Poster Day 2022: Abstracts: Medical Education

Joshua D. Collingwood, Cole S. Arnold, Benjamin L. Crews, Alina F. Faunce, Britton A. Ethridge, RN, BSN, Natalie Barefield, PA-C, Matthew Ragan, MD, Pankaj P. Dangle, MD, MCh, Sherry L. Roach, MD, FACS  

Mastery of basic surgical skills for open surgery, such as suturing, is important to a medical student preparing for a career in surgery. With the development of minimally invasive techniques, such as laparoscopy, students seek to broaden their mastery of basic skills. The purpose of this study is to assess academic surgeon perspectives on medical students’ preclinical exposure to laparoscopic simulation. 

Survey was administered to attendees of the Annual Meeting of the Alabama Chapter of the American College of Surgeons, and answers collected on Likert scale for the following statements: 

Statement 1: “Pre-clinical exposure to laparoscopic simulators is beneficial to the overall training and development of medical students.”

Statement 2: “I am more likely to allow 3rd and 4th year medical students to participate in laparoscopic surgery cases if they have had prior exposure to, and training with, laparoscopic simulators.”

Survey responses were collected from 18 surgeons (14 attendings, 2 PGY-5s, 2 PGY-3s). Of the 18 respondents, 17 reported working in academic medicine, overseeing the training of medical students. In response to Statement 1, 33% of respondents Strongly Agree and 67% Agree. In response to Statement 2, 61% of respondents Strongly Agree, 33% Agree, and 1% Neither Agree Nor Disagree.  

Our findings demonstrate that surgeons in medical academia see medical student preclinical exposure to laparoscopic simulation as beneficial to the overall training of medical students and are more likely to allow students with preclinical exposure to laparoscopic simulation greater participation in laparoscopic cases while on surgical rotations

Nick W. Lanpher*, Pedro Lima*, and James Nolin, FNP-C  (*: indicates co-first author, contributed equally to the work)  

There is a concerning amount of evidence that medical students are not receiving adequate surgical education in suturing and knot-tying during their years in medical school. Near-peer teaching has emerged as a tool to enhance learning in medical education. Our study aimed to evaluate near-peer teaching’s effectiveness in learning multiple surgical skills in isolation of other teaching methods.  

Near-peer surgical skills workshops were delivered separately to first- and second-year osteopathic medical students (N=45 and N=16, respectively). We assessed for confidence pre- and post- workshops using 5-point Likert scale questionnaires to determine self-perceived benefit and confidence in skill level. Additionally, effectiveness of near-peer teaching was assessed based on participants performance feedback, comfortability with asking questions, and efficacy when compared to lecture style learning using an additional 5-point Likert questionnaire of agreeability with each statement.  

Overall, we expect student confidence in completing one-handed knot tying and simple interrupted sutures to increase significantly post-workshop in both the first-year and second-year cohorts. Similarly, we expect a positive response towards near-peer teaching, especially when compared against lecture-based teaching.  

This study illustrates that near-peer teaching positively impacts first and second-year medical students’ confidence in fundamental surgical skills. The adoption of near-peer teaching for surgical skills provides benefits beyond lecture-based curriculum.  

Sunaina Malhotra OMS-II, Esteban Ramos OMS-II, Kamran Ather OMS-II, Philip Breton OMS-II, Andrew Cecol OMS-II, Richard R. Thacker, DO, MACOI., Gordon G. MacGregor, PhD, MBA 

Elective rotations are important for helping medical students decide which field of healthcare they are most interested in. These clerkships are chosen throughout the clinical years of medical school, years which are poorly understood until a student experiences them. Anesthesiology preceptors at clinical core sites are essential to building upon a medical student’s knowledge and understanding of clinical medicine in the field of Anesthesiology. To be a successful and efficient team member during clerkships, a medical student should be aware of the best resources and recommendations that preceptors have deemed effective and useful. 

This was a qualitative study involving 23 Anesthesiology preceptors throughout ACOM’s clinical core sites. These preceptors were chosen for their leadership in Anesthesiology and their important role in guiding and assessing medical students throughout their Anesthesiology rotation. 

There were 3 themes that were highlighted from the survey responses: procedural skills, pharmacological knowledge, and teamwork/leadership when part of the whole clinical team. Preceptors are satisfied overall with the performance of medical students, but there are many resources that they believe should be used by students. They also provided useful insight to how they perceive medical student’s performance.  

ACOM students that have had interactions with the surveyed Anesthesiology preceptors are leaving a good impression overall. There is always room for improvement and the preceptors think students should be utilizing more Anesthesiology-related resources and altering learning habits to improve learning outcomes as well as clinical competency and effective involvement during their Anesthesiology rotation.

Ahaj H Shroff, Mark J Hernandez  

Diverse teams are better equipped to address healthcare disparities(1) and they publish higher impact(3) research more frequently(2). We examined how efforts in addressing diversity were valued by students in MD and DO programs over the past decade through satisfaction instruments.   

We previously showed the validity of comparing satisfaction instruments published by AAMC and AACOM(2). The Medical School Year Two Questionnaire (Y2Q) and the Medical School Graduation Questionnaire (GQ) provide data from MD-granting medical schools. The AACOM Graduating Senior Survey Summary Reports (GS) provide data from DO-granting medical schools. We analyzed items that assessed student perception of how school faculty demonstrate respect for diversity (Y2Q and GQ) or how their school valued diversity (GS). Data analysis was conducted using Excel and R Studio. 

Student perception of how DO programs have valued diversity has increased since 2011. Student perception of how faculty from MD programs demonstrate respect for diversity has increased since 2013. Both satisfaction instruments indicated an increasing number of neutral responses rather than positive ones. Finally, respect for diversity was valued higher during pre-clerkship training (Y2Q) than graduation (GQ).

The results suggest that medical schools have only reduced the number of students that believe diversity is not valued, rather than increasing the number of students that believe it is. Potentially, the benchmark for being a diverse institution has been raised. Schools may be meeting 2011 diversity standards, but not the current standards. Further analysis is required to ascertain the improvements these medical schools have made.

Erika Haviland OMS-III, Jim Nolin FNP-C, Julia Alexander, MD  

The use of point-of-care ultrasounds (POCUS) is rapidly growing throughout most clinical care settings. There is increasing demand for the integration of ultrasound into undergraduate curricula. To promote early exposure in ACOM preclinical students to POCUS, the Radiology interest group provided participants with a multi-station interactive ultrasound workshop.  

A prospective study recruited forty-five first and second-year osteopathic medical students who participated in a one-day POCUS workshop. Participants rotated through five different stations that utilized live volunteers as well as simulation trainers and augmented reality. All were facilitated by either school faculty or radiologists from the community. The stations included live scanning of the right upper quadrant and neck and simulated scanning FAST exam, injection knee model, and central line placement. Varying the degree of intervention and simulation on multiple different bodily locations was designed to increase student comfortability with ultrasound. 

All 45 participants attended and completed the pre- and post-surveys. There was a significant increase in the student's self-reported comfort with ultrasound after the completion of the event (M= 1.15, SD=.37) than before the event (M= 2.69, SD = .97); t (25) = -7.625, p < .001. 

A one-day POCUS training increased medical students’ confidence in handling and using ultrasound in patient care. The workshop elements are implemented for third-year medical students during their rural health rotations.

Byron Kunst, Dr. Mark Hernandez 

The U.S. faces an impending shortage of PC physicians by 2034(1). PC practitioners played an integral role in triaging and testing patients during the U.S. response to the COVID-19 pandemic (2). Here we examined medical students’ interest in PC, and whether student’s change throughout their time in medical school. Medical student specialty selection has been previously examined; longitudinal national trends remain to be examined.    

We reviewed items that prompted students at osteopathic medical schools to select their interest in a PC-based specialty at matriculation and at graduation; Both surveys provide aggregate data from DO-granting programs.  Summary reports which provide data from MD-granting programs were also reviewed.  A construct of the data was developed using Excel and analyzed (t-test).

At matriculation, interest in PC specialties saw an overall decline from 2013-2021 (23% in 2013 to 19% in 2021). There was an increase in matriculating student interest in 2022 due to a change in the observed question (32%). Baseline interest increased from matriculation until graduation in 2013-2021 (M=1137, SD 295.9) and (M = 1671.1, SD 329.3).

Exposure to PC specialties during the preclinical years can positively influence students’ specialty choice (3) and those filled by U.S seniors saw a decline in 2022 from 2021 according to the National Resident Matching Program (4).  Interest in office-based PC specialties at DO-granting institutions increased after 1st year between 2013-2022 (before and after COVID). Further research should be explored to see how declining interest in matriculating DO students can be improved.

Devesh Dahale, Donna Yost 

Evidence based practices and key clinical concepts are generally available and accessible to clinicians, but not necessarily clearly understood and retained.  Current teaching methods that primarily rely on CBLs (Computer Based learning) use the method of teaching the material followed by an assessment exam). This method usually generates only moderate levels of interest and consequently comprehension and retention of material being taught. We designed an experiment to test the idea of “pre-test,  education, post-test” sequence of teaching and evaluated its effectiveness.  

1) Participants answer pre-reading questionnaire
2) Participants read article (Preventing falls in hospitalized patients - American Nurse (myamericannurse.com)
3) Participants answer post-reading identical questionnaire
4) Test scores are collected, tabulated and analyzed

Data collection: Paper copies were provided to the participants and their completed copies were assessed and analyzed using Excel and a statistical software (Minitab).

Date of trial: 08/24/2022: 
N= 13 participants
Pre-test: (perfect score: 11)
• Avg. score: 4.8
• Median score: 5
Post-test: (perfect score: 11)
• Avg. Score: 9.9
• Median score: 10

Avg. improvement in score per participant: 4.8 points (before vs after score) 

Using a pre-test and post-test questionnaire showed statistically significant differences in mean scores and a doubling of accuracy with the interventions of reading a relevant evidence based article between the two tests.  (p<0.005)

Pre and post questionnaires also generated an interest in the material being taught and created in intra and inter participant competitive spirit along with adequate comprehension and retention of the material being taught.

Hannah Gregory, Grant Gregory, Rahul Garg, PhD, MPharm, Wayne Parker, PharmD 

The opioid epidemic continues to elicit detrimental effects on the entire healthcare system. An active response must be taken among medical schools to address this public health crisis. This study describes the layout and impact of a comprehensive, multidisciplinary, and longitudinal opioid curriculum in medical school. The objective of this study is to determine the impact of such curriculum on first-year medical students’ knowledge and perceptions on opioid-related topics such as: addiction medicine, substance abuse, opioid pharmacology, opioid use disorder, and management of opioid use disorder.   

The effectiveness of this curriculum was assessed through a pre- survey administered prior to students receiving any formal education on opioid knowledge, related skills, and stigmas and a post- survey after completion of 14+ hours of this curriculum. Pre- and post- surveys were analyzed to assess the impact of this curriculum. 

There were 51 students who completed the pre-survey and 141 students who completed the post-survey. Students demonstrated significant improvement in knowledge on opioid-related topics such as addiction, substance abuse, opioid pharmacology, opioid use disorder, and management of opioid use disorder, increasing from 70.2% to 87.3% in the pre to post-test, respectively. Students also reported increased confidence in their ability to manage patients with opioid use disorder. Students demonstrated some improvement in their stigma scores, though to a lesser degree from 67% to 75.6%, respectively.

Medical students can greatly benefit from a comprehensive opioid curriculum. The adoption of such curriculum across widespread medical institutions may provide a much-needed breakthrough to combat the opioid epidemic. 

Thaddeus Derbyshire, Ivana Gutman, Joshua Collingwood, Cole Arnold

Many tools and resources on how to match into pediatric residency programs exist, yet there are much fewer on how to excel during rotations. Often, pediatric program directors list that a letter of recommendation from a pediatrician is one of the most valuable components of an aspiring resident's application. The purpose of this study was twofold: enhance the ability of the future medical student to succeed in pediatrics, as well as allow pediatric preceptors the opportunity to efficiently spend their time teaching.  

Our short survey of four questions was sent to preceptors within the Alabama College of Osteopathic Medicine core rotation network to elicit their opinions on what makes a successful rotating pediatric medical student. Topics included physical exam skills, character traits, and preferred sources of supplemental information. It’s apparent that while preceptors have varying preferences in terms of superlative features in their students, survey responses on other subjects such as prerequisite knowledge, physical exam skills, and third-party information indicated agreement in their importance.

An example of such was found in selections that showed a trend regarding what prior knowledge preceptors expected most. These include middle ear infections, gastroenteritis, and bacterial or viral infections. Minimal variance was found among these responses, resulting in 69% of respondents ranking one of these three topics at number 1 out of 8, with a mean ranking of 2.54 for each. A separate finding was noted, as pediatricians agreed in their preference for the use of Uptodate, with a mean ranking of 1.29.

Amin Wang M.S., Melinda Ledbetter PA-C, John-Paul Fattorusso and Isabella Fernandez

Studies have shown empathy declines during medical school and residency, which compromises clinician professionalism and may even threaten healthcare quality [1]. Most individuals can empathize more effortlessly when they relate to another person’s experience. Alabama College Of Osteopathic Medicine (ACOM) does not have a dedicated lifestyle medicine (LM) course at this time; however, LM topics are addressed sparingly throughout pre-clinical years and integrated into different systems courses. We hypothesize that having LM classes offered to students through a certification course before clinical rotations have the potential to increase students’ connectivity with their patient population and prepare students to counsel patients on the six pillars of LM.   

A certification course was created for 24 randomized ACOM students. The 24 participants were given three surveys: before taking the LM course, after completing the course, and a feedback survey for quality control. These surveys were designed to gauge the effectiveness of the LM certification course. 

Results showed that, after completing the LM certification course, most participants felt more confident in their knowledge of LM and in discussing LM topics with their patients and peers. Participants also showed an increase in their rating of the importance of incorporating LM when treating their patients. 

In conclusion, implementing the LM certification course into the osteopathic curriculum has shown to increase participants’ confidence levels regarding all aspects of LM, which could ultimately improve professionalism and healthcare quality.

Kim Chosie, LPCS and Dom Gigliotti, OMS III 

Background:

The medical school bootcamp pre-matriculation program was developed by a group of five third year osteopathic medical students to help prepare incoming first year osteopathic medical students for success in the rapid-paced environment of medical education. The program was designed to be completed by the students before starting their first semester and was divided into five major parts:  Time Management, Individual Learning Style, Becoming Familiar with Outside Resources, Study Techniques/Strategies, and Overall Student Perspectives.   

To assess student opinions related to the effectiveness of the program, three surveys were sent to the students: The first survey was before starting the modules, the second survey was immediately after completing the program, and the third survey was at the end of their first semester. 

56.0% of students selected that these materials either “well” (44.7%) or “very well” (11.3%) prepared them for medical school. 52.2% of students selected that these materials either “well” (40.9%) or “very well” (11.3%) prepared them for Anatomy course. 42.1% of students selected that these materials either “well” (28.3%) or “very well” (13.8%) contributed to their performance in the Molecular Medicine course. 

Overall, the program has perceived value from the students which was supported by the data. Further investigation will consist of tracking individual student performance in both Anatomy and Molecular Medicine, then surveying the students about their utilization of the medical school bootcamp pre-matriculation program.

Victoria Boyd, Kevin Allen, Shane Mohsin, Anagha Raghunandana, Dr. Christina Kennedy  

The relationship between attendance policies and student performance in medical school curriculums remains unclear. As an effect of the COVID-19 pandemic, attendance policies in one osteopathic medical school’s curriculum were suspended. The aim of this study is to determine the effect of removing the mandatory attendance policy on the performance of first-year osteopathic medical students in Anatomy and Molecular Medicine courses.  

Pre-pandemic course grades achieved by the classes of 2022 and 2023 under a mandatory attendance policy were compared to post-pandemic course grades achieved by the classes of 2024 and 2025 under no mandatory attendance policy. Shifts in grade distributions were analyzed between pre-pandemic and post-pandemic grades. Additionally, a voluntary survey was emailed to students in the classes of 2024 and 2025 to determine in-person lecture attendance and study habit preferences. 

Following suspension of the attendance policy, the amount of “A” and “F” final course grades in Anatomy increased from 14.09% to 17.46% and 0.83% to 4.56%, respectively. In the Molecular Medicine course, “A” and “F” final course grades increased from 10.74% to 19.42% and 2.76% to 4.07%, respectively. Survey data reveals that 81.01% of students prefer recorded lectures, 20.37% attend in-person lectures at least three times per week, and 40.13% “rarely” attend lecture in person.

The removal of an attendance policy shows a bimodal shift in the distribution of course grades. From these trends, we conclude that high performers excel without an attendance policy. Contrarily, low performers struggle without an attendance policy in effect.