this lab exercise successfully engaged students in integrating basic, clinical sciences and engineering innovation.  Limitations of the document analysis included a low but consistent inter-rater reliability (53%), reflecting differences in the raters' disciplinary backgrounds.  Future changes will include providing students the rubric in advance, converting from a 3- to 5-point rating scale to further differentiate outcomes, and fine-tuning rubric questions to better focus on how students apply foundational knowledge towards innovation. 


409 - Implicit Bias Training for First-Year Medical Students
Mary Duggan | Kristin Bertsch | Jillian Lucas Baker | Magdala Chery | Raul deLa Cadena | Nicole Vaughn | Millicent King Channell
Rowan University School of Osteopathic Medicine

PURPOSE: The new curriculum at RowanSOM includes a longitudinal Community Service Learning and Leadership component to prepare students to work with underserved communities. As part of that course, two sessions on Implicit Bias (IB) were designed and implemented for first-year medical students. The goals of the IB sessions were for students to understand the differences between explicit and implicit bias and the brain science behind bias creation, to examine the impact of IBs on healthcare relationships and health outcomes, to reflect on their own biases, and to identify strategies for disrupting and reducing the impact of IBs. 

METHODS: Medical students were pre-assigned materials, including the Harvard Implicit Association Test (IAT). Facilitators included interdisciplinary faculty and staff. First-year students (210) participated in eight hours of IB programming over the course of two days. Day 1: Included a large group lecture, small group assignments, and mixed media presentations. Day 2: Included a panel of physicians and small group activities. Students reflected on their own biases and thought critically about the potential impacts of their own IBs on their future work as physicians. Lastly, students engaged in goal setting to continue to challenge their IBs and promote behavior change. 

RESULTS: Students completed a reflection assignment on their experiences in the sessions and their IAT results. We are currently evaluating feedback from the assignments. Results will be presented at the conference, along with future recommendations. 

CONCLUSION: In order to train culturally competent physicians, it is essential to create opportunities to gain awareness of one's own IBs and their impact on relationships within the healthcare setting. Prior to doing community work, it is important for medical students to intentionally reflect on who they are and how they interact with the people around them.  These sessions could potentially serve as a model for IB training for other medical school programs. 


410 - Improvement in surgical and suture skills in medical students using origami and kirigami.
Vishnu Vardhan Byroju | Satyajit Patra
American International Medical University 
No poster provided

PURPOSE: Suture skills and handling minuscules is exigent for medical students interested in surgery. Hand-eye coordination and dexterity is significant in procedures of medicine, more so in the field of surgery. The traditional japanese art of origami and kirigami involves working with papers of various thicknesses and strengths, often using scissors when needed often, much like in surgery and procedures of medicine. 

METHODS: Students of the medical school were pooled based on their interest in surgery and their skills of handling instruments were assessed on an objective scale created by the faculty of the school based on medical simulation. Medical students from 2 years of basic sciences were involved (n = 86) in the experiment. After the students were ‘matched' into case and control groups based on assessment of interest, academics and the like, sessions of origami and kirigami and other fine arts were conducted in the medical school for one hour, every week on a Friday for a period of 3 months for the case group. Significance was placed on miniscule models and use of instruments. The students were then assessed for their skills in surgery (such as suturing, incisions) after 3 months based on the same objective scale using medical simulation. 

RESULTS: Compelling improvement has been observed in the case group observed with better performance on the objective test. Students of the case group were satisfied with their improvement and stated thoroughly enjoying the learning process. Care was taken to avoid any bias present by matching the students in groups. 

CONCLUSION:  Origami and Kirigami have improved outcomes of suture and surgical skills in medical students while being a fun activity. Caribbean medical schools, which often have relatively poor technological exposure owing to their geographical location can use such fun activities to train students. 


411 - Medical Student Utilization And Assessment Of A Pre-Clinical Peer-Assisted Learning (Pal) Program
Nikhil Mankuzhy | Jeanne Schulte | Anju Thomas | Patrick Karabon | Nelia Afonso
Oakland University William Beaumont School of Medicine

PURPOSE: Limited studies exist regarding peer-teaching of clinical skills in the pre-clinical setting of undergraduate medical education. Oakland University William Beaumont School of Medicine (OUWB) implements a formal peer-assisted learning (PAL) program in which trained and certified second-year medical students (peer-educators) assist second- and first- year students (tutees). We reviewed surveys completed by tutees after PAL sessions to identify areas in which tutees requested support and describe tutees' perceived experiences. 

METHODS: Tutees completed anonymous surveys after each 1.5-hour PAL session attended. Results were collected from one academic year. Surveys included an open-ended response to identify requested support for specific clinical skill components (CSC) and a Likert scale questionnaire regarding tutee perceived peer educator effectiveness and utilization of available CSCs. Data was analyzed using descriptive statistics. 

RESULTS: 228 surveys were completed, with 82 (35.96%) in the fall semester and 146 (64.04%) in the winter semester. Of the tutees, 168 (73.68%) were first-year students (M1) and 58 (25.44%) were second-year students (M2). 118 (51.75%) students requested support with one CSC during a session and 61 (26.75%) identified more than one CSC. Head and neck was the CSC most requested, 83 (36.40%), followed by neurological examination, 47 (20.61%). A smaller proportion of students, 25 (10.96%), requested assistance in history taking. Most of the students, 185 (81.14%), felt this session was time well spent. Additional description of the pre-clinical PAL program will be included as the collected data is further analyzed. 

CONCLUSION: These results demonstrate pre-clinical PAL for clinical skills development is feasible and effective. Tutees predominantly attended sessions to develop skills in a single CSC, which appear to align with the sequence that CSCs are introduced during the two-year pre-clinical curriculum. A large majority of students reported the time spent in sessions to be beneficial. 


412 - Near-Peer Teaching: A Method For Continuity In Fragmented Medical Education
Pallavi Juneja | Yenya Hu
Wake Forest University School of Medicine 

PURPOSE: Near-peer teaching has been lauded as an effective method to augment medical education for the tutor, tutee, and even the institution. This project will investigate the effects of near-peer teaching. The primary outcomes are three-fold: whether students who learn from near-peer instruction 1) perform better on a constructed post-test analysis; 2) perform better on the course exam; and 3) are subjectively satisfied by the learning process. 

METHODS: First-year medical students (MS1s) will be offered a one-hour review session by a third-year medical student on vascular neurology in the week preceding their clinical neurology course exam. Any MS1 can participate; the study is pending IRB approval. All MS1s will be administered a ten-question pre- and post-test; the questions will be different but evaluate the same neurology content. Students will self-identify as a) attended the session, b) reviewed the presentation remotely, or c) did not engage. The change between pre- and post-test scores and in-course examination z-scores will be compared among the three learner groups. A survey will qualify the learning experience. 

RESULTS: As a peer-assisted learning initiative, this session was offered to MS1s last year (2018). The feedback from the learners was immediately and overwhelmingly positive, resounding with clarity and relief. Learners perceived a gap between neuroanatomy and vascular neurology. They voiced appreciation for longitudinal development between the two topics that made their learning cumulative rather than additive. 

CONCLUSIONS: Based on the feedback after last year's near-peer teaching session, a learner need was illuminated: medical students in their pre-clinical years desire intentional continuity between the different topics they encounter. Furthermore, near-peer teaching appears to be an appropriate solution due to the social and cognitive proximity of senior students. In the upcoming months, we will quantify and qualify the outcomes after providing the same session to a new cohort of first-year medical students. 


413 - Pre-Clinical Peer Ultrasound Tutoring Program For Medical Trainees
Rachel Harvey | Nisha Patel | James Blumline | Rachel Kalthoff | Benjamin Malamet | Lucas Nelson | Dr. Arati Kelekar, MD
Oakland University William Beaumont School of Medicine 
No poster provided

PURPOSE: While developing point-of-care ultrasonography programs, medical trainees face limited trained faculty and resource availability. Oakland University William Beaumont (OUWB) School of Medicine adopted the model of near-peer education to develop an Ultrasound Peer Tutoring Program that provides students with ultrasonography training in the setting of limited resources. This abstract describes the program and future directions.  
METHODS: Five tutors were selected based on their demonstration of knowledge and teaching skills. Tutors reviewed relevant anatomy using online modules and were then trained by clinical faculty from various specialties at Beaumont Hospital. Each training focused on a specific system and lasted 2-3 hours. To date, tutors have completed respiratory and cardiovascular exams and plan to complete abdominal and neurovasculature imaging. Following training, tutors passed certification assessments demonstrating competence in image acquisition, relevant technology, and anatomy. Tutoring sessions are held at OUWB's Clinical Skills Center approximately once monthly. First, students are required to take a Pre-Quiz to assess their understanding of ultrasound. Then, a tutor-developed didactic lecture is given on ultrasound technology, specific systems exams, and clinical correlations; this content is reviewed by supervising faculty. Students are then divided into small groups to obtain hands-on experience and individualized instruction from tutors. Students are instructed to locate anatomical structures and describe their technique via teach-back methods. Finally, students will be asked to complete a Post-Quiz.  
RESULTS: In April 2020 participating students will be asked to complete a Post-Quiz. We will compare Pre- and Post-Quiz scores in order to assess the program's effectiveness.  
CONCLUSION: As Ultrasonography becomes increasingly integrated in medical practice, preclinical experience becomes imperative. We plan to extend this curriculum by involving trained medical student peer tutors in the education of internal medicine residents during their clinical rotations. 


414 - Simulation-The Undying Patient for Medical Education
Shivani K Modi | Satyajit Patra
American International Medical University 
No poster provided

Tell me about it and I'll forget, Show me and i may remember Involve me and I Understand it.  Although, practice is the life in medicine, practicing for it often remains its Achilles heel. Medical education has been evolving a lot during the last few decades. Major reason for this is the concern for patient safety and to avoid cases of patient injury and malpractice. Simulation-based education provides a structured, learner-centered environment in which students can learn or practice skills without causing harm to patients. Simulation is a great way to bridge the gap between theory and practice in medical education. The abstract describes the importance of stimulation-based learning for medical students.  

METHOD: The authors data was collected from a group of basic sciences students. A non-randomized study was performed. And a control study was conducted between the conventional way of medical education and simulation-based education for a period of 6 months. The results were compared by statistical distribution graph between the two groups.  

RESULTS: The improvement and academic outcome at the end of the 6 months were significantly higher for simulation-based education group. Medical simulation allowed the acquisition of clinical skills through hands-on practice rather than the conventional way of learning. The students not only had better academic outcomes but were trained with skills like suturing, giving IV lines, injections. At the end of the study, students were satisfied with simulation-based learning.  

CONCLUSION: In conclusion, the promise of simulation-based education offers useful opportunities to reduce risks to patients and learners, improve students' competence and confidence, increase patient safety, and reduce health care costs in the long run. Simulation is the cadaver in the future of medicine. The authors are planning studies with more complete evaluation. 


415 - Student Preferences And Performance When Transitioning From A Lecture-Dominant Format To Podcasts
Jeffery Fritz | Melinda R. Dwinell | Leslie M. Fischer | Roy M. Long
Medical College of Wisconsin 

PURPOSE: As medical school educators explore various content delivery mechanisms to enhance student learning, we explored student preferences and performance in a first-year medical school physiology course when content delivery transitioned from lecture to podcast. 

METHODS: On a Regional Medical School campus with a learner cohort of 21 students, course content was delivered initially by a series of 13, 50-minute lectures followed by a series of 9 podcasts ranging in duration of 9-21 minutes. Both delivery mechanisms included faculty selected readings, faculty prepared PowerPoints, content notes with learning objectives, and review sessions. Both delivery mechanisms were available to learners by live-streaming or recorded video. Student use of the lecture and podcast content in live-streaming or recorded format was evaluated. A single summative exam on course material from the 13 lectures and 9 podcasts was prepared and student performance on summative exam questions was compared between lecture- and podcast-delivered content. Additionally, a survey was administered one week following the exam to assess student preferences. 

RESULTS: The percent of students viewing live-streaming and recorded video was higher for course material delivered by lecture (mean=89% & 32%, respectively) compared to podcast (mean=75% & 24%, respectively; p<0.05 lecture versus podcast). Student summative exam performance was better on lecture delivered content than podcast (mean=92% & 84%, respectively; p<0.05). All students in the study cohort completed the post-exam survey. 76.2% of students preferred lecture format compared to podcasts. Student feedback focused on themes preferring lecture for its ability to foster better educator-learner engagement/interaction, and ease of learners reaching their goals. 

CONCLUSION: Regional Campus medical students preferred lecture delivery compared to podcast delivery of physiology content in a lecture-dominate curriculum and performed better on summative exam questions from lecture compared to podcast. Overall students found the podcast format less efficient in reaching their learning goals compared to lecture. 


416 - Student-Centered Teaching: The Faculty Perspective
Alexandra Clay | Colleen Croniger
Case Western Reserve School of Medicine 

PURPOSE: Medical knowledge is rapidly expanding, and medical school curricula are changing in response. Though there are studies that identify barriers to active teaching, no recent studies have assessed the readiness and willingness of faculty to engage with these technologies to adopt a more active teaching style. This qualitative study aims to assess barriers to active teaching methods and concerns regarding new technology and changes in teaching style for faculty members in one U.S. medical school. 

METHODS: Based on a medical student feedback session, we crafted questions for a faculty focus group that included six curriculum leaders and design team members. The session was transcribed without use of participants names to ensure confidentiality. The information from the session was then organized into themes to develop resources for faculty to utilize student-centered teaching methods. 

RESULTS: Themes included 1) qualities of a good lecture, 2) what faculty want to know about their students, 3) what faculty want to know about their lecture environment. Faculty recognized that a "good" lecture tends to be more interactive, and lecture could be improved by getting a greater proportion of students to read the recommended resources prior to lecture. Faculty wanted to know the most efficient ways that their students learn, as well as students' baseline knowledge in order to cater lectures to their level. With a new lecture hall, faculty are eager to know the best ways to incorporate interactive teaching methods but wary of technical difficulties. 

CONCLUSIONS: "Just in time learning" in video format for faculty may be useful in helping faculty feel comfortable in the lecture hall and boost comfort in using active teaching methods. By incorporating videos or USMLE resources, lecture prep work may be completed more often and student knowledge base may be more homogenous, making lectures easier to cater to students. 


417 - That's all I can eat? Experiential learning increases confidence and use of nutrition therapy among medical students
Aaron Marshall | Heather Christensen
University of Cincinnati 

PURPOSE: Nutrition as a component of patient care is widely recognized for contributing to optimal clinical outcomes. Despite increased efforts to teach nutrition basics to trainees, nutrition counseling remains woefully underutilized. This study assessed the impact of an immersive experience on medical students' knowledge, confidence, and clinical usage of medical nutrition therapy (MNT) in clinical practice as well as empathy for MNT patients.  

METHODS: Student volunteers attempted a MNT diet for two weeks and participated in focus groups (n=3), of which transcripts were evaluated for themes. Participants completed the Nutrition in Patient Care Survey (n=3) as a reliable measure of attitudes about nutrition, and custom surveys regarding knowledge, confidence and application of MNT. The Jefferson Scale of Empathy was employed at project conclusion for participants and non-participants.  

RESULTS: 80% of participants mostly or completely adhered to their two-week diet regimen. ‘Attempting the diet' and ‘peer discussions' were ranked as the most impactful project components. Participants felt comfortable advising future patients on their assigned diet (95% agree or strongly agree), while half (46%) felt they could advise patients on their peers' diets. Only 16% reported having knowledge to advise patients about other MNT (not encountered during the study). 100% of participants agreed or strongly agreed they had increased knowledge of adherence barriers for MNT patients and knowledge of how to address these barriers. Compared to non-participant peers (n=60), participants (n=26) reported significantly more confidence using nutrition counseling (n=60, p<0.001,t-test), and to date, 50% of participants report using knowledge from this project in clinical rotations.  

CONCLUSIONS: This experience increased students' knowledge of, confidence in, and intent to use nutrition counseling. They show increased empathy for patients, extending into other adherence-related issues. These data demonstrate the power of experiential learning, and that even a brief immersion experience has the opportunity to significantly impact medical student education. 


418 - Utilization Of A Teaching And Learning Center By Individual Colleges At A Major Health Science Center
Michael J. Herr | Melissa Taylor | Tom Laughner
University of Tennessee Health Science Center 

PURPOSE: University Teaching and learning centers (TLCs) principally serve to improve teaching at their institutions. The University of Tennessee Health Science Center (UTHSC) TLC serves six different colleges: medical, dental, nursing, pharmacy, health professions, and graduate health sciences. We sought to quantify the usage of the TLC over the course of one calendar year to demonstrate utilization by colleges, establish a baseline as new leadership develops the mission, vision, and goals for the center, and to plan for future years.  

METHODS: Data collection began January 2019 and included quantifying attendance at and evaluating TLC workshops, the number of TLC consultations, and Learning Management System (LMS) usage statistics.  

RESULTS: Over eleven months, UTHSC TLC hosted 39 total workshops open to faculty and staff from all colleges. The majority of workshops were held in April (11). Total attendance for all workshops was 413. Most faculty and staff attended workshops in June (134). Faculty and staff from the college of dentistry (115) were the majority in attendance for all workshops. The TLC completed 110 total consultations. August had the most consultations (20) and the College of Health Professions consulted with TLC staff the most (30). The LMS had the most active users in January (5,859) and least in March (3,070). The highest number of active courses was 1,451 in May and the least was 1,126 in October.  

CONCLUSION: Collecting data on TLC utilization in six different colleges that make up a major health science center provides insight into how the TLC may focus future efforts. It also provides other health science educators with an idea of how their TLC may be utilized and ways to assess TLC effectiveness. 


419 - Value of Podcast-Based Learning Modules for First Year Medical Students in an M1 Microbiology Course: A Randomized Controlled Trial
Survandita Tara Dhawan | Dr. Lee Ann Schein
Rutgers Robert Wood Johnson Medical School  

PURPOSE: We explored the role of podcasts as a new learning tool for the laboratory-related material covered in M1 microbiology. We also collected student feedback on the effectiveness of using podcasts, and whether students felt more confident in their understanding of labatory procedures after utilizing the podcasts as anew learning tool. This abstract describes the project and its outcomes. 

METHODS: The M1 Microbiology Course contains four bacteriology wet labs. Our project was to assign podcasts that we created for 2 of the 4 lab exercises for students to watch prior to coming to lab. These podcasts previewed the laboratory methodology as well as the foundational scientific principles behind the lab procedures. We also administered quizzes to student cohorts who received the podcasts (175 students in the class of 2022) as well as those who did not (166 students in the class of 2021). Moreover, we distributed a questionnaire at the end of the course to students to receive qualitative and quantitative feedback to assess the efficacy of the podcasts as a learning tool. 

RESULTS: We did not find any significant differences in quiz performances between the two groups of students who either viewed the podcasts or those who did not. The results of the questionnaire overall suggest a positive response to using podcasts to supplement lab exercises. 

CONCLUSION: We designed podcasts to help first year medical students learn the techniques and scientific principles behind their mandatory laboratory curriculum. Overall, students rated the podcasts as a favorable addition. Based on this feedback, we will permanently incorporated the podcasts into the microbiology curriculum.

422 - Implementation and Evaluation of a Self-Directed Learning Activity for First-Year Medical Students
Molly Hill
University of Oklahoma Health Sciences Center
PURPOSE: It is critical that medical students develop self-directed, life-long learning skills to navigate medical school successfully and to become competent healthcare professionals. Moreover, the Liaison Committee on Medical Education (LCME), the United States medical school accrediting body, requires activities designed to help students develop self-directed learning (SDL) skills in the preclinical years. We evaluated the feasibility and effectiveness of a self-directed learning activity in a six-week first-year medical student course. 
METHODS: We assigned infectious disease case studies to teams of first-year medical students who individually assessed their knowledge gaps of the case, identified scholarly sources to fill their knowledge gaps, shared the information with their teammates, and reflected on their ability to guide their own learning. We asked students to rate workload, team effort, acquisition of new clinical knowledge, and life-long learning skills. We also asked students to reflect on how this assignment affected their perception of their SDL skills. Descriptive statistics were used to analyze responses to the Likert scale questions. Thematic analysis was applied to the comments. 
RESULTS: Survey response rate was 80% (131/163). Students strongly or moderately agreed that 1) they spent an appropriate amount of time on the project (94%), 2) the workload was evenly distributed among their teammates (95%), 3) their teammates made significant and timely contributions to the project (97%), 4) the project contributed to learning new clinical knowledge (92%), and 5) the project contributed to the acquisition of life-long learning skills (85%). We identified four themes from student reflections on their perception of their self-directed learning skills: self-learning skills, meta-cognition, collaboration, and application. 
CONCLUSIONS: Study results demonstrated that we successfully implemented a case-based SDL activity in a first-year medical school course and that students perceived the activity as a valuable learning experience.


423 - Concept Maps As A Dynamic Tool For Teaching Scientific Thinking    
Aimee Pugh-Bernard | Scott Thompson  
University of Colorado Anschutz Medical Campus | University of Colorado Anschutz Medical Campus

PURPOSE Medical education and scientific thinking often involve understanding interrelated and multidimensional topics. We have employed the concept map as an active learning method for teaching a diversity of complex science concepts in an undergraduate scientific thinking course. Here we describe our implementation of concept maps and how it can be used as tool for instruction, assessment and team building. METHODS A concept map is a diagram used to organize ideas and depict their relationships, typically constructed of information presented in boxes with labeled lines drawn between them to indicate connections. In our implementation as a teaching tool, students write key concepts from assigned reading onto sticky notes and work in small groups using these notes and dry-erase markers to create a concept map on a whiteboard. The modular nature of this approach enables students to dynamically edit and rearrange concepts both during the initial construction and throughout a class period to incorporate new ideas. Students have created concept maps on topics including the scientific method, the diagnostic process for physicians and a variety of scientific research articles. RESULTS Concept maps created on the same topic by different groups are rarely identical, thus exposing the entire class to a diversity of understanding. When students have disagreements on ideas, the collaborative and flexible nature of these concept maps enable a constructive resolution and the addition of alternative thoughts and ideas. Additionally, over the course of the semester the sophistication of the concept maps evolves thus serving as qualitative assessment of student scientific thinking throughout the course. CONCLUSION Concept mapping enables students to collaboratively work towards understanding complex scientific ideas and to think critically about the relationships between them. Visualization of how students organize and structure knowledge facilitates the assessment of student growth and the diversity of understanding within a class.  


424 - Achieving Outcome Based Education Through Team Based Learning    
Rohini Karunakaran | Srikumar P S   
AIMST University 

PURPOSE Outcome-based education (OBE) is a method of curriculum design and delivery which focuses on what the students learn at the end of the course (learner-centred). OBE requires organising curriculum involving learning strategies and assessment process that is aligned with the learning outcomes. Team-based learning (TBL) is one of the significant collaborative learning methodologies in medical education. It also aims at exploring hints and tips for using TBL in medical education.

METHODS A systematic literature search was performed to identify research articles regarding achieving the outcomes through team-based learning. Relevant scientific online databases (MEDLINE, ERIC, EBSCO, google scholar, and Web of Science) were searched. Search terms used involved five keywords based on attributes that are common to collaborative group learning approaches: team-based learning, learning outcomes, curriculum delivery, teaching strategies and outcome-based education.

RESULTS The themes identified were the achievement of learning outcomes in outcome-based education through team-based learning. In TBL, the factors include curriculum design and delivery.

CONCLUSION It is suggested that TBL may enhance the OBE learning outcome domains like team-working skills, interpersonal skills, communication skills, personal skills, entrepreneurial skills, ethics and professionalism, Thus in medical education, it was shown that learners benefit from TBL and is essential for continuous curriculum design and delivery.    

502 - Changing Perception: An Evaluation of the Leeds Medical Education Academy Summer School
Alexander Bald
University of Leeds

PURPOSE: McLachlan (2005) suggests how WP (widening participation) initiatives should focus on outreach activities, with a lack of evaluation of the impact and effectiveness of WP activities. This research project will focus on the evaluation of the Leeds Medical Education Academy Summer School (LMEASS): a week-long outreach activity, which is created and delivered by medical students, doctors and admissions staff at the University of Leeds. The aim of the LMEASS is to shift the perception of medical school and raise the aspirations of WP students in applying to medical school. This study aims to assess how and the extent to which the LMEASS changes the perception and aspirations of students. 

METHODS: 22 participants were recruited via email to take part in an online questionnaire. Questions consisted of a mixture of Likert scale and open-text questions. The frequency and mode were calculated in the Likert scale data and open-text responses were thematically analysed. 

RESULTS: The Likert scale data showed a positive perception of the LMEASS, with modal responses in either ‘agree' or ‘strongly agree' in the statements which asked whether a shift in perception and aspiration occurred. Three themes were identified: sense of community, perception of medical school, and the journey into university. 

CONCLUSION: The Likert scale data showed a change in the perception and aspirations of students, with the themes of the study demonstrating how this was/wasn't achieved. The significance of WP medical student volunteers was highlighted in shifting the perception and aspirations of students and providing insight into medical school with a WP perspective. Seeing a student of a low-socioeconomic background in medical school inspired and motivated the participants in applying to medical school, which suggests that WP interventions should reflect the focus of WP in selecting WP medical students to volunteer. 


503 - Do Medical Students Have Healthier Behaviors Than Aged-Matched Peers of Other Graduate Programs?
Lisa Greco| Eleanor Yusupov | Michael Gindi | Lillian Niwagaba | Maria A. Pino
New York Institute of Technology College of Osteopathic Medicine (NYIT-COM) 

PURPOSE: Medical students face challenges, which may bring undesirable changes to their lifestyle habits. Students who establish a healthy lifestyle early in their training are more likely to counsel their future patients on adequate self-care than those that do not. This study examined the lifestyle habits of preclinical osteopathic medical students. We compared the results to age-matched peers in other areas of study, as the rate of burnout in this group is less than medical students. 

METHOD: A survey was administered to first and second year students of New York Institute of Technology College of Osteopathic Medicine (NYIT-COM) (Group I) and other graduate programs of NYIT (Group II). Questions were included to compare demographic, lifestyle, and self-medication habits between the two groups. A Pearson Chi-Square and student's 2-tailed t-test were used to evaluate for significance. 

RESULTS: 398 students responded to the survey; 83.2 % (N= 331) were from Group I and 16.9% (N=67) were from Group II. The mean age of the respondents was 25. Of significance, Group I (55%) reported to studying at least 5-10 hours per day, while 20% reported to studying more than 10 hours. Group II reported 37% and 9%, respectively. Group I exercised more times per week (2-3 times) than Group II and for a longer duration (30-60 min). Sleep duration was longer for Group I (6-8 h), yet they reported using more substances to stay awake than Group II. 

CONCLUSIONS: Medical students reported to sleeping and exercising more than their age-matched peers, but also using more substances to stay awake. While these aspects of the study are encouraging, increased efforts are needed to help medical students establish a balanced lifestyle, which can also support the wellness of their future patients. 


504 - Engaging Verbal And Non-Verbal Austism Spectrum Elementary School Students In The Anatomy Academy Service-Learning Enviroment
Ryan L. Jensen | Jared Duval | Jess Kudlacek | Amanda N Gonzalez | Chole Read | Sarah Nguyen | Elizabeth Banner | Kevin S. Steed | Jonathan J. Wisco
West Virginia School of Osteopathic Medicine | California Northstate University College of Medicine | Brigham Young University | Memory and Aging Center, University of California | Spectrum Academy | University of Utah Health Sciences | Boston University School of Medicine | University of Utah School of Medicine

PURPOSE: Children on the autism spectrum disorder (Students) often have significant support needs in the learning environment. Pre-professional and professional medical sciences students (Mentors) can serve as classroom paraprofessionals teaching anatomy, physiology, and nutrition concepts. In this study, we examined how Anatomy Academy (a service-learning program) has helped Students on the spectrum flourish with added support in a learning environment. 

METHODS: We aimed to answer one question: "Do Students on the autism spectrum participate in learning activities because Anatomy Academy provides engaged learning activities, one-on-one attention with Mentor paraprofessionals, or both?" We changed the format of a lesson in the Anatomy Academy curriculum. The lesson consisted of a Coordinator reading age-appropriate science material to the entire class in a group setting for 10 minutes, followed by individual Mentor-Student pairs reading together for 10 minutes. Subsequently, the Mentors switched to an engaged learning activity using medical devices for 10 minutes and concluded the lesson with a large group kinesthetic activity. In this IRB approved study, Students were filmed throughout the lesson for analysis. 

RESULTS: During the whole-class reading activity, Students were distracted, fidgety and unengaged. When the Mentor-Student pairs were established, the Students' behavior changed, becoming more involved in the activity, despite still being fidgety and distracted. When the medical devices were introduced for the engaged learning activity, the Students' attention was channeled towards the medical devices and this led to relevant, and engaging questions driving the learning process. 

CONCLUSION: Paraprofessional mentoring in the academic environment can help minimize distraction and change behavior in students on the autism spectrum. By implementing engaged learning activities with paraprofessional mentoring, the students are more likely to begin asking relevant questions and participating in the lesson. In doing so, students on the autism spectrum will likely find more success in their medical sciences curricula. 


505 - Generating Long-Term Resiliency Via Cultural Organization Affiliation In Medical School
Justin Chin | Patrick J. O'Toole III | Jun H. Lin | Michael Yep | Christine M. Lomiguen| Mark Terrell
Touro College of Osteopathic Medicine | Lake Erie College of Osteopathic Medicine 

PURPOSE: Resiliency comes from the Latin term resiliens, which describes the ability to spring back from difficulties and setbacks. In the past decade, numerous studies have identified resiliency as a key characteristic required to prevent physician burnout and promote healthy stress management skills. This abstract highlight how culturally-affiliated organizations can help build resiliency among medical students through the lens of the Asian Pacific American Medical Student Association (APAMSA) at Touro College of Osteopathic Medicine (TouroCOM). 

METHODS: First-year medical students identified a lack of representation, discussion, and extracurricular options regarding culturally-based health and healthcare within the curriculum at TouroCOM. To address this issue, medical students initiated the process to form a new student chapter of a national organization, consisting of the application and petitioning for approval from student government and administration. 

RESULTS: Medical students encounter difficulties for numerous reasons, from ineffective time management to lack of motivation. Culturally-affiliated student organizations can assist in ameliorating stress by building a sense of community through a shared heritage or experience in being of the same culture. Since its inception, the minority student chapter described has been one of the most active student organizations at the osteopathic medical school: organizing over 40 events, filling numerous regional and national leadership roles, and hosting the regional conference for the past 2 years and hosting the 2019 national conference. 

CONCLUSION: Through local, regional, and national initiatives, the organization offers the opportunity to cultivate a well-supported identity, networking, and sense of belonging, all of which have been shown to positively impact the personal and professional development of future physicians, thereby, improving student resiliency and wellness. This project will be replicated in the 2019-2020 academic year as a similar student chapter is established at a second osteopathic medical school, and results will be compared.



506 - Imposter Syndrome And Class Gender Ratios In Osteopathic Medical School

Courtney Shill Russell | Garrett Clement | Bryan Daines | Carson Russell | Isain Zapata | Melissa Henderson
Rocky Vista University College of Osteopathic Medicine, Ivins, UT 

PURPOSE: Imposter Syndrome (IS) has been shown to affect 25-50% of medical school students with a higher incidence in females.  This study investigates how the ratios of males to females in a medical school class influence the prevalence of IS seen in each gender. Additionally, it analyzes trends linking imposter syndrome and pre-matriculation data such as undergraduate science GPA and MCAT.  This preliminary study will explore factors that correlate to a higher prevalence of IS in osteopathic medical students.  

METHODS: Data was collected via an anonymous survey sent out to classes of osteopathic medical students at various campus locations. The survey asked students to self-report their class, gender, undergraduate science GPA, MCAT score, and the completion of the Young Imposter Scale survey.  

RESULTS: Preliminary data note statistically significant findings confirming a higher likelihood of IS with females in an osteopathic medical school setting.  The interaction effect tested was statistically significant (P=0.000180) which confirms the existence of imposter syndrome differences across campus, class and gender.  Independent of gender and class ratios, neither SciGPA nor MCAT score were statistically significant as predictors of IS (Full model P=0.208255).  This study is still ongoing, and more data will be collected from other medical schools across the nation.  

CONCLUSION: Our study supports the prevalence of Imposter Syndrome in medical students and specifically female medical students. Additional data from multiple osteopathic medical school campuses is needed to fully address the influence of class gender ratio of the prevalence of IS.  Our preliminary data demonstrates that pre-matriculation scores have little influence on the development of IS in osteopathic medical students.


507 - The Impact of a Shared Nature Experience on the Outlook of Medical Students
Kayleigh Helgesen | Matthew Linton
Rocky Vista University- Southern Utah | Rocky Vista University- Southern Utah

PURPOSE: The present study examined the influence of a multi-day backpacking experience on medical student happiness, optimism, self-empowerment, purpose, school satisfaction, and feelings of social support. It looked to see if prior research showing the effects of nature experience on mental health had the same outcomes on a population of medical students. 

METHODS: Participants (n = 9) were medical students at Rocky Vista University College of Osteopathic Medicine, Southern Utah Campus, who self-enrolled in a 3-day backpacking trip during the Spring Semester of OM II. Participants completed a 10-point questionnaire and answered three open-ended questions before the trip began. Each day included 8-12 miles of hiking through a desert canyon in Utah, all while individually carrying their supplies for the trip. Time was set aside for daily journaling and reflecting on their connection to nature and the importance of interpersonal relationships. Upon conclusion of the trip, the same questionnaire was completed by each student. 

RESULTS: Analysis showed significant improvements in feelings of support (between students, students and faculty, and other personal relationships) when measured before and after the shared experience (P < 0.01 via Student's T-Test). There was no significant change found in levels of overall happiness, optimism, self-empowerment, purpose, or school satisfaction. Personal relationships (family and friends) was also the most listed "primary source of happiness" both before and after the experience. 

CONCLUSION: These results suggest that a multi-day shared outdoor experience may help to improve students' capacity for social connection, especially towards their academic peers and close friends/family. It also shows that relationships are held in high esteem when medical students are weighing their sources of happiness. 


508 - Three-Year Outcomes Of A Student-Led Disciplinary Committee
Frances E Jack-Edwards | Morgan Jackson | Oregon McDiarmid | Linda R Adkison
Trinity Medical Sciences University 

PURPOSE:  In 2017, students recommended the formation of a Student Disciplinary Committee as a committee of the Student Government Association. Prior to this, all disciplinary actions were carried out by the administration. The purpose of the Student Disciplinary Committee was to hold hearings for students who were found in violation of policies and professional or academic misconduct.  

METHODS: The Student Government Association proposed a process to be followed for any complaint. This did not include issues regarding academic standards which were the responsibility of faculty committees. The members of the newly proposed committee and the chief justice were elected from the student body. Establishment of the committee was approved by the students and faculty. The committee was composed of the chief justice, two student representatives, a faculty representative selected by the students on the committee, and the Associate Dean-Student Affairs.  Each hearing consisted of four elements: case presentation, questioning of parties involved, questioning of witnesses, and closing statements.  The chief justice provided a formal report to the Associate Dean who informed the accused student in writing of any judgment and sanctioning by the Student Disciplinary Committee along with the procedure for appealing. 

RESULTS: From 2017-2019, there were 13 complaints made to the administration. Among these, four agreed to mediation and there were no re-occurrences.  Nine resulted in a hearing with the committee.  Among these, three students were recommended for dismissal. Four complaints were for harassment, one for disrespect, two for disruption of normal activities, and three for other policy breaches. Only those students who were dismissed appealed a decision.  

CONCLUSIONS: The formation of this student-led committee improved student accountability and acceptance of violations to the code of conduct.  This was an improvement over administration-directed actions.  In some situations, the committee was more stringent than the administration might have been.


509 - Is this really me?: imposter phenomenon among osteopathic medical and masters students    
Tipsuda Junsanto-Bahri | Evelyn Rajan | Minyoung J Park  
Touro College of Osteopathic Medicine

PURPOSE: Imposter phenomenon (IP) is a psychological patter in which people doubt their accomplishments and have internalized fear of being exposed as a fraud. IP is associated with anxiety, low level of self-esteem, and lack of confidence, which have potential implications in medical education. We sought to determine the frequency of imposter phenomenon among our preclinical medical (DO) students at our institution.. Our Master of Science (MS) program comprises student who plan to pursue a career in healthcare.age  METHODS: Participants completed a voluntary, validated, anonymous 20-item Clance IP instrument (5 point scale: "not at all true," "rarely," "sometimes," "often," and "very true") and 10-item demographic and background information. Dr Clance provided approval to disseminate the instrument. Surveys were distributed to MS and 1st and 2nd year DO students. Score: 40-61 (moderate), 61-80 (Frequent feelings), and &gt;81 (Intense experience). Descriptive analysis and t test are presented. RESULTS: Response rate is 40% (166/360): 1st year DO (N=65), 2nd year DO (N=72), MS year (N=27); unknown (N=2). 39% scored 41-60 (moderate; N=72), 51% scored 61-80 (Frequent; N=85), and 2% scored &gt;81 (Intense; N=4). Among those that scored &gt; 61: 46% were males, 58% women. There was statistical significance with 2nd year students and gender (p value = 0.06). For one question: "I often compare my ability to those around me and think they may be more intelligent than I am," 46% males and 61% females answered "often" or "very true." (p value= 0.08). CONCLUSIONS: Imposter phenomenon has strong implications among medical and MS students. Our results raise awareness of such phenomenon in undergraduate medical education. Awareness can help lessen the isolation and embarrassment of any feelings, especially if students know others have similar feelings. Given these findings, our institution can provide counseling and resources. Next steps: Identify non-traditional students and expand survey to other schools/professions.


Developing effective early interventions for the struggling first year medical student to optimize both academic achievement and wellness  
Curt Pfarr | Diego Nino | Cynthia Perry | Diana Pettit | Herb Janssen | Jorge Cervantes | Tanis Hogg | Ricardo Belmares | Ellen Dudrey | Niti Manglik | Hector Noriega | Martine Coue  
Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine 

PURPOSE Identifying struggling medical students early in the first year of the curriculum can be accomplished by examining pre-matriculation data and monitoring early performance on formative and summative examinations. However, developing effective interventions for both improving academic performance and enhancing personal wellness is more challenging, as each at-risk student has a unique set of cognitive skills, academic foundations, study habits and life circumstances. METHODS At the TTUHSC El Paso Paul L. Foster School of Medicine we have implemented several supportive approaches; including mentoring and study skills coaching, near-peer tutoring, a faculty-assisted small tutorial program (FAST Program), and learning communities consisting of Colleges with direct faculty engagement. These approaches have proved complementary, providing students with a supportive learning environment to help them rapidly develop academic skills for successful navigation of the curriculum. RESULTS We have generated several sets of student and faculty survey data for evaluation of near-peer tutoring, the FAST Program and the College system. Overlap and synergy between these varied approaches are apparent, along with important gaps that can inform further development. In particular, the FAST Program shows great promise in building important relationships between faculty and struggling students that can significantly reduce stress and stigma for students while rapidly ramping up their content mastery. We are developing instruments to formally assess outcomes of these interventions by comprehensive longitudinal tracking of student achievement. CONCLUSIONS By refining this unique multi-pronged approach at student academic support we hope to offer students both timely and efficient interventions that can maximize their chances for success.  By continual promotion of a robust learning community, we hope to create an optimal environment for both academic achievement and personal wellness.     


Inaugural Mentorship Program Promotes Personal and Professional Well-being in Medical Students
Aaron Atlas | Emily Seltzer | Leslie Goldstein | Min-Kyung Jung | Thomas Chan   
NY Institute of Technology College of Osteopathic Medicine

PURPOSE The Commission on Osteopathic College Accreditation guidelines encourage medical schools to provide student mentorship. To address the research shortage within Osteopathic institutions, this study assessed the mentorship experience and mentee satisfaction following implementation of formal mentorship at an Osteopathic medical school. We aimed to establish strengths and weaknesses of a rudimentary mentorship program.

METHODS The Student Advisement and Mentorship program was simultaneously introduced to the class of 2021 and 2022. Mentees and faculty mentors were recruited via validated online-questionnaire to evaluate the program. Frequency and comparative analysis were conducted between classes, and mentors of different experience and departments.

RESULTS Mentees First- and second-year students were included (n=121). Students rated mentors highly in active listening, constructive feedback, establishing relationships, motivating, and building confidence. Mentors were poorly rated in coordinating with other mentors, assisting with research goals, and helping acquire resources. First-year students rated mentors significantly better at providing constructive feedback, establishing relationships, employing strategies to improve communication, setting research goals, and helping network effectively. Students with previous mentorship experience said mentors were significantly worse at accounting for personal biases in the relationship. Overall, there was no significant difference in total survey scores between classes or those with previous mentorship experience. Mentors 40 mentors responded. Overall, mentors from the Clinical Specialties department self-rated most highly (mean=5.7/7) while the Biomedical Sciences department rated the lowest (mean=4.2/7). The Clinical Specialties department self-reported significantly higher ability to establish relationships, align expectations, consider personal and professional differences, help develop goal-oriented strategies, enhance knowledge, motivate, build confidence, facilitate networking, set career goals, balance personal life, and serve as a role model.

CONCLUSION This study found improved satisfaction in first-year students demonstrating an advantage of early mentorship in medical school. Additionally, faculty from clinical departments reported better mentorship ability than those from biomedical science and anatomy departments.

602 - Developing A Variation Of Problem-Based Learning
Courtney Cross | Shelby Miller
TCU & UNTHSC School of Medicine  

PURPOSE: U.S. medical schools use a variety of classroom methodologies, including problem-based learning (PBL), to satisfy the LCME 6.3 requirement on self-directed learning (SDL).  We wanted to develop a variation of PBL to meet our school's goals of developing students' skills in critical thinking, communication, and synthesizing and applying knowledge to patient care. 

METHODS: Staff, faculty and administration assembled a task force to strategize creative ways to address these educational goals.  We examined and established multiple factors and tested our process with a mock session and identified areas for improvement.  Additionally, we generated Standard Operating Procedures, solicited additional feedback from stakeholders, and informed faculty development related to the process. 

RESULTS: The task force developed a comprehensive model that is investigative, patient-centered, and empathetic.  Thus, the new blended process was renamed to Patient-Centered Inquiry Based Learning (PIBL).  A unique aspect of PIBL compared to PBL is virtual disclosure: an additional piece of information that is released during the week for the students to address and generate additional ALIs.  After the case conclusion, a second unique aspect of PIBL is "teach back" in which students explain a concept in the case to a specific audience, such as the patient, attending, or peer.  We recognized the need for flexibility and adjusted in response to student and facilitator feedback.  The full process development, modifications, and aggregated student feedback for most of the inaugural class will be presented. 

CONCLUSION: Key stakeholders were highly engaged in the development of PIBL and expressed high satisfaction with the speed to which students oriented to the process and developed critical thinking skills.  Similarly, students saw value in the skills acquired during PIBL. 


603 - Problem-Based Learning: To Test Or Not To Test
Denise Zwahlen, MD | Gary Doolittle, MD | Garold Minns, MD | Giulia Bonaminio, PhD
University of Kansas School of Medicine

PURPOSE: In 2017 the University of Kansas School of Medicine (KUSM) implemented a curricular change. The new active, competency-based and excellence-driven (ACE) curriculum focuses on achieving cognitive integration of clinical and basic sciences. Problem-Based Learning (PBL) provides a rich environment for translating basic science principles into a clinical context and was maintained in the transition from the legacy curriculum to the ACE curriculum. 

METHODS: The goal of PBL sessions is to facilitate student development of clinical reasoning skills, promote development of self-directed study skills, improve depth and focus of knowledge acquired and foster development of team skills. The small group sessions follow a traditional PBL format and attendance is required. Small group facilitators assess students' achievement of competencies and multiple-choice questions to assess students' achievement of case learning objectives were added to course examinations. 

RESULTS: As the inaugural year of PBL in the ACE curriculum unfolded, feedback indicated that the cases and the process were well-received by students and faculty. Required attendance and course examination questions based on the content from PBL sessions facilitated student engagement as expected. However, including PBL test questions on course examinations resulted in significant anxiety for students and facilitators. Students and faculty believed that the assessment of PBL learning objectives on summative examinations inhibited the desired development of critical thinking, problem-solving and team-work skills. 

CONCLUSION: Students and faculty are very satisfied with PBL as a learning activity in the new ACE curriculum. The utility of assessing PBL learning objectives on course examinations was revisited and creative solutions were implemented to preserve the integrity of PBL as an instructional method.



604 - Implementing the Modified Michaelsen-Koles' Peer Evaluation in a Team-Based Learning Curriculum
Jody K. Takemoto | Leanne Coyne
California Health Sciences University

PURPOSE In addition to be competent health care professionals, pharmacist work collaboratively on health care teams and manage pharmacy personnel. One aspect of managing personnel, is to provide feedback for growth; as such, skills are required to professionally communicate. In this study we focused on developing student pharmacists' communication skills in giving and receiving feedback and ability to self-reflect.  

METHODS One forum to be able to develop the knowledge, skills, and mindset of giving and receiving feedback are through peer evaluations. Peer evaluations are a component of Team-Based Learning (TBL) 1 that is critical for individuals to be able to work in groups and eventually form teams. We describe for the first-time, a implementation of a modified Michaelsen-Koles Peer Evaluation Method 2 with an additional self-evaluation component in 8-week pharmacy courses for students in pharmacy years 1 -- 3.  

RESULTS In this cross-sectional analysis of the midpoint peer evaluation, preliminary data suggests that, students developed skills to provide quality feedback and make self-improvements. The majority of students rated their own professionalism, participation/engagement, quality of work/contribution to the team, and communication lower than their team members. Individual student comments were in alignment with their team member's comment on their strengths and opportunities for improvement.  

CONCLUSION Opportunities for refinement of the implemented peer evaluation tool is required to reduce faculty labor intensity. Providing suggestions for improvements were difficult for all students, while helpful feedback was improved by increases in year in the program.

702 - Effectiveness of immersive classes with virtual reality for the teaching-learning process
Ana Gabriela Rodriguez Mendoza | Juan Pablo Nigenda Alvarez | Laura Patricia Aldape Valdes
Tecnologico de Monterrey  

PURPOSE: The classes with immersive activities based on virtual reality are contributing to improve the teaching-learning process by offering new learning experiences to the students, the accompaniment to the teachers in the design of the activities contributed to the strengthening of the competences declared at the level Learning. This summary describes the project and its results. 

METHODS: The planning and design with teachers was 12 months prior to the semester of teaching, during the period of August-November 2019, 27 teachers participated, in which immersive activities were developed using virtual reality, the team of experts who participated was integrated by technological  videogame developers, pedagogy experts and the teaching team, the practices were carried out in an academic space of 81 m2 that has an installed capacity of 32 participants,  4 Virtual reality stations and 10 Oculus Go stations. The teachers taught their classes using the resources, which role is of guiding the achievement of the declared skills. Surveys were sent to the 1300 students. 

RESULTS: The results of the surveys in 540 students from different disciplines; 45% general education, 33% health area, 17% business area and 5% in the Humanities area shows that the perception of the student in terms of usability is 90% satisfactory in the interaction of the experience, 91% of students felt more motivated to carry out the activities of the class and considered the interface effective, 84% considered that the activity designed for the immersive class helped to clarify correctly the concepts and 81% value that the content in the reality resource virtual helped to understand better the information 

CONCLUSION: As the results observed the design of an experience that includes the intervention of the teacher, instructional design, virtual reality resource design and adequate physical space for an immersive class favors the learning teaching process and a positive perception for motivation and student learning.


703 - From Chevys To Breast Pumps: Clever Use Of Hardware For Active Learning Stations In A Respiratory Course

Eliot Bethke | Donald Greeley | Kashif Ahmad
Carle Illinois College of Medicine - University of Illinois at Urbana Champaign

PURPOSE: The Carle Illinois College of Medicine has developed Medical Engineering Discovery and Innovation (MEDI) sessions which focus on integrating engineering into medicine. Group based work during MEDI sessions offers a pragmatic approach to deliver active learning. With limitations around accessing specialized equipment for educational purposes, there was a need to develop a novel simulator to demonstrate airway dynamics. 

METHODS: Four model stations were devised: a restrictive lung, an obstructive lung, an inhaler and spacer, and an image processing station to quantify the inhaler station results. Students worked in groups of four, spending 15 minutes at each station. At the restrictive and obstructive lung stations students followed an interactive program (Jupyter Notebook) to read and analyze pressure and air flow data from sensors embedded in the models. The sensors and model components were adapted from automotive and other commercial products. At the inhaler station, students used pH paper to detect pMDI medication deposition on a model oropharynx with and without the use of a spacer. Medication deposition was quantified through a computer vision routine at the final station. Two open ended summary questions were asked at each station. 

RESULTS: Analysis of the summary question responses from each station showed good comprehension of anatomy and physiology. An end of course survey item regarding quality of MEDI experiences yielded an average score of 4.0/5.0 (N=20) with mentions of high value for time committed, compared to 2.6/5.0 the year prior. 

CONCLUSION: With innovative use of hardware, a reasonable facsimile of a human upper airway was built that demonstrated key physiology concepts in respiratory medicine. Student satisfaction improved over past sessions that did not involve group work or interactive hardware.  The approach described here offers new possibilities for active learning in medical curricula.


704 - Increasing student engagement in learning cardiovascular pharmacology using simulation based software
Elizabeth Prabhakar and Richard Helyer
Queen Mary University of London, Malta Campus

PURPOSE: Formative assessments revealed students find difficulty with understanding mechanisms of drug action within traditional lectures and showed lack of engagement. Given the importance of safe prescribing for Tomorrow's Doctors, we hypothesised, that the use of the Human Patient Simulator to demonstrate the action of drugs would enhance engagement, achievement and an understanding of safe prescribing. 

METHODS: The CAE Muse  (CAE Healthcare, Fl, USA) was used to teach a large class of students.  The actions of cholinergic and adrenergic drugs on the cardiovascular system were displayed on a big screen in the lecture theatre.  Class I-IV drugs used in the treatment of cardiac arrhythmias and the effects of blockers were also modelled. Students were given structured worksheets to record responses to each pharmacological intervention. Physiological parameters like heart rate, systolic, diastolic blood pressures, and systemic vascular resistance were monitored and recorded and values for mean arterial blood pressure and total peripheral resistance were derived using equations. Students were asked to explain the results of their findings for each administered drug.  They were also asked to answer questions relating to the control of blood pressure. ECG traces displayed on the screen were made available to students to practice calculating heart rate. 

RESULTS: A student evaluation survey completed immediately following the simulation session, was overwhelmingly positive and the session rated 10/10. A written exam in the Drugs and Disease module, conducted 3 months after the simulation session, showed that student performance for this particular topic was higher (79%) than for any other topic (47%) which used didactic lectures in the module. 

CONCLUSION: Simulations were beneficial for increasing student performance and integration of teaching. Structured worksheets encouraged deeper learning, knowledge retention and the rudiments of safe prescribing. In future, use of simulations will be developed further to teach students about Adverse Drug Reactions.


706 - Utilizing computational algorithms to innovate learning environment in the pathology classroom
Ritcha Saxena | Ralph Crum | Kevin Carnevale | Michael Salzle | Ananya Raj | Ritwik Raj Saxena
Medical University of the Americas | Des Moines University    

PURPOSE: The most commonly used resource by medical educators and students is the paper medical textbook, which results in a massive divergence between the surplus data accessible via technology and the restricted printed resources. Computational pathology, a promising technological advancement, puts the role of pathology educator to empower the change agents of tomorrow, at the core of patient centered-medicine in order, by melding the fields of digital pathological and radiological imaging, immunohistochemistry, molecular pathology including omics, with electronic health records. We aim to develop programmed computerized algorithms to compile the vast amounts of information in a way that is easily accessible via computers, in an attempt to initiate learning in the arena of pathology informatics from the early stages of the training of medical students.

METHODS: A TBL session was organized where 5 groups were logically divided based on variations in background with respect to informatics. It was ensured that each group had at least one member had IT experience.  The students were provided with information covering radiological & annotated pathological imaging, molecular (multi-omics data) and clinical data pertaining to the tumors of different organ systems. Each group was assigned a system, to compile the data provided and design algorithms illustrating the identification, epidemiology, morphology and molecular pathology of the tumors. The faculty validated the accuracy and usability of the algorithms.

RESULTS: Overall data analysis demonstrated a significant positive interaction between iRAT (individual readiness assessment test) scores and student participation in the exercise. Survey results also indicated that the mean interest level and retention of students was significantly higher after the TBL exercise.

CONCLUSIONS: Designing of a computational process for the enormous amount of data would lead to delivery of a thorough picture of the disease, along with greater recall and smooth application of theoretical concepts.

802 - Adaptive Expertise in Dentistry: A Familiar Construct, in an Unfamiliar Niche
Homam (Alba) Albaghdadi | Maria Mylopoulos 
University of Toronto|Faculty of Dentistry|Mount Sinai Hospital|Center for Ambulatory Care Education|Women's College Hospital | Wilson Center|University of Toronto|Institute of Health Policy, Management & Evaluation|Medical Psychiatry Alliance

PURPOSE: The delivery of effective patient care is contingent on the accessibility and translation of domain-specific knowledge. Adaptive expertise is a desirable construct in the training of clinicians in today's increasingly complex clinical environments. Adaptive experts possess the procedural fluency but balance it with conceptual understanding, knowledge integration and innovation. Learning sciences have demonstrated that environments calibrated for longitudinal learning and productive struggle are supportive of adaptive expertise development. Dentistry, a surgical specialty concerned with the preservation of oral health, remains largely unexplored in learning sciences literature. Dentistry presents an interesting subject of study because it requires a developed knowledge of medical, biomaterial, and prosthetic sciences, fine manual dexterity, as well as unique communication and management skills. Dental residencies for general practice are typically elective after undergraduate training and often take place in the relatively foreign hospital setting, with the added complexity of managing multi-co-morbidities, complex dentofacial traumas and severe space infections. Here we aim to qualitatively elucidate the characteristics of learning taking place in a dental residency, borrowing from the social constructivist tradition and using adaptive expertise as a synthetizing lens. 

METHODS: In this qualitative description study, 20 former university of Toronto residents who completed a General Practice Residency at Mount Sinai Hospital in Toronto, Canada (between 2005-2020) were recruited to complete a semi-structured interview. This interview aims to deconstruct the retrospective learning experiences and contextual elements, especially those embedded in the emergency room (ER) rotation, given its perceived richness in complexity and novelty. A combined inductive and deductive thematic analysis is used to analyse the anonymized responses, where themes will be inferred from the data and contrasted against the published theoretical frameworks of adaptive expertise 

RESULTS: In progress and in the open coding stage. 


803 - Bridges to Research Collaboration: A Health Sciences and Medicine Endeavor
Emily A. Johnston | Tobias A. Krussig | Michael P. Flanagan | Penny Kris-Etherton
Penn State University, Department of Nutritional Sciences | Penn State College of Medicine 

PURPOSE: Medical schools across the country are increasingly requiring medical student research projects (MSR's). Students often struggle to find research mentors and can end up being involved in projects unrelated to their future career goals. We aimed to bring together health sciences researchers with medical students to increase collaborations and assist medical students in selecting meaningful MSR's. 

METHODS: A Nutritional Sciences doctoral student at Penn State (PSU) and a family medicine physician and faculty member from the Penn State College of Medicine (COM) planned two luncheons and invited health sciences researchers from PSU and medical students from the COM. 

RESULTS: Attendees included 11 medical students (9 MS 1 and 2 MS2), 10 researchers from the PSU College of Health and Human Development (HHD) and 3 COM faculty members. Post-lunch surveys suggest that two medical students found projects with one additional student reporting they made a connection that may lead to collaboration. Three faculty attendees reported finding collaborators and 1 made a connection that may lead to collaboration. Other comments and feedback included asking for a longer event next year to allow for more discussion and asking for more continuity, which may be accomplished through further collaborations and standing research placements for medical students. At the previous year's luncheon, two medical students were matched with research mentors in nutrition and kinesiology. 

CONCLUSIONS: Overall attendees had meaningful discussions related to health sciences research and this event brought together faculty, deans and department heads with collaborators from the COM. Additional ideas for cross-departmental collaborations were discussed. This program required few resources. We intend to continue this program on an annual basis and keep metrics on the success rate of matching collaborators. 


804 - Community Health Fairs: Emphasis On Preclinical Medical Knowledge Application, Communication Skills, And Health Literacy
Tipsuda Junsanto-Bahri | Minyoung J. Park | Evelyn Rajan
Touro College of Osteopathic Medicine 

PURPOSE: We describe our model student-led health fair model. Outreach events serve as a medium for preclinical students to apply their class coursework and develop communication and health literacy skills. Our school is located in an urban neighborhood comprised primarily of minority and immigrant populations. In addition to screenings, students provide information recommended by Health People 2020 (e.g. Diabetes, cardiovascular disease, Cancer screening, LGBTQ health, nutrition, and women's health) and local resources. Faculty supervisors provide informal feedback and additional assistance. Students encourage participants to follow-up with abnormal screenings.. 

METHODS: Attendants completed a voluntary, validated, anonymous 37-item survey, modified from an existing instrument (Stamat, et al. 2008).  The survey serves as feedback and needs assessment. Data was obtained from 2015 to 2018 health fairs. The survey is comprised of medical history, tobacco/alcohol use and physical activity (33 questions) and a demographic section. Descriptive analysis is presented. 

RESULTS: There is a 90% response rate (163/180). Ethnicity/Age: 66% Black/African-American, 14% Hispanic/Latin American, 10% White, and 49% &gt;age 55 years. Some attended a previous health fair 9% (16/180); some attended our health fair at least twice before 12% (22/180). Health screening: 38.7% had &gt;30 minute daily physical activity, 15% currently smoke, 21% have diabetes, After discussion with student screeners,  33% (134/180) reported they would follow-up with a physician; 76% (137/180) reported they will change their lifestyle, and 8% (14/180) reported a preference for DO physician. Qualitative comments describe participant's enthusiasm and satisfaction from student interactions. 

CONCLUSIONS: In a community with healthcare barriers associated with socioeconomic and immigration status, health fairs are effective in initiating healthy behaviors. Early interactions provide our students have an opportunity for hands-on application of preclinical coursework, ability to cultivate their communication and health literacy skills, and build rapport with their community. Next step: to survey student on their experiences.


805 - IAMSE's Student And Faculty Members: A Dichotomy

Andrew Binks | Committee for Student Professional Development
Virginia Tech Carilion School of Medicine

PURPOSE: The vast majority (75%) of pre-clinical basic science educators are basic scientists, compared to 11% who have medical degrees. This is somewhat reflected in the faculty membership of IAMSE, most of whom have PhDs. The purpose of this study was to determine whether the current IAMSE student membership reflected these proportions, or whether improved outreach was needed to optimize IAMSE's impact on future medical educators and education. 

METHODS: IAMSE's Committee for Student Professional Development determined the aspirant degree of each student members between 2017-2019 via web searches for each individual. Degrees were designated as either clinical, basic science or educational. The degree type and designation was then compared with the degrees of 2019 faculty membership. 

RESULTS: Aspirant degrees were identified for 124 (77%) of the 161 IAMSE student members. Five student degree types were clinical (MD=55%, DO=14%, PA=10% DVM=2%, MSW=1%,), three were basic science (PhD=12%, MS=2%, MPH=1%) and two were educational (EdD=2%, BEd=1%) Faculty membership (n=1096) included 19 degrees of which eight were clinical (MD=26.4%, DO=2.7%, PharmD=1%, DPT, DVM, DDS, MSW and PA all <1%), eight were basic science (PhD=56.2%, MS=2.9%, BS=2.3%, MA=2%, DPhil, MPhil, MBA, MPH all <1%), and three were educational (EdD=3%, MEd and MLIS both <1%). As such, there was a wide discrepancy between student and faculty members who will have/have a clinical degree (81% vs. 31% respectively) or a basic science degree (15% vs. 65%). The number of educational degrees was comparable but small for student members (3%) and faculty (3.7%). 

CONCLUSION: The degrees and career path of IAMSE student membership do not reflect those of the current IAMSE faculty membership nor the current pre-clinical science educator population. This demonstrates a need for IAMSE to reach out to current basic science students who are more likely to become the next generation of medical educators.


806 - Impact of ECFMG's 2023 regulation on Caribbean medical schools' processes
Sateesh Babu Arja | Simi Paramban | Samir Fatteh | Sireesha Bala Arja
Avalon University School of Medicine  

PURPOSE: The numbers of Caribbean medical schools are increasing day by day, and the little is known about Caribbean medical schools. More than 50% of graduates from these medical schools are involved in primary care in the USA. And Caribbean graduates contribute significantly to the healthcare workforce in the USA. The accreditation requirements of local governments vary from one island to another island. Because of this, the announcement made by the Educational Commission for Foreign Medical Graduates (ECFMG) is significant, which enforces the Caribbean medical schools to go for accreditation by the year 2023 as graduates of these schools require ECFMG certification.  This study aims to find out the impact of accreditation on Caribbean medical schools' processes. 

METHODS: This is a qualitative study, and data analysis was done by framework analysis. We employed the semi-structured interview method to interview the academic leaders (deans/associate deans) and faculty members from three different types of Caribbean medical schools; accredited medical schools, non-accredited medical schools, and a school never applied for accreditation. 

RESULTS: A total of 12 participants participated in the interview process. Out of these 12 informants, 4 of them are deans, 2 are clinical deans, 3 are associate deans, one is the director of quality assurance, one is a curriculum committee chair, and another one is a junior faculty member from 6 different Caribbean medical schools. Results have shown that themes derived from this study coincide with the themes of Blouin et al. (2018) study a study conducted across Canadian medical schools. Results have shown that Caribbean medical schools are changing their educational and self-evaluation processes. 

CONCLUSIONS: Further studies are required to be conducted if the changes made by Caribbean medical schools are reactive changes to the accreditation site reports to satisfy the accreditation standards, or are they trying to set up the culture of continuous quality improvement? 


807 - Integrating An American Sign Language And Deaf Culture Student Interest Group Into Medical And Graduate Education
Britney Pitter | Danita Eatman | Sarah Greene
Morehouse School of Medicine  

PURPOSE: Although there are known healthcare disparities between hearing patients and those who are d/Deaf and hard of hearing (DHH), the literature related to training future health care professionals about working and communicating with this patient population remains sparse. In addition to communication barriers, the medical profession also tends to hold a negative, pathological view of deafness, and may have little knowledge of the positive, cultural view of deafness. To address these issues, an American Sign Language (ASL) and Deaf Culture (DC) Student Interest Group (SIG) was founded at Morehouse School of Medicine (MSM) in 2019. 

METHODS: In preparation for becoming an official SIG, the founding members created the mission of the group, which was "to train future professionals to advance health equity by increasing awareness of ASL and DC while providing an opportunity for interprofessional relationships." It was determined that membership would be open to students in all programs at MSM, and meetings would be on a monthly basis. Group activities would include learning about Deaf Culture through videos and presentations by members of the DHH community, learning basic ASL, attending Deaf Community events, and hosting a Deaf Panel focusing on experiences in health care, which would be open to all students, faculty, and staff at MSM. 

RESULTS: The ASL/DC SIG was formally approved, and all members of the student body were invited to join. Student officers were elected at the first meeting. By the third meeting, 50 members had joined across four degree programs. 

CONCLUSION: As the inaugural year of this SIG progresses, feedback will be sought to better understand the impact of attending meetings and events. It is expected that those who participate in SIG activities will gain perspective and awareness of Deaf Culture, as well as effective means for communicating with those in the DHH community. 


808 - Perceptions Of Yoga For Wellbeing: A Survey Of Medical Students And Alumni At An Osteopathic Medical School
Mariluz Henshaw | Alessia Zambrano | Haley Megarity
Touro College of Osteopathic Medicine 

PURPOSE: Yoga enhances wellbeing and is a viable option in the management of physical and psychological health concerns. We conducted a survey to understand the perceptions of yoga as a personal and healthcare practice in students and alumni of TouroCOM-NY. This abstract describes the preliminary results of the survey. 

METHODS: The survey was sent by email to all matriculated students of TouroCOM-NY and its alumni with the link to the online survey. The study was open for approximately 4 weeks. Participants were categorized into yogis (active practitioners), contemplators (intend to start) and nonyogis (no active practice and no intention to start). 

RESULTS: We received 83 responses with 70 completed submissions forming this initial dataset. 72.6% of respondents were females, 80% students and 72.6% between the ages of 25-34. All survey participants have tried yoga at least occasionally, with 37.1% yogis, 24.3% contemplators and 38.6% nonyogis. Across all three groups, breathing, physical poses, and mindfulness were the most common practices associated with yoga. Yogis were more likely to include meditation and self-compassion as additional aspects of yoga. Personal benefits from yoga practice mentioned include stress reduction, improvement in balance and flexibility, relief of pain, and anxiety reduction. All participants expressed some openness in referring patients to yoga as part of treatment, with yogis (57.7%) more likely to refer patients without question compared to contemplators (29.4%) and nonyogis (25.9%). Conditions wherein yoga is deemed appropriate as a treatment modality include improving balance (65.7%), anxiety (62.9%) and low back pain (61.4%). 

CONCLUSION: Personal experience in yoga seemed to play a role in participating in the survey and in endorsing practices and benefits associated with yoga. These results suggest the importance of developing strategies to make yoga more accessible to students as part of self-care and highlight its potential as a complementary treatment modality in healthcare practice. 


809 - Student Led Campaña de Salud, an Engaging Opportunity for Medical Students to Connect and Serve Local and Underrepresented Community
Alex Lucas | Dylan Mann | Jennifer A. Cortes | Spencer Mamer | Carlos Dostal | Kashif Ahmad
Carle Illinois College of Medicine 

PURPOSE: Campaña de Salud started as a health fair in Champaign-Urbana seven years ago with the mission: To educate underrepresented and uninsured groups about pertinent health issues through informative and comprehensive discussion and screening. Since then, the annual fair has varying degrees of success through several generations of medical students. We believe that gathering health fair participant data and sharing available resources can provide consistent healthcare that will benefit the local community and expand the Campaña mission. 

METHODS: Each fair consists of three primary objectives: to educate, connect, and to screen patients in the community who may not have access to healthcare. A team of trained volunteer students screens patients for chronic medical conditions. Informational booths provide pertinent health and lifestyle information. Lastly, community partners who work with disadvantaged and uninsured individuals to provide health services have representation at Campaña.  Patient information and vitals are gathered through anonymous ‘passports' (IRB approved), which also aid the patients in seeking out necessary community organizations and information booths. 

RESULTS: Previous fairs have shown that a large portion of disadvantaged members of the community does not receive regular medical care. These individuals also often have undiagnosed or poorly managed lifestyle conditions, including hypertension, diabetes, and hyperlipidemia. Also, the fair shows the language barrier that further complicates receiving consistent health care. The fair has been successful for health screenings and sharing information about the available health resources. Besides, medical students learn about healthcare challenges facing this underrepresented community. 

CONCLUSION: The Campaña mission plans to iterate and improve the open annual health fair process, to provide long-lasting community health support and collect data about health trends in the local underserved and underrepresented community. We propose the need for more student-led health fairs that allow them to hone their leadership and advocacy skills towards community engagement.


810 - The Collaborative Cadaver: Utilizing Traditional Undergraduate Medical Education Anatomy Facilities to Enhance Graduate Medical Education

Emma EH Huston | Carol M Gilbert
Virginia Tech Carilion School of Medicine | Virginia Tech Carilion School of Medicine; Carilion Clinic
No Poster Provided

PURPOSE: Just as undergraduate medical students use cadavers to comprehend the complexities and variation in the human body, graduate medical students need cadavers to refresh and expand their region-specific anatomy knowledge. Residents find more value in cadaveric exposure than their first-year counterparts; however, many hospitals and residency programs lack resources for such exposure and are instead turning to simulation training, despite studies showing an increased benefit from cadaveric exposure. Our undergraduate medical school offered our partnered medical center an anatomy laboratory to use in collaboration with fourth-year medical students to decrease cadaver waste and increase educational benefit to both residents and medical students.  

METHODS: The laboratory was a UGME laboratory prior to collaboration with the GME program. To initiate the collaborative effort, GME programs requested dissections or procedures to perform, which the lab manager then scheduled for each cadaver in order of region, procedural needs, and date. These labs were scheduled concurrently with fourth-year electives to effectively and fully utilize each cadaver.  

RESULTS: The commencement of this collaboration resulted in an organized GME lab schedule, decreased cadaver waste, and increased participation among GME programs. Two programs participated at the beginning of the first year, increasing to nine programs at the end of the first year. Anecdotal evidence from the first year of laboratory collaboration shows enjoyment and appreciation from residents and directors of the opportunity to give all residents hands-on cadaveric practice.  

CONCLUSION: Training exceptional physicians is the goal of undergraduate and graduate medical education. Knowledge and skill has shown to be enhanced with cadaveric opportunities during residency, but many programs lack access to cadavers and anatomy laboratories. This collaboration between a medical school and a medical center's GME program trains residents in a low-pressure environment, while reducing cadaver waste via cadaveric collaboration with fourth-year students.


811 - Twelve Tips For Successful Integration Of Foundational Science In The Post-Clerkship Curriculum
Kimberly Dahlman
Vanderbilt University Medical Center

PURPOSE: Traditional medical curricula generally place the majority of foundational science learning into the pre- clerkship years. Practical solutions are needed to incorporate foundational sciences into the clinical years of undergraduate medical education. This abstract describes the lessons learned after purposeful integration of foundational sciences with clinical experiences in the post-clerkship curriculum at Vanderbilt University School of Medicine (VUSM). 

METHODS: Five years ago, VUSM formally launched "Integrated Science Courses" (ISCs) that combine rigorous training in the foundational sciences with meaningful clinical experiences. These courses were designed and led by clinical and foundational science experts and undergo a rigorous evaluation process. Immediately after finishing each course, students completed an anonymous course evaluation. Course materials and assessments were reviewed by a panel of experts annually. Furthermore, course enrollment data were assessed annually and the ISC leadership met with the ISC directors monthly to better understand their needs. Student focus groups were also assembled for courses with lower than expected enrollment. 

RESULTS: Between AY 15-16 and AY 19-20 eleven to sixteen ISCs were delivered annually. Overall, students were highly satisfied with the integration and utility of foundational science learning with their clinical experiences. However, it became clear that students gravitated to some courses over others and that ISC educators required additional training. We have formulated twelve tips for successful implementation of foundational science integration in the post-clerkship curriculum that encompass student buy-in, diversity of course offerings, tailoring of courses to student interests, faculty development, and long-term sustainability. 

CONCLUSION: The teaching of foundational sciences in the clinical workplace in the post-clerkship medical curriculum is challenging and resource-intensive, yet feasible. Course enrollment data and results from the course evaluation process drove faculty development and refinement of the ISCs to better meet the needs of educators and students. 


812 - Usage Of Retrieval Practice As A Learning Strategy
Jaehwa Choi | Hye Yoon
Mercer University School of Medicine  

PURPOSE: Retrieval practice has been suggested as an effective learning strategy. However, retrieval practice is not a naturally occurring nor the most popular learning habit. The purpose of the current study is to assess students' adoption of retrieval practice in their learning. 

METHODS: A week before the orientation day, incoming students enrolled in the pre-clinical program were advised to watch a set of online videos that explained retrieval practice as an effective learning strategy and introduced techniques for retrieval practice. After their second set of tests in three courses, a survey was conducted on their exam scores, knowledge in the retrieval practice-based learning, and their actual usage of retrieval practice techniques. 

RESULTS: Forty-three out of 52 students participated in the survey. Students responded to the majority of the questionnaire, but only 29 students revealed their test scores. The majority (90%) responded that they practice recall of materials after reading a chapter, rather than re-reading the chapter. However, 41% of the students answered that they will remember more in the long term if they repeat the study material rather than practicing recall and testing it. Students reported using 2-8 (average of 5) different strategies for practicing recall. Students chose to make outlines or reviewing sheets (17.5%), doing practice problems (15%), self-testing (15%), and re-reading notes or textbooks (12.50%) as their most favored studying strategies. Seventy-three percent of students indicated they practice recall; 71% of students responded that they re-read notes or textbooks.  Fifty-one percent of students used flashcards, but only 7.50% chose using flashcards as their favorite studying strategy. 

CONCLUSIONS: In conclusion, although most students are aware of retrieval practice strategies, they do not necessarily all agree that retrieval practice will lead to long term retention of learning. Furthermore, many students re-read materials and consider it as their favorite studying habits.