Emily Moorefield
University of North Carolina at Chapel Hill, School of Medicine

Purpose
Small group learning is becoming increasingly popular in medical education and essential to its success is positive group dynamics. Tuckman described 5 stages of group development: forming, storming, norming, performing, and adjourning. Although team building resources exist to help groups progress through these stages, resources that can be adapted for medical students in a single session are scarce. This resource was created to be a 45-minute session focused on creating positive group dynamics that provide a strong foundation for group development and more efficient collaborative learning.

Methods
191 first-year medical students attended the required team building session at our institution. Students were divided into approximately 6-person small groups across 5 rooms, each facilitated by a second-year medical student. The team building session consisted of 4 prompts for group discussion based on the forming and storming stages of group development each followed by class sharing: group introduction, goals for the semester, rules, and expectations for the group, and working through common small group conflicts. Students completed a 7-question survey at the end of the session.

Results
118/191 (61.8%) of students completed the survey. 113/118 (95.8%) agreed with the statement, “This session was a valuable use of my time”. Students also expressed strong agreement for various statements assessing forming (i.e., communication and understanding group goals and expectations) and storming concepts (i.e., confidence in overcoming group conflict).

Conclusions
This resource helped students build a foundation in key concepts related to the forming and storming stages of group development. This session is an adaptable option for medical educators who desire to improve group dynamics but lack the schedule capacity to conduct extensive workshops.

Michael Shalaby
Texas Tech University Health Sciences Center

Purpose
Recent changes in the TTUHSC SOM curriculum prompted the addition of interactive learning modules into the Biochemistry and Cell Biology units in the General Principles of Infection (GPX) block. Consequently, interactive sessions termed Cognitive Integration and Development of Clinical Reasoning Skills (CICR) were incorporated with the goal of enhancing student performance on these historically challenging topics.

Methods
Two, separate interactive CICR sessions were created, each containing approximately 20 questions. In addition to reviewing important concepts, these sessions exposed students to an advanced order type of questions and problem-solving strategies. Students could choose to attend the sessions in-person or over Zoom (active learning group). Additionally, students could access the questions in Examplify independently (passive learning group). Student attendance and participation were recorded with students being divided into three groups: Interactive, Passive learning groups (Examplify quiz only), and those that did not participate at all. Exam performance both overall and on specific questions was evaluated. In addition, anonymous student comments regarding the utility of these sessions will be collected.

Results
The exam average on the biochemistry-focused exam was 86.5%, n=189, s.d. ±11.63. The active learning group averaged 88.73%, n=100, s.d. ±10.86 for the first exam. Additionally, the group that did not participate had an average of an 83.50%, n=63, s.d ±11.09.

Conclusions
Preliminary data suggest that interactive CICR sessions correlate with increased overall exam performance. Moreover, student comments suggest that many students found the CICR sessions to be a useful tool that was well received. In conclusion, interactive learning sessions that expose students to advanced order questions are valuable tools in the medical educator toolbox.

Chasity O'Malley
Wright State University Boonshoft School of Medicine

Purpose
Problem-based learning (PBL) and inquiry case learning (IQ) are ideal teaching methods to promote self-directed learning. Transitioning from PBL to IQ can be challenging for medical students since IQ is more advanced and student time-intensive. Students begin with PBL in their preclerkship curriculum. About halfway through their second semester, students engage in a novel transitional PBL/IQ hybrid format before continuing with standard IQ for the remainder of their preclerkship . To improve student performance and comfort level, this PBL/IQ hybrid transition period was created to help students start strong when they move to dedicated IQ. This poster describes the PBL/IQ hybrid model and provides student perspectives.

Methods
An anonymous survey was given through RedCap during the final week of the 1st course with standard IQ. The survey assessed attitudes and preparedness of students for the IQ sessions, along with narrative free response for direct feedback on the hybrid model. Pearson correlation and Cronbach’s alpha were calculated to examine correlations and reliability of the survey questions.

Results
76.74% of students found the PBL/IQ hybrid format helped their transition to the full IQ format. Additionally, students found that the hybrid format increased their confidence in the IQ format. From narrative statements, students appreciated the ability to get a feel for the IQ sessions and to lead as a team using the hybrid format. Positive correlations were found between many factors of the hybrid format (p<0.05).

Conclusions
Students found the PBL/IQ hybrid exposure to be helpful to transition to the IQ style of problem-based learning. In the hybrid, students had the opportunity to perform the tasks of the IQ leader as a pair of co-leaders, reducing the effort load initially, but still giving them a good overall experience of what they need to do when they conduct IQ as independent leaders.

Denise Zwahlen
University of Kansas - School of Medicine

Purpose
Problem-based learning (PBL) cases at Kansas University Medical Center (KUMC) contained instances of bias and racism based on student and faculty feedback. Initial response eliminated diversity from PBL cases. The next goal was to develop a panel of PBL cases that provided diversity, inclusion and a method to teach the identification and mitigation of systemic bias in medicine.

Methods
All PBL cases were reviewed by a faculty physician using a checklist structured to identify instances of racism and bias. All PBL cases were evaluated by DHEI curriculum thread-heads for presence of racism and bias as well as for alignment with the longitudinal DHEI curriculum. A committee of faculty and students was formed to integrate feedback from the bias checklist and the DHEI committee to repair instances of bias and to rebuild diversity and inclusiveness in PBL cases.

Results
At least one instance of bias was identified in all PBL cases. Results of the faculty bias checklist will be presented, identifying the most common instances of bias in the PBL cases at KUMC. Our structure for reintroducing diversity will be shared along with common changes to PBL cases in order to mitigate identified instances of bias.

Conclusion
Collaboration with DHEI faculty and a PBL committee allowed the re-building of PBL cases to represent diverse populations and improve inclusivity. The strategic effort built opportunities to enhance the longitudinal DHEI curriculum by imbedding DHEI content into PBL cases to facilitate application of the concepts in a clinical case. The methods we present can be applied by other institutions striving to provide PBL cases that promote diversity and inclusion.