University of Wisconsin–Madison Medical College of Wisconsin

Proceedings from the 2022 Medical College of Wisconsin Innovations in Healthcare Education Research Annual Conference

WMJ. 2023;122(2):149-151.

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The following award-winning abstracts were presented during the 9th Annual Medical College of Wisconsin (MCW) Innovations in Healthcare Education Research (IHER) Annual Conference on September 20-22, 2022. Health care educators and researchers from MCW and other national institutions meet annually at IHER to present their research and innovative ideas and to learn from one another about the new and creative approaches to educating students and residents. The 3-day conference includes nationally recognized keynote speakers, panel sessions, workshops, roundtables, oral presentations, and posters which can be viewed at https://www.mcw.edu/IHER2022. Two-hundred ninety-five participants hailed from 31 states and 7 countries. The winning oral presentations and posters in the research and innovations categories are published below.

Best Oral Presentation – Innovations

Using Personal Narrative as Foundation for Health Equity Education: Creating a Curriculum on Asian American, Native Hawaiian, and Pacific Islander Health

Ming Lin, MS; Joyce H. Lee, MS; Iaong Vang, Lana Minshew, PhD; Kajua Lor, PharmD

Problem Statement: Within health education (eg, medicine, pharmacy, nursing, dentistry, etc), there are currently limited opportunities for educating and training learners on Asian American/Native Hawaiian/Pacific Islander (AANHPI) health and health disparities. As more institutions continue to voice commitment towards greater diversity, inclusion, and cultural competency in curricula, spaces also must be created deliberately for AANHPI voices. Additionally, nationally there is currently no established curriculum or educational framework tailored to trainees at health professions schools on AANHPI health. Prejudices, biases, xenophobia, and microaggressions toward AANHPIs continue to persist. It is imperative to increase visibility, inclusion, and action for advocating for AANHPI health as part of anti-racism efforts at health institutions, as well as in the greater fight towards true health equity.

Approach: In response to current gaps in health education on AANHPI health and health disparities, our team developed the “Health Advancement for Asian Pacific Islanders through Education” (HAAPIE) Initiative in 2021. Curriculum development proceeded through 3 main phases. First, our team established the values, objectives, and educational framework for learning and evaluation by exploring our experiences as AANHPIs and the narratives of the broader community. We determined the 2 main goals of increasing knowledge of AANHPI health issues and building cultural humility towards AANHPIs. Second, curriculum content utilized the cultural intelligence framework1 to present information through the lens of history and intersectionality. Third, through purposeful collaboration with AANHPI communities and organizations, we continually refine and develop content that is relevant and practical.

Lessons Learned: Providing the historical context behind the social, political, and health issues faced by diverse AANHPIs served as an effective starting point for learners. Educational materials aimed to be varied, integrative, interactive, and purposefully equitable, which were appreciated by learners. We utilized case studies as a window to broader concepts, such as intersectionality, microaggressions, health literacy, and other social determinants of health. We highlighted AANHPI populations that faced inequities within the broader community. Learner evaluation consisted of self-reflection: “what do I currently know,” “how do I put this to practice,” and “what did I learn?” While Google Classroom was feasible, it had barriers for accessibility and presentation and organization of materials. Learners encouraged information be presented through more engaging ways than PowerPoints.

Significance: With only 0.17% of total National Institutes of Health funding dedicated to AANHPIs,2 this population continues to be highly overlooked in health care. HAAPIE is the first comprehensive curriculum of its kind nationally on AANHPI health, which may provide a useful framework for future work in health equity education.

References
  1. Minshew LM, Lee D, White CY, McClurg M, McLaughlin JE. Cultural intelligence in pharmacy education: understanding student experiences. Am J Pharm Ed. 2021; 85(9):8580. doi:10.5688/ajpe8580
  2. Ðoàn LN, Takata Y, Sakuma KL, Irvin VL. Trends in clinical research Including Asian American, Native Hawaiian, and Pacific Islander participants funded by the US National Institutes of Health, 1992 to 2018. JAMA Netw Open. 2019;2(7):e197432. doi:10.1001/jamanetworkopen.2019.7432.

Author Affiliations: School of Medicine, Medical College of Wisconsin (MCW), Milwaukee, Wisconsin (Lin, Lee, Vang); School of Pharmacy, MCW, Milwaukee, Wis (Minshew, Lor).

Best Poster Presentation –  Innovations

Seeking Peer Outreach: An Integrated, Tiered Approach to Address Stigma and Isolation in Medical Education

Molly Thapar, BS; Omeed Partovi, BS; Andy Petroll, MD, MS; Himanshu Agrawal, MD; April Zehm, MD

Problem Statement: It is well established that early communication and clinical competency training is a crucial ingredient in creating an outstanding physician.1,2 Despite this evidence, interpersonal skills training is still undervalued and underrepresented within undergraduate medical education, especially at the preclinical level.2,3 While the Medical College of Wisconsin (MCW) offers much-needed communication training for difficult patient encounters in the form of a fourth-year elective course, there are currently no options available that train preclinical medical students to conduct difficult conversations. By the time medical students reach their clinical rotations in their third year, most have not witnessed, and therefore do not possess, the skills to properly address an uncomfortable or difficult situation. The lack of training also fosters anxiety and fails to build students’ self-efficacy prior to clinical encounters.

Approach: In academic year 2021-2022, two cohorts of preclinical MCW medical students voluntarily participated in our semester-long extracurricular program, Operation Conversation (OC). Each OC participant attended 3 once-monthly virtual workshops. Students were assigned in pairs and grouped with a MCW faculty/resident facilitator who observed the student roleplays and provided immediate feedback. The roleplaying student physician, the roleplaying student patient, and the physician facilitator completed the same validated assessment tool to evaluate the student physician’s performance. Following each workshop, students completed a self-reflection survey on their performance. After finishing the final workshop, participants completed a program evaluation survey. Data analysis is ongoing. We plan to discuss findings with the Kern Institute and develop a program manual for dissemination to other institutions.

Lessons Learned: Twenty-eight students and 14 facilitators attended the Fall 2021 program. Thirty-six students and 18 facilitators attended the Spring 2022 program, including some repeat participants. Attendance at workshops neared 100%.

After the final fall workshop, 22 out of 42 of participants (52%) submitted program evaluations. On preliminary analysis, 3 distinct findings were noted. First, nearly all participants (95.5%) said they would recommend the program to future students. Second, participants noted the best parts of the program to be skill development and sense of community within their groups. Finally, participants offered insightful critiques on all aspects of the program: scripts, learning materials, workshop format, and small-group cohesion. Further analysis of the communication assessment tool and student self-reflections from both semesters will determine OC’s efficacy in building communication skills.

Significance: Despite known importance, interpersonal skills training is not prioritized in undergraduate preclinical curricula. Addressing this gap through the use of active roleplay, spaced learning, and reflection has applicability for MCW curriculum improvement, in addition to medical curricula elsewhere.

References
  1. D’Souza PC, Rasquinha SL, D’souza TL, Jain A, Kulkarni V, Pai K. Effect of a single-session communication skills training on empathy in medical students. Acad Psychiatry. 2020;44(3):289-294. doi:10.1007/s40596-019-01158-z
  2. Sahu PK, Chattu VK, Rewatkar A, Sakhamuri S. Best practices to impart clinical skills during preclinical years of medical curriculum. J Educ Health Promot. 2019;14(8):57. doi:10.4103/jehp.jehp_354_18
  3. Meyer EC, Seller DE, Browning DM, McGuffie K, Solomon MZ, Truog RD. Difficult conversations: improving communication skills and relational abilities in health care. Pediatr Crit Care Med. 2009;10(3):352-359. doi:10.1097/PCC.0b013e3181a3183a

Author Affiliations: School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Thapar, Partovi, Petroll, Agrawal, Zelm).

Best Oral Presentation –  Research

Institutional Strategies to Combat Hospitalist Burnout and Improve Wellness

Komal Khoja, BA; Marie Luebke, MHS; Mohamed Abdelrahim, MA; Parsia Vazirnia, BS; Brian Quinn, MD; Muhammad Hammad, MD; Pinky Jha, MD

Introduction: Over 50% of practicing physicians in the United States report burnout, with internal medicine displaying some of the highest rates. There has been limited research on the impact of the COVID-19 pandemic on the psychological well-being of hospitalists. Our study seeks to assess wellness strategies and institutional recommendations to reduce burnout among frontline providers.

Methods: Academic hospitalists at Froedtert Hospital and the Medical College of Wisconsin were recruited to participate in qualitative focus groups conducted via Zoom during February 2022. We utilized a question guide developed by the research team, which covered contributors to burnout, the impact of COVID-19, and strategies to improve wellness. We conducted 4 focus groups with 21 hospitalists in total. These sessions were audio-recorded, transcribed, and coded for emergent themes by a team of medical students using Taguette, an open-source qualitative data analysis software.

Results: A ubiquitous theme to combat burnout was increasing social interactions to allow providers to share experiences and seek guidance from one another. Specific suggestions included a workroom with windows, increased space, refreshments, and comfortable seating. It was also noted that space constraints have led to new hires being scattered, further increasing isolation. Suggestions for social interactions outside of work included a retreat, arranging activities for like-minded people, and holiday parties. Another emergent theme included providing avenues for 2-way communication between leadership and providers to share concerns and illicit feedback, allowing providers to feel more empowered.

Conclusions: Hospitalist burnout has been a prevalent issue prior to the onset of the COVID-19 pandemic. As the pandemic continues, the ongoing social isolation and lack of effective communication between providers and leadership contribute to further fatigue and frustration, which may worsen burnout. Enhancing community and fostering collaborative decision-making may positively impact the well-being of frontline hospitalists and reduce burnout.

Significance: Investigating changes in the mental health of hospitalists is crucial due to the ever-evolving COVID-19 burden. Our results may be useful in guiding institutional programs to mitigate burnout.


Author Affiliations: School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Luebke, Abdelrahim, Vazirnia, Quinn, Hammad, Jha).

Best Poster Presentation – Innovation

Mentee Feedback from a Year in Review of F1-Doctors: A National Student-Led Platform for International Pre-Health Students

Gopika SenthilKumar; Kalina Tenorio L. Machado; Salvatore Capotosto; Deepali Bhalla; Rachel Jaber Chehayeb; Nicole Belliard Martuscelli; Abubakr El Sobky; Zezhou (Zach) Zhao; Salome Da Silva Duarte Lepez; Matheus M. S. Peraci

Introduction: International students interested in health sciences have limited availability to mentorship and trustworthy resources and face unique numerous challenges in the United States1. F1Doctors (https://www.f1doctor.com/) is the first national, student volunteer-led, online platform that connects undergraduate students with international medical students (M1-M4 students on a F1 visa), residents, and attending physicians in the US. The F1Doctors website also features reliable resources on universities that accept international students, funding/loan options, application requirements, etc. F1Doctors is maintained and overseen by a board of volunteer students, who not only keep the website updated and ensure effective communication between mentors and mentees, but also (1) host panel events with premed offices throughout the country; (2) collate stories for the F1Doctors podcast; (3) maintain an active social media presence featuring Q&As, Instagram Live events, and short infographics; (4) host virtual events to engage mentors and create a sense of community; and (5) disseminate surveys to assess the platform’s benefits and areas of improvements. This study analyzes mentee feedback after a year of the platform’s existence.

Methods: An open-response survey asking mentees about “the best part of their experience” and “areas to work on” was distributed through mailing lists and social media. Responses were deidentified. Two independent reviewers conducted a thematic analysis of responses. This methodology was selected to overcome response biases due to language concerns and/or differences in cultural interpretations of pre-drafted statements.

Results: Of the 115 students who responded, 73% sought out mentors for MD applications. The remaining were interested in MD-PhD, DO, residency, and dentistry. Forty-two percent of responses identified “positive attributes of their mentor’s personality” as one of the best parts of their experience. Thirty-four percent mentioned “relating to mentors/mentors sharing their own experiences” 21% mentioned “getting helpful/useful premed advice,” and 9% mentioned “feeling a sense of community.” Fifty-seven percent of mentees said there were no areas for improvement. The remaining responses suggested topics for resources on the website and highlighted the need for ensuring timely response from mentors.

Conclusion: F1Doctors is well-received by mentees, and it is effective at proving relatable mentorship and creating a national community for international students interested in graduate health programs. The results of this survey will be used to guide future improvements and research directions for the platform..

Reference
  1. Jaber Chehayeb R, SenthilKumar G, Saade Z, Gallo Marin B, Aghagoli G, Virji AZ. Examining the first peer-to-peer mentorship program (F1Doctors) for international medical students. J Interdiscip Stud Educ. 2022;16(1):102-125.

Author Affiliations: School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (SenthilKumar); Emory University School of Medicine, Atlanta, Georgia (Machado); Renaissance School of Medicine, Stony Brook, New York (Capotosto); Yale School of Medicine, Yale University, New Haven, Connecticut (Chehayeb); Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (Martuscelli); Connecticut College, New London, Connecticut (El Sobky); Harvard Medical School, Boston, Massachusetts (Zhao); Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Lepez); Touro College of Osteopathic Medicine, Middletown, NY (Peraci).
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