Presented By: Brook Hubner, University of Alabama at Birmingham Marnix E. Heersink School of Medicine
Co-Authors: James Baños, University of Alabama at Birmingham Marnix E. Heersink School of Medicine

Purpose 
Locus of Control (LoC) refers to perceptions of whether internal or external factors influence life outcomes. Internal LoC is associated with a sense of control over life's outcomes. External LoC attributes outcomes to outside factors. Although LoC is associated with well-being, academic, and job-related outcomes, there is limited medical education research into LoC. This study is a preliminary examination of LoC in relation to demographic factors and wellness outcomes. 

Methods
In 2023, the Levenson Multidimensional Locus of Control IPC Scales (IPC) were included in an annual M1-M4 wellness survey. The IPC scales assess internal LoC (I), external LoC related to chance (C), and external LoC related to powerful others (P). Analyses include intercorrelations of IPC subscales, demographic correlates, and relationships to other outcome measures (stress, well-being, affect, and burnout). 

Results
The analysis included 470 completed surveys. We found a high correlation between the P and C subscales. The I subscale was consistently the highest and most stable across the four years. The P and C scales were highest for M3s and dropped for M4s. Women scored slightly lower on the I subscale. No URiM effect was observed. There was a modest correlation between LoC and overall well-being. All LoC scales were related to stress and affect to some degree. External LoC related to exhaustion and cynicism.

Conclusions 
Despite consistently high ratings of internal LoC, fluctuations in external LoC across the years suggest that control perceptions may be shaped by the learning environment. Consistent with other studies, LoC appears to be related to psychological wellness and appears to be environmentally malleable, opening avenues for potential intervention. Although our findings are interpreted cautiously given the correlational nature of the analyses, the findings support the idea that LoC warrants further investigation as a potentially relevant factor in student wellness.

Presented By: Ashin Mehta, Medical College of Wisconsin
Co-Authors: Alejandro Rivas, Medical College of Wisconsin
Robert Treat, Medical College of Wisconsin
Jeffrey Whittle, Medical College of Wisconsin

Purpose
Medical school debt has been rising at a rate beyond inflation for the past several decades. In 2003, median debt was $100,000 for public medical school graduates and $135,000 for private school graduates. In 2021, the average medical school debt had increased to $203,062. IM residents have multiple subspecialty options with significant differences in expected income. The goal of this study is to understand IM residents' attitude towards debt and its potential impact on subspecialty selection.

Methods
626 United States IM program directors and their administrators were sent a de-identified Qualtrics survey to distribute to post-graduate year 3 (PGY-3) IM residents. The survey queried debt amount, debt's influence on subspecialty choice and practice type, stress levels from debt, past education, and whether the resident had a plan to pay off their loans.

Results
115 PGY-3 IM residents responded. Average respondent debt was $187,415, with 23.5% of residents reporting no debt. The average debt amongst those with debt was $240,659. Only 46% of residents stated debt had no impact on their subspecialty choice, and 6% of responders reported it influenced their choice "A lot." 52% stated debt impacted their practice type. The average stress score on a scale of 0-10 caused by student debt was 4.7. The average planned time to fully pay off debt was 7 years.

Conclusion
Rising student debt burdens medical graduates, and influences subspecialty choice and practice type in over half of internal medicine residents. Limitations of our study include a small sample size and a possible response bias due to individuals who feel more strongly about student debt being more likely to respond to the study.

Presented By: Emilie Allaert, University of California Davis School of Medicine

Purpose 
This study explores the impact of Anki, a spaced repetition flashcard app, on academic performance and well-being in the UC Davis School of Medicine's class of 2026. It investigates whether medical students who use Anki as their primary study method during the first-year curriculum achieve higher exam scores and experience lower stress levels compared to peers who do not use Anki. 

Methods 
The study spanned the academic year 2022-2023 and targeted participants from the UC Davis School of Medicine's class of 2026. One survey was administered after the completion of each course, four total during the study. A minimum of 80 students voluntarily completed an anonymous nine-question survey following the completion of each course. This survey covered study methods, exam scores, daily study time, perceived stress levels, involvement in extracurriculars, and advice for future students. No personal information was collected during the survey process. 

Results 
The data indicates that Anki users consistently achieve higher scores, underscoring the potential effectiveness of this study tool. High-scoring Anki users also report lower stress levels, suggesting a positive correlation with reduced academic stress. Despite a slight increase in daily study time among Anki users with higher scores, the tool's efficacy extends beyond time commitment alone. We are confident that employing Anki does not adversely impact students' academic performance. However, it's essential to acknowledge the limitations of data collection, not based on controlled experiments, which may introduce confounding variables. Despite these considerations, the results thus far provide confidence in the overall benefits of Anki for students. 

Conclusion 
The intricate interplay between stress levels, study duration, and academic achievement emphasizes the need for a holistic approach to evaluating study tools. These findings provide valuable insights for educators, students, and researchers, prompting further exploration into the multifaceted dynamics of learning methodologies and their impact on academic success and well-being.

Presented By: Nelda Ephraim, American University of Antigua College of Medicine
Co-Authors: Qunoot Almecci, American University of Antigua College of Medicine
Tony-Ann Huggins, American University of Antigua College of Medicine
Lyudmila Rubinshteyn, American University of Antigua College of Medicine

Purpose 
The Clinical Scholars Program at a Caribbean Medical School consists of high achieving students and alumni who provide near-peer academic support services to clinical students under the direct supervision of the university's Clinical Education Enhancement Department. Those who serve in the role of Clinical Scholar have excelled on their Step 2 CK exam with a score of 240 or above and have gone through a strict vetting process to assume this critical student support role. One of the student support initiatives provided via the Clinical Scholars Program is the Question Partners Shelf Prep Series, a voluntary student success initiative which includes a pre-arranged number of small group sessions (2:1) between the students and the Clinical Scholar, with the purpose of enhancing clinical judgement and test taking skills in preparation for the NBME CCSSE. This descriptive study seeks to examine the outcomes of the Question Partners Shelf Prep Series for those who enrolled in the program. 

Method 
The sample population includes medical students from a Caribbean Medical School that participated in the Clinical Scholars Program Question Partners Shelf Prep Series within the months of 10/1/2022 through 9/30/2023. Students who participated in the program via direct referral after an advising appointment and students who had not yet taken their exams were included in the dataset. Descriptive statistics were utilized to analyze the frequency of medical students who participated in the program, gender, standard program or FIU certificate program, the Question Partners Shelf Prep Series taken, the CCSSE taken, and the exam outcome (pass or fail). 

Results 
93% of students who participated in a Shelf Prep Series successfully passed their CCSSE. Frequencies for each variable will be provided. 

Conclusion 
Student success initiatives such as the Clinical Scholars Program Question Partners Shelf Prep Series and similar programs can improve clinical clerkship student outcomes.

Presented By: Stephanie Neary, Yale University; Medical University of South Carolina
Co-Authors: Benjamin Doolittle, Yale University
Martina Mueller, Medical University of South Carolina
Michelle Nichols, Medical University of South Carolina

Purpose 
The purpose of this study was to investigate flourishing among medical (MD), physician assistant (PA), and nurse practitioner (NP) students, using a novel Secure Flourish Index (SFI) and other validated instruments.  

Methods
PA, NP, and MD students from two institutions completed an online survey. Participants first completed the traditional SFI and then applied a percentage weight to each of the six flourishing domains (maximum total 100%) based on perceived relative importance to their overall flourishing to create a novel self-weighted SFI score (swSFI). The Bland-Altman (BA) plot was used to assess the magnitude of agreement or disagreement between the two scoring approaches. 

Results 
For the 281 students included in the study, BA plot revealed a mean bias of .07 (95% CI -.50,.63). Eighteen participants (6.4%) fell outside of the calculated BA Limits of Agreement [-9.3 [95% CI -10.3, -8.5] and 9.5 [95% CI 8.5, 10.4]. Linear regression revealed that mean BA score is significantly predictive of the mean difference between the scores [R2 = 0.07, F(1, 280) = 21.1, p <.001] indicating bias in agreement between the two scoring systems as mean flourishing score changes. The resulting regression equation is predicted mean difference = 6.9 - 0.8(mean flourishing score).  

Conclusion 
Accounting for individual values is an important piece of measuring student flourishing that is missing from current operant definitions. The overall mean difference (bias) in tSFI and swSFI scores is minimal (.07, possible range 0-120). However, the bias becomes larger as individual mean flourishing scores move towards both the high and low ends of the flourishing spectrum. This indicates that the influence of weighting flourishing domains is larger for individuals with high or low flourishing than those with moderate flourishing. Further exploration of how student demographics, life experiences, and values influence perceived relative weights of flourishing domains is needed to promote learning environments that foster individual flourishing.

Presented By: Kevlian Andrew, St. George's University
Co-Authors: Robert Hage, St. George's University
Deepak Sharma, St. George's University

Purpose 
Medical education increasingly relies on online resources for exam preparation, yet the abundance of anatomical and clinical information on websites poses challenges due to potential inaccuracies. This study aims to address this issue by proposing a novel method to instill a critical mindset among medical and veterinary students, ultimately enhancing their ability to discern reliable information from online sources. 

Methods
A comprehensive analysis to evaluate the accuracy of anatomical and clinical information on commonly used medical websites was conducted. The study systematically identified prevalent errors and inconsistencies, emphasizing the need to foster critical evaluation skills among students. To address this, a proposal was developed to motivate students to actively participate in error detection. A virtual point system was suggested to recognize and reward students for their contributions to dtecting the accuracy of online medical content. 

Results 
The investigation revealed that despite the valuable role online resources play in exam preparation, they frequently contain inaccuracies such as outdated information, misinterpretations, and inconsistencies. In response, the proposal to incentivize students through a virtual point system emerged as a viable solution to augment the overall quality of online medical information.  

Conclusions 
To cultivate lifelong learners in the medical field, a proactive examination of online materials is crucial. This study highlights the prevalence of errors in online medical resources and introduces a practical strategy to empower students in the validation process. The implementation of a virtual point system represents a promising avenue for educational institutions to encourage student involvement in detecting the accuracy and reliability of online medical information. This initiative aims to foster a culture of critical thinking and quality assurance among the future generation of healthcare professionals.

Presented By: Nina Li, Eastern Virginia Medical School
Co-Authors: Curt Bay, A.T. Still University
Uzoma Ikonne, Eastern Virginia Medical School
Danxun Li, Eastern Virginia Medical School

Purpose 
The recent pass/fail scoring change for the USMLE Step 1 exam has significant implications for residency applicants. It is anticipated that research productivity will gain greater importance in the evaluation process. The NRMP provides quantitative data on residency applicants' publications. However, there is a scarcity of studies focusing on their research experience. To support medical students, we aim to understand their attitudes, motivations, and experiences in conducting research. 

Method 
This is a cross-sectional study among second-year medical students at Eastern Virginia Medical School between October and November 2023. A questionnaire was used to assess students' motivations and perceived barriers towards research in medical school. Students' experiences were assessed on a Likert scale. A Mann-Whitney U test analyzed differences in attitudes and Pearson correlations quantified the relationship between perceived specialty competitiveness and research activity. 

Results 
Preliminary results reveal that out of 61 respondents, 68% reported that the USMLE STEP-1 transition to pass/fail influenced their attitudes about research in medical school. The top motivating factors for conducting research were to be competitive for residency and to differentiate oneself from other medical students. The top barriers were lack of time, mentorship, and opportunities. Perceived specialty competitiveness is correlated with research participation but not with research publication output. There were significant differences in research output by students who indicated interest in internal medicine, general surgery, and otolaryngology. There is no statistically significant difference between genders in motivations and barriers to research, publications, or competitiveness of interested specialties. 

Conclusion 
The shift to pass/fail scoring in the USMLE STEP-1 exam has impacted MD medical students' attitudes on research, with many considering research output a significant differentiating factor in residency candidacy. The difference in perceived competitiveness is reflected in students' research participation. Findings from this study may inform institutions as they aim to optimize students research.

Presented By: Andrea Belovich, Idaho College of Osteopathic Medicine
Co-Authors: Mariluz Henshaw, Touro College of Osteopathic Medicine
Jennifer Hotzman, Idaho College of Osteopathic Medicine
Anne Weisman, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas

Purpose 
Professional identity formation (PIF) is influenced by multiple factors including individually-held personal values. This study aims to identify changes in values held by students in undergraduate medical education (UME) to inform strategies for PIF development. 

Methods 
An IRB-approved survey containing an externally validated inventory of personal values and the Physician Values in Practice (PVIP) questionnaire was administered to students at three U.S. medical schools. Demographic information including program year (PY) was collected. The most commonly held values were determined for each PY, and a linear regression analysis was conducted to determine which values changed in frequency. The top PVIP values were determined using a 5-point Likert scale. 

Results 
99 respondents completed the survey. The most highly ranked values were Compassion (PY1 and PY3), Caring (PY2), and a tie between Caring, Adaptability, Resilience, and Self-Discipline (PY4). Of the ten values most common to all respondents, Resilience increased in frequency with PY (R2 = 0.957, p = 0.02), while Trust (R2 = 0.922, p = 0.04) and Personal Growth (R2 = 0.925, p = 0.04) decreased. The top-rated values in the PVIP questionnaire included: "enjoy life outside of work" (4.80), "time for family and friends" (4.79), "do what I think is right" (4.67), "time for leisure" (4.47), "high level of autonomy" (4.28) and "serve the local community" (4.25). 

Conclusion 
The increased importance of Resilience is expected as students advance through UME, although the decreased importance of Trust is concerning, since trust is required for effective teamwork in patient care. The top PVIP values pertained mostly to work/life balance and autonomy, rather than team-oriented activities. These data raise questions about why medical students' PIF might shift away from growth- and team-oriented values. More research is needed to determine the prevalence of these trends and how educators may intervene.

Presented By: Stephanie Neary, Yale University; Medical University of South Carolina
Co-Authors: Benjamin Doolittle, Yale University
Martina Mueller, Medical University of South Carolina
Michelle Nichols, Medical University of South Carolina

Purpose 
The social determinants of health (SDOH) overlap with the domains of the Secure Flourish Index (SFI). The purpose of this study was to determine if demographic, intrapersonal, social, or economic factors are associated with perceptions of flourishing among medical (MD), physician assistant (PA), and nurse practitioner (NP) students. 

Methods 
This study consisted of a single survey using a cross-sectional design. Current MD, PA, and NP students from two academic medical centers were recruited to complete an online survey between August 6 and October 9, 2023. Survey questions included demographics and the following validated instruments: SFI, WellRx, 2 Question Maslach Burnout Inventory, Brief COPE Inventory, the Short Grit Scale, and Duke University Religion Index. Descriptive statistics, t-tests, ANOVA, correlation, and regression analyses were performed with an alpha of 0.05. 

Results 
A total of 280 out of ~1820 (15.4%) eligible students participated in this study. Flourishing scores were significantly higher with higher grit (r=.368, p<.001), intrinsic spirituality (r=.186, p=.003), or organized religious participation (r=.153, p=.013). Similarly, flourishing scores were significantly higher for married (M=86.7, SD=15.8) versus not married students (M=82.6, SD=14.6; p=.036) or those with more legal dependents (r=.135, p=.027). However, flourishing scores were lower with higher social needs (WellRx; r= -.336, p<.001), burnout (r= -.466, p<.001), or avoidant (r= -.453, p<.001) or emotional (r= -.126, p=.043) coping styles. Flourishing scores were also lower for students who had considered leaving training in the past 6 months (M=75.3, SD=16.2) than those who had not (M=85.6, SD=14.4; p<.001). Regression revealed that burnout accounts for 23.4% of variability observed in flourishing scores, followed by avoidant coping style (13.7%) and social needs (4.7%).

Conclusion 
Student flourishing is highly correlated with intrinsic factors including avoidant coping style, grit, and burnout. The correlation between social needs and flourishing highlights the importance of expanded support for students that is informed by the social determinants of health.

Presented By: Uzoma Ikonne, Eastern Virginia Medical School
Co-Authors: Carrie Elzie, University of Texas Health Science Center San Antonio
Nina Li, Eastern Virginia Medical School

Purpose
Teaching assistants (TAs) play a vital role in the education of medical students serving as peer teachers in the instruction of students in the course. Serving as a TA has been demonstrated to help develop competencies that are needed to be an effective educator. Previous studies focused on student teaching within a course focused on a single discipline, primarily anatomy, whereas, this study focuses on the experience of TAs within a multidisciplinary course. The purpose of this study was to explore the motivations of why medical students serve as TAs and their perceived benefits from the experience in an integrated first-year medical course. 

Methods 
TAs served as peer teachers to the first-year medical students in an interdisciplinary course, by leading five large-group review sessions. TAs were sent a pre-experience questionnaire about their motivations for engaging in the teaching experience. After TA peer teaching sessions were completed, a post-experience questionnaire was sent to the TAs. Survey responses were summarized using percentages. 

Results 
Quantitative data from the pre-experience survey revealed TAs served because they wanted to solidify their knowledge of course material, aid in the preparation of Step -1 and improve their confidence in public speaking. Data from the post-experience survey revealed that TAs perceived that their experience solidified their knowledge and increased their likelihood of participating as a TA in different phases of their medical education. Further, thematic analysis of open response data revealed students were motivated to serve as TAs to help other students in their learning experience. 

Conclusions 
Students are motivated to serve as TAs for varied reasons including solidifying course knowledge and preparing for licensing exams. Further, students serve as TAs to improve their communication and teaching skills. This information will help in recruiting students into and developing a standardized Student-as-Teacher program to foster the next generation of physician educators.

Presented By: Mohammed Al-Hor, Qatar University
Co-Authors: Manal Abdalla, Qatar University
Shaikha Al-Kuwari, Qatar University
Noora Al-Sulaiti, Qatar University
Noora Alkorbi, Qatar University
Mohamed Emara, Qatar University
Muhammed Naseem Khan, Qatar University
Michail Nomikos, Qatar University
Shireen Suliman, Hamad Medical Corporation

Background
Mentorship programs have emerged as a crucial element within the realm of medical education and the advancement of students' professional growth. However, since its establishment in Qatar University, the mentorship program was never studied or assessed before. The objective of this mixed-method study was to determine the predictive factors independently associated with the utilization of the mentoring program, perceived academic benefits (quantitative), and the perceptions of the mentors in the College of Medicine at Qatar University (qualitative). 

Methods
Year 2 to year 6 students (mentees) were assessed through validated instruments, including the Munich Evaluation of Mentoring Questionnaire (MEMeQ), Strength of Motivation (SMMS-R), Rosenberg Self-Esteem (RSS), and Academic Stress Questionnaires along with the active participation in the college mentoring program. A multivariate logistic regression model was used to determine factors associated with the utilization and perceived academic benefits. This was followed by a qualitative phase, which explored the perceptions of the mentors involved in the mentoring program through semi-structured interviews. 

Results
Only one-fourth of the students actively met their mentors at least once in each semester. Active participation and perceived academic benefits were independently predicted by the quality of the mentoring program, with higher quality leading to better participation and perceived academic benefits. The mentors recommended mandatory first meetings and gender alignment as possible solutions for improving participation in the mentoring program. Students also suggested having multiple mentors and giving them the flexibility to choose their mentors could improve the program. 

Conclusion
Only a quarter of the students are actively participating in the mentoring program which could be improved with considering satisfaction, as one of many associated variables, that can affect participation in the mentorship program. Keywords: Mentoring program, academic stress, medical education, self-motivation, self-esteem

Presented By: Lisa Lin, University of Pittsburgh Medical Center

Purpose
Medical imaging is an integral part of medicine. However, how imaging is taught is highly variable, with one in six medical schools with no recognized imaging curriculum. A national study performed on PGY-1 residents demonstrated a lack of confidence in basic imaging skills, such as recognizing abnormal from normal, indications for specific tests, and understanding adverse effects of contrast. This study sought to evaluate the status of medical imaging education throughout the pre-clinical years at Oregon Health and Science University.

Methods
Medical students were invited to complete a seven-question survey containing multiple choice, Likert scale, and open-ended questions aimed at evaluating students' confidence in interpreting basic findings on common studies, exploring resources currently utilized, and determining what additional training opportunities students desired. A repeat survey is being conducted to gauge the effectiveness of changes implemented and guide further improvement.

Results
Students expressed lower confidence regarding interpretation of basic imaging modalities and a strong desire for educational resources. Responses indicated that most students did not utilize already available resources provided by faculty and instead relied primarily on external resources such as google images and Radiopaedia. Changes were thus made to: (1) increase visibility of available resources on the course website, (2) identify and link videos that provide a framework on evaluating scrollable images and facilitate landmark recognition, and (3) develop additional practice, such as flashcards, for structural identification and recognition of common imaging-relevant pathologies.

Conclusion
The course website was revised to improve visibility of existing educational resources, and additional resources were added and developed to enhance the medical imaging curriculum in accordance with reported learner preferences. Students will be re-surveyed to determine whether these interventions improved confidence in basic imaging skills and to inform further curricular changes.

Presented By: Shiyuan Wang, Rowan-Virtua School of Osteopathic Medicine
Co-Authors: Pamela Basehore, Rowan-Virtua School of Osteopathic Medicine
Krisha Patel, Rowan-Virtua School of Osteopathic Medicine

This survey study aims to understand how osteopathic medical students prepare for both COMLEX Level-2CE and USMLE Step-2CK exams. Literature on study strategies of these two exams is limited regarding osteopathic medical students who chose to take both exams and how this decision impacted their study strategies. A survey was distributed in October to the current 4th-year medical students after most students took the exams. Questions included how they distributed study time, how frequently different resources were used, whether they study alone or in group, and how Pass/Fail Level 1/Step 1 policy impacted study strategies. Most students (N=38 of 42, 90.5%) focused on Step 2CK first and only dedicated some time for osteopathic manipulative medicine (OMM, not in Step 2CK), and 71.4% began their study before finishing third-year clerkships, particularly during the second half of MS3. Heavily used resources were question banks and practice exams. UWorld, including both its question banks (100%) and practice exam packages (72%) was the mostly used vendor, followed by NBME self-assessment (76%) as most favored practice exams. Review tools such as Anki or Video/Podcast were also used most or all the time by 23.8% students. Few students used Review books or Board preparation programs. For OMM, the most widely used resource was question banks (49.2%) particularly COMQUEST, followed by review books (23.8%). Most students (60%) chose to study with peers. 45.7% students indicated the pass/fail policy significantly impacted their study strategies regarding amount of study time, question banks and practice exams but not the type of resources used. This survey provided insights in terms of time arrangement, resources, and other study patterns for students who chose to take both exams for better student support in the future. More data will be collected to address the limitation of these preliminary results.

Presented By: Jessica Chacon, Texas Tech University Health Sciences Center - El Paso
Co-Authors: Keshav Bharadwaj, Texas Tech University Health Sciences Center - El Paso
Nathan Holland, Texas Tech University Health Sciences Center - El Paso
Mariela Lane, Texas Tech University Health Sciences Center - El Paso
Komal Marwaha, Texas Tech University Health Sciences Center - El Paso
Glenn Yri, Texas Tech University Health Sciences Center - El Paso

Purpose
The TTUHSC El Paso Health Education and Awareness Team (EP-HEAT®) has an ongoing project (Busting Myths in Healthcare) that consists of collaborations between the community, Promotoras (Community Health Workers), medical students, and healthcare experts, to identify and dispel myths in healthcare. Previous studies analyzed the project's impact on the community, but questions persisted about the program's impact on medical student professional development.

Methods
Medical students that participated in the Myth Busters project were emailed an anonymous survey to assess if student professionalism, communication, networking, and teambuilding improved after participating in the events. Surveys consisted of questions related to demographics, Likert - like questions about professional development, and open-ended reflections on participation experience, challenges, and feedback for quality improvement.

Results
Participation in the project improved medical student professional development, team building, communication skills, networking, and medical students' ability to relate with the El Paso community.

Conclusion
This study offers some valuable preliminary data on medical student professional development in a border community that can aid in future studies and quality improvement of future initiatives.

Presented By: Ana Muñoz Juárez, Asociación Mexicana de Médicos En Formación A.C.
Co-Authors: Marco Antonio Castañón Gómez, Asociación Mexicana de Médicos En Formación A.C.
Cinthya Margarita Flores Félix, Colectivo Medicxs en Formación
Irene Gómez Oropeza, Asociación Mexicana de Médicos En Formación A.C.
Hassler Stefan Macías Sánchez, Asociación Mexicana de Médicos En Formación A.C.
Xavier Abraham Rodriguez Bello, Asociación Mexicana de Médicos En Formación A.C.

Purpose
The COVID-19 pandemic brought various positive and negative changes in all biopsychosocial axes of medical students and medical education. Therefore, it is relevant for medical education to evaluate the sequelae acquired after the pandemic period derived from the SARS-CoV2 infection.  

Methods 
The present article is a cross-sectional online survey that aims to assess the self-perception of the practical clinical skills of medical students in Mexico. The questionnaire contained 24 items to evaluate on a numerical scale from 1 to 10 the self-perception of these skills plus if the student associates the capacity level with online education during the pandemic period. We shared the survey with physicians in training from a students' association called AMMEF through a Google Gmail Server. The practical clinical skills were defined as writing a medical record, bandages and splint application, beginning cardiopulmonary resuscitation, medical procedures, knots and sutures techniques, and performing physical examination. 

Results 
We received 147 answers from medical students from 33 medical schools in Mexico. The gathered data showed that just one practical skill learned during the COVID-19 pandemic was considered by the students affected by the online educational strategies implemented. This skill was writing medical records.(p=0.001; OR=0.17; IC=0.0602 to 0.5183). Nevertheless, at the end of the survey, open space was left so they could share any other skill not integrated into the survey that was self-perceived as unable to perform.  

Conclusion 
This study showed that Mexican medical students are self-perceived as unable to write a medical record. This finding represents an educational opportunity for medical schools when they return to clinical rotations in hospitals, as well as giving courses to their students to ensure the development of these capabilities in their doctors in training.

Presented By: Jutta Sylvester, St. George's University

Purpose 
In contemporary healthcare, the recognition of addressing emotional components in patient care and enhancing doctor-patient relationships has become increasingly acknowledged. The 2023 AAMC Annual Meeting echoed this sentiment by highlighting from patient feedback the importance of acknowledging patients first. Thus, high-quality patient care is reliant upon healthcare providers having the knowledge and training in effective communication skills and emotional management. 

Methods 
A selective course was developed at St. George's University, School of Medicine (SGUSOM) which was tailored to Basic Sciences medical students. The pilot selective was limited to fifteen students who registered based on interest. The course aimed to expose medical students to emotionally demanding patient encounters while considering the cultural, social, and ethical aspects of their patients. Moreover, it emphasized collaborating with interdisciplinary teams and prioritizing self-care to navigate challenging conversations and emotions, and providing constructive ways in which students could best manage these inevitable future encounters. The weekly sessions were fifty minutes long and delivered synchronously and asynchronously, for ten weeks. The interactive and experiential learning consisted of lectures, group discussions, role-playing scenarios, reflective and meditative exercises. It encouraged students to explore their emotional responses, biases, and to find coping strategies when dealing with emotionally demanding patient interactions. A survey was administered to gain students' feedback and reflective experiences of their learning throughout the course. 

Results 
Results from the feedback were positive, with constructive suggestions for program improvement. Role-playing exercises were highlighted as valuable, alongside the benefit of learning from experienced healthcare professionals and their stories of emotionally difficult patient encounters. 

Conclusion 
Introducing emotional components in patient encounters early within the medical school curriculum provides more time for students to harness essential skills, thus potentially improving the quality of future patient care.

Presented By: Ryan Ellis, University of South Carolina School of Medicine Greenville
Co-Authors: Renee Chosed, University of South Carolina School of Medicine Greenville
Victoria Costello, University of South Carolina School of Medicine Greenville
Shannon Ellis, University of South Carolina College of Engineering and Computing
Jennifer Grier, University of South Carolina School of Medicine Greenville

Purpose
With the transition of Step 1 to pass/fail, many medical students are seeking out ways to distinguish themselves from their peers when applying for residency. Research posters and oral presentations offer students a way to showcase their research experiences and results. The purpose of this work was to develop and evaluate the success of an institutional student-focused summer research symposium. 

Methods 
The University of South Carolina School of Medicine Greenville (USCSOMG) developed and hosted a student research symposium from 2019-2023, to provide a platform for students to practice their presentation skills and receive feedback. Current second-year students were invited to present their work based on their summer research projects. The symposium has included oral presentations, rapid-fire poster presentations and poster sessions, with the format adapting yearly to submissions numbers and environmental considerations. Audience and committee-judged awards were bestowed. Student participation was tracked and post-symposium qualitative student and faculty feedback was collected. 

Results
Medical student participation in the symposium increased each year from 28 in 2019, to 52 in 2020, 71 in 2021, 82 in 2022, and 88 in 2023. Qualitative data revealed themes reflecting positive experiences and satisfaction from the students and faculty mentors. Limitations to student research engagement included a decreased access to in-person research activities in 2020 due to pandemic conditions. 

Conclusion 
The student focused research symposium developed at USCSOMG in 2019 has shown increasing numbers of student presenters and higher satisfaction from event attendees. Future efforts will monitor how students' participation in the institution-based symposium increases students' involvement in research as they continue through their medical education, as well as their overall satisfaction with research and residency options. Continued growth of this event and overall student participation in research opportunities are key elements in the development of well-rounded and successful future-physicians at USCSOMG.

Presented By: Mariana De Lorenzo, Rutgers New Jersey Medical School
Co-Authors: Humberto Baquerizo, Rutgers New Jersey Medical School
Steven Munoz, Rutgers New Jersey Medical School
Pranela Rameshwar, Rutgers New Jersey Medical School
Lauren Sherman, Rutgers New Jersey Medical School

Purpose 
Lack of representation of racial and ethnic minorities in the healthcare workforce, in particular clinician scientists, remains a challenge. The goal was to reduce this gap through early mentorship, combined with organized workshops and networking. We also applied self-assessments to assess the role of mentorship in fostering diversity, improved educational experiences and research efforts, and interaction with clinician-scientists. These topics will benefit imposter syndrome that can impede career aspirations. Participants have a space to learn from each other, reflect, and discuss the academic medicine environment and future goals with diverse clinician scientists and academic leadership from across the health care workforce. 

Methods 
Three cohorts of trainees from the Multidisciplinary Summer Research Education Program for Health Professional Trainees-NIH (R25) at Rutgers University. Trainees were from Rutgers medical, dental and the school of health professions. The 52 questions evaluated various domains: psych-emotional support, communication, professional development, role modeling, prior research experience, and mentorship before and after program participation using a Likert Scale.

Results 
The surveys indicated a positive impact of mentorship: students firmly understood the clinician-scientist role and valued mentorship. Participants reported high levels of satisfaction and felt motivated by their mentors. The curriculum's formal and informal activities enhanced their sense of belonging within the scientific community, further mitigating a pre-participation sense of imposter syndrome. 

Conclusion 
The findings highlight the value of mentorship in enhancing diversity, fostering career aspirations, and addressing the needs of academically diverse students. This study underscores the need for mentorship in medical education to develop a more inclusive healthcare workforce of clinician-scientists, which will benefit both students and patients. Simultaneously, this study will have an impact on closing the gap in teaching a more culturally competent workforce across the healthcare enterprise.

Presented By: Zachary Leavitt, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas

Purpose 
Medical school is rigorous, even for the brightest students. Despite the selective nature of medical school admissions, students are forced to remediate each year. If grit is correlated to success in medical school, it could be combined with other criteria to aid admissions and education processes.

Methods
Data was collected using a validated 12-item questionnaire to assess grit. The voluntary grit questionnaire was sent to all active students at the Kirk Kerkorian School of Medicine (n=250). Grit scores (scale 1 - 5) were stratified by students with mean grit scores ? 4 (high grit; n=10) versus those below 4 (n=20) and correlated with metrics using a two-sided T-test to evaluate statistical significance.

Results 
The response rate to the grit survey was 30%. There was a negative correlation (-0.460; p = 0.011; n=30), between grit scores and stress levels during pre-clinical years. High grit students (n=10) had significantly less stress compared to students with lower (n=20) grit scores (p=0.012). A positive correlation (0.401; p=0.028; n=30) was identified between grit scores and pre-clinical biomedical exam scores. High grit students significantly outperformed lower grit students on pre-clinical exams (p=0.005).

Conclusion 
Students with high grit scored significantly higher on pre-clinical exams compared to their colleagues with lower grit. In addition, the high-grit students had significantly less stress during this phase of the curriculum. Our results suggest that grit could be a predictor of performance and perceived stress in medical students and could help identify at-risk students. Our future goal is to conduct a longitudinal study to determine if grit changes during medical school and whether it could predict performance on USMLE exams and other important medical school milestones.

Presented By: Emily Tran, University of Arkansas for Medical Sciences
Co-Authors: Erica Malone, University of Arkansas for Medical Sciences

Purpose 
Students in health professions experience a great deal of stress that can negatively impact their performance. Finding a way to actively study that also relieves stress would be ideal for students. This project aims to investigate the use of artistic methods in learning retention and stress levels. 

Methods 
Subjects included volunteer students from both physician assistant and nurse anesthesia programs enrolled in the summer anatomy course at the University of Arkansas for Medical Sciences. Data was gathered regarding preferred study methods and stress levels before, during, and after the course. Academic performance was evaluated based on exam scores, and stress levels were measured using the Perceived Stress Scale (PSS). Study habits were evaluated with Likert-scale surveys. 

Results 
Eleven students out of 48 participated in the study. Data from students who participated consistently were evaluated (art = 4, no art = 4). The first and second average PSS score were calculated for each group (art = 14.5, 19.0; no art = 20.5, 19.0). There was no score for the last PSS. The average Likert-score for stress levels was calculated (5 = very stressed) and revealed a significant difference (p = 0.00763): art = 2.0 (SD = 1.1), no art = 0.20 (SD = 0.45). The average grade was calculated and was not significant (p = 0.939): art = 85.00 (SD = 5.66), no art = 84.75 (SD = 2.75). The average grade for the 11 participating students was 84.80 (SD = 3.40). 

Conclusion 
The group of students who made art reported feeling more stressed. There could be underlying factors that contributed to stress levels or influenced participation including perceived creative ability. The primary limitation of this study was the number of participants. Further research should seek larger sample sizes.

Presented By: Abigal Schuch, Wayne State University School of Medicine
Co-Authors: Matthew Brennan, Wayne State University School of Medicine
Chayton Fivecoat, Wayne State University School of Medicine
Raghav Rajesh, Wayne State University School of Medicine
Riya Shah, Wayne State University School of Medicine
Marissa Zhu, Wayne State University School of Medicine

Purpose
The USMLE Step 1 exam is a crucial board exam U.S. medical students take in their undergraduate medical education. Although the consequences of this exam are wide-reaching, little is known about how medical schools approach situations where students are not prepared to sit for Step 1 or fail an attempt. The aim of this study is to review the Step 1 policies for U.S. M.D. medical schools.

Methods
This document analysis study will include all 155 U.S. M.D. medical schools. Our approach involves two primary data collection strategies: 1. Document Review: We'll conduct a review of publicly available documents, including student policy handbooks, official websites, and academic resources. This will help us gather detailed information on each school's Step 1 policies. 2. Direct Inquiries: Where information is not publicly available or needs clarification, we will reach out directly to the institutions. We will use a standardized spreadsheet to ensure uniformity and ease of comparison across different schools. The specific data points we will focus on are t ming, eligibility criteria, dedicated study period duration, exam deferment options, and retake policies.

Results
We anticipate the results of this data collection to identify commonalities among schools regarding Step 1 exam timing, eligibility criteria, and provisions for students who do not pass their first attempt. Given the decline in Step 1 pass rates, we expect that many policies have been recently updated accordingly. We hope to identify trends in Step 1 policies with the goal of developing best practices for the Step 1 study period.

Conclusion
We anticipate that our systematic review will provide a greater understanding of the wide variety of Step 1 policies at M.D. medical schools. Our study will help medical students and administrators determine the Step 1 policies that will best prepare students for success in their medical careers.