Shekitta Acker
Mayo Clinic Alix School of Medicine

Purpose
High cognitive test anxiety can lead to academic performance concerns in students. This cross-sectional study investigated the distribution and relationship between cognitive test anxiety (CTA), academic resilience (AR), and the demographics of physician assistant (PA), nurse practitioner (NP), and physical/occupational (PT/OT) students.

Methods
PA (65), NP (118), and PT/OT (26) students from seven universities across the United States were invited to participate in the study. Participants completed two validated surveys; Cognitive Test Anxiety Scale-2(CTAS-2) and Academic Resilience Scale (ARS-30) along with demographic-related questions. Responses were analyzed using one-way ANOVA, linear regression, and multiple linear regression.

Results
Two hundred and forty-seven students from seven programs participated in the study and two hundred and nine students were included in the final analysis. Sixty-three percent of students in this study presented with moderate (41%) to high (22%) CTA. The prevalence of high CTA among PA, NP, and PT/OT students was 8%, 30%, and 19%, respectively. Non-White students had a statistically significantly higher mean CTA score than White students. There was no statistically significant difference in the CTA between students by program year, gender, or age. Forty-two percent of students presented with high AR among health professions. There was no statistically significant difference in the mean AR between students by program year, gender, race, or age. AR explained 14.2% of the variance of CTA among students. And about 11.5% variance in current self-reported GPA and 20% variance in the confidence levels of passing their licensure examination was explained by CTA and AR model.

Conclusions
High CTA does exist in health professions students and may significantly impact their academic performance. Non-white students present with higher rates of CTA. With matriculation and retention rates among underrepresented minorities being a challenge, identifying students early and finding interventions to improve students' academic success will be imperative.

Danielle Eames
Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas

Purpose
Research supports the notion that medical school is inherently stressful and that addressing healthcare disparities in a diverse nation requires an equally diverse physician workforce. To accomplish the latter, medical schools must seek students historically underrepresented in medicine from diverse socioeconomic, educational, and occupational backgrounds. As “non-traditional” students, they may have unique perceptions of stress and varying social support from family and friends. The purpose of this study is to compare perceived stress during undergraduate medical education between four key demographic groups to help guide student support for constructive stress management to ultimately graduate a diverse student body.

Methods
The Perceived Stress Scale (PSS) was administered to all cohorts up to four times: prior to matriculation, after the pre-clinical phase, after clerkship, and upon graduation. Using independent samples t-tests, mean PSS scores were compared among the following demographic groups: Under-Represented in Medicine (URM), Socioeconomic Status (SES), First-Generation medical student (Firstgen), and age 30 or older at matriculation (Over30).

Results
Prior to matriculation and after the pre-clinical phase, URM, Firstgen, and Over30 groups reported lower stress. URM, Firstgen, and SES groups reported higher stress at the end of clerkship specialty rotations. At the end of their clerkship training, “Firstgen” students had significantly higher PSS scores than their non-first-generation peers (mean 7.69 vs. 6.49, p=0.026).

Conclusions
A complex etiology of perceived stress exists throughout medical school, which may relate to demographic factors such as age, socioeconomic status, educational background, and historical underrepresentation in medicine. In our study, first-generation medical student stress peaked at the end of their clerkship training. With the established need for increased physician diversity comes the requisite for diversity among medical students. Demographic composition of medical student cohorts will fluctuate, and medical schools need to understand how demographics factor into students’ perceived stress so that they can provide suitable resources to support students navigating the challenges of medical education.

Aaron Marshall
University of Cincinnati

Purpose
Cadaveric dissection has been a cornerstone of medical education. Given the hands-on nature, it is important to recognize the student experience will vary for many reasons. Some may enter the cadaver lab ill-prepared for the violent reality of human dissection. Students respond to discomfort in a multitude of ways: use of humor, desensitization, or avoidance. To mitigate the discomfort and promote student well-being, a team of faculty and students designed a series of meditative practices to offer preceding the cadaveric dissection. The purpose of this study was to assess (1) the feasibility of implementation for this practice and (2) the acceptability of this offering by medical students.

Methods
Meditative reflections were structured similar to a surgical "timeout". Participating students gathered around a cadaver table, fifteen minutes prior to the scheduled dissection. Specific dissections were selected for this offering, using considerations for the sensitivity of the anatomy being studied or the amount of physical violence that occurred during the dissection. The practice was guided by a trained faculty member and consisted of, centering the mind of the breath, reflecting on the act of dissection, acknowledging any internal feelings, and offering gratitude toward the donor.

Results
The methods described have proven feasible to implement, requiring the tacit permission of anatomy faculty. Following three reminders of this optional meditative activity, 83 students (46%) participated in the first offering. Future iterations will include brief, valid survey instruments (e.g. Perceived Stress Scale) to assess potential impact(s) on student.

Conclusions
We expect this curricular offering will allow students to intentionally contemplate the innate dignity of the human being they will dissect, as well as grapple with the nature of the dissection procedure itself. Bringing activities of well-being into the formal curriculum in such a manner is innovative, generalizable, and simple - but the impact is significant.

Spencer Taylor
Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas

Purpose
Previous literature has reported that post-baccalaureate career changers had significantly lower USMLE Step 1 scores, but limited data is available on the role of matriculation age on student success in medical school. A small proportion of matriculants each year are over age 30, and it is essential to understand how this may impact their performance compared to their younger counterparts. Several factors could affect performance in older matriculants, including lack of social bonding, differences with peers, familial and economic burdens unique to older students, and a longer pause between undergraduate education and medical school.

Methods
Data was gathered from 6 student cohorts at a single medical school. Students were stratified based on matriculation age, with 30 as the cutoff point. MCAT, USMLE STEP1 and STEP2 scores, and pre-clinical biomedical science NBME exam scores were analyzed using a two-sided T-test to assess statistical significance.

Results
326 students were under 30 and 34 were age 30+ at matriculation. Older matriculants had significantly lower MCAT scores (p = .031 ). This trend continued for older students who scored significantly lower on Step 1 (p = .005), clinical specialty shelf exams (p =.001) and Step 2 (P=.001). Older students scored lower on pre-clinical NBME exams, but significance was not reached.

Conclusion
Matriculants aged 30 and over come into medical school with significantly lower MCAT scores and this trend continues throughout medical school, with lower scores on vital performance benchmarks, which could impair their ability to compete against younger students during the residency match. With this data, medical schools should monitor and provide enhanced strategies to support this subgroup of students.

Catherine Coe
University of North Carolina

Purpose
The transition between the pre-clinical and clinical phases of medical education often feels disparate rather than facilitate by a smooth transition. Lack of student support during transition can lead to burnout for students and challenge their developing professional identity and career selection. The University of North Carolina's Patient Centered Care Course (PCC) introduces first- and second-year medical students to the history and physical exam components necessary to become a physician. Taught in small groups, the course facilitates a safe space for acquisition of skills and unique setting to promote the transition.

Methods
In 2021, the PCC Course launched an additional experience for students transitioning to clinical rotations. Students meet three times with their PCC cohort and three times in individual meetings with their tutors to receive feedback, coaching, and peer support while on clinical rotations. Students process clinical encounters and various aspects of medicine in a safe space and share elements of mistreatment and receive referrals to appropriate supports.

Results
For the 2020-2021 and 2021-2022 academic years, a total of 380 students and 52 faculty participated in the additional semester. Students commented on satisfaction with the course and both students and faculty indicated that the program fills a unique role within professional identity formation of students. Students process difficult patient and teammate encounters, their role on the medical team, and career selection.

Conclusion
This model includes coaching, mentorship, and advising. Students are supported by faculty that they know well and who do not have any bearing on their grade in the clinical rotation. This ensures unbiased feedback and students share without fear of retribution. The psychological safety provided ensures students can learn without fear of comparison or embarrassment and supports their development as future clinicians.

Jay Babu
Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas

Purpose
Non-traditional majors (humanities, music, business) enter medical school with different experiences and exposures, which could impact their academic success. It is essential to understand the performance differences between these students and those from more traditional STEM majors on key medical school benchmarks. If non-traditional students can perform on par with traditional students, medical school admissions committees should evaluate their selection criteria to ensure the non-traditional approach to medical school preparation is given equal weight during the selection process.

Methods
Participants were stratified based on their undergraduate major (STEM vs. non-STEM). MCAT, STEP1, STEP2, and pre-clinical biomedical science NBME block exam scores were compiled and analyzed using a two-sided T-test to assess their significance.

Results
The majority of students, 325, were from traditional STEM majors and 35 were from non-STEM, non-traditional majors. Non-traditional students entered medical school with higher mean MCAT scores (511 vs. 509; p = .078). During our curriculum's pre-clinical biomedical science phase, non-traditional students had significantly higher mean NBME exam scores (84 v. 82, p=.02). These students continued to score higher on USMLE Step 1 and Step 2 exams, but it did not reach significance.

Conclusions
Matriculants from non-traditional majors entered medical school with higher MCAT scores and significantly outperformed their traditional-major counterparts on pre-clinical NBME exams. Medical students from non-traditional majors possess unique experiences that their traditional counterparts might lack. With this data, pre-med students can choose a major that truly interests them, and admission committees can focus more on diversity in majors when accepting applicants. Further research should be conducted to assess differences in attributes among non-traditional majors entering medical school.