Didactic Sessions Research Articles

Expanding a Regional Sickle Cell Disease Project ECHO® to Rapidly Disseminate COVID-19 Education.

PurposeHealthcare providers faced numerous knowledge gaps and challenges with adapting practice behaviors in light of the COVID-19 pandemic. In response, an established virtual sickle cell disease (SCD) telementoring program rapidly expanded from monthly evidence-based didactic sessions focused on medical and psychosocial complications of sickle cell disease, to additional supplemental COVID-19 sessions with emerging pandemic topics and forums for shared experiences to address this timely educational need among multidisciplinary healthcare providers.MethodsIn March 2020, the COVID-19 and Sickle Cell Disease Project ECHO® telementoring series was launched with a rapidly evolving curriculum of contemporary topics and case presentations. Topics included COVID-19 specific management for children and adults with sickle cell disease and strategies to adapt care and communication during the pandemic. Participants completed evaluations after each session.ResultsFrom March 2020 to February 2022, there were 20 COVID-19 and SCD Project ECHO® sessions held with an average of 43 participants per session, which is over a 170% increase from the average SCD ECHO monthly attendance pre-pandemic. Participants represented 21 states and 3 countries. A majority of participants (91%) self-reported significantly improved knowledge of COVID-19.ConclusionProject ECHO® is a successful educational strategy to diffuse knowledge using a virtual platform during a public health emergency, by facilitating shared learning among a community of practice that specializes in the management of sickle cell disease.

A Peer-to-Peer Suicide Prevention Workshop for Medical Students.

IntroductionAn estimated 11% of medical students experience suicidal ideation during medical school. Many medical schools teach students how to intervene on behalf of patients experiencing suicidal ideation, but no curriculum in MedEdPORTAL teaches students how to intervene on behalf of peers.MethodsThe authors designed, implemented, and evaluated a 2-hour workshop to equip medical students with skills and resources to intervene on behalf of a peer in crisis. This workshop comprised a peer-led didactic session and small-group sessions with role-plays and a guided debrief. The resource included a slide deck for the didactic session, a facilitator guide for the small-group session, a student handout with role-plays and self-evaluation questions, and the pre-/postsurvey.ResultsThis workshop was conducted with cohorts of first- and second-year medical students (n = 273) in October and November 2019. Pre-/postsurveys showed the greatest improvements in suicide prevention knowledge (self-rated) and the confidence in and likelihood of asking peers about suicide.DiscussionStudent feedback indicated that the most valuable parts of the workshop were the peer-led nature of the didactic session, the perspective of a peer's lived experience, and the role-plays. Opportunities for improvement included the scheduling of the session, the potentially triggering nature of the role-play exercises, and the importance of enabling students to opt out discreetly. A version of this workshop is now a permanent part of the first-year curriculum at our institution.

Assessment of an intensive education program for pharmacists on treatment of tobacco use disorder using an objective structured clinical examination: a randomized controlled trial

BackgroundTobacco use is one of the major public health threats globally. Community pharmacists are uniquely positioned to offer tobacco cessation services owing to their easy accessibility by the public. To prepare Qatar community pharmacists to develop the competencies and skills required to offer smoking cessation services, an intensive tobacco control education program was designed and implemented. The study aimed to assess the impact of the tobacco education program on the pharmacists’ skills and competence.MethodsA random sample of community pharmacists in Qatar was chosen for participation in the program. Consenting participants were randomly assigned to either intervention or control groups. The intervention group received an intensive education program on treatment of tobacco-use disorder, while a short didactic session on a non-tobacco-related topic was delivered to the control group. The pharmacists’ tobacco cessation skills and competencies were assessed using an Objective Structured Clinical Examination (OSCE).ResultsA total of 54 and 32 community pharmacists in the intervention group and the control group, respectively, completed the OSCE. The intensive tobacco education group achieved significantly higher total scores than the control group in all the OSCE cases. Specifically, the mean total scores for the intervention group were 15.2, 15.3, 14.2, 14.6, 16.3, and 15.2 compared to 8.8, 6.2, 7.7, 9.2, 8.3, and 11.3 for the control group (p < 0.001) for cases one to six respectively.ConclusionThe study demonstrated that an intensive tobacco cessation education program can improve pharmacists’ tobacco cessation skills and increase their tobacco cessation counseling abilities.Trial registrationClinical Trials NCT03518476 (https://clinicaltrials.gov/ct2/show/NCT03518476) Registration date: May 8, 2018.

Should Radiological Assessment be Part of Core General Surgery Competency? A Survey of the General Surgery Residents.

Radiological assessment is an important skill to develop in general surgery training. Therefore, we aimed to determine general surgery residents' points of view on receiving formal radiology didactics. We performed an anonymous survey of general surgery residents throughout the USA. The survey queried the residents' postgraduate year, training program type, diagnostic radiology education in their training program, as well as the residents' comfort level in interpreting various imaging modalities, followed by a series of images to assess the residents' ability to interpret images showing various surgical disease processes. A total of 365 residents responded to the survey. In total, 76.6% of the respondent states that there is no structured didactic session in their program on radiological studies. However, 66.3% felt that interpretation of radiological images should be used to determine surgical competency and promotion to the next academic year. In terms of accurately reading images-68.7% of the residents were able to read an X-ray showing cecal volvulus correctly, 51.9% were able to read a cholangiogram correctly, and 95.3% were correctly read an X-ray showing free under the diaphragm. Most residents favored having radiological assessments as part of the competency evaluation. Furthermore, a curriculum and inbuilt training structurethat aimsto ensure residents develop competentclinicalimage interpretationabilitiesmay enhance the development and retention ofsuchskills, ultimately influencing patient outcomes.

Reuniting Long Lost Cousins: a Novel Curriculum in Imaging Informatics for Clinical Informatics Fellows.

We developed a curriculum of imaging informatics for clinical informatics fellows. While imaging informatics and clinical informatics are related fields, they have distinct bodies of knowledge. The aim of this curriculum is to prepare clinical informatics fellows for questions regarding imaging informatics on the clinical informatics board certification examination, prepare fellows to handle issues and requests involving imaging informatics in their future roles as clinical informaticists, and develop sufficient knowledge and skills in order to interface with imaging and radiology domain experts. We mapped ACGME core competencies for clinical informatics and the clinical informatics skills and attributes to topics covered in this curriculum. Topics covered included orders vs. encounter-based workflow, understanding imaging informatics operations and the differences between an IT department leading digital image management and the radiology department, clinical decision support for radiology, procuring and integrating new modalities into a PACS system, troubleshooting slow application performance in a PACS environment, imaging sharing, artificial intelligence (AI) in imaging including AI bias, validation of models within home institution and regulatory issues, and structured reporting vs. Natural Language Processing to mine radiology report data. These topics were covered in interactive didactic sessions as well as a journal club. Future work will expand to include hands-on learning and a formal evaluation of this curriculum with current fellows and recent graduates.

Pilot Trial of Online Measurement Training and Feedback in Family Therapy for Adolescent Behavior Problems

ABSTRACT Objective Pragmatic procedures for sustaining high-fidelity delivery of evidence-based interventions are needed to support implementation in usual care. This study tested an online therapist training system, featuring observational coder training and self-report fidelity feedback, to promote self-report acumen and routine use of family therapy (FT) techniques for adolescent behavior problems. Method Therapists (N = 84) from nine substance use and mental health treatment sites reported on 185 adolescent clients. Therapists submitted baseline data on FT technique use with clients, completed a workshop introducing the 32-week training system, and were randomly assigned by site to Core Training versus Core Training + Consultation. Core Training included a therapist coder training course (didactic instruction and mock session coding exercises in 13 FT techniques) and fidelity feedback procedures depicting therapist-report data on FT use. Consultation convened therapists and supervisors for one-hour monthly sessions with an external FT expert. During the 32 weeks of training, therapists submitted self-report data on FT use along with companion session audiotapes subsequently coded by observational raters. Results Therapist self-report reliability and accuracy both increased substantially during training. Observers reported no increase over time in FT use; therapists self-reported a decrease in FT use, likely an artifact of their improved self-report accuracy. Consultation did not enhance therapist self-report acumen or increase FT use. Conclusions Online training methods that improve therapist-report reliability and accuracy for FT use may confer important advantages for treatment planning and fidelity monitoring. More intensive and/or different training interventions appear needed to increase routine FT delivery.

A Pediatric Resident Curriculum for the Use of Health Literacy Communication Tools.

Background:Despite evidence that use of evidence-based communication tools (EBCT) with a universal precautions approach improves health outcomes, medical trainees report inadequate skills training.Objective:We developed, implemented, and evaluated a novel, interactive curriculum featuring a 30-minute, single-session didactic with video content, facilitated case-based discussions and preceptor modeling to improve use of EBCT among pediatric residents. A direct observation (DO) skills checklist was developed for preceptors to evaluate resident use of EBCT.Methods:Shortly after implementation of the curriculum, residents completed a survey assessing self-reported frequency of EBCT use both pre- and post-intervention. DOs were conducted 2 to 3 weeks after the didactic was completed and scores were compared among residents who participated in the curriculum and those who did not. A longitudinal 6-month follow-up survey was also distributed to assess changes over time.Key Results:Forty-seven of 78 (60%) of residents completed the survey and 45 of 60 (75%) of the eligible residents participated in the DO. There was significant change in self-reported use of all but one EBCT after participation in the curriculum. Residents reported sustained increased frequency of use of all communication tools except for Teach Back, Show Back, and explanation of return precautions in the 6 months following the curriculum. Notably, there was no significant difference in resident scores in the DO among residents who participated in the didactic session and those who did not.Conclusions:This novel interactive curriculum addresses ACGME (Accreditation Council for Graduate Medical Education) core competencies and fulfills a needed gap in resident curricula for health literacy-related skills training. Findings suggest a small, positive affect on frequency of self-reported use of health literacy EBCT. However, our findings demonstrate a lack of parallel improvement in resident performance during DO. Future curricula may require certain modifications, as well as reinforcement at regular intervals. [HLRP: Health Literacy Research and Practice. 2022;6(2):e121–e127.]Plain Language Summary:Use of evidence-based communication tools, such as presenting information in small chunks and avoiding complex medical terms among pediatric trainees, is limited. This study describes a new and interactive health literacy curriculum, with emphasis on preceptor modeling and DO to improve use of evidence-based communication tools among residents. After participation in the curriculum, residents report greater use of evidence-based communication tools. However, results from DO of residents did not demonstrate similar improvements.

476 Training basic researchers in translational approaches to facilitate the application of laboratory discoveries

OBJECTIVES/GOALS: To maximize health outcomes from their work, basic researchers must understand the process by which lab discoveries are translated into clinical care. We developed an academic course designed to provide students in our Clinical and Translational Sciences PhD program with an in-depth understanding of translational applications of basic research. METHODS/STUDY POPULATION: A preliminary needs assessment was done with students, educators, and clinicians to identify the course content. Based on these data, didactic modules including research question identification, research team development, participant recruitment, and research data collection were piloted in a synchronous, virtual course. Then, for 6 weeks, students shadowed clinical mentors who worked in the students research areas. Finally, with their mentors, students developed and presented clinical research protocols. Student pre- and post-course surveys gauged alignment of course objectives and learning outcomes. A post-course, focus group with students gathered feedback on course content, structure, and students confidence in implementing their experiences from the course into real-world settings. RESULTS/ANTICIPATED RESULTS: Six MD/PhD and PhD students participated in the pilot course. Pre/post-assessments (n=4) showed students were more confident in clinical question/research protocol formulation, development of patient recruitment/enrollment strategies, and integration of research methodologies into their research projects after completing the course. Students asked for additional content on budgeting and grant funding. Post-course focus group participants (n=2) appreciated the experience of writing a clinical protocol and the flipped classroom teaching style, which allowed them to network with clinical faculty leading didactic sessions. Students also noted course content was relevant and motivating, although they suggested adding content about clinical trials measures to enhance their shadowing experiences. DISCUSSION/SIGNIFICANCE: A course that combines didactic and clinical experiential training provides a robust, translational research foundation for basic scientists. This training is critical to help them contribute to the effective/efficient translation of lab discoveries to clinical practice. Future course development will include students from other PhD programs.

Case Based Learning as a Teaching Learning Tool for Microbiology

Introduction: Medical and health care related education is currently changing. In the present day scenario, didactic lectures are the main stay of teaching Microbiology in most of the medical Colleges. However didactic lecture is a teaching centered method that promotes passive learning. Active learning that integrates the knowledge of basic sciences with clinical conditions is the need of the hour. Case Based learning (CBL) is an interactive student centered approach that engages students in the process of making real world decisions.&#x0D; Aim: The present study has been planned to assess the effectiveness of case based learning as compared to traditional lecture in teaching Microbiology and also to find out the students and faculty perception on Case based learning.&#x0D; Materials and Methods: The study was conducted in the Department of Microbiology, ACS Medical College and Hospital, Chennai. Two diseases namely Hepatitis-B and Rabies were selected. Study involved 104 students from II MBBS and they were divided into two groups. Group A underwent a CBL session on Hepatitis-B and Group B had the Didactic lecture session on the same topic and the groups were crossed for the second phase on Rabies. Pre and post-test were conducted for both the groups and the results were analyzed using paired and unpaired t-test. Lastly structured feedback questionnaire on acceptability and usefulness of CBL was obtained from the students and the faculty.&#x0D; Results: The performance of the students showed a significant improvement after the CBL sessions when compared to the Didactic lecture. Majority of the students felt that CBL is better in understanding Microbiology topic.&#x0D; Conclusion: The present study shows that CBL is a better method than Didactic Lectures. Therefore CBL can be used as an adjunct to the lectures to strengthen the traditional T/L methods through active learning.

557 Introduction of a Pediatric Burn Education Program in an Adult Hospital

IntroductionAt a newly developed burn unit, the program decided to expand further and start admitting pediatric patients. While there are many working parts to this endeavor, we will primarily address staff preparedness. Prior to the introduction of a burn education course entitled Burns in the Pediatric Population, only a handful of nurses had received any hospital-based education for caring for pediatric patients. A previous pediatric course had been taught, however, this course focused primarily on illnesses of childhood. Staff had voiced on many occasions that they felt the education they received was not adequate and felt uncomfortable taking care of pediatric burn patients.MethodsAll Burn Intensive Care (BICU) nurses, regardless of having received the prior pediatric education, were required to take Burns in the Pediatric Population (n=42). The course content was based on the Burn Nurse Competencies. The course consisted of didactic lectures and hands-on sessions. Each participant was required to take a pre-test before the class and a post-test at the conclusion. The test included knowledge-based questions and self-rated confidence level questions. In addition, each participant was sent a survey three months after the completion of the class to evaluate their knowledge and confidence level.ResultsAt the conclusion of the class, the average test score went from 49.3% to 92.7%. Both the pre-test and post-test had each nurse evaluate their own confidence level for caring for a pediatric patient. Initially, 19.5% of the nurses stated that they had no confidence in caring for a pediatric patient. At the conclusion of the class, all nurses expressed some confidence with caring for a pediatric patient, with the majority, 72.7%, stating they had moderate or high confidence.The return rate of the three-month evaluation was 81% (n=34). The knowledge-based test had an average score of 71%. 30.3% of the staff stated that their confidence in caring for a pediatric patient increased, 54.5% stated their confidence level remained the same, and 15.1% of those returning the survey stated that their confidence level decreased in the three month time period.ConclusionsThe results from the three-month survey have been utilized to edit and make our pediatric mock codes and course more specific to the needs of the bedside nurses. In addition, we are planning to increase the frequency and the level of participation in our pediatric mock codes. All Burn ICU nurses will need to participate in a pediatric mock code on a semi-annual basis. In addition, there will be a section that is added to each Burn ICU nurse’s annual competency specifically covering pediatric burns.

Increasing Patient Safety Event Reporting Among Pediatric Residents.

Background and objectiveDespite their role as frontline providers, resident physicians often underreport adverse patient events or safety issues they encounter. The objective of this study was to increase the number of patient safety events (PSE) reported at our institution through the implementation of a longitudinal, multi-pronged approach.MethodsWe designed and implemented a series of interventions focused on increasing patient safety events reported by resident physicians from October 2018 to April 2021. Interventions consisted of formal didactic sessions, increasing awareness among organizational leaders about the integral role of residents, implementing a direct feedback process to residents regarding the events, and encouraging them to develop solutions to their PSE that were associated with a financial incentive. We collected the rates of reports every month to assess the impact of our interventions.ResultsThe mean number of PSEs submitted monthly increased from zero to two reports at baseline to 10.4 during the study period. The mean number of PSE increased to 5.8 (range: 2-11) at the end of the first intervention. Following the third intervention, the average number of reported PSE was 12.3 (range: 5-18). There was a continued increase in the number of events reported across the study period, which was sustained. The outcome of interest was not achieved after intervention 1 but was achieved in 27% and 62% of months following interventions two and three. By theend of the study period, our goal of >13 PSEs per month was consistently met. The most significant increase in reporting occurred when residents received positive timely feedback regarding their reports.ConclusionsThe number of patient safety events reported by pediatric residents increased at our institution following the implementation of a multi-pronged approach including enhanced education, recognition of the residents as frontline reporters among institutional stakeholders, and direct feedback regarding submissions. Our strategies may be replicated at other residency programs seeking to establish resident involvement in safety initiatives. Further work is necessary to ensure residents gain an understanding of how patient safety events are addressed and prevented at an organizational level.

Core components of a Community of Practice to improve community health worker performance: a qualitative study

BackgroundCommunities of Practice (CoPs) offer an accessible strategy for healthcare workers to improve the quality of care through knowledge sharing. However, not enough is known about which components of CoPs are core to facilitating behavior change. Therefore, we carried out a qualitative study to address these important gaps in the literature on CoPs and inform planning for an interventional study of CoPs.MethodsWe organized community health workers (CHWs) from two tuberculosis (TB) clinics in Kampala, Uganda, into a CoP from February to June 2018. We conducted interviews with CoP members to understand their perceptions of how the CoP influenced delivery of TB contact investigation. Using an abductive approach, we first applied inductive codes characterizing CHWs’ perceptions of how the CoP activities affected their delivery of contact investigation. We then systematically mapped these codes into their functional categories using the Behavior Change Technique (BCT) Taxonomy and the Behavior Change Wheel framework. We triangulated all interview findings with detailed field notes.ResultsAll eight members of the CoP agreed to participate in the interviews. CHWs identified five CoP activities as core to improving the quality of their work: (1) individual review of feedback reports, (2) collaborative improvement meetings, (3) real-time communications among members, (4) didactic education sessions, and (5) clinic-wide staff meetings. These activities incorporated nine different BCTs and five distinct intervention functions. CHWs reported that these activities provided a venue for them to share challenges, exchange knowledge, engage in group problem solving, and benefit from social support. CHWs also explained that they felt a shared sense of ownership of the CoP, which motivated them to propose and carry out innovations. CHWs described that the CoP strengthened their social and professional identities within and outside the group, and improved their self-efficacy.ConclusionsWe identified the core components and several mechanisms through which CoPs may improve CHW performance. Future studies should evaluate the importance of these mechanisms in mediating the effects of CoPs on program effectiveness.

Can surgical skills be taught using technological advances online? A comparative study of online and face-to-face surgical skills training

IntroductionOnline teaching has rapidly emerged as a viable alternative to traditional face-to-face education. How to teach surgical skills in the online environment, however, has not yet been fully established nor evaluated.MethodsAn international 1-day online surgical skills course consisting of lectures, pre-recorded virtual workshops, live demonstrations and along with surgical skills teaching in breakout rooms was organised. Based on existing learning theories, new methods were developed to deliver skills teaching online. Simultaneously, traditional in-person surgical skills teaching was also conducted and used as a benchmark. Skills development was assessed by trained demonstrators and self-reported competency scores were compared between the online and face-to-face event.Results553 delegates from 20 different countries attended the online course. Of these, 64 were trained in breakout rooms with a 1:5 demonstrator-to-delegate ratio whilst the remaining 489 delegates participated in didactic skills development sessions. In a separate face-to-face course, 20 delegates were trained with traditional methods. Demonstrators rated the competency of delegates for suturing, tendon repair and vascular anastomosis. There was no significant difference in the competency ratings of delegates receiving online teaching or face-to-face teaching (p = 0.253, p = 0.084, p = 1.00, respectively). The development of the same skills to “articulation” were not different between formats (p = 0.841, p = 0.792, p = 1.00, respectively). Post course self-rated competency scores improved for all technical skills (p < 0.001). Small group sessions, both online and face-to-face, received higher satisfaction ratings compared to large group sessions in terms of clarity of instructions, answers to questions and demonstrator feedback. Overall feedback on teaching quality, however, was equivalent across both groups.DiscussionOnline teaching of surgical skills for early training years is an appropriate alternative to face-to-face teaching.

Comparative study of self-directed learning and traditional teaching method in understanding cardio- respiratory physiology among medical undergraduates

Introduction and Aim: Active and learner centred learning methods specially, self-directed learning is considered to be an important method of blended learning approach of imparting knowledge among under graduate medical students in new curriculum through integrated approach. The aim of the study is to analyse the impact and benefits of self-directed learning sessions for understanding cardio- respiratory physiology among phase one MBBS students. Design and Methods: This cross-sectional study was conducted among 250 students of Phase I MBBS for CVS and RS modules. Two groups of students were made Group A (n=125) was administered with self- directed learning sessions, while group B (n=125) was administered with normal didactic lecture session for the same topics. Following each session an objective assessment was conducted for all the topics covered in SDL and lecture sessions and the results were assessed and compared. Results: The maximum marks secured in objective assessment by Group A students post self-directed learning sessions for both cardiovascular and respiratory physiology modules were 31.2% (39/125) and 32.8% (41/125); while moderate marks were secured by 47.2% (59/125) and 48% (60/125). For assessment conducted after lecture sessions for both cardiovascular and respiratory physiology module, maximum marks were obtained by 25.6% (32/125) and 24% (30/125); while moderate marks were obtained by 21.6% (27/125) and 23.5% (29/125) respectively. Significant difference was found in the p values of marks for both modules(n=0.009) (n=0.008). The internal assessment scores showed considerable difference in the maximum marks obtained by students attending SDL sessions (80-89%) as compared to didactic learning sessions (70–79%) with p value = 0.0190, 0.01179 and 0.0192, a0.01184, respectively for both modules. Conclusion: Self-directed learning method seems to be more effective way of delivering the concept as compared to traditional lecture sessions.

CASCADE your teaching session!

Medical education has seen a shift toward interactive teaching in small groups that actively involves students in learning. However, didactic teaching, despite drawbacks such as student isolation and low stimulation of critical thinking, is still a very commonly used teaching method. For didactic teaching to be effective, teachers must possess strategies and skills that enable them to teach effectively in large groups and increase students' knowledge retention. This can be achieved if class sessions are planned in advance with the aim of making them interactive and engaging with all students. In the following article, I write about my experiences using the CASCADE method, an acronym of the words "create," "assess," "sequence," "charisma," "activate," "discussion," and "e-device," which creates interactive didactic sessions.

Applying a Modern Pedagogy to Emergency Residency Ultrasound Education.

BackgroundModern technology has revolutionized pedagogy in medicine. With the availability of high-quality resources in the palm of our hands, the flipped classroom model has gained widespread support. Additionally, devices such as “clickers” allow for the ability to interact much more directly with lecture participants.ObjectiveWe aimed to investigate the impact of a modern refresh to our emergency point of care ultrasound (POCUS) curriculum on resident exam performance and satisfaction.MethodsIn 2021, we conducted a single-site pre-post interventional study with Emergency residents as eligible participants. The interventions included two modifications to the POCUS curriculum. First, residents prepared and delivered mini-lectures in lieu of formal didactic sessions. Second, weekly image review was reimplemented with more active participation. Our primary outcome was end-of-rotation exam performance and our secondary outcome was learner satisfaction.ResultsDuring the study period, 19 residents participated in the curriculum. Exam scores were similar, 90.84% +/- 2.27% and 89.34% +/- 3.43% (p = 0.105) for pre and post-intervention scores respectively. Satisfaction surveys were completed by 12 of the 19 participants. On a scale of 1-5, average satisfaction was fair (3.9 to 4.1) regarding the mini-lecture intervention and high (4.3 to 4.6) for the active weekly image review modification.ConclusionsThe POCUS curriculum refresh was well-received by emergency medicine residents. However, there was no clear competency benefit when compared to the traditional approach. The modified active weekly review was particularly well-received amongst our residents and maybe a strong model for emergency POCUS programs across the country.

Feasibility and Effectiveness of a Quality Improvement Curriculum for Combined Medicine Subspecialty Fellows.

The Accreditation Council for Graduate Medical Education (ACGME) requires training in quality improvement (QI) yet many programs struggle to incorporate appropriate content. Small fellowship programs may find it particularly difficult, limited by a lack of well-trained faculty. We report on the feasibility and effectiveness of a consolidated curriculum for subspecialty fellowship programs. Two QI experts were identified to design a curriculum. Interactive didactic sessions were created to guide development and implementation of fellow QI projects. All projects culminated in abstract/poster presentation. Seven of 10 eligible fellowships participated. Twenty-four projects were completed with 70% reaching improvement in process measures. Trainees improved confidence in 11 of 12 QI domains. Program directors stated enhancement in QI education with 100% recommending program continuation. Consolidating teaching efforts with existing QI experts can lead to an effective QI curriculum for fellowship programs. This model can be expanded to other graduate medical education trainees as a means to increase QI proficiency.

223 Development of Online Surgical Skills Education

Abstract Introduction Online teaching rapidly emerged as a viable alternative to traditional face-to-face education. However, how to teach surgical skills in the online environment has not been established nor evaluated yet. Method An international one-day online surgical skills course consisting of lectures, pre-recorded virtual workshops, live demonstrations, and surgical skills teaching in breakout rooms was organised. Simultaneously, a traditional face-to-face surgical skills teaching was held and used as benchmark. Skills development assessed by trained demonstrators and self-reported competency scores were compared between the online and face-to-face event. Results In total, 553 participants from 20 different countries attended the online course, 64 were trained in breakout rooms with a 1:5 demonstrator to candidate ratio whilst the remaining candidates participated in didactic skills development sessions. In a separate face-to-face course 20 candidates were trained with traditional methods. Post course competency ratings by demonstrators in suturing, tendon repair and vascular anastomosis were not significantly different between students receiving online breakout room or face-to-face teaching (ps&amp;gt;0.05). The development of the same skills to “articulation” were not different between formats (ps&amp;gt;0.05). Post course self-rated competency scores improved for all technical skills (p&amp;lt;0.001). Small group sessions, both online and face-to-face, received higher satisfaction ratings compared to large group sessions in terms of clarity of instructions, answers to questions and demonstrator feedback. Conclusions Online teaching of surgical skills for early training years is an appropriate alternative to face-to-face teaching with the ability to define clear learning objectives, effectively teach surgical skills and achieve similar learning outcomes.

Students' resilience and mental health in the dental curriculum.

Dental education is perceived as a source of students' psychological and occupational stress. Resilience has been proposed as a protective factor that may support students' in managing that stress. The objectives of this study were twofold: to map the mental health and well-being content in the curriculum of the Faculty of Dentistry (FoD) at the University of British Columbia (UBC) and to investigate factors influencing resilience levels amongst dental students at UBC. The curricular database and website of UBC's FoD were used to gather information on mental health content. A survey with the Connor-Davidson 10-Item Resilience Scale was distributed to dental students at UBC (N=289). Students' de-identified demographic data were also collected. Two main mental health and well-being curricular components were identified: one didactic session on stress management and one interactive workshop on resilience. The response rate for the survey was 68.2%. Students who did not receive any mental health content (2020/21year 1 students) had higher resilience scores (p=.043) when compared to students who received both components (2019/20year 1 students and 2018/19year 2 students). The multiple regression analysis highlighted North American/European ethnic origins as a predictor for higher resilience levels (p=.008). The results of this study showed that ethnic origins and major life events, such as the pandemic, influenced resilience. Curricular activities promoting resilience seemed to not necessarily impact students' resilience. Further longitudinal studies are needed to assess the curricular and non-curricular activities influence over dental students' well-being.

A92 EDUCATIONAL INTERVENTIONS TO IMPROVE ERGONOMIC PERFORMANCE IN GASTROINTESTINAL ENDOSCOPY: A SYSTEMATIC REVIEW

BackgroundPhysicians in procedural specialties, such as gastrointestinal endoscopy, are at a high risk of musculoskeletal injuries (MSPI) which can affect physician wellness and productivity. Training in ergonomic principles for endoscopy may help reduce and prevent the incidence of MSPI.AimsThe aim of this systematic review was to identify educational interventions using ergonomic strategies that target the reduction of MSPI and/or pain from GI endoscopy.MethodsWe conducted a systematic search following PRESS guidelines in MEDLINE, EMBASE, PsycINFO, Web of Science, Scopus, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews for articles published from inception to December 16, 2020. Studies were included if they investigated educational interventions aimed at changing knowledge and/or behaviours related to ergonomics in gastrointestinal endoscopy. After screening and full-text review, we extracted data on the study design, participants, type of training and assessment of primary outcomes. We evaluated study quality with the Medical Education Research Study Quality Instrument (MERSQI). A qualitative synthesis of the data was conducted.ResultsOf the initial 575 records identified in the search, 5 met inclusion criteria for qualitative synthesis. We found that most studies (n=4, 90%) were single armed interventional studies that were conducted in simulated and/or clinical settings. The most common types of intervention were didactic sessions and/or videos (n=4, 80%). Other interventions included individualized feedback (n=2, 40%), checklists (n=2, 40%), and simulated training (n=1, 20%). Two (40%) studies used both standardized assessment studies and formal statistical analyses to assess primary outcomes. All included studies reported a benefit of their interventions on their respective dimensions assessed for ergonomics. The mean MERSQI score was 9.7.ConclusionsThere is emerging literature demonstrating the effectiveness of interventions to improve ergonomic performance in gastrointestinal endoscopy, which is likely to reduce MSPI among endoscopists. Further higher quality research in this field is required to make robust recommendations. Study flow diagramFunding AgenciesNone