Moderated by Anna Blenda

PRESENTATION 1 - Transitioning Medical Students During the Global Covid-19 Pandemic to Complete Service-learning by Helping With Testing and Vaccination Clinics    
Rhonda Cochran    
Oklahoma State University College of Osteopathic Medicine

PURPOSE Due to the COVID-19 pandemic, community partners were forced to restrict medical students from participating in service-learning opportunities as a part of the Service-Learning and Community Engagement (SLCE) course at Oklahoma State University College of Osteopathic Medicine (OSU COM). Because of our inability to have students in the community, there was a need to transition the medical students from our typical community-based experiential education to a focused initiative that was safe, impactful, relevant, and educational. We did this by creating service-learning opportunities for our students at COVID-19 vaccination Clinics both in Tulsa and in Tahlequah, OK.

METHODS New experiences were required for the SLCE course. There was also a developing need in the community to provide locations for the distribution of COVID-19 vaccinations. OSU COM in Tulsa partnered with OSU Medical Center (OSUMC) while OSU COM CN partnered with the Cherokee Nation Health Services (CNHS) in Tahlequah to create vaccine clinics. Students assisted with administering the vaccination, patient form completion, running supplies, and monitoring the patient observation areas. Students were required to complete six two-hour sessions. Sign-Up Genius was utilized to create the schedule and select times throughout the semester that fit with our students' courses. Communication was vital to ensuring a positive learning experience for students and ensuring the service provided was adequate and helpful.

RESULTS There were 170 first-year medical students in SLCE I for the Spring 2021 semester. End-of-course reviews suggested positive learning experiences that include an enhanced understanding of the importance of health promotion, using skills to help the community, and feeling like they were part of a larger healthcare professional community. SLCE students assisted with the administration of about 13,500 COVID-19 vaccinations.

CONCLUSION Transitioning our medical students from our typical service-learning activities to the Vaccination Clinics was a worthwhile and practical measure that benefited the community and the learning experience of our students.

PRESENTATION 2 - Developing a Continuous Improvement Model of Program Evaluation Using a Competency-based Approach to Anesthesia Simulation Training in Veterinary Education    
Julie Noyes    
American Association of Veterinary Medical Colleges

PURPOSE Evaluation of clinical competency, particularly for high-risk activities such as anesthesia management, is a major challenge for healthcare education. We developed a competency-based, immersive anesthesia simulation program according to a continuous improvement training model to not only evaluate learning but also to inform subsequent training with evidence produced by granular skill data analyses.

METHODS We designed a competency-based, immersive anesthesia simulation training program for veterinary nurses.  Three validated assessment instruments were aligned with the competency-based training and included clinical performance rubrics for four anesthesia scenarios, a self-efficacy inventory, and a procedural knowledge test.  All instruments were aligned at the skill level to evaluate specific cognitive, psychomotor, and affective domains required to appropriately manage four common complications in canine anesthesia. A pilot study was conducted at an accredited veterinary technology program to evaluate learning and performance at the competency and granular skill level.  This allowed us to identify specific training areas requiring improvement and to provide students with customized skill reports to guide their individual future anesthesia training.

RESULTS The pre/post-test pilot stage of the study included data from nine first year veterinary nursing students and revealed significant improvement (p>0.001) in self-efficacy, knowledge, and all clinical outcomes evaluated by the standardized, competency-based rubrics. Analyses at the skill level revealed specific skills the group did not acquire, thereby providing a continuous improvement strategy to inform subsequent trainings.  Additionally, individualized skill level performance reports were generated to guide subsequent learning pathways.

CONCLUSION This study describes the development of competency-based training according to a continuous improvement model of program evaluation. In addition to understanding whether training enhances general performance measures, this method provides granular information pertaining to specific skills in anesthesia management and that data can be used to inform and enhance subsequent training methods as well as to create individualized learning pathways.

PRESENTATION 3 - Using Script-concordance Testing in Osces: a Pilot to Encourage Integration of Foundational Knowledge Into Clinical Thinking    
Mary Donovan    
Georgetown University School of Medicine

PURPOSE Objective Structured Clinical Exams (OSCEs) often include post-encounter evaluative exercises such as student documentation of the standardized-patient (SP) visit in "note" format. We piloted the use of Script Concordance Testing (SCT) in OSCEs to highlight the application of foundational science to clinical experiences, incorporating conditions of diagnostic uncertainty and interpretation.

METHODS During our 8-week transition-to-clerkship course, students experience a formative OSCE. We replaced one post-encounter note write-up with SCT. Questions presented students with potential differences or changes in the patient's situation, symptoms or history. Students determined how that change impacted the likelihood (more, less, or no impact) of potential diagnoses, recommended testing or treatment. Students individually debriefed their experiences with the SPs and with the OSCE team during an optional review session.

RESULTS 192 students completed the OSCE with SCT and 174 (90%) attended the review session. Students expressed surprise at how small changes in a patient's story could have significant impact on diagnosis and care. They commented on the value of SCT-thinking in compelling application of foundational knowledge to their clinical reasoning and for their preparation for clinical rotations.

CONCLUSION Our pilot experience supports use of SCT to help students apply foundational science knowledge to clinical situations. It provides students the opportunity to experience the real life adjustments to interpretation/reasoning when further data becomes available or as conditions progress. Our next steps include incorporation of SCT into our capstone OSCE for senior students and comparison of post-encounter SCT vs note write-ups in their impact on student application of scientific knowledge to clinical scenarios.

PRESENTATION 4 - Effect of Dissection-based Lab Versus Virtual Anatomy Lab on Student Learning in a Neuroscience Course    
Elizabeth Moffett    
Rocky Vista University 

PURPOSE: With the onset of the COVID-19 pandemic safety measures such as social distancing was implemented to protect against transmission of the virus. Student cadaveric dissection as part of a medical gross anatomy curriculum was one of the previously in-person experiences that Rocky Vista University moved to a virtual lab format in response. The purpose of this study is to examine the effect of a virtual versus in-person format on student performance on anatomy of the Neurosensory system.

METHODS: Here we compared student performance in the Neurosensory system, which covers the anatomy of the head, neck, and central nervous system, when students experience in-person dissections versus a completely online format. For the online group, live streamed prosection demonstrations over the Zoom platform allowed students to view relevant anatomy, ask for additional views, and have questions answered. Anatomy lab evaluations were also virtual through the ExamSoft platform consisting of static pictures of dissected cadavers. We compared the completely online students to students who experienced hands-on, student-led dissection based learning of the same cadaveric structures. All assessments were kept as similar as possible to allow direct comparison between groups. Student's t-tests were employed to assess differences in mean performance between groups.

RESULTS: We saw a significant decrease in student performance on anatomy practical exams after learning via the virtual format, even after assessment changes to match were made.

CONCLUSIONS: These results support previous research demonstrating the value of cadaveric dissection or prosection style gross anatomy labs. While a virtual lab was acceptable during a public health emergency, it is not sufficient for proper education in the structure and function of the human body.