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    Near Peer Ultrasound Education Evaluation
    (2023) Wyszynski, Katy; Thompson, Jordan; Young, Katherine; Vasilev, Viktor; Weeks, Cassidy; Weindruch, Louisa; Gibson, John
    Ultrasound training is incorporated throughout the medical curriculum at Texas College of Osteopathic Medicine (TCOM) beginning in the Year 1 Physical Exam Course where students are introduced to the fundamental of Ultrasound as it pertains to each organ system being taught. In Year 2, the training is included in the Simulation Lab curriculum. In the past 4 years, ultrasound education at TCOM has become more formalized with the use of second year students as ultrasound teaching assistants. The purpose of our study is to examine the effectiveness of near peer teaching in the setting of ultrasound. Near peer teaching occurs when material is taught to students by their peers, and this has been proven to be an effective teaching technique in other settings. We hypothesized that medical students prefer near peer teaching to learn ultrasound, and that student teaching assistants will facilitate a better learning environment. Medical students from the classes of 2022, 2023, 2024 and 2025 were surveyed about the effectiveness of near peer education. Results were initially published at RAD 2021, however in the past 2 years the Ultrasound teaching assistant program has expanded and become more formalized. 138 medical students completed the survey, and 78% of students responded that they learn effectively during ultrasound taught near peer sessions. 67% of medical students indicated that they prefer near peer teaching to another teaching style. In addition, the teaching assistants from the TCOM classes of 2022, 2023, 2024 and 2025 were surveyed with 33 responses. 100% of the teaching assistants surveyed indicated that through the use of near peer education, being a TA enhanced their medical education. Our results across multiple years of medical students demonstrate the utility of near peer teaching and that students prefer this method of learning. Point of Care Ultrasound is becoming a necessary part of medical education, as its importance in clinical medicine grows. Near peer teaching can be one way to implement ultrasound into medical school curriculums.
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    An Analysis of Student Satisfaction with Active Learning Techniques in an Online Graduate Anatomy Course: Consideration of Demographics and Previous Course Enrollment
    (2023) Bradley, Libby; Meyer, Kim; Robertson, Taylor; Kerr, Marcel; Maddux, Scott D.; Heck, Amber; Reeves, Rustin; Handler, Emma
    Purpose: Online learning has become an essential part of mainstream higher education, allowing greater access for students. With the increase in online course enrollment, specifically that of anatomy, understanding online teaching best practices is critical. Active learning has previously shown many benefits in face-to-face anatomy courses, including increases in student satisfaction. Currently, no research has measured the satisfaction of several active learning techniques implemented in an asynchronous, online graduate anatomy course. Methods: This study compared the student satisfaction achieved by four active learning techniques with consideration of demographics and previous course enrollment. Survey questions consisted of multiple-choice and Likert-style that asked students to indicate their level of satisfaction with the active learning techniques. One hundred seventy (170) students completed the online anatomy course and surveys. Results: Students were more satisfied with question constructing and jigsaw than with concept mapping and team-learning module. Additionally, historically excluded student groups (underrepresented racial minorities) were more satisfied with active learning than White students. Age, gender, previous anatomy experience and/or online course experience did not influence the satisfaction of the active learning techniques. However, students with higher GPAs and those who had no graduate degree were more satisfied with the active learning techniques than students who had lower GPAs and those with a graduate degree. Conclusion: These findings provide evidence that students enrolled in an online graduate anatomy course were satisfied with the active learning techniques, dependent on the specific technique, demographics, and previous course enrollment. Results provide anatomy educators with a better understanding of which techniques work best in an online anatomy course. Currently, there is a lack of research comparing active learning techniques in an online learning environment. These findings provide online anatomy educators with evidence that active learning techniques improve satisfaction, with consideration of student demographics and previous course enrollment.
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    Incorporating ultrasound imaging in graduate gross anatomy labs improves learning
    (2023) Robertson, Taylor; Meyer, Kim; Kerr, Marcel; Reeves, Rustin; Handler, Emma
    Purpose: Teaching ultrasound imaging is on the rise in both undergraduate and medical anatomy education. Despite the vast literature surrounding these areas, there is little research exploring the use of ultrasound in preparatory graduate programs, which emphasize credential enhancement for professional school applications. The purpose of this study is to identify the effects of ultrasound imaging inclusion in a graduate gross anatomy course. Methods:Students in the Master of Medical Sciences program enrolled in the gross anatomy course, a prosection-based cadaver lab that included pinned cadaver stations and an ultrasound station. Using ultrasound, teaching assistants imaged live human volunteers to demonstrate anatomical structures that students previously learned at the cadaver stations. To assess learning, students were given one ultrasound image question on each lab practical exam. Students also completed a pre- and post-course survey regarding perceptions of ultrasound inclusion in the course. Student lab practical scores and final course grades from the 2019 cohort were used as a historical control. Students in the 2022 cohort’s lab practical grades, final course grades, and survey data were used in statistical analysis. Classes disrupted by Covid-19 were excluded (2020 & 2021 cohorts). Results: 205 students from the 2019 cohort and 167 students from the 2022 cohort participated in this study, with 29 students from the 2022 cohort responding to the surveys. Students in the 2022 cohort had significantly higher lab practical scores in practicals 2 (p<.001, d=.361), 3 (p<0.001, d=1.038), 4 (p<.001< d=.487) and 5 (p<.001, d= .412). Survey data revealed that there was a significant increase (p<.001, d=1.203) in learning outcome achievement from pre-survey to post-survey. Students who correctly answered the ultrasound question performed significantly better on practicals 3 (p=.005) and 4 (p=.005) than those who missed the ultrasound question. Conclusion: These findings suggest that ultrasound imaging in a gross cadaver lab is beneficial to masters' students’ learning and understanding of gross anatomy and structural relationships. The utilization of ultrasound during cadaveric anatomy courses improves learning and outcome achievement in these graduate students. This hands-on instructional procedure would likely have the same effect on other cadaveric anatomy courses such as those in health sciences and medical curricula.
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    Evaluating student responses to incorporate Vulnerable Patient Population centered content into the curriculum
    (2023) Panzanaro, Victoria; Kremer, Timothy; Srivastava, Prakriti; Valdez, Alia; Wiemann, Natalia; Basha, Riyaz; Garcia, Joanna
    Purpose: Vulnerable patient populations are considered groups of people who cannot access healthcare resources or services due to social barriers. Despite advances in the healthcare system and medical education, providers still report feeling less comfortable caring for these patients, and medical students around the country report not feeling this topic is adequately addressed in their curricula. The goal of this project was to evaluate students’ responses to introducing an optional curriculum dedicated to discussing four vulnerable populations (Transgender Patients, Incarcerated Patients, Housing Insecure Patients, and Intellectually and Developmentally Disabled Patients). Our expectation is that students will feel more comfortable being a part of these patient’s healthcare teams, and determine the value of providing students with a manageable curriculum focused on these topics. Methods: The tested curriculum consists of four modules, with each dedicated to one of the populations. Each module consists of a pre-recorded video lecture, a supplemental article, and an optional 30 minute interactive session with a content expert who is currently a healthcare provider focused on each population. Texas College of Osteopathic Medicine students voluntarily participated in this evaluation activity. A literature review was performed to create the content outline and objectives. This information was presented in a short pre-recorded video lecture taught by peers. Supplemental articles were chosen to pair with each video. After completing the modules, participants had the option to a virtual interactive meeting where a content expert that works with each of these patient populations had 30 minutes to talk about their experiences and answer questions. The students then consented to an anonymous post-survey to evaluate if they feel that taking this course has benefited their educational experience and if they feel more prepared to be a part of a healthcare team for these patients. All content and materials were reviewed by content experts. Results: 26 students signed up to take the course, and 20 students completed the modules and attended the optional content expert session. Of those 20 students, 90% completed the post-course survey. The survey showed that students feel vulnerable patient populations are important to learn about, that each population has specific healthcare considerations that should be taught, and that a course similar to this is beneficial to their education. Participants reported feeling more informed about caring for these patients and have taken away information that will be valuable in their future practice. Conclusion: Medical students feel that vulnerable patient populations and their barriers to healthcare are important topics that should be discussed in medical school curriculums. Students recognize that each population has specific healthcare needs that should be individualized to them, and that incorporating a course that discusses this would be beneficial to their classroom and clinical training. The participating students reported that they gained new, useful knowledge that will help them be more supportive for these patients, and wish to see similar content incorporated into the curriculum and expanded on in the future. In conclusion these results are interesting and suggest conducting a research study in the future.
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    Implications of Interactive Online Medical Education for TCOM Musculoskeletal Education
    (2023) Crowther, Jacqueline; Frangenberg, Alexander; Nesterenko, Alissa; Maharjan, Laura; Meyer, Kim; Webb, Brian
    Purpose: In the modern medical curriculum, students are required to learn increasing amounts of information, and the ability to adapt and expand the threshold of fundamental concepts is becoming increasingly important. Most recently, the COVID-19 pandemic has forced the medical education system to adapt to a new challenge - delivering a comprehensive medical education to students remotely without compromising the quality of education. As a result, online interactive learning modules were introduced into the second exam portion of the TCOM Musculoskeletal Systems 2 (MSS2) course. This study aims to retrospectively review the effects of this online, interactive, module-based format. Methods: A retrospective review was performed to compare student performance before and after the implementation of these pandemic related changes. De-identified student data (n=685) from the 2019 pre-pandemic cohort and the 2020 and 2021 post-pandemic cohorts were utilized for the study. The dataset included student cumulative medical school GPA prior to the beginning of the course, class quartile rank, MSS2 exam scores and final course grades. Standard post-course surveys were utilized for the qualitative portion of the analysis, and an additional course satisfaction survey administered via google polls was added for the purpose of collecting anonymous student feedback and suggestions for improvement. Quantitative analysis was conducted on parametric and non-parametric variables. For parametric variables, the independent sample T-test was utilized to assess significant differences in a number of different variables, including both broad and specific statistical questions regarding the data. Results: The implementation of the online musculoskeletal modules correlated to a significant difference between the course grades of the 2019 and 2020 cohorts with mean scores of 88.4 and 87.2 respectively (p=.025). A significant improvement was found in the second exam for the 2019 and 2020 cohorts (p=.006), whereas no significant difference was revealed between the first exam grades of the two cohorts (p = 0.49). The data analysis from the two years following the pandemic demonstrated a successful implementation of online modules with the significant improvement of exam grades in the second exam where the modules were incorporated, including in the 2021 cohort. These significant findings indicate a benefit of introducing such modules into the second exam. Post-course surveys revealed that 57% of students want to see interactive modules in future courses, with an additional 28% being neutral. Conclusions: The addition of interactive modules to the MSS2 curriculum was beneficial as students were able perform significantly better on the relevant exam material despite entering the course with significantly lower GPAs. Furthermore, the majority of students responded positively to the possibility of seeing interactive modules used in future courses.
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    Program Director Survey Determining Effects of Single Accreditation and Pass/Fail Licensing Exams on Osteopathic Medical Students Applying for Surgical Residency
    (2023) Panchal, Olivia; Pereira, Kenneth; Brennan, Zachary; Taylor, Casey; Paluri, Sarin; Young, Grace; Burns, Bracken; Conrad-Schnetz, Kristen; Gudakunst, Craig
    Purpose Prior to the single accreditation system (SAS), some residency programs were accredited by the American Osteopathic Association (AOA), rather than the Accredited Council for Graduate Medical Education (ACGME) and trained osteopathic (DO) graduates only. Recently, United States Medical Licensing Examination (USMLE) Step 1 and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level-1 transitioned from numeric scores and pass/fail outcomes to pass/fail only. The purpose of this survey was to examine the effects of these changes on DO students applying for surgical residency. Methods A voluntary, anonymous survey was distributed five times over 9.5 weeks to 1539 surgical program director (PD) emails collected from the Fellowship and Residency Electronic Interactive Database (FREIDA). 302 responses were received (response rate 19.6%) and 244 survey responses were included in statistical analyses. 58 responses were excluded because of incompletion, the respondent was not a PD, or the respondent disqualified DO students from matching. Results For DO applicants, most former-AOA programs recommend Step 1 while most non-AOA programs require it. The majority of both program types require Step 2 CK. When deciding whom to interview, former-AOA programs significantly preferred Level-2 scores and completion of an acting-internship at the program while non-AOA programs significantly preferred the Medical Student Performance Evaluation and clerkship grades/evaluations. Both program types highly valued Step 2 CK scores and letters of recommendation. Conclusion Based on this study, DO applicants should almost certainly take both Step 1 and Step 2 CK (in addition to Level-1 and Level-2) to be considered competitive. Additionally, the results underscore the importance of identifying surgical residency programs as former-AOA or non-AOA– particularly when prioritizing where to complete acting-internships. Despite the SAS, former-AOA and non-AOA surgical residency programs differ in their preferred medical licensure examination and metrics for determining competitiveness. DO students should consider these differences to improve osteopathic surgical match rates.
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    Geriatric Practice Leadership Institute (GPLI): An Age-Friendly Program
    (2023) Murphy, Sara; Soto, Maria; Camp, Kathlene E.; Severance, Jennifer; Fairchild, Thomas
    Purpose According to the Institute of Medicine, immediate steps must be taken to educate and train both the current and future health care workforce to work collaboratively in addressing the diverse needs of the growing older adult population. Most healthcare professionals had very little education or clinical training in the care of older adults nor the most effective ways to work as a clinical team. Methods The Geriatric Practice Leadership Institute (GPLI) is a collaboration between two universities providing interprofessional teams of early and mid-career professionals with the skills and knowledge needed to leverage leadership skills to effectively work within interdisciplinary teams to provide age-friendly care to older adults. The GPLI incorporates the Institute for Healthcare Improvement (IHI) Age-Friendly Health Systems 4Ms’ Framework into the training. The GPLI is an on-line, team-based program which engages 5-7 teams each session. Module topics include Age-Friendly Health Systems, organizational culture, leading self, leading interprofessional teams, and quality improvement. Additionally, teams select and complete a quality improvement project based on the Age-Friendly Health Systems 4Ms and submit final report and presentation. The teams are also assigned a coach for support. Continuing education credits and a micro-credential are available to participants. Participants complete a survey following the completion of the program. The GPLI has been funded by the Health Resources and Services Administration (HRSA) Geriatrics Workforce Enhancement Program grant (numberU1QHP2873), which currently covers all costs for participants. Results The GPLI has trained over 175 healthcare professionals during the past 7 years with teams representing ambulatory to emergency responder organizations. Participants were all asked to complete a survey to gauge the program's success. When asked about how valuable the information was in the program in a post-completion survey, 100% of participants answered 'very’ or 'extremely’ valuable. Additionally, all participants answered either 'very’ or 'extremely’ valuable when asked how useful their executive sponsor was in supporting their team's involvement and project. Conclusion After many years of offering the program, many lessons have been learned, and consistent themes have emerged from the teams who have been the most successful. These include team representation from all levels of the organization, a focus on culture change, and flexibility to change and adjust, especially during the COVID-19 pandemic.
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    Evaluation of Create-Your-Own-Adventure Activities on Student Knowledge and Critical Thinking Skills in Second-Year Student Pharmacists
    (2023) Phillips, Heather; Aguiniga, Ashlyn; Howard, Meredith
    Purpose: Create-your-own-adventure (CYOA) activities are educational innovations where students choose the "best pathway” of treatment. Current literature suggests increased student perception of knowledge and critical thinking skills with use of CYOA activities; however, evidence that such skills ultimately improve is lacking. The primary objective of this study is to assess changes in knowledge and critical thinking after completing a CYOA activity. Methods: Seventy-five second-year pharmacy students completed a CYOA activity on venous thromboembolism, with a six-question quiz immediately before and after. Questions were mapped to pre-set learning objectives with slight alterations to questions on each assessment. Four questions were then mapped to the final exam which occurred approximately three weeks after the activity. Friedman’s two-way analysis and Cochran’s Q test were used to evaluate differences in scores. Descriptive statistics were used to describe student perceptions and scores on a modified Need for Cognition scale. Results: There was a significant decrease in mean scores for each assessment (68.1% vs. 64.9%, vs. 40.0%; p<0.001). Similar results were found when stratifying scores by question. Of the 48 survey responses, 94% preferred the CYOA activity and perceived increased critical thinking skills. All Need for Cognition items scored >3.5, indicating satisfaction in critical thinking. Conclusions: Although we hypothesized an increase in scores with use of CYOA activities, there was a negative association between the activity and scores. Possible limitations include mapped questions that were too dissimilar, VTE management being too multivariate, and lower student retention of cumulative material on finals. These limitations will be addressed in future CYOA activities.