133 - Implementation and Evaluation of Virtual Laboratory Tours for Laboratory Diagnosis of Hematologic Disease

Teresa Scordino
University of Oklahoma College of Medicine

Purpose: Diagnostic testing for hematologic malignancies takes place in a number of different specialty laboratories; however, the laboratory can seem like a single “black box” to students and trainees. For medical students, confusion about ancillary testing can present an obstacle to learning and retaining the diagnostic criteria for hematologic diseases. Knowledge gaps in laboratory medicine can persist into the resident and fellow training stages, where they manifest as laboratory ordering errors and overutilization or underutilization of diagnostic tests, leading to potential delays in diagnosis. These knowledge gaps are recognized in the literature, with few publications discussing educational innovations to overcome these gaps. Familiarizing learners with the distinct laboratories and test methodologies is a potential way to help learners conceptualize the differences between these tests. Laboratory tours are a way to provide this kind of exposure; however, physical tours can be logistically difficult to arrange for classes of 150 or more students, and the benefit to the learner may vary depending on the tour guide or the timing of the tour.  Additionally, large in-person tours are not feasible during the Coronavirus pandemic. Virtual laboratory tours, with video and voice-over PowerPoint components, are a potential way to provide a standardized educational experience that the learner can access at their convenience.

Methods: We developed a laboratory medicine curriculum that included a series of video tours that followed specimens through the cytogenetics, flow cytometry and molecular laboratories. The curriculum was delivered to first-year medical students as part of their four-week hematology course. The students took a pre-test prior to completing the activity, and a post-test following the activity.  The quiz questions were clinical vignettes that posed a specific clinical question, and the students had to select the most appropriate test for each question. The quizzes included questions about the students’ level of confidence with their answer choices. Attitudes about the strengths and weaknesses of the curriculum were be assessed by anonymous survey questions on the end-of-course evaluation.

Results:  The average score on the pre-test was 59.8%, and the average score on the post-test was 92.2%.  The students’ degree of confidence with their answers also improved; the number of students reporting that they were either confident or highly confident with their responses with 6.02% for the pre-test and 84.94% for the post-test.  Student narrative feedback about the activity was positive, and included requests for virtual tours of additional laboratories.

Conclusion:  Virtual laboratory tours were an effective and enjoyable way for students to learn about laboratory diagnosis of hematologic malignancies. This is an effective distance-learning method that could be easily tailored to teach relevant laboratory testing topics in other systems courses or to students in other health professions.

135 - It Takes a Virtual Village: Interdisciplinary Zoom Interactive Session

Tipsuda Junsanto-Bahri, Kamilah Ali, Maysa Azzeh, Stacey Fanning
Touro College of Osteopathic Medicine

"Background:   Our 2nd year curriculum offers a flipped classroom, organ systems-based with pre-recorded lectures and interactive sessions. Systemic Pathology (SysPath), Pharmacology (Pharm), and Medical Microbiology and Immunology (MMI) courses have 50-minute in-person mandatory weekly sessions. Boards-style multiple choice questions (MCQs) are presented. Students collaborate to determine the correct answer, use iClicker polls, and are able to ask faculty questions.

With the COVID-19 pandemic, we transitioned to remote learning, using Zoom teleconference platform. Each course had separate sessions with optional attendance.  During this time, students faced challenges such as keeping track of several Zoom links, Zoom fatigue, asynchronous learning, retention of prior module content, and social isolation with decreased peer interaction.

We report a pilot test of 3 virtual Integrated Interdisciplinary sessions covering topics in Gastrointestinal, Neuromusculoskeletal, and Oncology. Our goals were to:

•      Minimize student' Zoom fatigue
•      Integrate concepts covered amongst disciplines and prior modules
•      Promote peer interaction/learning
•      Ensure student preparedness for exams

Design: Faculty met weekly to plan the 1.5 hour sessions and finalize MCQs. Student groups were assigned (8-9 per group). Attendance was mandatory. Students received full credit equal to one quiz grade per session. Questions were distributed 10 minutes prior to the session. Students spent 10 minutes in breakout sessions to discuss a 2-part MCQ, then re-convened to review all MCQs with polling. Each team provided brief explanations of their assigned MCQs. Faculty provided clarification. A 16-question post-survey, comprised of 4 scales: Group interaction, Question format, Student preparedness, and Session format, with 4-point Likert-type scale (Satisfied, Neutral, Good, Excellent) was distributed for feedback.

Results: 124/129 responses were received (96% response rate). Students preferred integrated sessions (75%) over traditional sessions (24%). They spent 1-5 hours (50%) or 30 minutes “ 1 hour (38%) preparation for the session, stated poll time should be lessened and that 1.5 hours was not enough time to cover content and allow for adequate discussion.

• Group interaction: Rated ""Good/Excellent""regarding group collaboration (85%), meaningful contribution (98%), teamwork (81%), and active participation (71%).
• Question format: Rated ""Good/Excellent""regarding integration of 1st semester content (78%), sufficient integration (69%), quality of questions (95%), improvement of knowledge from faculty explanations (81%), and good learning tools for exam preparation (89%).
• Student preparedness: Rated ""Neutral""(9%) versus ""Good/Excellent€(87%) regarding ""if not prepared, gained a better understanding of the content,""whereas  ""Neutral€(19%) versus ""Good/Excellent€(76%) for session preparedness.
• Session format: Rated ""Neutral/Satisfactory€(40%) and ""Good/Excellent€(40%) regarding session helpful in synthesizing skills, and ""Good/Excellent(66%) regarding sufficient time for breakout sessions.

Discussion: Students preferred integrated sessions, MCQs, and breakout room activity.  The decreased time from 3 separate sessions to one helped reduce Zoom fatigue. Student preparedness was good. Despite little preparation, students thought sessions helpful in bringing concepts together.  They requested questions be released 1 day prior rather than before class, so they can have more time to review/synthesize the entire question bank rather than only the questions assigned to their group."

141 - A Virtual Pathology Residents-As-Teacher's Program During Covid-19

Lianna Goetz, Nicole Williams, Elizabeth Frauenhoffer, Francesca Ruggiero, Olajumoke Oladipo, Evelyn Potochny, Melissa George, Rachel Casas
Penn State Milton S. Hershey Medical Center
 

Background:

Residents are tasked with teaching their peers and medical students but are often not trained in medical education. Pathology residency is multifaceted with both anatomic pathology (AP) and clinical pathology (CP) being highly subspecialized. This presents a unique challenge for resident-teaching, given the multiple settings in which teaching must occur. Interestingly, Residents-As-Teachers curricula exist for many medical specialties across the US, but there are few published examples for Pathology.

Aim:

The aim of this initiative was to develop a Residents-As-Teachers Program that would educate participants about medical education, with the goals of enhancing resident preparedness to teach and improving resident learning.

Materials/Methods: 

A Needs-Based-Assessment was conducted using a digital survey tool to assess resident perspective on the need for training in medical education.

A curriculum was developed based on the resident and faculty selected topics of:

• Giving effective presentations and photomicrography
• Giving feedback and peer review
• Motivation €“inspiring learning, teamwork, leadership
• Teaching while working (eg. while grossing, during autopsy, frozen sections, at the bedside in the apheresis suite)
• Adult learning theory

Interactive virtual attending-led sessions were initiated via Zoom „¢ and will continue over a 4-month period followed by post-session surveys.

A post-program survey will be conducted at the end of the 4-month period to obtain a retrospective re-assessment of resident' self-perception of competency in medical education, perception of preparedness to teach and the helpfulness of sessions in their role as clinical-educators.

Results:

Needs-Based Assessment

The Needs-Based-Assessment showed that Pathology residents have attributed approximately 47% of what they learn in residency to what is taught to them by other residents. However, most residents attributed only 20% of their time teaching peers.  90% of the residents felt that it was important to be trained in medical education. When asked about competency in medical education only 55% of residents rated themselves as competent while 45% rated themselves as neutral (neither competent or incompetent).

This Needs-Based Assessment validated the need for Medical Education Training within our department and helped guide the topics chosen and format of the sessions.

Post-Session Survey on session #1:

Residents expressed an increased understanding of the session topic and reported feeling more prepared to teach. They also reported the usefulness of this session as very useful and extremely useful.

Discussion:

Virtual settings pose limited types of feedback and engagement. Technical issues can impede quality engagement and the risk of resident multitasking and ""sham-participation""during virtual sessions is increased. However, utilizing a virtual setting allows ease of access to sessions and the recorded format allows for asynchronous learning in the future. The interactive format helped to minimize potential distractions and post-session surveys allow feedback and tailoring of the program to meet resident' needs and increased effectiveness in the future.

Conclusion: 

We demonstrate that developing a structured medical education curriculum for Pathology residents can help increase resident preparedness to teach. These sessions can be effective even in a virtual setting and will equip residents with the tools needed to execute teaching in an efficient and meaningful way."