Kosha Gala    
International Federation of Medical Students' Associations    

Purpose
Social accountability of medical schools is defined by the WHO as the obligation to direct their education, research, and service activities toward addressing the priority health concerns of the community they serve. At the height of the pandemic, healthcare systems and medical schools faced global challenges that showed their limitations regarding health crises. The International Federation of Medical Students' Associations assessed the social accountability of medical schools worldwide during the COVID-19 pandemic.

Methods
IFMSA conducted an online survey in 2021 using the IFMSA Social accountability assessment tool (a combination of THEnet Framework for Socially Accountable Health Workforce Education and the AMEE Aspire criteria for recognition of excellence in Social Accountability) to explore the social accountability status before and during the pandemic.

Results
The Survey sample comprising 178 medical students was from 129 countries in all 5 regions of the IFMSA, representing their medical schools. Statistics showed almost equal division between schools that had improved, had the same, or had worsened their social accountability during the pandemic. Active service to the community was acquired by medical schools before the pandemic as it was during it. Research and services weren't affected by the pandemic and remained oriented toward the community's needs in most cases. Many students believed that the positive impact of their schools on the community remains unchanged by the pandemic.

Conclusion
This work showed us that social accountability remains unchallenged even in the biggest crises. Social Accountability practices in medical schools having a good assessment remained the same and those with low impact weren't able to improve. The majority of students agreed that medical school's actions in practicing accountability were inadequate during the pandemic while unanimously agreeing on the need for standardization of social accountability by all medical schools.

Emanuel Zayas-Diaz    
Universidad Autonomy de Guadalajara - School of Medicine    

Purpose
Our understanding of the genetic basis of diseases has grown exponentially, allowing the identification of individuals at risk for genetic disorders or abnormal response to treatments, nevertheless uptake and acceptance of genetic testing in clinical practice remain low. Main reason being an undereducation of healthcare providers. Our purpose was to assess the students' attitudes, knowledge, and abilities for Genomic Medicine prior and after the instauration of a Genomic Medicine course to the curriculum.

Methods
We underwent a prospective study to report changes in attitudes, knowledge, and abilities for Genomic Medicine after the implementation of a course consistent of theoretical and practical activities with the purpose of students being able to interpret and provide basic information about genetic test results to patients. Attitudes, knowledge, and abilities were measured with the use of EBPAS-GII scale. For statistical analysis, we used mean and SD for descriptive purposes. The inferential phase was done with ANOVA to examine significant associations between attitudes,

Results
We included results from 46 professors and students' pre-exposure and 72 post exposure. No differences were observed in terms of demographic characteristics among groups. Cronbach's alpha was <0.7 for all scales. We found an increase in the scales of knowledge and abilities (p< 0.05), while the attitudes stayed high pre and post exposure. After a multivariate analysis no other variable was associated to the increase in knowledge and abilities including age >30, degree, or previous research experience.

Conclusion
Our findings suggest that prior to the exposure students had a deficit in their familiarity and comfort interpreting and using genomic information. This reinforces the importance of prioritizing genomic medicine education, especially with practical activities, among institutions.

Jennifer Ekemerereh Margarita Uyere    
Universidad Autónoma de Guadalajara

Purpose
Presently, an on-going implementation of changes is being made to the graduate medical education at Universidad Autónoma de Guadalajara (UAG). The main purpose of these changes is to improve how medical education is imparted and increase mastery resulting in overall student success during the didactic years of graduate medical education. The importance of graduate medical pedagogy and curriculum design is seen in the rates of students that achieve educational milestones. Thus, UAG has adapted its philosophy of education to meet the changing needs of its students and the evolving tenets of evidence-based medicine.

Methods
Statistical data analysis will be performed to analyze the effects of the implemented changes and determine whether they positively impact overall student success. To address the changing needs of today's medical students, UAG is introducing new teaching methods at various stages of the medical school curriculum. These include: active learning, simulation using state-of-the-art technology, student-centered approach problem-based learning that diverges from the traditional model, and virtual reality using the Oculus Medical Realities Platform.

Results
It is expected to observe overall increased student success with the implementation of the stated curriculum changes.

Conclusion
Technological advances are moving medicine forward at a rapid speed, new opportunities in medical school pedagogy are driving an urgent need for UAG to evolve its teaching methods. The implemented changes embrace the UAG system by continuing to support students and alternative pathways in attaining competency. It will preserve opportunities for creativity and pursuit of individual interests, such as advocacy, research, and leadership. UAG will continue to produce highly skilled doctors that will move health care forward.

Katherine Brown
Meharry Medical College

Purpose
The concept of a Community of Practice (CoP) was first proposed by a cognitive anthropologist Jean Lave and educational theorist Etienne Wenger-Trayner in 1991 through their book, "Situated Learning". Wenger expanded on the concept of community of practice in his book, "Communities of Practice" published in 1998. This presentation explains the importance of a CoP model to the need to continually align medical education and clinical transformation with contemporary health issues.

Methods
This presentation describes the objectives of the National Center for Medical Education Development and Research (NCMEDR) established at the Meharry Medical College located at Nashville, Tennessee, USA. It describes the evolution of the process of creating three CoPs, one each for LGBTQ+ persons, people experiencing homelessness, and migrant farm workers at the National Center (NCMEDR) based on identified objectives and the advantages that an interprofessional, transdisciplinary team can provide to curriculum development in medical schools. It also details the strategies that were used for leveraging the CoPs as a model for transforming medical education and clinical practice and how the methodology could be applied to addressing the changing needs of socially vulnerable populations such as sexual and gender minorities (LGBTQ+), persons experiencing homelessness, and migrant farm workers.

Results
The three CoPs we created were able to achieve the objectives of the center in creating curriculum, conducting research, assessing the needs of vulnerable populations and disseminating findings that can generate best practices and better evaluation tools for the assessment of these interventions.

Conclusion
The CoP-led activities, achievements, and value creation in medical education by the NCMEDR could serve as a model to transform faculty development, student engagement and clinical practice in several allied health professions schools.

Alexandra Gates    
Elizabethtown College    

Purpose
The LGBTQIA+ community endures limited access to quality, patient-centered care delivered by healthcare providers knowledgeable on the unique care needs of each population within the community. This may reflect a training gap in the form of non-standardized inclusion of such topics within professional curricula. While Professional Medical Associations (PMAs) do not accredit or regulate educational programs directly, they nonetheless remain largely influential over current areas of focus within healthcare professions and shape curricula development through their publications and policies. To understand the inclusion - or exclusion - of LGBTQIA+ specific topics in professional curricula, we assessed the current stances of influential PMAs on the subject.

Methods
United States-based PMAs were selected across several healthcare professions including those affiliated with physicians, nurses, and Emergency Medical Technicians. From the websites of these organizations, we conducted a literature review of open access material pertaining to LGBTQIA+ patient care published within the last 10 years in order to infer each PMA's stance on the subject. Additionally, a thematic and content analysis was performed to assess the existence, depth, specificity, and actionability of each publication.

Results
While LGBTQIA+ healthcare has been discussed and highlighted as an area of importance by many PMAs, variation in emphasis on the importance of this topic exists both within and across the PMAs representing healthcare professions. 

Conclusions
The unique care needs of each population within the LGBTQIA+ community are not universally recognized or emphasized by PMAs across the healthcare field. Until all providers are trained to recognize these needs and treat all sex and gender minorities with equitable practices, the health outcomes and patient experiences for LGBTQIA+ patients may remain wholly inadequate. PMAs across every healthcare profession should prioritize improvement of LGBTQIA+ patient care and encourage educational reform to better prepare all providers to adequately meet the diverse needs of this community.

Faith Reid    
Eastern Virginia Medical School    

Purpose 
Peer assisted learning in the medical field allows students to combine knowledge and learn more efficiently, while increasing motivation, comfortability, and autonomy of both teacher and student. The goals of this research was to evaluate peer teaching assistance (PTA) using a standardized method of reading medical images (MI).

Methods
During 9 weeks of human structure module, PTA, trained by an expert in the field, coached students in small groups integrated in the Human Laboratory session using a wide screen to utilize the "VOID" (Visualize Observe Identify Describe), algorithm when assessing images. MI included the normal and pathological presentations of various anatomical structures from X-ray, CT, and MRI.

Results
Every student (n=152) passed Human Anatomy Module. Students' responses were overall satisfactory from the course evaluation. They include that such learning experience makes it easier to understand human structure, modalities and engage participation and discussion among group. Peer-to-peer interactions facilitated higher knowledge retention and emphasized collaboration. For example, student felt more comfortable to sharing their knowledge and leading to a more fruitful conversation of clinical scenarios.

Conclusion
Overall, both students and peer teachers reported feeling more involved and improved their ability to consolidate radiology knowledge long-term. PTA also learned how to teach and explain difficult concepts in a clear and concise manner, which is imperative for a physician in later life.

Alan Detton    
Columbia University    

Purpose
An estimated 0.5-2% of the world's population identifies as intersex, however, intersex health education is limited in medical school curricula and potentially driven by language to which people who identify as intersex object. As a result, medical students and providers may lack knowledge of intersex variations and affirming care principles leading to inadequate or harmful care for intersex patients. To address educational deficits about intersex individuals, educational materials were developed.

Methods
A student advocacy group performed an extensive literature review regarding intersex anatomy and healthcare and collaborated with intersex individuals to identify the most relevant concepts pertaining to affirming care for this population. Concise, focused lecture slides were created on variations in reproductive anatomy during embryologic development, variations in pre- and post-natal hormonal pathways and sex characteristics, and information on affirming intersex healthcare. Anatomy and endocrinology were selected as ideal courses in which these concepts could be applied and integrated, and the student advocacy group met with faculty to discuss integration of the curated content into existing lecture material.

Results
The developed intersex content was successfully incorporated into the anatomy lecture on genital anatomy and sexual differentiation and delivered to all 220 first year medical and dental students. Furthermore, students involved in the creation of the material were invited to attend the lecture and extend an invitation personally to the incoming class to become involved in the advocacy efforts. Ongoing efforts are being made to include an adapted version of the slides within the upcoming endocrinology course. 

Conclusion
Healthcare trainees and providers must understand intersex health to provide affirming and compassionate care for intersex individuals. Student and faculty collaboration in ensuring medical education is inclusive of all identities can help train a cohort of more open-minded and compassionate providers.

Andreas Seyfang    
University of South Florida Morsani College of Medicine    

Purpose
During the COVID-19 pandemic in Academic Year 2020-21, the preclerkship curriculum of the USF medical school curriculum switched to online class delivery via live streaming by Microsoft Teams. The purpose of this study was to investigate how this affected the academic performance in the first course of a medical school curriculum compared with previous and subsequent in-person course delivery.

Methods
Academic performance of the 8-week Course 1 "Cancer Biology & Core Principles of Medical Sciences" in Fall 2020 as an online course was compared to face-to-face in-person class delivery in Fall 2019 and 2021 again. The material and lectures had remained identical for the online course delivery in 2020.

Results
The class average for the online delivery in 2020 (mean 87.2%, SD 6.7%) remained within the same range compared to the in-person delivery in 2019 (mean 88.0%, SD 6.0%) and 2021 (mean 87.9%, SD 6.3%). However, a larger tail of lower performing students was observed for the online delivery in 2020 compared to the face-to-face course deliveries.

Conclusions
The academic performance was not affected by online course delivery during the COVID-19 pandemic in 2020, however less opportunities for in-person social interactions in this first course of the medical school curriculum may have affected more the lower performing students as indicated by a larger tail of lower performing students for the online course.

Gloria M. Conover    
Texas A&M School of Medicine    

Purpose
Individualized coaching and faculty mentor feedback fosters medical students' critical thinking skills for research and scholarship. Critically appraising and communicating research discoveries and their application to patient care, however, are challenging skills for medical students to become confident and proficient in. To address this, we developed Medical Scholar Research Pathway Program (MSRPP) in a learning environment adapted to a community-based multi-campus public medical school.

Methods
MSRPP student program educational milestones and research deliverable outcomes were tracked in the inaugural two years, after completion of the pilot phase. Through individual student coaching meetings with the Program Director, school-wide research interest surveys, and assessments of research deliverable output; descriptive analysis was conducted using a cross-sectional study design using frequency and percentage distribution. Early outcomes of medical students' attitudes and behaviors toward research were obtained by using thematic analyses of live interview testimonials and interest surveys.

Results
MSRPP students attending a medical school without a curricular research requirement, tremendously benefited from a structured tailored formal research program. Early indicators show that individual coaching sessions with the program director set priorities for UME learners across their pre-clerkship and clerkship curriculum. Furthermore, long-range program priorities were based on the school-wide student career goals, which were captured through an interest survey. Strikingly, more MSRPP students produced a significantly higher number of research deliverables than non-MSRPP students, such as research presentations at conferences and peer-reviewed journal articles. Thematic analysis of student testimonials revealed high student satisfaction in being able to confidently blend academic research with the practice of medicine.

Conclusions
After completion of MSRPP, medical students have the confidence and skill set to establish and sustain productive research collaborations while conducting rigorous academic research. This study will aid other medical schools to cultivate curricular priorities to prepare healthcare providers to deliver state-of-the-art medical diagnoses and treatments.

Catherine Coe    
University of North Carolina    

Purpose
Over the last decade, US medical schools have sought to develop innovative curricula to address the physician workforce shortage, rising medical student debt, and burnout. The University of North Carolina launched an accelerated curriculum in 2015 to address these pressing issues. The FIRST Program is a unique longitudinal curriculum that combines three years of enhanced, expedited medical school, with a directed pathway to affiliated residency programs in family medicine, general surgery, pediatrics, and psychiatry, linked to three years of service in a rural/underserved area of the state.

Methods
The FIRST Curriculum provides students with a longitudinal clinical experience from their first year of medical school. Carefully tailored lectures and workshops ensure student preparedness throughout the accelerated curriculum. Key partnerships with the regional medical school campuses allow students to individualize their medical school experience and be actively engaged in their future residency (GME) and community they will ultimately serve. Upon completion of the required program, students join their selected residency program.

Results
To date, 31 students have matriculated into the program, with 19 out of the eligible 25 having graduated and progressed to residency. Of the two classes who have completed residency, 100% of the participants are working in a rural/underserved area of the state. The FIRST Program has affiliation with over 9 different GME programs in five regional campus locations.

Conclusion
The FIRST curriculum includes innovative, value-based educational experiences, specialized mentoring and specifically designed longitudinal placement in teaching practices. The ability to facilitate a student's trajectory throughout the program ensures an individualized experience, tailored to the community they will serve.

Jaya Yodh    
Carle Illinois College of Medicine    

Purpose
Biochemistry education at health professions institutions poses challenges for both educators and students due to increasingly compressed pre-clerkship curricula in which foundational sciences are often deemphasized and fragmented within clinically integrated frameworks. Consequently, students have difficulty applying biochemistry concepts to clinical cases they encounter during training. Therefore, faculty must be adept at identifying key opportunities to introduce and revisit biochemistry topics across the curriculum. To address these issues, we developed an educational tool that links common clinical presentations to pertinent biochemistry concepts.

Methods
This project was initiated by a faculty subgroup of the Association of Biochemistry Educators (ABE) Education Resources Development Committee to create resources for curricular mapping of biochemistry content. It was introduced via an ABE 2021 meeting workshop, spearheading a multi-institutional research collaboration between 16 basic science professors (PhD and/or MD) at U.S. medical schools with diverse basic science and clinical backgrounds and instructional experience in traditional and integrated curricular settings. Our team met regularly, focusing our research on biochemistry underlying clinical presentations.

Results
Our Clinical Biochemistry Thread Mapping Tool maps ~40 common clinical presentations to their underlying biochemistry. We will present examples that include differentials, etiology, and mechanisms, which are referenced via accessible, established resources. Our tool offers flexible application for the end-user to map from either clinical or molecular vantage points. Faculty may use this tool to map and teach content within their specific curriculum; while students may use it to cognitively integrate and apply basic sciences in clinical training.

Conclusions
Our multi-institutional collaboration has created a novel and versatile mapping tool for integration of basic and clinical sciences. Future steps for its finalization will include vetting by clinicians and applicability testing at our institutions. An IAMSE 2023 focus session will further explore interdisciplinary expansion of this map across the foundational sciences.

Michael Zawada    
Rocky Vista University, Montana College of Osteopathic Medicine    

Purpose
Medical students consistently report stress, anxiety, and feeling overwhelmed, even in a successful curriculum. Medical student feedback at Rocky Vista University College of Osteopathic Medicine (RVUCOM) revealed high levels of stress due to competing demands. RVU's newest campus, Montana College of Osteopathic Medicine (MCOM), offers a unique opportunity to customize an already-proven curriculum by mitigating competing demands of certain courses with the intent of reducing student stress.

Methods
Using the established RVUCOM preclinical curriculum as a foundation and retaining the system-based spiral curriculum, modifications were made to the scheduling of content delivery to decrease competing curricular demands on students.

Results
Longitudinal clinically-oriented courses presented concurrently with the biomedical systems courses allow for content integration but can contribute to content overload and competing demands leading to student stress. The MCOM team revised the course delivery schedule such that these longitudinal courses were strategically placed across the curriculum to be delivered during dedicated non-overlapping biomedical systems weeks. To promote integration, student well-being, and reduce content overload, we carved out two-week-long periods each semester that are lightly scheduled with no new systems course content in which students engage in clinical integration and scholarly activities, tracks and electives, reflection, and remediation. To promote the longitudinal strengthening of competencies, we scheduled regular open labs where students "drop in" to practice clinical skills, osteopathic manipulative treatments, ultrasound, simulation, and study gross anatomy outside the formal didactic sessions. Live lectures were replaced by more concise faculty-curated independent self-study modules coupled with in-person engaged learning sessions. 

Conclusion
The MCOM curriculum development team created an innovative approach to medical school scheduling and content delivery aimed at reducing competing demands on students, decreasing stress, and improving overall well-being. We plan to report on the effectiveness of this approach following the completion of 2023-2024 academic year.

Byonghun (Danny) Kim    
University of Central Florida College of Medicine    

Purpose
Despite national directives to improve opioid/substance use disorder (OUD/SUD) healthcare education in response to the opioid epidemic, deficiencies persist in integrating diversity into curricula. Since biases and misconceptions about pain and addiction are common and negatively impact patient care, improvements are essential. This study aimed to evaluate medical student misconceptions/biases and perceptions of OUD/SUD education integrating diversity at our institution to inform improvement.

Methods
A Likert survey was developed with the themes: Bias/misconceptions on OUD/ SUD (B-M); Concern for SUD patients (C-SUD); Educational activities in diverse populations (Ed-Dp). Three medical student cohorts were invited to participate: E-M2:N=34 emerging second-year; E-M3:N=27 emerging clerkship; E-M4:N=26 emerging fourth-year. OUD/SUD topics were covered at the end of M2 and throughout M3. E-M2 served as a baseline (novice cohort) for comparison.

Results
Mean Likert scores were used in statistical comparisons; % were reported for descriptive purposes. For B-M, >90% identified SUD as a medical illness, but racial bias was evident: 29%(E-M2), 40%(E-M3), and 46%(E-M4) misbelieved African American-identifying patients were more genetically prone to addiction. For C-SUD, 80%(E-M2), 87%(E-M3), 63%(E-M4)) displayed concern for SUD treatment. For (Ed-Dp), >80% of E-M4/E-M3 agreed OUD/SUD general education was sufficient; 19% of E-M2 agreed; significant differences E-M2 vs. E-M3 or E-M4 (p<0.01). No cohort perceived education in OUD/SUD bias was sufficient: 50%(E-M4), 37%(E-M3), and 35%(E-M2).

Conclusion
Students perceived M2/M3 curricula were successful in general OUD/SUD education and better in comparison with M1 but insufficient in addressing diverse OUD/SUD patients and in bias training throughout medical school. A large percentage demonstrated persistent misconceptions/racial bias about SUD. SUD patient concern declined while bias increased in E-M4 after M3 clinical exposure. Thus, our data support national findings that much improvement is needed in integrating bias and diverse patient experiences into OUD/SUD teaching at all educational levels to reduce healthcare disparity. 

Tracy B. Fulton    
University of California San Francisco

Purpose
This study explores the form that basic science knowledge (BSK) takes in clinical learning environments (CLE), interactions associated with its presence, and its narration by medical team members.

Methods
We are conducting ethnographic observation of Internal Medicine teams over a 6-month period. To date, we have collected data from six teams through 20 hrs of non-participant observation of patient rounds and informal teaching, and 18 interviews with attendings, residents, and students. Constructivist grounded theory and constant comparative methodology guide analysis of field notes and interview transcripts, with the goal of developing theory to characterize the presence of BSK in this setting.

Results
We characterize BSK as a mostly implicit ("beneath the surface") presence that is periodically made explicit by attendings through questions or informal teaching. Some learners described thinking of basic science mechanisms independently and used BSK in explanations to patients. Participants often described believing that BSK was present in others' minds during rounds, yet also hinted at BSK being "separate" from clinical knowledge or patients themselves. Participants defended the importance of BSK mastery in providing safe and effective patient care, associating it with elevated status (ie "the best" attendings have it). Paradoxically, they also questioned its relevance and even avoided it. While participants justified use of BSK in making decisions about patients that "don't fit the algorithm," these mechanisms were rarely visible in such discussions. Participants associated BSK with "slowing" and "sitting down," which in our observations the frenzied pace of clinical work rarely affords. The diversity of ways in which clinical team members define and describe basic science, and the contrast between its aspirational importance and its actual use may contribute to confusion and disagreement about the value and aims of basic science education.

Conclusions
Preliminary data analysis has provided new representations of how BSK is perceived and used in the CLE.

Tracy Fulton    
University of California San Francisco School of Medicine    

Purpose
A challenge for health professions educators is to motivate and support their learners in achieving cognitive integration of basic science concepts with their clinical application. Learning objectives (LO) aid students and faculty in forging these connections. Preclerkship basic science objectives often lack deliberate connections to the knowledge necessary for clinical decision-making. The Association of Biochemistry Educators (ABE) developed a process to mitigate this gap by generating new clinically-oriented biochemistry objectives mapped to integrated learning objectives (ILO) developed by Aquifer Sciences that represent authentic actions that advanced clerkship students must take and justify to ensure safe and effective patient care.

Methods
A community of practice (COP) including biochemists and physician scientists representing 15 institutions was initiated at a 2021 ABE Conference workshop. Meeting regularly since then, the group identified Aquifer Sciences ILOs that require foundational biochemistry knowledge and mapped them to existing ABE LOs. After identifying gaps and redundancies, the group created a new set of clinically-oriented biochemistry objectives and refined the existing foundational ABE LOs to support the knowledge necessary to meet these clinically-oriented objectives.

Results
Our COP has developed a set of nested LOs representing foundational and clinically applied biochemistry knowledge achievable during preclerkship learning. These LOs represent the continuum of learning necessary to meet the clerkship level Aquifer Sciences ILOs as well as to understand less common but biochemically important disease conditions (e.g. inborn errors of metabolism).

Conclusions
After vetting by ABE, the preclerkship nested LOs will be available through publication and the publicly available portion of the ABE website. They are designed to be adaptable to different curricular formats and provide connections between foundational knowledge and clinical decision-making. Our process could also serve as a model for any basic science content area, allowing for collaborative cross-discipline mapping to Aquifer Sciences ILOs.

Amanda Chase    
Nova Southeastern University    

Purpose
Metacognition refers to awareness of one's own knowledge and consists of the self-assessment skills: planning, monitoring, and evaluating. These important skills reduce self-assessment errors, such as hindsight bias, among healthcare providers. The purpose of this study was to design a case-based simulation to facilitate the application of metacognitive processes by interprofessional healthcare students including medical, physician assistant, pharmacy, nursing, dental, optometry, occupational therapy, and physical therapy.

Methods
The Junior Metacognitive Awareness Inventory, an 18-item instrument designed to measure two factors 1) knowledge about cognition and 2) regulation of cognition, was distributed as a pre- and post-questionnaire.

Results
There was a significant positive correlation (p<0.001) between the pre and post change in the two factors. A chi-square test of independence, performed to assess the relationship between health professions program and the change in the two factors corresponding to knowledge and regulation of cognition, showed that there was not a significant relationship between the two variables. The pre and post knowledge of cognition score for students in the age group of 31-54 was significantly higher than the other age groups.

Conclusion
Following the simulation, there was sufficient evidence to support that a majority of students saw an increase in their regulation of cognition. This case-based simulation provided students from the various health professions with an opportunity to appreciate how the application of metacognitive skills can enhance workplace performance, team communication and healthcare outcomes within the clinical setting.

Daniel Lovasz    
Texas Tech University Health Sciences Center    

Purpose
Participating in meaningful research projects during undergraduate medical education (UME) can provide students with opportunities to develop professionalism, work in teams, build relationships, and understand the significance of research in medicine, under the guidance of a mentor. Students develop a hypothesis, collect and analyze data, and form conclusions. An innovative aspect of the Paul L Foster School of Medicine (PLFSOM) is the required research component, Scholarly Activity and Research Program (SARP). SARP requires students to identify a faculty mentor and conduct a scholarly research project that will be presented at an internal symposium. Depending on the student's background and research interests, they may conduct projects in any of the following categories: 1) basic, clinical and translational research; 2) epidemiology, community-based, behavioral, public and environmental health, or global health; and 3) medical humanities, medical education, or health policy. This project focused on which category students selected for their research.

Methods
We analyzed student projects completed for the Academic Year (AY) 2021-2022. Each project was then assigned to one of the research categories named above.

Results
In AY 2021-2022, 119 SARP projects were completed, with 46 projects presented by MS2s, 22 projects presented by MS3s and 51 projects presented by MS4s. Out of the completed projects, 61% percent of students completed their research projects in Category 1 Whereas 31% of students conducted research in Category 2. Finally, 8% of student projects focused on Category 3.

Conclusions
Based on our data from AY 2021-2022, student research projects primarily focused on basic, clinical, and translational research. Implementing a research component into the UME curriculum may encourage in-depth study, scholarly activity, increasing research activity, and influencing career decisions. Additional studies need to identify whether students and faculty went beyond the required research, and presented their work at conferences or published in peer-reviewed journals.

Sylvia Nelsen    
Oregon Health & Science University    

Purpose
In 2014, we integrated the majority of the anatomical sciences content into systems-based blocks to emphasize its functional and clinical application. We used the Plan-Do-Study-Act (PDSA) cycle as a framework for data-informed continuous quality improvement of the educational experience and learning outcomes. 

Methods
A review of each PDSA cycle revealed several key interventions during the 8-year span targeting three domains of the learning experience - assessments, sequencing and pacing of content, and methods of delivery. For each domain, performance on exams pre- and post-intervention was compared, and student satisfaction was investigated using thematic analysis of anonymous feedback. 

Results
Based on our analysis, two key interventions to the assessment domain were implemented: in the third iteration of the curriculum we added a practice exam; in the fifth iteration, we increased the weight of the exams toward the course's passing threshold. Surprisingly, there was no significant difference in student performance with the practice exam, but comments expressed appreciation for this change and indicated reduced anxiety. Student performance did improve after increasing the grading weight, and the improvement was sustained each year post-intervention. Though some students expressed dissatisfaction with the change, they acknowledged the importance of understanding the anatomical sciences. Several changes were also identified in the domains of sequencing and pacing of content and methods of delivery to provide more time and guidance for learning, but students continue to report insufficient time for preparation.

Conclusion
Data-informed revisions to curriculum design and delivery can lead to changes in learner outcomes and satisfaction over time, and it can reveal when interventions are not addressing the root cause of a situation. Importantly, longitudinal analysis provides more robust results that are less dependent on the characteristics of individual cohorts. This information is vital to understanding and improving the effectiveness and feasibility of the curriculum.

Janine Corley    
Case Western Reserve University School of Medicine    

Purpose
This study evaluates the effectiveness of incorporating content on climate change and its health effects into the Case Western Reserve University SOM first-year curriculum. Our curricular model will provide data on how climate change can be integrated into first-year medical education.

Methods
Baseline climate change curriculum is presented in Block 1. All first-year students completed a 3-question survey at the end of Block 1 to test understanding and perception of climate change and its health effects. This project expands climate change topics longitudinally over 9 months in small-group problem-based cases and a standardized patient interaction. Students will complete a reflection following the patient interaction. At the end of year 1, students will again complete the 3-question survey. The results will be compared to the pre-intervention survey results.

Results
180 first-year medical students enrolled in the CWRU SOM University Program completed the pre-intervention survey. Students answered 3 questions that: 1) assessed their understanding of the drivers of climate change and downstream effects, 2) ability to discuss the effects of climate change on health with future patients, and 3) belief that climate change and its effects on human health are important topics for students to understand. Students ranked the questions from 1 to 4, 1 being strongly disagree to 4 being strongly agree. The percentage of agree and strongly agree responses, respectively, for each question are: 1) 54.4% and 41.7%; 2) 51.7% and 40%; and 3) 44.4% and 51.1%. The reflection answers and post-intervention survey results will be collected in the Spring 2023 and compared to this data.

Conclusions
Students appear to have a strong baseline understanding of and appreciation for climate change and health. Building upon this foundation will both further prepare students to address climate change impacts in their future patients and provide a climate change curricular model to other health professional schools.

Nyla Dil    
University of Central Florida    

Purpose
At UCF-COM, medical microbiology and infectious diseases (ID) are taught in the last quarter of M1 pre-clerkship phase. Basic microbiology is delivered in self-learning module (SLM) style prerecorded lectures and majority of infectious disease curriculum in 22 small group case based learning (CBL) sessions (3 sessions per week, 4 ID cases per session) in a 10-week module. Frequency of these sessions, the number of diseases per session, and repeating these cases yearly has presented as a major challenge which is indicated by a decline in learner engagement and a rise in the feedback on these sessions.

Methods
We have employed the themes and principles learned from the IAMSE Essential Skills in Medical Education (ESME) course in 2022 to revise and renew the Preclerkship M1 medical microbiology and infectious disease curriculum. These themes include, specifying and using learning outcomes, curriculum planning, methods of teaching and learning, and assessment. Reflections on "role of the teacher as effective leader" theme provided backbone for the curriculum renewal process.

Results
By utilizing ESME principles and themes, we have developed 9 team based learning (TBL) sessions to teach basic medical microbiology and infectious diseases to the first year medical students. These TBLs will replace the SLMs and CBL sessions and will occur at a frequency of one session per week. This renewed curriculum exploits the inherent benefits of TBL to foster complex problem-solving, critical thinking, collaboration, time management and accountability skills in our learners in a team setting.

Conclusions
Applications of ESME themes and principle provided a useful framework to bring about a change in the curriculum in an organized and methodical way. While this has been a very rewarding experience on the teacher's part we will collect learner's experience data in spring during execution phase and present our findings at IAMSE 2023.

Heather Ontiveros    
California Baptist University    

Purpose
California Baptist University's (CBU) IPE interdisciplinary faculty task force has designed and facilitated a fully integrated IPE 3-course curricula aligned with the IPEC domains. The curricula is housed in the College of Nursing and encompasses learning experiences across six healthcare programs, including nursing, physician assistant, speech and language pathology, athletic training, social work and public health.

Methods
Over a 2-year period, students complete a total of three courses. The first course titled IPE Exposure requires a large-scale table-top simulation (problem-based learning scenario) focusing on "roles and responsibilities" and "demonstrating awareness of interprofessional communication and teamwork." The second course titled IPE Immersion, requires learners to work within their program activities to build on the foundation established in Exposure. Programs will integrate multifaceted active teaching methods such as simulation; problem-based learning, clinical practicum, community-based projects, or service learning. Lastly, the third course titled IPE Competence, integrates advanced learners to work collaboratively as appropriate, to assess, plan, provide care/intervention and make decisions to optimize client/patient, family, and community health outcomes. This is accomplished through a University wide IPE simulation. All activities involve over 200 learners, and in some activities over 100 simulated patients. We have integrated 5 additional programs in the community to collaborate during the Immersion phase and have involved over 40 faculty and facilitators in both Exposure and Competence events.

Results
The curricula has been enormously successful with student/facilitator feedback overwhelmingly positive. A pre-post administration of the Interprofessional Collaborative Competency Attainment Survey (ICCAS) along with qualitative data was collected. We will report preliminary data and will explain how this data has been used to enhance and modify the IPE course sequence.

Conclusion
Integrating graduate healthcare learners in IPE curricula allows them to learn and grow together. When professions learn about, from, and with each other it enables effective collaboration and improves health outcomes.

Judith Aronson    
University of Texas Medical Branch, John Sealy School of Medicine    

Purpose
SEA-CHange was a pilot competency-based medical curriculum track that was deployed at UTMB from 2016-2018. To analyze lessons learned from this short-lived pilot, we embark on a retrospective curriculum evaluation using a contribution analysis framework. This is to our knowledge the first application of contribution analysis to competency-based medical curriculum.

Methods
Contribution analysis has been proposed as a valuable method to evaluate competency-based medical education programs, as it accounts for complexity and acknowledges that multiple factors contribute to achieving program outcomes. It uses a systematic approach to evaluate the evidence that program activities are linked to desired program outcomes. Using planning and program documents, curriculum maps, student reflections and assessments, and focus group transcripts, we are examining how the SEA-CHange curriculum influenced the development of compassionate lifelong learners and competent physicians.

Results
We have developed a postulated theory of change, a program logic linking outputs, immediate outcomes, intermediate outcomes, and final outcomes. At each link in the chain, underlying assumptions, risks, and external influences are identified. SEA-CHange outputs are curricular elements promoting early clinical immersion, explicit integration of foundational and clinical sciences, professional identity formation and communication skills. Immediate outcomes address learner progress towards defined competencies during the two-year pilot curriculum. Intermediate outcomes refer to learner milestones achieved after two subsequent years in the standard curriculum clerkship phase. We report the development of a fragment of the overall contribution story, analyzing likely impact of output [curricular elements favoring integration of foundational science and clinical skills] on an immediate outcome [learners who can apply foundational science to clinical decision making.

Conclusion
Contribution analysis is well suited to evaluation of SEA-CHange, and will require a rigorous, iterative and collaborative process testing links in the theory of change in order to build plausible associations between intervention and impacts.

Afua Ofori-Darko
Case Western Reserve University School of Medicine    

Purpose
Black maternal health disparities in the US continue to occur at unacceptably high rates. By working with our community partners, we aimed to determine the doula perspective on 1). their role on the healthcare team and 2) ways their training impacts confidence and communication with healthcare providers. Lastly, we intend to use the data from this project to enhance lecture series previously taught to doulas and discover more innovative ways to enhance doula training.

Methods:
n accordance with community-based participatory research (CBPR), we partnered with Birthing Beautiful Communities (BBC) to perform a series of focus groups among 6-8 birth doulas per session. Focus groups were recorded and transcribed. Trained reviewers alongside BBC performed thematic analysis of each recording.

Results
Results showed that doulas felt barriers to communicating with other healthcare workers due to their gaps in health knowledge. In addition, focus group discussion was centered around the role of doulas on health care teams, barriers to work performance, gaps in knowledge, and ways to improve doula training and education. The thematic analysis reveals that doulas would like more training to improve their health literacy.

Conclusions/Future Directions
Future CBPR should center the doula perspective in delineating ways to strengthen the comfort level of doulas during the labor and delivery process. This is especially important when we consider that the practice of doulas has been shown to decrease adverse events and unnecessary interventions during labor. We believe this work is an innovative approach that joins the movement to address the pervasive crisis of Black maternal healthcare in this country. Future projects will focus on gathering the perspectives of birthing people, midwives, and physicians that interface with doulas. The perspectives elicited will be used to strengthen prior efforts to enhance doula training via lectures and skills workshops.

Shekitta Acker    
Mayo Clinic Alix School of Medicine    

Purpose
The Interprofessional Education Collaborative (IPEC) developed core competencies for health professions students to help break down silos that exist in our current training models. 1 The SBAR communication was developed and used by the United States military to improve communication between team members. 2 Because Mayo Clinic has endorsed SBAR as its verbal handoff communication framework, embedding it into health profession education is essential. The Agency for Healthcare Research and Quality (AHRQ) recommended that all professions be trained on SBAR to achieve maximum effectiveness in interprofessional healthcare settings.

Methods
Twenty-two PA and twenty-eight PT students met to discuss each other's roles, responsibilities, and overlaps in their knowledge. A PA and PT students were paired for two different simulated experiences. Both students were given a portion of the patient's past medical history. The students were expected to communicate the patient history according to the SBAR framework and assess the patient as they saw fit. Qualitative data were collected on students' perceptions of their collaboration experience.

Results
While challenging, students thought it was beneficial to see how to communicate and collaborate with another profession in an urgent/emergent patient care situation. Students felt this experience will improve team collaboration in future clinical settings.

Concluisons
This IPE-simulated experience closed the gap between education and clinical practice for PA and PT students. They understood how to enhance team-based communication effectively and how their roles intertwine and complement each other.

Kearney T. W. Gunsalus    
AU/UGA Medical Partnership    

Purpose
Effective nutrition training is fundamental to medical education and creating an equitable healthcare system. Current training is inadequate; students and physicians lack confidence counseling patients about nutrition. Weight bias is prevalent among healthcare professionals, resulting in well-documented harm to patients. Our aim is to replace practices that perpetuate harm to students and patients with those that address challenges, including disordered eating, nutrition access and knowledge limitations, and weight stigma.

Methods
Medical nutrition education should be rooted in basic science, informed by current literature, and conscious of the impact of bias on well-being. To that end, we formed a team including a medical student, psychiatrist, and basic scientist to gather perspectives from students with eating disorders and review our institution's explicit and silent curriculum. We reviewed the literature on nutrition education; disordered eating; and interactions between nutrition, weight, bias, and health. We identified ways of thinking and communicating that exacerbate, rather than address, problems relating to weight stigma, disordered eating, and social determinants of health. We developed alternatives that are evidence-based, patient-centered, and respectful of diverse experiences and circumstances.

Results
We began implementing these changes in our pre-clerkship curriculum. We will evaluate students' communication skills and knowledge of nutrition, weight stigma, and their clinical implications. We will conduct student focus groups to obtain feedback.

Conclusion
Students and patients are harmed by cultural messaging that frames nutrition and weight as moral issues. Reframing these conversations to be grounded in basic science and current evidence while sensitive to people's circumstances will lead to better outcomes. Making these changes in medical education can be challenging; nutrition touches every aspect of integrated medical curricula and requires collaboration among faculty. Our recommendations are specific, evidence-based, designed to counter rather than perpetuate harm to students and patients, and could readily be implemented at other institutions.

Antoinette Polito    
Elon University Department of PA Studies    

Purpose
A recent doctoral research study surveying US physician assistant program educators regarding obesity curricula may be generalizable to other medical sciences. Obesity is a complex, multifactorial chronic disease of epidemic proportions worldwide. Forty percent of US adults are living with obesity. It is correlated with 6 of the 10 top causes of death in industrialized nations and impacts the lives of 2 of every 3 patients a PA will see. To what degree PA programs include obesity-related topics in their curriculum?

Methods
A quantitative cross-sectional study utilized a web-based survey distributed to 700 publicly identifiable PA educators in programs across the US to focus on 3 research questions: Is obesity being taught in US PA programs? Is the amount of obesity-related content associated with its declared importance among PA educators? Does a PA educator's obesity bias predict how much content they will teach?

Results
PA educators identified strongly with the importance of teaching obesity-related topics; however, the actual amount of content taught amounted to less than 2 hours in the average PA program. Educators identified multiple barriers to incorporating obesity-related content; a significant negative correlation found that as barriers decrease, the number of topics taught increases. Respondents registered in the mid-range of scores for obesity bias on a well-validated tool. The study was not able to demonstrate a correlation between educator bias and number of topics taught. Eighty eight percent of educators were not familiar with international evidence-based competencies for caring for individuals with obesity. Forty percent of programs plan to add to their obesity curricula within 3 years.

Conclusion
Many Americans are at risk of marginalization within the healthcare system given larger body size. Training future practitioners how to care for these individuals is the duty of all medical educators.

Kyle Bauckman    
Nova Southeastern University Kiran C. Patel College of Allopathic Medicine

Purpose
Scholarly productivity is one of most discussed attributes in medical school lexicon. Transition to evidence-based medicine care shifted research from an interest to a priority. National changes to metrics of ranking students like the STEP1 have only served to exasperate the current climate. While this environment allows for growth and appreciation of EBM learning modalities, it creates risk of toxic research behaviors. NSUMD created mechanism to provide core career building research skills throughout the curriculum to ensure timely and relevant discussions. Creation of a longitudinal research program guided by a dedicated student research director (SRD), allowed for customized scholarly growth ensuring students pursued endeavors that were qualifiers for their career of choice in a methodical and meaningful manner.

Methods
Longitudinal research consisted of three phases. Phase one involved introduction of research concepts including types of research ethics, biosafety training, frequent journal clubs, and more. Performance was tracked, and formative feedback provided to students. Students met with the SRD to identify research projects based on their career goals. This included identification of mentors and assistance with scholarship applications. Phase two consisted of students engaging in a dedicated research course. The course focused entirely on engaging in a research project allowing time to develop a project. Phase three involved continued feedback of their research productivity and expanding on key research topics.

Results
Students expressed satisfaction with the research requirements dispersed through the curriculum. The creation of a SRD to work with students throughout their education created a means to track student involvement in research and provide guidance for important career building opportunities including abstract submission, scholarships, and writing. Customized guidance fostered diversity of the types of scholarship.

Conclusion
Student engagement in research is an essential way for them to develop as future physicians but intentional training and monitoring is required to ensure healthy habits are acquired.