Education
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Item Improving Pain Management Education in US Medical, Nursing, and Pharmacy Schools: Making an Impact on Patient Safety(2017-03-14) White, Annesha; Vernachio, Kimberly; Jiandani, Simone; Licciardone, John C.; Barbé, Tammy; Suzuki, Sumihiro; Rhoads, DavidObjective: Over 100 million patients in the US deal with some sort of pain. The NIH has considered pain management one of the most urgent problems facing health care today. The number of opioid prescriptions has been increasing over the past several decades and along with this the rate of opioid overdose deaths has nearly tripled in the past fifteen years. Proper pain management by health professionals can lead to better patient outcomes including patient safety. However, evidence has suggested that pain management education is not being sufficiently addressed in pre-licensure programs such as nursing, medicine, and pharmacy. The objective of this study is to examine current practices in pain management education within medical, nursing, and pharmacy schools, identify educational gaps, and make recommendations for improvement in education. Methods: This descriptive cross sectional study focused on pre-licensure programs in medicine, nursing, and pharmacy. A two-part survey was administered to schools nationwide to evaluate the depth and breadth of pain education. The first part of the survey focused on questions regarding the scope, quantity, and delivery of pain education. This part was adapted from a previous survey by Mezei and colleagues to assess pain curricula in US and Canadian schools. The second part of the survey focused on opioid education. The survey also assessed different teaching methods that are used, and additional demographic information regarding the participating institutions. Results: This study is ongoing with results from the survey still being received. Preliminary results show that the most common teaching methods used are didactic lectures, as well as case-based activities and clinical experience. Few institutions are utilizing team-based and interprofessional learning. When looking at opioid education, results show that programs are consistently providing education about behavorial and non-pharmacological management. However, interventional methods, and opioid contracts are not widely taught. Once the survey is completed, analysis of variance (ANOVA) will be conducted to look for differences between educational program types as well as geographical regions. Conclusions: Based on early results, it is clear that pain education needs to focus more on patient education, and interprofessional learning opportunities. Improving pain education should not just focus on the quantity of time spent in teaching students, but also the quality of educational experiences delivered. Didactic teaching still seems to be the most common method used, but students would benefit from the opportunity of more interprofessional activities as well as team-based learning. The consensus is that medical, pharmacy, and nursing schools should establish formal pain management education in each year of their curricula. Through improving pain management education, health care professionals of the future will be better prepared to manage their patients, which will directly result in improved outcomes, and patient safety.Item A Retrospective Analysis and Curricular Mapping Assessment of Student Engagement in Research Design in Classes Offered by the College of Pharmacy at University of North Texas Health Science Center at Fort Worth(2017-03-14) Mukasa, Kevin; Torres, Oscar; Clay, PatrickPurpose: Currently, UNTSCP does not have a process or a methodology developed to identify classes within its curriculum that offer the opportunity to learn, understand, and/or develop research design as outlined by the ACPE in 2016 Standards document. The aim of this study is to create a methodology and physical repository necessary to identify and classify core and elective classes offered by UNTSCP, which have provided opportunities in “research design”. This study is being submitted to receive feedback from students and faculty on classes, where at least one of the four key components of research design is presented, discussed, tested and actively practiced as outlined in the 2016 Standards document created by ACPE. Significance: The tool developed in our research will potentially allow pharmacy students to search for and identify classes offered at UNTSCP that have provided exposure to research design and identify which of the four key components of research design each class has covered. Faculty may even use the results of this study to elicit changes to the class curriculum. In addition, the administration of UNTSCP has its first full accreditation review in May 2017. To prepare for this, the administration of UNTSCP may use the results of this quality assurance project to show its compliance/adherence to the 2016 standards in the section detailing “Research Design.” Materials and Methods: Three stages will be undertaken in order to achieve the specific aims outlined. These stages include a curricular mapping assessment looking at course syllabus objectives and then verifying the results obtained with students through surveys and faculty via personal interviews. Conclusions: The results of this quality assurance project may lead to increased reproducible and meaningful research conducted by students and faculty at UNTSCP as a result of improved or increased research design experiences in the offered curriculum. This project could also lead to assessments done in other schools within UNTHSC such as School of Public Health, School of Health Professionals, and Texas College of Osteopathic Medicine (TCOM).Item Role of Service Learning in Medical Students’ Clinical and Professionalism Competencies (2017)(2017-03-14) Yang, Mei; Dolan, Kathryn J.Background: The role of service learning in students’ acquisition of knowledge, skills and professional attitudes is poorly understood. Osteopathic medical students perform service during the first two years as one of the required elements of their ‘doctoring’ course. The availability of this data provides opportunities to more systematically examine the role of service learning in students’ acquisition of clinical skills and professional attitudes. Methods: Self-report data from osteopathic medical students’ required service is required for each activity or event and is now collected electronically. Starting in Fall 2015 semester, this data is now collected electronically. Data includes the type of service, and Likert scale ratings of students overall satisfaction with the experience, and the extent to which each activity meets certain learning objectives and promotes professional values such as service, integrity, respect and collaboration. Results: Data from 690 students with a total of 4,700 service learning evaluation reports are available for analysis. The most common types of service are assisting at indigent clinics, health fairs, sporting events, health education and safety for children and direct health services including OMM. The majority of students strongly agreed or agreed the overall experience of a specific event was good for of them. The majority strongly agreed clinical skills objectives were met during homeless services events and for school and sports physicals. Students ratings of the extent to which various service activities promoted UNTHSC values vary. Basic descriptive statistics facilitate understanding of students’ attitudes toward various types of service activities and generate additional hypotheses regarding satisfaction, learning objectives and professional values. Conclusions: Service learning is designed to provide opportunities for students to engage in experiential learning which is task and problem specific, improve their clinical skills, and experience the benefits of altruistic behavior. The model of learning applied here originated with John Dewey (1938) and further developed by Kolb (1984), and Boyatzis (2000) who addresses issues of emotional intelligence in professional competencies. This is a step in understanding on the impact of service learning in meeting specific objectives in medical education.Item Correlation Between Online Content Viewing and Classroom Performance(2017-03-14) Papa, Evan; Mabutas, Kimberly; Noble, Spencer; Vastine, Mikyla; Richardson, MikePurpose: Several physical therapy programs have applied flipped teaching methods to deliver content within the expanding physical therapy curricula.1, 2 A study at a health professions school showed at least 90% of students felt a flipped class promoted understanding and application of material.3 Additionally, graduate students enrolled in a modified flipped class scored significantly higher (P 4 The purpose of this study was to determine how consumption of flipped material correlates with class performance for year one Doctor of Physical Therapy (DPT) students. We hypothesize that time viewing at-home lecture material will be significantly related to exam performance. Methods: Forty-four first year DPT students completed a final practical and a comprehensive written exam as part of a Therapeutic Interventions I class. Exam and overall course grades were compared to weekly viewing times provided by the Canvas Learning Management System. All participants were provided with electronic informed consent. This study was approved by the Institutional Review Board at the University of North Texas Health Science Center (UNTHSC). Results: Increase in weekly time viewing at-home lecture material was correlated with increase in both written and practical exam scores, r(44)=0.383, p=0.009, and r(44) =0.424, p=0.003. There was a low correlation between weekly viewing time and achievement of 90th and 20th percentile class ranks, r(44)= -0.373, p=0.011 and r(44)=0.336, p=0.02. The ROC analyses demonstrated weekly viewing time had good ability to discriminate between students who scored in 90th and 10th percentiles on the comprehensive exam (AUC=0.87; 0.80, P=0.014; 0.005) and overall class grades (AUC=0.82, P=0.007). The cutoff point showed students had to view the minimum of 30.8 minutes each week to achieve the 90th percentile, 25.5 minutes or more to earn an ‘A’, and 18.9 or fewer minutes to obtain the 10th percentile. Conclusions: Weekly viewing time is associated with student performance on exams. Time spent viewing lecture material per week predicts various levels of success or poor performance in the flipped class. This sample was limited to year 1 DPT students at UNTHSC in one course and may not be generalizable beyond these conditions.Item Factors Influencing a Medical Student's Choice of Specialty(2017-03-14) Vu, Andy; Felini, Martha F.; Edwards, MadisonBackground: Specialty selection by medical students is a complex decision driven by many factors. The goal of this study was to understand and quantify factors of primary importance as assessed by the students themselves when choosing a medical specialty. Materials and Methods: One hundred and forty five of 230 (63%) medical students in Year 2 at Texas College of Osteopathic Medicine completed an online survey using Qualtrics. The 38 question survey was used to collect demographics and most desired specialty choices at time of survey. Students were also asked to rate the importance of 27 pre-selected factors involved in specialty choice. Responses were measured on a likert scale of 0 (very uninfluential) to 10 (very influential). The same online survey was dispersed in Year 3 after clinical rotations were complete (n=92, 40% response rate). Principal factor analysis with promax rotation was conducted to calculate eigenvalues and generate scree plots for determining the most appropriate factor solution. Results: Seventy three participants completed the pre-rotation survey and a subsequent post-rotation survey. Over half (59%) were female, 63% were Caucasian, and ages ranged from 22 to 38 years old. The top specialty choices prior to Year 3 rotations was Dermatology and Neurology; choices changed to Family Practice and OB/GYN or Pediatrics after Year 3 rotations. The highest ranking factor influencing choice of specialty was having a positive Year 3 rotation followed by the ability to do major and minor procedures within their field of choice. Ten of 25 factors assessed decreased in importance significantly after post rotation. Four factors with eigenvalues [greater than] 1 accounted for 85.4% of common variance. These factors explained the largest variances across the 25 factors and included academic performance, personal value, early role model, and future time investment. Conclusions: Factors influential in determining specialty choice change after year 3 clinical rotations. The results of this research can be utilized by medical schools as a platform to adapt to the education of this generation of medical students.Item Evaluating the Impact of the Core Geriatric Clerkship(2017-03-14) Marquez-Hall, Sandra; Keplin, TaylorPurpose: Clinical clerkships provide training for medical students in concentrated areas of study. A component of the Reynold’s Interprofessional Geriatric Education & Training in Texas (IGET-IT) program is the Core Geriatric Clerkship. Knowledge of geriatrics is gained through self-study, case reviews, and clinical case discussions. The goals of the clerkship were aligned with the eight AACOM Osteopathic Core Competencies for medical students, including Osteopathic Principles and Practices, Medical Knowledge, Patient Care, Interpersonal and Communication Skills, Professionalism, Practice-Based Learning and Improvement, Systems-Based Practice, and Health Promotion/Disease Prevention. This study examined the geriatric clerkship and whether or not it improved the ability of medical students in AACOM competency areas. Methods: Students were required to take a pre and post self-assessment of ability in nine competency areas. The instrument asked students to rate their ability on a 4-point Likert scale, ranging from 1-4; (1) no ability, (2) some ability, (3) significant ability, and (4) complete ability. Data were collected over a five year period (2011-2016) with a total of N=1024 responses collected. A paired T-test for significance as well as mean responses were calculated using SAS Version 9.3. Results: A statistical difference (pEnd of Life Care with a 51% increase between pre- and post- assessment results and Community Resources (48%) ; with somewhat less increase in Continuum of Care (46%) , Neuropsychological Testing (44%), and Geriatric Syndromes (34%). Lowest levels of improved ability were found in Home Safety Evaluation (32%), Medication Reviews (27%), Osteopathic Principles (22%), and Professionalism (10%). Conclusions: Including a mandatory geriatric clerkship for fourth year students provided a way for undergraduate medical students to increase their knowledge and self-efficacy in the care of aging adults. The core geriatric clerkship pre- and post- survey results showed increased confidence levels in all the competency areas measured.