Leadership & Scholarly Activity
Abstracts are in the order they will be presented for both Lightning Talk blocks on Monday, December 5
Lisa Tshuma
A.T. Still University, School of Osteopathic Medicine in Arizona
Introduction: Integrating behavioral health in primary care medical homes is a proven and effective way to expand access to behavioral health services and improve health outcomes. However, many healthcare faculty and preceptors have not had the opportunity to learn about evidence-based integrated behavioral healthcare delivery models. While exemplar organizations exist, there remains a tremendous need to expand PCBH training in the current and future healthcare workforce in the USA.The Integration Pathways training program described in this presentation aims to address this gap and improve the knowledge and skills of an interdisciplinary primary care workforce needed to address the behavioral healthcare needs of diverse patients and populations.
Methods: In partnership with the National Association of Community Health Centers, A.T. Still University is educating interdisciplinary healthcare providers and medical students through an innovative clinically-focused approach. The Integration Pathways training program is grounded by am Integrated Care Alliance of medical educators, Community Health Center (CHC) leaders, and interdisciplinary healthcare providers who regularly meet online to share experiences, best practices and collectively solve clinical issues. Participation in the Integrated Care Alliance is the first of three vital components in the 1-year provider/preceptor training program. This program provides support for customized training (component 2) to address trainee-specific educational needs and integrated care interests. Finally, trainees apply learning through an integrated behavioral health quality improvement (QI) project. These QI projects not only strengthen the delivery of healthcare, but also provide unique learning opportunities for health center employees, faculty and medical students.
Results: To date, 32 practicing clinicians/preceptors from 10 different healthcare disciplines have successfully completed the Integration Pathways training program in 7 health centers and communities across the USA. Collectively, these provider-trainee champions have developed and implemented 14 quality improvement projects, including several multi-year projects aimed at improving the structures and processes needed to provide high quality healthcare. Additionally, there are 10 interdisciplinary clinician-trainees enrolled in the current cohort. Through the Integrated Care Alliance, CHC leaders not only transform their own clinics and communities but share best practices with other CHC integrated care champions across the nation. The Integration Pathways training program provides an innovative, practical model that can be adapted to train the current and future healthcare workforce to provide team-based, patient-centered integrated behavioral health in primary care settings worldwide.
Junhua Xiao
Swinburne University of Technology, Melbourne, Australia
Anatomy, a prerequisite for medical sciences, is shifting towards a greater focus on adopting digital delivery. This, however, is still a relatively nascent domain, especially in Australian Universities. The development and use of technology in the classroom pose many challenges to academics and students, resulting in hesitance in engaging in such endeavours. Recently, the Covid-19 pandemic induced sudden move to online teaching has shown the benefits of online resources that help replace the in-person experience of the anatomy laboratory. However, using commercially available resources are often financially inhibitive, while developing bespoke resources are time consuming and requires skills that not all anatomy educators possess. A more collaborative approach, where skills as well as resources can be shared, and where experiences regarding the best implementation of these resources can be discussed may be the solution. To establish such collaboration across Australia, anatomists from eleven universities have established a virtual Digital Anatomy Network since 2021. This network meets bimonthly with the aim to catalyse anatomy education and research collaboration involving digital technologies. We share digital teaching practices in anatomy education that have taken place as a result of the Covid-19 pandemic and importantly discuss evidence-based anatomy pedagogy as the world enters the post-pandemic phase and beyond through both virtual forum and scholarly publication. Here we present the framework of our virtual network and highlight proposed features that we believe would benefit all users and enhance anatomy education. We welcome academics who have a genuine interest in digital anatomy education to join our network to enrich our online anatomy education landscape.
Caroline Mueller
Ohio University Heritage College of Osteopathic Medicine
There is limited research related to the experiences of early career medical educators. While prior studies have analyzed novice professors, they have not focused on medical educators entering full-time positions. This population of educators may differ from more experienced colleagues in age, knowledge, skills, priorities, values, and responsibilities and are therefore faced with challenges and advantages unique to their position. In order to better support early career medical educators, the current study aims to identify the specific challenges and advantages experienced by this group. To address this aim, an anonymous, voluntary survey was distributed via medical education professional society forums, social media platforms, and direct emails to professional societies. The survey collected demographic data and included open-ended questions concerning perceptions about challenges and advantages experienced by early career medical educators. Demographic data were analyzed using descriptive statistics. Written responses were analyzed using thematic analysis which was completed by creating codes and then grouping codes into themes. A total of 49 responses were collected, with 39 individuals qualifying as early-career (>10 years of teaching with terminal degree). The majority of qualifying respondents were female (71.8%), in their thirties (56.4%), Caucasian (79.5%), taught anatomy (61.2%), and have taught for an average of 4 years. Thematic analysis revealed that the major challenges facing early career faculty were balancing responsibilities, lack of research support, and inequality as a faculty member. Major advantages included an ability to understand students, possessing specific knowledge and skills, and the ability to innovate. When asked about being closer in age to students, early career faculty reported the following challenges: lack of student trust, difficulty maintaining professional distance from students, and unequal treatment based on position. However, the decreased age gap also made early career faculty more approachable and facilitated a connection with students. Despite the efforts of many institutions and professional societies, there are still many opportunities to improve assistance for early career faculty entering medical education. Many early career faculty desire more support and equality in their workplace. Overall, the results of this study indicate a continuing need to provide adequate professional development and resources for early career faculty members.
Elisabeth Schlegel
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
We present a new approach to scholarship in health professions education (HPE). Through a proposed innovation in scholarship - micro-scholarship - we will illustrate how this approach is similar to and an extension of bite-size or micro-learning and workplace micro-practice related to just-in-time (JiT) learning settings. Further, the small steps for generating and engaging with micro-content can be similarly applied to micro-scholarship, which can then be combined and scaled up. Modern changes in the pace and means by which we conduct and experience teaching and learning have resulted in producing succinct, bite-sized content that consumes less cognitive bandwidth with reduced cognitive load. Compact modular content is also ideal for just-in-time (JiT) micro-learning and workplace micro-practice or on-demand learning and practice (Yilmiz et al., 2022). Mobile technology tools and platforms support open display of, access to, and iterative engagement with this content by a community of practice (CoP), both in learning and scholarship [Goh et al., 2021; Schlegel, 2021; Schlegel & Primacio, 2021; Goh & Sandars, 2020]. However, a close examination of the generation and dissemination of micro-content shows that they also fall within the categories of scholarship proposed by Boyer. Innovative JiT micro-content disseminated through, e.g., Twitter, blogs, apps, or modular courses, is easily accessible for members of a CoP to engage with, evaluate, critique, and build upon. This public reaction to and appraisal of content compares to wide audience post-publication peer review (PPPR), with the added value of a feedback loop through responses on comments. After refinement, these pieces can be combined into larger pieces of macro-scholarship and scaled up through network effects to macro-levels and "traditional-size" scholarship at macro-levels [Azhar, 2021]. Finally, the process of generating scholarship mirrors the stepwise, sequential, cumulative process of learning, and training for proficiency and mastery in any area of reflective practice. Our roles as practitioners, educators, and scholars are all informed by learning science. However, taking a step back and reflecting on work from a meta-perspective allows refinement and growth, supporting the entire CoP. Thus, combining small components of content, from micro to meta levels, can be an effective strategy for scholarship and collaboration within a CoP in HPE.
References on request: Azhar, A. (2021). The Exponential Age - How Accelerating Technology is Transforming Business, Politics and Society. Diversion Books, New York City. Goh, P.S., Roberts-Lieb, S., & Sandars, J. (2021). Definition of Micro-Scholarship. https://microscholarship.blogspot.com/ Goh, P.S., & Sandars, J. (2020). Rethinking scholarship in medical education during the era of the COVID-19 pandemic. MedEdPublish, 9(97). https://doi.org/10.15694/mep.2020.000097.1 Schlegel, E. (2021). (Not Only) for Medical Students: [blog]
Samuel Robinson
Lewis Katz School of Medicine at Temple University
Problem: Despite high interest, medical students often struggle to efficiently and effectively participate in research while in medical school. MD programs are faced with the task of providing students with the basic aptitude needed to identify research mentors, secure funding, and execute research protocols. Approach: The Medical Student Research Initiative (MSRI) at the Lewis Katz School of Medicine (LKSOM) at Temple University was established in August 2020, as a quality improvement project. Alongside a group of faculty advisors, the longitudinal program was designed by students, for students, with the principal objective of engaging medical students and paired faculty mentors in meaningful research endeavors. MSRI followed a multifaceted strategy to provide students with opportunities to (1) enroll in a new elective course that offers introductory research and grantsmanship skills, (2) access to a network of faculty to serve as mentors and provide research experience, (3) connect with a peer support network of MD and MD/PhD students to discuss prior research and mentorship experiences, (4) utilize a research toolkit with educational resources regarding basic, translational, community-based and clinical research and funding opportunities, and (5) provide feedback so that they may have a voice in the type research support provided to them. The QI's impact was quantified by analyzing pre- vs post-initiative survey data.
Outcomes: Since the program's launch, the MSRI online platform has gained 154 members with thousands of webpage interactions. Forty-three students have completed the Research and Grantsmanship for Medical Students elective course. Survey data demonstrates MSRI resources have led to increased student interest in research, contributed to the submission and awards of medical student funding proposals, and have facilitated the connection of many students with peer and faculty research mentors.
Next Steps: The MSRI committee members plan to collaborate with the LKSOM offices of Student Support, Medical Education, and Research Administration to further disseminate information to increase awareness of the program, respond to research needs of medical students and residents, and strengthen the network of faculty and student mentors.
Benjamin Krasnyanskiy
SUNY Downstate Health Sciences University
Introduction: Research production in medical school has become a crucial part of the residency application process. The ability to produce, edit, and submit projects for acceptance relies on the diligence and productivity of a research laboratory. But, what should be clarified in an applicable sense is whether an individualized- or team-based approach bolsters student participation and productivity.
Methods: A retrospective collection of an orthopaedic research laboratory department from the years 2011 to 2022 was undertaken. Prior to 2021-22, the orthopaedics lab took an individual-based research approach, as compared to 2021-22, which adopted a new, teams-based approach. Student participation, submissions, and acceptances were quantified and used as the basis for comparison. Since abstracts are typically short-term contributions, they will be used as an indicator of participation within the lab.
Results: During the 2021-22 school year, a total of 124 students contributed to the lab, the largest contribution compared to previous years. Students were separated in teams of 5 to 10 people, and projects were disseminated within each group, led by one or two team leaders. Within one academic year, 803 abstracts were submitted, of which 232 were accepted. Of those 232 abstracts, 27 were accepted as podiums and 205 were accepted as Posters or ePosters. Furthermore, 110 manuscripts were accepted for publication within various journals, the most popular being topics of adult reconstruction-, spine-, and trauma-based journals (64% increase from last year, alone).
Conclusion: A teams-based approach significantly bolstered student participation and research output compared to an individual-based approach. Though this was just an analysis of one lab, other labs should adopt a similar approach to test functional outcomes, and adapt if necessary to aid medical students and other researchers in their academic goals, alike.
Jonathon Reynolds
Noorda College of Osteopathic Medicine
Introduction: Prior to the COVID-19 pandemic, electronic device use in medical education had already become increasingly prevalent and utilized by medical students. However, COVID-19 has only accelerated the adoption of electronic use. Social distancing practices resulted in a significant increase in virtual activities, extending the amount of time that a student will spend in front of electronic devices. Our institution is a new medical school that aims to create new and innovative approaches adapting to modern technology that is already prevalent in student's daily lives. Implementation of pre-recorded lecture material requires an additional 4-6 hours of electronic screen exposure. Computer vision syndrome (CVS) is a condition caused by extended screen exposure that can lead to eye discomfort and vision changes which can affect quality of life and educational performance. The purpose of this study is to better understand the overall prevalence of CVS among students, faculty, and staff as well as to educate and promote awareness of CVS.
Methods: In this study, we disseminated an anonymous online survey, comprised of 21 questions related to eye conditions, use of digital devices, symptoms of computer vision syndrome, an open-end comment section, and a demographics section. Information on CVS symptoms and prevention was provided for participants to download. Faculty, staff, and students (class of 2025) (N=150) were invited to participate. P-values were calculated using chi-squared test.
Results: 79 responses were received, medical students (37%), faculty (28%), and staff (34%). 3 staff members and 2 faculty members indicated part time. 42 respondents were female (53%) and 37 were male (47%). Of the participants who used a device for more than 1 month, 47% (n=37) reported increased vision fatigue. Compared to males (46%), a greater percentage of females (60%) reported having experienced 6 or more symptoms related to CVS, but this result was not statistically significant with a p-value of 0.227. Unexpectedly, 91% of faculty reported having 6 or more symptoms related to CVS, compared to 52% of students (p-value= 0.0028). There was no significant difference between students and staff.
Conclusions: While this study highlights the prevalence of CVS among faculty, staff, and students, these results may help identify individuals at high risk of CVS, which can lead to increased awareness and resources that can help reduce the negative effects of CVS. Future directions include disseminating the survey in the 2022 fall semester to the student class of 2026 (N=135), any new faculty and to the surrounding community which would allow comparison and correlation between the two demographics.
Spencer Lambert
Noorda College of Osteopathic Medicine
Introduction: Our school integrates wellness in the curriculum. The rigorous preclinical curriculum, examinations, and strive for performing well can be stressful for students. A 2016 systematic review estimated that 27% of allopathic medical students had depressive symptoms and 11% had suicidal ideation (Dyrbye LN. Acad Med. 2006). These studies did not include osteopathic medical students. The osteopathic principles advocate a balance "between the body and mind." There is not much in the literature regarding how exercise and osteopathic tenets play a role in students' mental health. We hypothesize that osteopathic students may have a better mental health profile compared to allopathic students and want to determine: 1) The prevalence of depression amongst osteopathic medical students, 2) The correlation of exercise with the degree of depression, and 3) Whether the application of the osteopathic principles and tenets play a role in their mental health and correlate with their level of physical activity.
Methods: Voluntary and anonymous paper surveys are distributed to the 1st and 2nd year students. The survey is comprised of: the Beck Depression Inventory (BDI-ii). Morgenstern Exercise Survey (MES), osteopathic tenets questions, and demographics. The BDI-ii is shown to correlate with clinicians' ratings of depression (Beck A, et al. Clin Psychol Rev. 1988). The prevalence of no (score 1-10), light (score 11-20), moderate (score 21-30), and severe (score >31) levels of depression are obtained. Participants are provided a list of wellness resources, where they are encouraged to seek advice. The MES is a physical activity survey that captures types and levels of exercise which are applied to medical students' lifestyles. The osteopathic tenet-related questions: 1) "Do you feel that your values towards mental health and exercise align with an osteopathic mindset?" and 2) "Do you feel that your values towards mental health and exercise played a factor in applying to osteopathic medical school?"
Results: Response rate: 26% (58/225). Levels of depression: None-65% (21Male;16Female), Light-31% (10Male; 8Female), Moderate-2% (1Male), Severe-2% (1Male). Exercise hours: Up to 5hrs/week: Light 76%, Moderate 71%, and Vigorous 74%. 6-19hrs/week: Light 17%, Moderate 22%, and Vigorous 19%. Osteopathic alignment: 86% strongly agree/agree that their values align with an osteopathic mindset and 60% strongly agree/agree that their mental health and exercise were a factor in osteopathic medical school application. Conclusions: The research is ongoing and awaiting further statistical analysis. The issue with students and levels of depression (majority have light level) needs to be addressed. Students spend up to 5hr/week with combinations of light, moderate, and vigorous exercise. Our campus environment and the alignment of osteopathic tenets may contribute to decreased prevalence of depression amongst our students.
Regina Russell
Vanderbilt University School of Medicine
Introduction: Academic Health Centers are organizations that combine a formal research and teaching focus with patient care. These organizations create structural relationships between clinicians and researchers that encourage the rapid translation between scientific study and health care application. The traditional biomedical sciences have infrastructures to integrate scientific insights with clinical needs. There are ongoing calls for the increased influence of the social and behavioral sciences (SBS) on health research and health care practices. This will require deeper connectivity between academic social scientists and health care practice communities.
Theory: Knowledge-practices are the regular ways that individuals and organizations engage with knowledge to solve problems and answer complex questions over time. Knowledge-practice networks are the connections created and sustained through these activities. From a complex systems perspective, these networks are important sources of learning and innovation in professional practice settings.
Literature: There are multiple mechanisms and pathways for knowledge-practices, including research, to impact organizational outcomes. Recent European studies demonstrate that research hospitals with faculty active in cardiac-related research have lower 30-day mortality for heart conditions than other hospitals. It is not clear whether SBS research has a similar impact on outcomes. The rate of hospital-acquired conditions is likely an organizational outcome influenced by social principles and research.
Methods: Patient outcomes for heart conditions and hospital-acquired conditions are quantified in the U.S. Center for Medicare/Medicaid Services Hospital Compare Database (period captured is 2018). The Web of Science bibliometric tools analyze the disciplinary focus and volume of published research associated with each health center affiliated university (period captured is 2012-2016). Hypotheses that specific hospital outcomes are associated with related research output of affiliated universities are tested with regression analyses.
Results: A higher volume of cardiac-related research output in U.S. academic health centers is associated with better cardiac outcomes in affiliated hospitals. Likewise, a higher volume of management research is associated with fewer hospital-acquired conditions. Implications are 1) patient outcomes vary along with the character of research generated in local networks and 2) the research output for SBS and bio-medical research are similarly related to patient outcomes, explaining 7% and 9% of variation respectively. However, the overall volume of SBS research is much lower than biomedical research at all AHCs. Expansion and integration of SBS research throughout AHCs is needed. As is research and education on sustaining diverse knowledge-practice networks that effectively join relevant academic research with health care practice.