Moderated by Danielle Dicke
Session Coordinator: Terence Ma

Presentation 1 - Balancing the Scales: Utilizing Conflict Management and Appreciative Inquiry to Improve the Medical Education Learning Environment    
Michael Dewsnap    
Texas A&M School of Medicine

Purpose
The purpose of Texas A&M University School of Medicine's (TAMU-Medicine) learning environment program is to improve the learning environment for students and address related metrics within the AAMC Graduate Questionnaire (GQ). This comprehensive program is theoretically framed by conflict management principles and Appreciative Inquiry and launched at TAMU-Medicine in 2018 to over 4,500 faculty, staff, and students.

Methods
TAMU-Medicine reimagined nurturing the learning environment by: 1) focusing on all stakeholders (i.e., faculty, staff, and students); 2) implementing a peer-to-peer conflict management intervention modeled, with approval, after Vanderbilt's Center for Patient and Professional Advocacy (VCPPA) Cup of Coffee initiative; and 3) creating a transparent school-wide process (Environment Awareness System) for stakeholders to submit reports on negative, and positive, behaviors.

Results
Student data from the GQ showed four-year improvement of perceptions of the learning environment above the national mean. For example, in 2018 the learning environment scales from the TAMU-Medicine GQ survey were 10.1 (out of 15) for climate and 14.5 (out of 20) for student-faculty interaction compared to all United States medical schools at 9.5 and 14.3, respectively. In 2022, same scales for TAMU-Medicine measured 11.2 and 16.1 compared all medical schools at 9.6 and 14.2. Student responses to knowing where to report mistreatment increased from 86.1% in 2018 to 97% in 2022 (7% higher than the national average).

Conclusion
The year-after-year improvement in GQ metrics for TAMU-Medicine garnered nationwide attention with over 23 entities at TAMU as well as medical schools and health care organizations nationwide requesting over 30 presentations on TAMU-Medicine's learning environment program. In spring 2022, Texas A&M University approved scaling the program through its Office for Diversity to over 85,000 faculty, staff, and students. The initial focus is leveraging Appreciative Inquiry to a) promote positive behaviors; b) operationalize the University's core values; and c) enhancing the University's climate.

Presentation 2 - Make a Wish - Wellness Initiative Supporting Health (Wish) Mini-grants in an Academic Medical Department    
Sandra Haudek    
Baylor College of Medicine

Purpose
With burnout on the rise among health professionals, academic leaders are searching for effective strategies to enhance well-being among their faculty and staff members. While accrediting organizations begun incorporating recommendations for wellness activities for learners (students, residents, and fellows), few guidelines and resources exist for faculty and their teams. The Wellness Initiative Supporting Health (WISH) Grant program aims to 1) Enhance well-being among faculty and staff members through innovative collaborations, and 2) Solicit creative proposals for wellness activities from across an academic medical department.

Methods
In 2018, the Department of Medicine at Baylor College of Medicine created the WISH Grant program. Applications (limited to 500 words) to fund small wellness projects of up to $500 are solicited annually. While the primary applicant must be a faculty or staff member in the department, participants may include trainees and family members. External reviewers using a specified scoring system scored applications. Grant recipients were sent a brief anonymous post-program evaluation survey.

Results
Over four cycles of grant solicitation between 2018-2022, 36 of 65 (55%) applications received funding. The most commonly proposed objectives included (1) individual wellness strategies, (2) team-building activities, and (3) networking events. 53% of awardees provided program feedback. The events had high participation rates, fostered inter-disciplinary, cross-institutional collaboration, and demonstrated positive outcomes. All awardees reported that the funded activity helped enhance wellness among participants and 82% felt that the program had an impact beyond direct participants. All strongly agreed with continuation of the WISH Grant initiative.

Conclusions
The robust response of innovative wellness proposals suggests a clear need to create new programs and enhance ongoing wellness opportunities within this Department of Medicine. With minimal funds, effective inter-disciplinary initiatives can be developed and/or supplemented to foster wellness among faculty and staff members within a large, diverse academic medical department.

Presentation 3 - The Development of Branching Scenarios in Healthcare Education    
Meredith Ratliff    
University of Central Florida College of Medicine

Purpose
The integration of cases can help students build clinical decision-making and reasoning skills. However, integrating cases with coursework effectively can be challenging. Branching scenarios have shown promise in delivering introductory clinical experiences and by using evidence-based approaches, branching scenarios can allow for learning experiences that are effective and engaging.

Methods
Four branching scenarios were developed for a pediatric nursing course at a university in the United States. These were developed by a team of instructional designers using the Agile eVidence-based Instructional Design Model (AVIDesign Model) in collaboration with the course instructors. Based on desired course outcomes, identified needs, and available related evidence, two branching scenarios were developed to be piloted in summer 2022. From the results of the first two cases, two more cases were developed, with all four cases implemented in fall of 2022. The cases were developed using H5P which allowed for interactive elements as well as branching questions.

Results
Preliminary results were extremely positive. Students found the cases more engaging than "paper" presentations. Students found the feedback and rationale for each set of questions (both branching and interactive elements) to be beneficial. The branches were given as a formative assessment, allowing students to redo each case until they passed an acceptable score. Initial results show improvements in test scores on related questions (this data is still in progress but will be completed by the conference).

Conclusion
Simulations can be time consuming and expensive to develop, but as technology progresses, simulations such as branching scenarios show promise in being an effective way to reproduce clinical experiences, saving both time and resources over traditional simulations. Using an evidence-based approach and systematic design helps ensure the experience is effective and engaging.