We are delighted to announce the awardees for the thirteenth annual Innovations in Education Intramural Grants program.
Peter Croft, MD1; Rebecca Lufler, PhD2
1Maine Medical Center, 2Tufts University School of Medicine
“Integrating Ultrasound into the First-Year Medical Curriculum”
Combined and integrated learning has become more pervasive throughout undergraduate medical education (UME) in recent years. Part of this phenomenon is the advent and availability of technology at the level of the patient. This allows for the union of both diagnosis and therapy. At its core, bedside ultrasound achieves this goal - provision of visual, instantaneous information for both the practitioner and the patient. The introduction of ultrasound imagery and acquisition will play a vital role in the future lives of our medical students. This study will address this venture at the level of Clinical Anatomy and the Physical Diagnosis courses. Ultrasound (US) will be incorporated into these courses in the form of brief informational videos and activities within laboratory sessions. Students will be able to correlate their anatomical dissections with US images in the anatomy laboratory and then practice acquiring images during the physical diagnosis labs. The effectiveness of this initiative will be assessed using both quantitative and qualitative measures, including exam questions, and survey items elucidating students’ perceptions of skills and confidence. This project aims to deliver a resourceful and more interactive clinical approach to first-year medical students with the inclusion of focused, bedside ultrasound applications.
Peggy R. Cyr, MD, MS; Julie Schirmer, LCSW; Corinn Martineau, Pharm D; and Vicki Hayes, MD, Maine Medical Center
“Incorporating Interprofessional Standardized Patient Experiences into the TUSM 3rd Year Clinical Skills Interclerkship Day”
Interprofessional education (IPE) is a critical and central aspect to training today’s physicians. Medical students who learn with, from and about learners from other disciplines have been shown to develop skills and habits that create more effective and safe health care teams. 1 It is often technically challenging to create IPE learning situations for students. We propose to develop and pilot two interprofessional scenarios into the Clinical Skills Interclerkship (CSI) for third year medical students, using student “confederates” from other disciplines. A confederate is an “individual other than the patient who is scripted in a simulation to provide realism, additional challenges, or additional information for participants.” 2 Students will meet with confederate learners from social work and pharmacy and then with the patient and family member(s) to develop and implement a treatment plan. The two scenarios will focus on chronic pain and end of life care, both high stress, complex situations which require interprofessional teamwork.
Participating students will complete pre and post scales measuring team skills (Team Skills Scale) and perceptions (Interdisciplinary Education Perception Scale). Feedback will be guided by an observational checklist of teamwork behaviors and skills (Individual Teamwork Observation and Feedback Tool). We anticipate showing improvements in students’ teamwork behaviors and skills over time, as more interprofessional activities get built into the Tufts curriculum. Our final product will be a TUSM medical student who is inspired to continually increase their IPE knowledge and skills throughout the rest of their medical school education.
Jeffrey K. Marchant, PhD; Robert F. Willson, PhD, Tufts University School of Medicine
“Student-driven small-group learning: the use of student “group leaders” in the gross anatomy laboratory”
Learning gross anatomy is a fundamental prerequisite for medical students and one that represents a particularly difficult challenge given the volume of material that must be mastered. Our experience has been that the current preparation materials for the lab are insufficient and most students arrive unprepared and unsure of what to do. Consequently, the material is not learned efficiently and long-term retention is low, a problem often cited in the clinic. Our proposal offers a two-tiered solution that we believe will significantly improve learning and long-term retention.
First, high quality videos of dissections will be prepared that carefully describe the anatomy and relevant clinical correlations. The videos will offer: 1) a description of the dissection that had been done and note any problem areas or anatomical variations; 2) dissection techniques that will yield the best results and 3) a review of the material, noting names, muscle origins/insertions as appropriate, innervation, blood supply and clinical relevance. Second, a student at each table will be assigned as a “Group Leader” (GL). The GL will use the videos, and other materials on TUSK, to become as prepared as possible prior to the dissection and then guide their table through it. A given student would have this responsibility two times during the course, each time for back-to-back laboratories. This wouldn’t necessitate that they do the dissecting but they would be responsible for getting everyone up to speed, essentially serving as the facilitator for "small-group learning”.
We will assess the effectiveness of the videos and GLs by comparing test results between tables that had GLs vs those that did not. Additionally, we will assess individual performance on exams when students served as a GL vs when they did not. We anticipate the assessment results may reveal a trend, i.e. increased scores in the tables with GLs and for students while serving as a GL.
Shira Pedan, MD; Mary Brown, MD, MS; Tufts Medical Center
"Training Medical Students to Effectively Communicate an Initial Consultation Request: A Study to Evaluate the Effectiveness of an Online Lecture and a In-Person Workshop"
Consultation occurs in a variety of medical settings in order to improve the quality of patient care. Poor communication during this process may lead to medical errors, delay in appropriate medical care, and decreased patient satisfaction. The AAMC recognizes that the skills needed to provide an effective consultation request should be acquired before the start of residency. However, formal education on requesting a consultation during medical school is rare.
The purpose of this project is to educate and train 3rd year medical students on how to perform an effective initial consultation request and increase student confidence when requesting a consult. Using a flipped classroom design, the primary intervention group will view an online lecture and participate in a in-person workshop. The secondary intervention group will only view the online lecture and the control group will not participate in any formal training. The interventions will be evaluated by pre- and post- clerkship surveys and by the student’s performance on a consult request simulation exercise.
We hypothesize that any formal training will increase confidence and knowledge in requesting a consult and lead to superior communication during the simulated consult exercise — with the greatest benefit to be seen in the primary intervention group. If effective, the curriculum may be expanded to include the entire third year class helping Tufts University students prepare for residency, fulfill AAMC requirements, and ultimately improve patient care.
Debra Sepulveda MD, MPH; Kalli Varaklis, MD, Maine Medical Center
“Design and Implementation of a Multifaceted Quality Improvement and Patient Safety Curriculum”
Literature supports the clinical clerkship as an optimal setting for quality improvement and safety curriculum, yet effective models are lacking. Our own experience with Tufts medical students within our obstetrics and gynecology clerkship indicates that students would benefit from a quality and safety curriculum integrated within the clinical setting.
The goal of this project is to implement a multifaceted quality improvement and patient safety curriculum bundle for students within the obstetrics and gynecology clerkship, with a “teach- the- teacher” component for faculty and residents. Delivery methods for the curriculum and deliverables for the project include: online modules with case application of concepts, review articles, a flipped classroom approach, self-education guides and Direct Observation Cards (DOC cards) for clinical application, an OSCE, a “teach-the-teacher” workshop for faculty and residents, and a guide for facilitators of focus groups. The entire curriculum and evaluation will be packaged on an on-line learning platform, ‘Canvas’, which will facilitate adoption by other specialty clerkships. The final curriculum bundle will include direction for application to other specialty clerkships and a framework for integration within a broader, four year overview of quality and safety concepts.