Promoting a Sense of Belonging Among Underrepresented Medical Students Through Cross-Cultural Programming

Background and Hypothesis: Despite improvements in recruiting trainees from underrepresented backgrounds, there is a paucity in programming designed to enhance underrepresented in medicine (URM) students’ sense of belonging and well-being. In addition to academic stressors, URM students may experience discrimination and stereotype threat, all of which contribute to burnout. Although Indiana University School of Medicine is one of the largest and more diverse medical schools in the country, URM students continue to experience disconnectedness from peers, mentors, and faculty from URM backgrounds due to the regional campus model. To address the complex challenges URM students face, the Cross-Cultural Student Success Retreat (CCSSR) was created. We hypothesize that URM students will feel an increased sense of belonging through participation in the retreat. Project Methods: The CCSSR was developed in partnership between Medical Student Education and the Office of Diversity Affairs as a response to concerns of isolation and burnout among URM students. The program is designed to be cohort style where day-long events take place twice an academic year to engage students with minority faculty and activities designed to promote sense of belonging, retention, and success. The retreat is broken into four sessions; self-discovery, self-efficacy, bias/perception, and well-being. Each of the sessions includes a presentation, discussion, and activity. Results: The retreat was found to be a success, with positive responses received from 36 participants across each session. Outcomes included an increased awareness of personal biases and prejudices, heightened sense of belonging among peers, and a feeling of empowerment to make their environment more inclusive. Conclusion and Potential Impact: The positive outcomes of the retreat strongly suggest a need to implement long and short-terms programs catering specifically to the success of URM students. Ultimately, addressing the specific challenges faced by URM students will decrease rates of burnout and isolation among this population.

Exploring how national educational organizations can promote educational research amongst members: a survey-based study

Background: Engagement of academic faculty in research remains low. While barriers to research have been explored, there are no data on how national organizations can help overcome these barriers. Our study explored faculty satisfaction and motivational drivers for engagement with research opportunities offered by the Council on Medical Student Education in Pediatrics (COMSEP), an organization of pediatric medical educators, and characterize strategies perceived by faculty to promote the use of these opportunities.Methods: In 2021, 5 survey questions were administered to faculty members of COMSEP to explore satisfaction with COMSEP’s research offerings, the perceived value of educational research, and the facilitators, barriers and potential opportunities for COMSEP to promote research. Clark’s Commitment and Necessary Effort model on motivation served as the theoretical framework for our study, which explores motivation, self-efficacy and contextual factors influencing individual’s pursuit of goals. Chi-square analysis and Wilcoxon Signed Ranks Test were used to compare categorical and scaled variables among groups who did and did not avail of COMSEP’s research offerings.Results: 90 (25%) of 360 recipients responded. Sixty-one percent expressed satisfaction with COMSEP’s research offerings. Sixty-eight percent indicated research was an expectation of their academic appointment, that education was their primary research focus (74%) and that they did not have other research opportunities that met their needs (58%). Of respondents, 75.7% of females had submitted a proposal versus 60% of females who had not. The comparison by gender was not statistically significant. Exploration by academic rank revealed that 35% of instructor/assistant professors had submitted a proposal compared to 65% of associate professors/professors (p=.05). Barriers leading to non-submission to any of the offerings included having too much other work, lack of enjoyment in writing and inability to find mentors. Respondents endorsed the importance of several strategies to promote engagement in research-skill building opportunities, personalized consultations and increased funding. Conclusions: Faculty educators value the importance of educational research and recognize that research opportunities offered by COMSEP address an unmet need, but express ambivalence in the enjoyment of writing (reflecting their mood), and endorse structural barriers, that are amenable to change, affecting their personal agency.

The perceived impact of the Covid-19 pandemic on medical student education and training – an international survey

Background The Covid-19 pandemic led to significant changes and disruptions to medical education worldwide. We evaluated medical student perceived views on training, their experiences and changes to teaching methods during the pandemic. Methods An online survey of medical students was conducted in the Autumn of 2020. An international network of collaborators facilitated participant recruitment. Students were surveyed on their perceived overall impact of Covid-19 on their training and several exposure variables. Univariate analyses and adjusted multivariable analysis were performed to determine strengths in associations. Results A total of 1604 eligible participants from 45 countries took part in this survey and 56.3% (n = 860) of these were female. The median age was 21 (Inter Quartile Range:21–23). Nearly half (49.6%, n = 796) of medical students were in their clinical years. The majority (n = 1356, 84.5%) were residents of a low or middle income country. A total of 1305 (81.4%) participants reported that the Covid-19 pandemic had an overall negative impact on their training. On adjusted analysis, being 21 or younger, females, those reporting a decline in conventional lectures and ward based teaching were more likely to report an overall negative impact on their training (p ≤ 0.001). However, an increase in clinical responsibilities was associated with lower odds of participants reporting a negative impact on training (p < 0.001). The participant’s resident nation economy and stage of training were associated with some of the participant training experiences surveyed (p < 0.05). Conclusion An international cohort of medical students reported an overall significant negative impact of the Covid-19 pandemic on their undergraduate training. The efficacy of novel virtual methods of teaching to supplement traditional teaching methods warrants further research.

Cross-Sectional Survey of Students and Instructors on Virtual Dermatology Teaching in a Competency-based Format

Background Due to the COVID-19 pandemic in the Spring of 2020, the dermatology rotation at the Penn State College of Medicine was converted into a 4-week virtual format. Given these rapid changes, we aimed to assess student and instructor satisfaction to the virtual course and if the course fulfilled the six ACGME core-competencies for medical student education required in a traditional teaching format. Methods We conducted a cross-sectional study to assess PSCOM student and instructor satisfaction to the elective. Surveys specifically inquired about course learning objectives, interaction, and teaching in the virtual setting based on a 5-point Likert scale and asked to provide qualitative feedback. Results Medical students (n=15, response rate=52%) were satisfied with learning objectives geared towards the ACGME core competencies in five of the six competencies. Instructors (n=7, response rate=58%) reported satisfaction with convenience, university support, and technical training, but less with student-to-student interaction, gauging comprehension, and fostering critical thinking. Qualitative feedback reflected these results. Conclusions From our survey data, students and instructors were generally satisfied with the virtual rotation’s dermatology teaching during the uncertain times of the COVID-19 pandemic and holds potential to expand dermatology education, with a future focus on improving student engagement in a virtual format.

Curricular Recommendations for a National Family Medicine Subinternship: A Qualitative Analysis From Multiple Stakeholders

Background and Objectives: The 2011 Alliance for Clinical Education panel recommended the development of a specialty-specific curriculum for all subinternships (sub-Is). A 2019 CERA survey found that 58% of family medicine clerkship directors agreed that a standardized curriculum would be helpful. The goal of this study was to explore attitudes and preferences regarding a national family medicine sub-I curriculum among a broad set of stakeholders. Methods: Focus groups were conducted with medical students, residents, residency faculty, and undergraduate medical education faculty at the 2020 STFM Conference on Medical Student Education. Focus groups were transcribed, and a qualitative analysis was conducted with participants’ responses about the benefits and characteristics of a family medicine sub-I, recommendations for core sub-I skills/objectives, likelihood of using a national curriculum, and preferred student and program evaluation methods. Results: There were four focus groups with a total of 24 participants. The following main themes emerged: the family medicine sub-I has distinctive characteristics from other sub-Is and provides unique benefits for students and residency programs, a standardized curriculum should allow for adaptability and flexibility, and the sub-I evaluation for the students and program should be specific and experience-focused. These themes were classified into specific subthemes. Conclusions: The stakeholder emphasis on themes of uniqueness, adaptability, and specificity within evaluation will help educators structure a comprehensive framework for national recommendations for the sub-I curriculum. A well-designed family medicine sub-I may provide rigorous educational training for students and may also encourage career commitment to the discipline.

SP2.2.9Using high fidelity simulation to improve hospital-based medical student education

Introduction The evidence shows that experiential learning has multiple benefits in preparing medical students for foundation training. An immersive ‘on call simulation’ session was designed for final-year medical students at a district general hospital. The aim of this project was to assess how beneficial the sessions were and how they can be improved. Methods Pairs of students received 12 bleeps over 2 hours directing them to wards where mock patient folders were placed. Students prioritised bleeps involving deteriorating patients, chasing results and dealing with nursing queries. Simulated senior input was available from the session facilitator. A structured debrief session allowed discussion of each case. Quantitative feedback was gathered using a sliding scale (measured in percentage) for confidence before and after the session. Qualitative feedback was gathered using a free-text box. Results Four sessions were held between October 2020 and January 2021 for a total of 28 students, of which 26 provided feedback. Average confidence increased from 38% to 66%. 96% of students were ‘extremely satisfied’ with the session. Feedback included: “Incredibly immersive and fun” and “I was made to think through my priorities and decisions”. Improvements could be made by using actors/mannequins to simulate unwell patients and by use of skills models. Conclusion High fidelity simulation training is valuable and should be considered a standard part of the student curriculum. It is particularly suited to final year students who have the required clinical knowledge for foundation training but are still developing confidence in clinical decision making and prioritisation.

The Utility of PathElective.com as a Curricular Adjunct in Laboratory Medicine Education

Introduction/Objective PathElective.com was founded as a means of combating stagnating resident and medical student education due to halting of in-person educational activities during the COVID-19 pandemic. The site has since grown to be included in medical student and resident training programs at numerous institutions across the world, serving as a unique means of delivering high-quality and trackable laboratory medicine education. Methods/Case Report The PathElective website was developed using Squarespace, video lectures were recorded by each professor or sourced from openly available web resources incorporating virtual slides, reading assignments, or relevant podcasts at the course director’s discretion. Monthly website traffic data were obtained through Squarespace analytics for the first 11 months of the website being available (May 1, 2020, to April 22, 2021). Geographic and source data were obtained through deidentified IP address analysis built-in to Squarespace analytics. Students who registered to take the online courses were assessed before and after interacting with the course materials using a dual form crossover quiz design to prevent memorization of questions and assess comprehension. Quiz data were all anonymous and improvement was determined using a paired t-test. Comparisons between courses were made via percentage improvements. Results (if a Case Study enter NA) Over the tracking period, PathElective.com received 352,012 page views, 73,550 visits, 33,225 unique visitors, and accrued 5,815 registered users. Most of the visitors (72.8%) arrived at the site via a direct URL input, 14.9% through a search engine, and 10.6% through social media. Most visitors were from the US (43.8%) or India (11.9%). With a total of 1598 test pairs being analyzed from all clinical pathology modules, the average increase in score was 14.4% (95%, CI=10.3-18.6, p=0.0052). All courses experienced a statistically significant increase in scores except for Clinical Chemistry lesson 3.2 (7%, -1.8-15.9% CI, p=0.12). Courses were well received with a median satisfaction score was very satisfied in all six assessment categories. Conclusion PathElective.com is a free and effective means of enhancing clinical pathology training in medical education. Students liked the online format, the quality of the lectures, and course faculty, and felt they could get help if needed. An area of improvement for this platform would be the interaction with students on social media.