Browsing by Subject "Students, Medical"
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Item The Art of Observation: A Qualitative Analysis of Medical Students' Experiences(2019-01-22) He, Bowen; Prasad, Smriti; Higashi, Robin; Goff, HeatherCONTEXT: Although the inclusion of arts in medical school curricula has garnered much attention, little is known about the effect of arts-based interventions on the behaviors, attitudes, and technical skills of students. The Art of Observation is an optional elective at UT Southwestern Medical Center in collaboration with educators from the Dallas Museum of Art. We utilized a qualitative approach to describe in-depth how engaging with art influences the development of medical students' observation skills and empathy. METHODS: We analyzed evaluations from 65 medical students who completed the course between 2015-2017. Evaluations contained open-ended questions that asked students to reflect upon their experiences and describe their perceptions, thoughts, and feelings after guided museum visits. Two investigators independently read all evaluations line-by-line and used open coding to generate a codebook, which was refined by consensus and discussed with a third investigator experienced in qualitative methodology. We then employed axial coding to identify sub-themes and discover relationships between the major themes. RESULTS: We report three main findings and several subthemes from the data: (1) Enhanced observation skills: by engaging with art and completing relevant activities, students developed the ability to synthesize a compelling narrative in addition to learning technical skills; (2) Improved physician socialization: students reported enhanced self-awareness, increased tolerance of ambiguity, and development of a humanistic view of medicine, key components of physician socialization; and (3) Reduction in burnout symptoms: students reported an enhanced sense of well-being after each session, which mitigates the process of burnout. CONCLUSIONS: Fine arts can be used to teach technical skills, stimulate personal reflection, and prevent burnout. A meaningful engagement with the arts can play an important role in developing physicians who are observant, empathetic, and more well-rounded.Item Assessing the Need for and Developing a Standardized Patient Handover Curriculum for Undergraduate Medical Education(2017-04-03) Gajera, Prakash; Reed, W. Gary; Greilich, Philip; Ambardekar, AditeeBACKGROUND: Improving patient handoff communication is a national patient safety goal; however, few medical schools have standardized handoff training curricula for their medical students. Studies show that a large number of medical students perform handoffs and observe handoff errors during their clerkships [1,2]. This lack of formalized training has a negative impact on medical student perceptions of handoffs [3]. This project assessed the need for handoff education at our institution and developed a curriculum aimed at medical students. IMPLEMENTATION: Clerkship directors were interviewed & preclinical medical students were surveyed for a stakeholder analysis. Prior to starting core clerkships, 200 total students participated in four 1-hour workshops consisting of a 20-minute lecture and three 10-minute handoff scenarios. Trained residents performed the scenarios and led group discussions. Pre- and post-course engagement surveys were used to evaluate the workshop. EVALUATION & OUTCOMES: Clerkship directors desired handoff training before clerkships; however, there was concern that the curriculum would be too advanced. Survey of pre-clinical students showed 71% had heard of standardized patient handoffs, but 94% had no training. 75% believed training should be done prior to core clerkships, and 64% believed handoff simulations were the best method for learning. Students scored 10.7% higher on the post-engagement quiz and 98% of students believed they better understood the elements of a good handoff after the workshop. IMPACT & LESSONS LEARNED: Standardized patient handoff curriculum designed for preclinical medical students improved confidence and knowledge about the handoff process. Concerns about creating handoff curriculum for medical students were addressed by focusing on general concepts rather than specific handoff tools and by creating simple handoff evaluation scenarios. Further work will focus on evaluating the impact of this workshop on the handoff experience during clerkships.Item Biomedical Innovation Manual for Medical Students(2018-03-26) Sotman, Timothy; Rege, Robert; Beres, Alana; Barker, BlakeBACKGROUND: The UT Southwestern Biomedical Innovation program is modeled to a large degree after the Stanford Biodesign program. The program is based on the hypothesis that innovation can be learned, and it offers a step-by-step process which has been shown to result in successful new biomedical technologies. From a high level, the process involves starting with a broad list of needs in the healthcare sector, selecting a smaller number of these needs to focus on based upon criteria such as group capability, resources, and strategic fitness, devising a number of solutions to these needs, narrowing the number of solutions based upon feasibility, and then iteratively prototyping and testing the leading solution to develop a final working solution. Other academic institutions such as Johns Hopkins Center for Bioengineering and Design, Dukes Institute for Health Innovation, and University of Utah's Bench to Bedside have devised similar but distinct methodologies for teaching the skills involved in innovating new healthcare solutions and bringing those solutions to market. Since the passage of the Bayh-Dole Act in 1980, US universities have become increasingly involved in the business of technology transfer. Entire departments, such as UT Southwestern's Office of Technology Development have been formed for the purpose of protecting intellectual property and licensing it to existing companies or startup ventures. This has the benefit of increasing the chances that a technology with the potential to improve the lives of others will come to fruition while also serving as a source of revenue for universities. The financial and strategic importance of encouraging innovation and pursuing intellectual property and licensing agreements for US universities has become clear. The UT Southwestern Biomedical Innovation program hopes to encourage innovation at UT Southwestern Medical Center through the continued development of the Biomedical Innovation curriculum and organization. OBJECTIVE: Writing and distributing a primer on Biomedical Innovation to first year medical students will increase their confidence and competence as they embark on their first Biomedical Innovation projects. METHODS: Using Biodesign: The Process of Innovating Medical Technologies as a primary resource, an outline for a 10 chapter primer on medical device design for medical students was developed. Information from several primary resources and from local experts in medical technology development was collected and compiled into a short, accessible manual. Approaches and curricula from other medical schools were also incorporated. Efforts were made to introduce everything a medical student would need to know when embarking on her first medical technology design and development project. RESULTS AND CONCLUSIONS: A 45 page introductory manual targeted at first year medical students learning how to perform their first biomedical innovation program was written. The manual covers topics such as clinical observation, project management, brainstorming, prototyping, patents, and pursuing FDA approval for a medical device. It presents each of these topics at a level appropriate for medical students and includes information relevant to students at UT Southwestern (e.g how to access prototyping resources on campus). The resulting manual will improve the resources available to UT Southwestern medical students interested in Biomedical Innovation and will increase the long-term stability of the Biomedical Innovation program by forming a more permanent body of institutional knowledge and standardizing the curriculum from year-to-year.Item Current Trends in Teaching Design-Thinking in Medical Schools, and Outcomes from the UT Southwestern Biomedical Innovations Program(2018-03-26) Das, Thomas M.; Beres, Alana; Majewicz Fey, Ann; Barker, Blake; Rege, RobertBACKGROUND: With the proliferation of new medical technologies and the emergence of career clinician innovations, many major American medical centers have recognized the need to foster innovative thinking amongst their students. To this end, several medical schools have integrated design-thinking and innovation initiatives into their curriculum. UT Southwestern's Biomedical Innovations (BI) program is one such initiative. OBJECTIVE: This thesis project seeks to explore the current landscape of teaching biomedical technology innovation in medical schools, as well as the efforts, outcomes, and next steps of UT Southwestern's own Biomedical Innovations program. METHODS: The Biomedical Innovations program encompasses a pre-clerkship enrichment elective, a Scholarly Activity in Biomedical Innovations, and an optional Distinction in Biomedical Innovations. Program success is measured by student participation, faculty participation, and post-course surveys. Additionally, recent UT Southwestern graduates who previously completed an innovation course were surveyed to assess their comfort with the core competencies of design-thinking. RESULTS: Since 2011, over 140 students have completed a pre-clinical innovation enrichment elective; after finishing the course, 39 of those students chose to remain involved as student facilitators. Post-course survey data shows that the majority of students either strongly agree or agree that they have a better understanding of biomedical innovation after finishing the course. This data also identifies course organization as an area for improvement. Recent alumni survey data indicates comfort with the core principles of biomedical innovation amongst former students in clinical practice. Survey responses from former student facilitators show that working as a facilitator helped develop key leadership skills. CONCLUSION: UT Southwestern's Biomedical Innovations program is in alignment with current trends in teaching design-thinking in medical schools. The consistent interest shown by the student body, the positive post-course survey results, and the influence the course has had on recent alumni demonstrate the success of the BI program. As faculty support and institutional memory continue to grow, the Biomedical Innovations program can prepare students to address the problems facing modern medicine with new and innovative technologies.Item Development of a Holistic Specialty Interest Assessment Tool: A Pilot Project for a Resource Allocation Paradigm(2021-05-01T05:00:00.000Z) Raphel, Tiana Janae; Sulistio, Melanie; Sendelbach, Dorothy; Trello-Rishel, KathleneBACKGROUND: Current specialty matching tools quantify students' enjoyment completing highly specific tasks. However, the importance of accounting for multifaceted influences on specialty choice grows. OBJECTIVE: Our purpose was to better understand how personality and personal values affect ultimate specialty choice. METHODS: We performed a literature search to identify important drivers of specialty choice. Next, we created and administered an original specialty interest assessment tool in response to literature search. We used the Ten-Item Personality Inventory (TIPI) to measure personality and we performed multivariate logistic regressions to assess for the significance of personality and personal values in determining specialty choice among current physicians and graduating medical students. RESULTS: Two-hundred and eight non-graduating medical students, 66 graduating medical students and 819 physicians completed administered surveys. Agreeableness and conscientious were significant in choosing Primary Care (PC) and Life Style Friendly (LF) specialties. Importance of salary was a significant predictor of choice of both PC and LF specialties. CONCLUSIONS: Personality and personal values were found to be significant predictors of ultimate specialty choice.Item Development of a Web-Based Patient Case Study Template for Nutrition Education(2006-12-19) Klein, Belinda Jeanne; Krumwiede, Kimberly HoggattThis thesis project attempts to build a model-teaching tool by creating a computer-based patient case study. The goal of this thesis was to create a model for an interactive website that presents a patient case study for fourth-year medical students that will potentially facilitate diagnosis and treatment of patients with a nutritional condition. A preliminary step to this thesis project was the development of a web-based patient case study template. The objective was to use metabolic syndrome as an exemplary nutritional patient case study within the template. The metabolic syndrome content included meets the requirements for medical students and the incorporation of the nationally recognized research at the University of Texas Southwestern Medical Center's campus. Additionally, the uses of different types of media (photographs, MRIs, animations, interactive diagrams, and graphs) were used to present information in an effective manner. The test site was posted on the Internet for fourth-year medical students to review and participate in an informal survey to gather their responses on the template and its components. The website was created in a program format that meets the requirements of the campus on-line curriculum and can easily be updated in the future to ensure that information remains current and new patient case studies can be added.Item Development of Video and Simulation-Based Communication Skills Learning: Responding to Emotions(2021-05-01T05:00:00.000Z) Nguyen, Trung Tan; Siropaides, Caitlin; Sendelbach, Dorothy; Abraham, ReeniPROBLEM: Responding appropriately to patients’ emotions and concerns is vital for excellent patient care and outcomes. There is a lack of training in this area, with the need to educate healthcare providers about how to appropriately respond to emotions. While communication skills training programs exist for undergraduate medical education, medical students often feel unprepared in responding to patients’ emotions INTERVENTION: A 90-minute small group exercise was developed for second-year pre-clinical students at a large United States medical school in Texas. The exercise consisted of faculty-facilitated small group discussion of two video examples of a patient encounter, comparing clinician responses to patient emotions. The exercise utilized a framework for identifying skills and patient impact of verbal expressions of empathy to different patient emotions. CONTEXT: This curriculum sought to demonstrate examples of strong patient emotions for preclerkship students, and introduce a framework of concrete communication skills that can positively impact a clinical encounter. Data was collected by questionnaires delivered immediately pre-session and post-session, as well as 3 months post-session. Survey questions assessed student perception of effectiveness of the exercise, student-reported preparedness and feeling equipped to perform various communication skills during clinical visits. Paired t-tests were performed and data analyzed for qualitative responses. OUTCOMES: The process evaluation yielded a positive subjective learner response to the exercise which was sustained at 3-month follow-up. The students (N=161 paired for the immediate pre- and post-survey) reported significant increases in knowledge and preparedness to recognize and appropriately respond to different patients’ emotions (P= 0.001). Qualitative data were also captured in the surveys. LESSONS LEARNED: This video-based small group discussion of skills to express verbal empathy is perceived by pre-clinical medical students to be beneficial, and to improve their knowledge and preparedness for using empathic skills in the future. There is a need for further investigation whether this type of communication skills training results in behavior change and is sustained long-term.Item Diverse medicine: developing a sustainable medical workforce to meet the needs of our patient population(2020-01-31) Okorodudu, DaleItem Erosion of empathy in medical trainees(2015-10-02) Abraham, ReeniItem Formative Feedback Passport: A Tool to Engage Students in Reflecting on and Incorporating Mid-Point Feedback(2022-05) Postma, Heather Elizabeth; Abraham, Reeni; Collins, Sarah; Brinker, StephanieBACKGROUND: The importance of formative feedback in undergraduate medical education is widely appreciated; however, it is historically inadequate. The formative feedback passport (FF tool) was developed and implemented in the Internal Medicine (IM) clerkship at UT Southwestern to address these concerns. OBJECTIVE: This dissertation examines the FF tool's role in facilitating an optimal formative feedback process. METHODS: Initially, a pre-intervention study was conducted, in which randomly selected, de-identified FF tools from the 2018-2019 IM clerkship were analyzed for content and quality of student reflection. Results revealed that student reflection on feedback was insufficient, with transformative, thoughtful reflection seldom occurring. In response to these findings, the FF tool's instructions were augmented with a module to encourage critical reflection. Subsequently, a post-intervention study was conducted, in which randomly selected, de-identified FF tools from the 2020-2021 IM clerkship were analyzed in the same manner as the pre-intervention study. RESULTS: 149 feedback tips from 50 FF tools were included in the pre-intervention study, and 162 feedback tips from 54 FF tools were included in the post-intervention study for a total of 311 feedback tips from 104 FF tools analyzed. In both studies, most of the feedback tips aligned with established standards for resident and faculty evaluators. In addition, the mean scores for each REFLECT Rubric criterion were significantly higher in the post-intervention group than the pre-intervention group. CONCLUSION: The FF tool is an invaluable electronic feedback tool in the IM clerkship at UT Southwestern. It enables documentation of formative feedback and promotes critical student engagement, reflection upon feedback, and the development of plans to implement feedback for improvement. Study results demonstrate that students receive formative feedback from an attending, resident, or patient that is appropriate in content. Additionally, study results demonstrate that the intervention improved student engagement and quality of reflection on feedback using the FF tool.Item Histology of the Female Reproductive System: An Interactive Educational Module(2013-04-11) Gove, Mollie; Calver, Lewis E.; Diehl, Angela Marie; Hoffman, Barbara L."Histology of the Female Reproductive System: An Interactive Learning Module" is an interactive animated video project designed to address the need for a complete educational exploration of female reproductive histology for medical students and residents in Obstetrics and Gynecology. The content was developed by Dr. Barbara Hoffman and Dr. Kelley Carrick, and was designed to accompany the existing histology literature in McGraw-Hill’s Williams Gynecology textbook. The project features 18 video animations that present normal and pathological histology features set in an interactive interface. This interface offers primary and secondary menus, as well as an interactive illustration showing the complete female reproductive system. The module was evaluated by current UT Southwestern medical students and residents for its perceived educational value. After using the module, surveys on the efficacy of the project were completed by eleven students. Analysis showed that the project was considered a useful resource for understanding female reproductive histology.Item How Learning Strategies and Academic Parameters Predict Medical Student Success(2024-01-30) O'Connell, Michael; Badia, Rohit; Tellez, Juan; Cook, Grayden; Sachs, ArleneBACKGROUND: Student scores on the Learning and Study Strategies Inventory (LASSI), an assessment of academic skills, have been shown in previous studies to be significantly different between U.S. medical students based on their scores in various examinations during the preclerkship curriculum. This study aimed to evaluate LASSI and other early academic performance markers for predicting the likelihood of shelf exam underperformance in third-year medical students. METHODS: A retrospective analysis of student-specific demographic information and medical school exam performance from 220 medical students from the University of Texas Southwestern was performed. Students were then categorized based on underperformance (score in <25th percentile) on each NBME shelf exam and statistical analysis was performed to identify predictors of shelf underperformance. RESULTS: For predicting Surgery shelf underperformance, pre-clerkship final exam average (PCA), STEP 1, and LASSI Time Management (TMT) were statistically significant in univariate analysis. Internal Medicine: PCA, STEP 1, LASSI Attitude (ATT), Test Strategies (TST), and TMT. Pediatrics: PCA and STEP 1 quartile. Obstetrics-Gynecology: PCA, STEP 1, and LASSI Anxiety (ANX), with ANX an independent predictor on multivariate analysis. Neurology: PCA, STEP 1, LASSI ANX, Information Processing (INP), TST, and average LASSI, with PCA, LASSI Concentration (CON), TMT, and ANX independent predictors on multivariate analysis. Family Medicine: PCA, STEP 1, LASSI ANX, TST, and Using Academic Resources (UAR), with PCA an independent predictor on multivariate analysis. Psychiatry: only STEP 1 was significant. CONCLUSION: In contrast to previous studies, no single LASSI scale was significantly associated with underperformance on all 7 NBME shelf exams. Univariate analysis identified several LASSI scales that correlated with NBME underperformance, but the drastic inter-clerkship heterogeneity makes use of these scales in early academic intervention impractical. Conversely, PCA was found to be strongly associated with shelf exam underperformance.Item Identifying Predictors of Performance on USMLE® Step 1(2017-03-27) Shah, Sachin; Sendelbach, Dorothy; Mihalic, Angela; Sachs, ArleneBACKGROUND: USMLE® Step 1 is considered by residency program directors to be one of the most important factors in selecting medical students for interviews, so it is important for both students and medical schools to maximize scores. However, despite its importance, very little has been studied to determine indicators of performance on the exam. OBJECTIVE: The goals of this study are: 1) to determine if data available prior to admission can predict Step 1 performance, 2) to evaluate if success in pre-clinical courses at UT Southwestern correlates to success on Step 1, 3) to analyze survey data and determine correlations between studying resources/strategies and Step 1 scores, and 4) to develop a mathematical model to flag students at risk of scoring poorly on Step 1. METHODS: This study utilized data from the UT Southwestern Medical School Class of 2018 (n=238). First, Undergraduate GPA, MCAT® scores, and demographic information were correlated with Step 1 scores and medical school grades to determine if pre-admissions factors could predict Step 1 or medical school performance. Second, medical school exam scores from the second pre-clinical year and NBME® Comprehensive Basic Science Self-Assessment (CBSSA) scores were analyzed to determine their correlation with Step 1 scores. Third, the class was surveyed during a dedicated six-week study period before the exam as well as after the exam, and results were analyzed to determine how students prepared. Each question from the surveys was correlated with exam scores to identify which factors led to higher test scores. Finally, the factors with the highest correlations to Step 1 scores were used to develop a mathematical model to predict Step 1 scores using multiple linear regression. This model was then tested to determine its effectiveness at identifying at-risk students. RESULTS: MCAT® biological and physical sciences scores and undergraduate GPA had moderate correlation with Step 1 scores (both R2 = 0.10) and weak correlation with medical school grades (R2 = 0.060 and 0.058, respectively). Of all factors studied, the initial CBSSA scores had the highest predictive value of Step 1 scores (R2 = 0.60). Cumulative medical school grades were also highly correlated with Step 1 scores (R2 = 0.52). The weekly pre-exam surveys indicate that each successive week of study produced smaller gains in points on Step 1, and most students did not see significant point increases after 6 weeks of study. The post-exam survey shows that students who answered greater than 4000 practice questions scored an average of 254 ± 5.3 (95% CI), whereas those who answered fewer than 1700 questions scored an average of 230 ± 10.6 (95% CI). There was no significant difference between those who studied 4 versus 7 dedicated weeks, or those who studied fewer than 250 hours versus more than 600 hours during the dedicated study time. However, students who started to study 6 months prior to the exam scored 252 ± 6.9 (95% CI), whereas students who waited until the dedicated preparation time scored 237 ± 3.6 (95% CI). A model incorporating a pre-admissions and medical school performance factors was developed that accounted for 64% of the score variability, with a standard error of ±8.87. When used to identify those at risk of scoring below 220, the model had a sensitivity of 81% and specificity of 86%. CONCLUSION: The study finds that MCAT® and undergraduate GPA are mediocre determinants of medical school and USMLE performance and should be used cautiously in the admissions process. Conversely, medical school grades and CBSSA scores are very accurate predictors of Step 1 scores, and students who do well on medical school exams generally do well on Step 1. Students should plan five to six weeks for dedicated study, but start reviewing material as early as possible and focus on question-based resources. The model developed from this data can be a useful tool to identify at-risk students for early intervention. This project demonstrates that objective data analysis can be used to guide students towards optimal preparation for Step 1, as well as identify those at risk of performing poorly on the exam.Item Improving Medical Student Performance on Clinical Skills Exams(2019-04-01) Thomas, Areon Scott; Wagner, James; Lysikowski, Jerzy; Reed, W. GaryBACKGROUND: Clinical Skills Exams were created in an effort to determine the readiness of medical students to enter into residency. These exams place students in a simulated patient encounter and grade them on their proficiency in handling that encounter. The National Board of Medical Examiners (NBME) instituted the United States Medical Licensing Exam: Step 2 Clinical Skills (CS), a Clinical Skills Exam, as part of the pathway to licensing physicians. LOCAL PROBLEM: UT Southwestern (UTSW) has noticed a rise in the number of students failing CS. The grading of CS is confidential; therefore, it has been difficult for UTSW to assess which students are at risk for failure. Through the initiation of the school administered clinical skills examination, The Objective Structured Clinical Exam (OSCE), UTSW was able to correlate poor performance on the exam with an increased likelihood of failure on the CS. This correlation has also been demonstrated in other studies. However, information on what factors lead to improved student performance on a clinical skills exam was lacking. METHODS: We reviewed 236 student records for the class of 2020 to ascertain what extracurricular clinical experiences students had taken in advance of the exam. We used bivariate and multivariate analysis to determine which of these experiences significantly impacted a student's OSCE exam score. The OSCE uses the same published grading criteria as the CS and is treated by the university as a proxy for the CS. The students are graded in three categories: Integrated Clinical Encounter (ICE), Spoken English-Language Proficiency (SEP) and Clinical Interpretation Skills (CIS). They are graded by their standardized patients and by faculty members overseeing the exam. The scores for each encounter are then averaged together to create a student's final score. We grouped the score into three categories for bivariate analysis: High Pass, Low Pass, and Fail. We then analyzed the number of students that fell in each category. We also used a separate computerized exam, the Clinical Data Interpretation (CDI) Exam, to ensure a representative sample. Box Plots, Chi Square, and multivariate analysis were used to analyze our data. We chose to use Box plots to examine the distribution of the data, and give us a starting point for analysis. From there chi-square analysis provided us with information on which intervention had the most significant effect on OSCE Scores. Finally multivariate analysis was performed to search for interaction between the interventions, and to check for a linear relationship between MOSCE and OSCE scores. INTERVENTIONS: Mock OSCE (MOSCE), Student-Run Free Clinic (SRFC) Volunteering, and Thee Longitudinal Outpatient Orientation Clerkship (LOOC) RESULTS: As SEP scores were well above 90% for all students and no significant findings were discovered in our initial box plots, it was dropped from further analyses. Our box plots suggested a positive association of OSCE CIS and ICE subcomponent scores taking the MOSCE. This association proved to be statistically significant by linear regression, multivariable regression, and multivariable analyses. There was insignificant association of OSCE exam with participation in an SRFC by Chi Square analysis. These results may have been insignificant due to insufficient study power. CONCLUSION: Based on these results, it appears that taking the Mock OSCE examination is associated with improved student performance in both the CIS and the ICE subcomponents of the OSCE. In light of these findings, we suggested making the Mock OSCE more widely available to all UTSW students for the 2018 administration of the exam.Item A Look into the Future(1953-07-25) Aagaard, George N.Item [News Item](1953-06-11) Aagaard, George N.Item [News Item](1952-12-15) Aagaard, George N.Item [News Item](1953-02-26) Aagaard, George N.Item [News Release](1952-12-03) Aagaard, George N.Item [News Release](1952-12-03) Aagaard, George N.