Expert Faculty Research Articles

Evaluating the Role of Universities as Knowledge Hubs: Jordan University of Science and Technology as a Case Study

لا يختلف اثنان على الدور الرئيس للجامعات في التنمية الاقتصادية والاجتماعية والعمرانية. وهذا ما حدا بكثير من الباحثين لتركيز اهتمامهم على الدور الذي يمكن للجامعة أن تؤديه باعتبارها محوراً معرفياً. وتسعى هذه الدراسة إلى تقييم الدور الذي يمكن للجامعة الأردنية للعلوم والتكنولوجيا أن تقوم به كمركز معرفي له إسهاماته في الدفع بعجلة التنمية في مجالات الاقتصاد والعمران. تعتمد هذه الدراسة على المنهج الوصفي التحليلي ومنظومة تقييم التنمية العمرانية القائمة على المعرفة. تم إجراء مسح لاستطلاع آراء عينة من أعضاء هيئة التدريس والطلاب والباحثين وأصحاب المصلحة، بغرض جمع البيانات الضرورية لمؤشرات الأداء. وتم قياس أداء الجامعة الأردنية كمركز قائم على المعرفة ينمي الرؤى الإبداعية وحالات الابتكار. وتشير النتائج إلى وجود الكثير من التحديات التي تقف عائقاً أمام الجامعة الأردنية في أدائها لهذا الدور المعرفي كحاضنة للشركات الناشئة وتحفيز البحث العلمي مع ضمان تنوع ضمن أعضاء الهيئة التدريسية. وعليه، خلصت الدراسة إلى أن الجامعة الأردنية للعلوم والتكنولوجيا غير مؤهلة في الوقت الراهن للقيام بدورها كمحور معرفي بكفاءة وذلك لعدة عوامل ذكرها من لهم علاقة بالموضوع. ولعل عدم وضوح فكرة المحور المعرفي من أساسه لدى فئة الطلاب أحد هذه العوامل. وبناء على ذلك، توصي الدراسة بضرورة إحداث تحول في دور الجامعة من مجرد مركز تعليمي وبحثي إلى نواة للتنمية الاقتصادية واجتماعية. وهناك أيضاً حاجة للقيام بمزيد من البحوث في هذا الموضوع وسبل جعل الجامعات محاور معرفية.

Abstract PO-062: Flipping the switch to virtual community engagement: Strategies and future directions for online cancer education

Abstract History The University of Chicago Comprehensive Cancer Center's HealthyU program started as a health education initiative to reach University of Chicago Medicine employees from across a variety of sections and departments. HealthyU consisted of weekly workshops, called Workshop Wednesdays and pledge cards for cancer screenings. HealthyU programming was only done during awareness months for the “screenable” cancers: breast, cervix, colon, and lung. Attendance at our workshops was sporadic and completed pledge cards usually did not meet programmatic goals. Making the Switch to Virtual Programming Beginning in October 2020, in the wake of the COVID-19 pandemic, we took the HealthyU program online for Breast Cancer Awareness Month. Our breast cancer programming consisted of four educational webinars to encourage breast cancer screening, a digital screening pledge card, and a mammogram toolkit with printable resources to promote mammography. We had 50% more webinar participants and 23% more pledge cards signed virtually than we did in October of 2019 during our in-person programming. The success of our virtual Breast Cancer Awareness Month programming prompted us to expand HealthyU dramatically. Cutting out the logistics of on-campus programming has allowed us to broaden the scope of the HealthyU program in the following ways: 1. The target audience has grown beyond UChicago Medicine employees to include a variety of community partners across greater geographic areas both within and outside of our catchment area. 2. We host webinars on a weekly basis and for a wide range of cancer-related topics. 3. Our physical pledge cards are virtual and have grown to include pledge cards for other cancer screenings and risk-associated behaviors. 4. We created online toolkits to share with our community and UCM partners with information and shareable resources that can be used online or printed and distributed. 5. We have incorporated virtual contests to encourage cancer screening advocacy and awareness. 6. We designed self-guided cancer education modules and an online video library to supplement our programming. 7. We leveraged our social media presence to engage in real-time cancer-focused conversations online. 8. We developed other online webinar series, including documentary short screenings, survivorship storytelling, researcher/survivor summits, and singular webinars on public health topics. Outcomes & Future Directions Through the HealthyU program, we've connected over 100 UCM employees and community partners with 64 different University of Chicago faculty experts and 26 community experts. We plan to use the techniques and outreach strategies learned to expand our reach in other areas, including an online training course for cancer investigators and community members on the principles of community-based participatory research, and a community-scientist virtual summit on Cancer and the Microbiome. We have leveraged the success of this program to secure device donations to expand our outreach to communities with inadequate technology access. Citation Format: Alia Poulos, Gina Curry. Flipping the switch to virtual community engagement: Strategies and future directions for online cancer education [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-062.

The Power of Connections: AAP COVID-19 ECHO Accelerates Responses During a Public Health Emergency.

Pediatric providers across the United States have sought guidance on how to care for the nation's children during the uncertain historic times of the COVID-19 pandemic. The health care community has been challenged by the unprecedented burden of caring for patients when they have evolving guidelines and limited information about the effects of the virus on children. In response, the American Academy of Pediatrics (AAP) rapidly launched a national initiative to increase child health professionals' knowledge, skills, and self-efficacy. This COVID-19 ECHO (Extension for Community Healthcare Outcomes) program created communities of learners among child health professionals and subject matter expert faculty using didactic and case-based presentations that foster an "all-teach, all-learn" approach. The initial AAP COVID-19 ECHO program hosted more than 900 participants in 127 individual virtual sessions, with approximately 25 participants per session. The evolving nature of the pandemic necessitated dynamic and continuous bidirectional flow of concerns and information relevant to participants. Session topics were selected in a "just-in-time" fashion based on participant feedback from the prospective postsession surveys and faculty recommendations; speakers brought data and expert recommendations. To assess impact, the AAP used a mixed-methods approach to evaluate the program's effectiveness in meeting its educational objectives. The 2-phase evaluation collected quantitative and qualitative data through an integrated feedback structure that utilized prospective postsession and retrospective postprogram surveys, along with postprogram focus groups. As the COVID-19 pandemic surges and another influenza season is upon us, the ECHO model is an effective strategy for facilitating bidirectional communication and education to build child health professionals' knowledge, skills, and self-efficacy during an unprecedented and ongoing public health emergency. The ECHO model is an effective strategy for health care organizations to facilitate bidirectional communication and education in building health professionals' clinical knowledge, skills, and self-efficacy during the unprecedented and ongoing public health emergency of the COVID-19 pandemic.

970. Medical Student Engagement with the COVID-19 Pandemic Is Increased Through Participation in a Preclinical Elective

BackgroundThe medical field’s response to the Coronavirus Disease 2019 (COVID-19) pandemic required a multifaceted approach. Medical students were often excluded from the initial phases of pandemic response, resulting in feelings of disengagement. This study aimed to determine if offering educational experiences on current events related to the COVID-19 pandemic could increase medical students’ understanding of, and engagement with, the pandemic.MethodsIn Fall 2020, an elective course reviewing several aspects of the COVID-19 response was implemented. Preclinical medical students attended a discussion-based seminar series given by expert faculty on a variety of topics including pathophysiology, vaccine development, telemedicine, and others. Upon course completion, students were asked to complete a survey quantifying their understanding of the overall COVID-19 response, understanding of various individual facets of the response, and feelings of personal engagement on a Likert scale from 1-5, with 5 representing the most understanding or engagement. The differences in pre-course and post-course mean scores were compared using a Wilcoxon matched-pairs signed rank test for each question.ResultsA total of 65 students completed the course; 35 (54%) students filled out the final course survey. Results showed significant improvement in students’ perceived holistic understanding of the pandemic response (2.67 pre-course vs. 4.36 post-course; p < 0.001), and their feelings of personal engagement (3.06 pre-course vs. 4.33 post-course; p < 0.001). Students also reported significantly increased feelings of understanding for each individual facet of the pandemic response reviewed during the course (8 questions total, all p-values < 0.001).ConclusionPreclinical medical student participation in a course reviewing COVID-19 pandemic response significantly increased feelings of engagement with and understanding of the medical field’s response to the pandemic. Students showed improved understanding of each aspect of the pandemic response that was covered in the elective. Therefore, it appears that seminar- and discussion-based electives can be a useful tool for fostering preclinical student engagement in current events in medicine.Disclosures Prathit A. Kulkarni, M.D., Vessel Health, Inc. (Grant/Research Support)

Course Review: Doctors Academy Basic Sciences and Clinical Application for the Membership of the Royal College of Surgeons Part A Course.

The Membership of the Royal College of Surgeons (MRCS part A and B) is a mandatory examination that is required by all trainees to enter the surgical speciality training programme in the United Kingdom. Students and clinicians alike often find it a struggle to succeed in passing these exams given the breadth and depth of knowledge required across a spectrum of surgical sciences. There are several factors contributing to success, including ethnic background, number of attempts, and medical school performance. Studies have also shown that a marker of success for Part B was influenced by the Part A performance. During the COVID-19 peak, the MRCS Part A written exam has had its format changed to an online exam reflecting the policy surrounding social distancing. Due to this, the pass mark has become more difficult to attain compared to traditional face-to-face settings. As such, many trainees are finding it more difficult to succeed in the exam, leading to more emphasis on more thorough preparation for exams. This can be in the form of courses, textbooks, and using more of the online question banks.The Basic Sciences and Clinical Application for MRCS A Course is organised by the Doctors Academy group and details an intensive and interactive three-day revision course held intermittently throughout the year in Cardiff, Wales multiple times a year. Delivered by an expert faculty, it aims to provide maximum preparation in the lead up to the MRCS Part A exam with emphasis on retaining high-yield knowledge and application of key exam revision techniques. We reviewed the post-course surveys from 2019 to 2021 and found that the majority of attendees found the course content to be excellent and relevant to the exams. These questions were a mandatory part of the course and reflect a variety of training grades from foundation to core training/speciality training (CT1/2 to ST1/2). Overall, candidates found that this course aided their exam preparation immensely and contributed to passing.

Developing a Small Business Educational Program for Growing Rural Businesses

This paper elaborates on the development of a small business certificate program in rural Kansas. Researchers and local practitioners suggest that there are differences between rural and urban small businesses and that most educational programs do not account for these differences. After exploratory research, the university team identified specific needs facing local businesses and tailored a program for their needs. A program structure and set of topics, paired with faculty experts was developed and implemented. Topics focused on developing an entrepreneurial orientation, as well as certain business fundamentals that were deemed critical to small rural businesses. Each topic was oriented toward the rural context where face to face business is more essential. A feedback loop was implemented leading to a shorter 8-week timeframe and some topic adjustments. To date, 378 firms have participated in the program and have shown an 80% survival rate. Specific feedback has indicated that business growth has occurred and that the respondents do perceive development in their entrepreneurial orientation. In addition, specific skill areas related to unique businesses have been improved. Lastly, the program participants have grown their regional business networks, which has been shown to be an important factor for rural business success.

Abstract 9038: Success of Online CME at Improving Competence and Confidence Related to Treatment Adherence in Pulmonary Arterial Hypertension

Introduction: Despite treatment advances in PAH, many patients have difficulty adhering to therapy, resulting in decreased persistence and poor outcomes. We sought to determine if online continuing medical education (CME) could improve the competence and confidence of cardiologists related to strategies to improve treatment adherence in PAH. Methods: This CME intervention comprised of a 15-minute online video-based rapid-fire discussion between 2 expert faculty. A repeated pairs pre-/post-assessment study design was used and McNemar’s test assessed significance (P &lt;.05 is considered significant), with Cohen’s d being used to assess educational impact (.20-.49 a small effect, .50-.79 a moderate effect, and &gt; .80 a large effect). The activity launched October 1, 2020 and data were collected through January 11, 2021. Results: In total, 180 cardiologists were included in the analysis. Overall, there were competence and confidence improvements seen among participants from pre- to post-assessment: • 13% of cardiologists (P&lt;.01) improved at selecting the most appropriate PAH therapy for better adherence for a patient who requires treatment escalation due to intermediate-risk status yet struggles to follow a rigid medication schedule • 27% of cardiologists (P&lt;.001) improved at selecting the most appropriate strategy to manage PAH treatment-related side effects • 36% of cardiologists had a measurable increase in confidence in ability to manage side effects during uptitration of PAH specific therapiesContinued educational gaps:• 61% of cardiologists failed to choose appropriate therapy to improve adherence for an intermediate-risk patient who struggles to follow a rigid medication schedule • 50% of cardiologists failed to select the most appropriate strategy to manage PAH treatment-related side effects Conclusions: This study demonstrates the success of online CME on improving competence and confidence of pulmonologists related to treatment adherence in PAH. Continued gaps were identified for future educational targets.

Abstract 9037: Effectiveness of Online CME at Improving Cardiologists’ and Pcps’ Knowledge and Confidence Related to Diagnosis and Treatment of Hereditary Transthyretin Amyloidosis

Introduction: Despite advances in hATTR management, patients experience delays in diagnosis and initiation of targeted treatment, resulting in suboptimal care. We sought to determine if online continuing medical education (CME) could improve the knowledge and confidence of cardiologists and primary care physicians (PCPs) related to diagnostic features of hATTR and targeted treatment strategies for hATTR. Methods: This CME intervention comprised of a 30-minute online video-based discussion between 2 expert faculty. Responses to 3 multiple-choice, knowledge questions and 1 self-efficacy, 5-point Likert scale confidence question were analyzed using a repeated pairs pre-/post-assessment study design. A chi-square test (P &lt;.05 is considered significant) assessed pre- to post-activity change. The activity launched March 26, 2020 and data were collected through June 10, 2020. Results: In total, 144 cardiologists and 384 PCPs were included in the study. Overall, there were knowledge and confidence improvements seen among all groups from pre- to post-assessment: • 8% of cardiologists (P=ns) and 16% of PCPs (P&lt;.0001) improved at identifying diagnostic features of hATTR • 23% of cardiologists (p&lt;.001) and 27% of PCPs (p&lt;.001) improved at selecting MOA of current treatment approaches targeting TTR in patients with hATTR • 40% of cardiologists and 56% of PCPs had a measurable increase in confidence in recognizing early diagnostic features in patients with hATTR Continued educational gaps: • 12% of cardiologists and 14% of PCPs failed to select diagnostic features of hATTR • 59% of cardiologists and 58% of PCPs failed to select MOA of current treatment approaches targeting TTR in patients with hATTR Conclusions: This study demonstrates the success of online CME on improving knowledge and confidence of cardiologists and PCPs related to recognition of diagnostic features in patients with hATTR. Continued gaps were identified for future educational targets.

Future Studies: Dimensions and Components in the Educational System of a University of Medical Sciences

Background: One way to make change in the field of education is through future studies. Considering the role of future studies in building a better future for the country’s medical education and health system, the establishment of the required bases in medical education is necessary. Objectives: The present study aimed to investigate the dimensions and components of future studies in the educational system of a university of medical sciences. Methods: In this grounded-theory study, the statistical population included expert and knowledgeable faculty members with an experience of delivering services as directors, principals, and deputies of the faculties of Babol University of Medical Sciences, Mazandaran, Iran. In-depth and exploratory individual interviews were held through a questionnaire containing six standard items within October and December 2018.The interview process was completed based on the data saturation law, and the required conclusion was drawn with 10 samples. Results: A questionnaire with 50 components in three main dimensions, including infrastructure (25 components), management and faculty members (9 components), and outputs (16 components), was designed. Moreover, the validity and reliability of the questionnaire were confirmed. Conclusion: It is time to build necessary capacities for future studies in the universities of medical sciences and provide the possibility for extensive participation and support of researchers and faculty members in future studies programs in the field of medical education and health research in Iran. The dimensions and components obtained from this study can be helpful in this regard.

Online CME As a Tool to Increase Clinicians' Ability to Identify and Diagnose Paroxysmal Nocturnal Hemoglobinuria

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is an extremely rare clonal hematopoietic stem cell disorder characterized by episodes of hemolysis and a high risk of thrombosis [Hill A, et al. Nat Rev Dis Primers. 2017;3:17028.]. PNH has diverse clinical manifestations, which contribute to its particularly challenging diagnosis. As a result, diagnostic delays are common, and patients often experience complications of untreated PNH [Mancuso S, et al. Hematol Rep. 2018;10:7523.]. Due to the rarity and confounding presentation of PNH, many members of the healthcare team are challenged to accurately recognize signs and symptoms of the disease and implement appropriate diagnostic methods. The objective of this study was to determine if an online continuing medical education (CME) intervention could improve hematologists' and primary care physicians' (PCPs) ability in identifying and diagnosing patients with PNH.Methods: The activity consisted of an approximately 2,000-word text-based interview between a moderator and a single expert faculty [Weitz I. https://www.medscape.org/viewarticle/943900. 2021.]. Educational effect was assessed with a repeated pairs pre-/post-assessment study including a 3-item, multiple choice, knowledge/competence questionnaire and 1 confidence assessment question, with each participant serving as his/her own control. Pre- and post-assessment scores were compared to determine relative changes in the proportion of correct responses to knowledge/competence questions. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating, and McNemar's test was conducted at the learning objective level (5% significance level, P <.05). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses (<.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). The activity launched 15 January 2021; data were collected until 3 May 2021.Results: Overall, statistically significant improvements in knowledge/competence were seen after education consumption for hematologists (N=55, P <.001, Cohen's d=.59) and PCPs (N=332, P <.001, Cohen's d=.47). 5% of hematologists and 17% of PCPs improved (P <.317 and P <.001, respectively) and 78% and 57%, respectively, reinforced their knowledge regarding the clinical manifestations of PNH. 29% of hematologists and 40% of PCPs improved (P<.001) and 69% and 36%, respectively, reinforced their competence related to establishing a diagnosis of PNH. Following the activity, 38% of hematologists and 52% of PCPs had a measurable increase in confidence regarding their ability to evaluate patients with suspected PNH.Conclusions: Participation in a text-based CME-certified activity resulted in statistically significant improvements in knowledge/competence and measurable increases in confidence of hematologists and PCPs regarding the diagnosis of PNH. These results have the ability to translate to improvements in clinical care. The need for additional educational activities was also identified to address residual gaps and further increase clinicians' ability in this rare clinical setting. DisclosuresWeitz: Apellis Pharmaceuticals: Consultancy, Honoraria; Alexion: Consultancy, Honoraria, Speakers Bureau; Biocryst: Consultancy, Honoraria; Novartis Corporation: Consultancy, Honoraria; Sanofi Genxyme: Consultancy, Honoraria.

Augmentative and Alternative Communication Course Design and Features: A Survey of Expert Faculty and Instructors.

Multiple surveys have been used to investigate augmentative and alternative communication (AAC) coursework offered in speech-language pathology programs in the last 3 decades. These studies primarily explored the availability of AAC courses and reported a limited number of course characteristics. Because few studies to date have specifically examined the AAC course design, the purpose of this study was to investigate the design and features of AAC coursework, such as learning objectives, course content, assignments, and readings and resources, currently taught in the United States. An online survey was developed and distributed to faculty or instructors with AAC expertise associated with 265 speech-language pathology programs in the United States. A total of 64 surveys were completed for a response rate of 24.2% (64/265). Quantitative and qualitative analyses were used to evaluate the survey data. Patterns are reported related to a number of course design elements and features, including enrollment, course delivery, learning objectives, content, case-based instruction, assignments, in-class activities, and readings and resources. This study reports the design and features of AAC courses presently taught by faculty and instructor experts in the United States. The results have direct implications for faculty and instructors who teach AAC coursework and provide state-of-the-art information needed for continuous improvement of AAC preservice education. Resources and considerations are provided for scholarly teaching and evidence-based education.

Building Implementation Science Capacity in Academic Pharmacy: Report of the 2020-2021 AACP Research and Graduate Affairs Committee

EXECUTIVE SUMMARY The 2020-2021 AACP Research and Graduate Affairs Committee (RGAC) continued the work begun by the 2019-2020 RGAC to increase awareness of and capacity for implementation research to advance practice transformation in academic pharmacy. AACP President Anne Lin charged the RGAC with developing resources and programs for training faculty and graduate students in implementation science. The committee was further charged with developing a mechanism to pair pharmacy faculty and implementation experts on practice advancement projects. In its work, the committee focused on generating near-term opportunities for pharmacy practice faculty to pursue projects while developing programs that would support ongoing career development and future implementation practice and research by pharmacy faculty and trainees.

Can Content Experts Rely on Others to Reliably Score Open-Ended Questions on Summative Exams?

Purpose: Although the multiple-choice question format is the primary means of assessing medical students’ knowledge, interest in the use of open-ended questions (OEQs) for assessment is growing. 1 Time burden and subjectivity of grading OEQs are cited as concerns. 2,3 Recruitment of graders without content expertise could reduce the time burden of grading. However, it is unclear if rubrics can be reliably used by individuals who are not content experts. The objective of this study was to evaluate the interrater reliability (IRR) of OEQ scores by faculty, students, and noncontent expert faculty. Approach/Methods: Content experts at 3 U.S. medical schools created 3 questions testing the knowledge of the pathophysiology of the gastrointestinal system among first-year medical students (MS1s), based on a set of learning objectives that were identified collaboratively. Rubrics consistent with the school’s assessment program were created internally at each school. Schools A and B used a holistic rubric based on a 6-point scale with descriptive anchors. Based on this scale, a categorical determination was made as to whether the student’s response met expectations (5–6 points), was borderline (3–4 points), or did not meet expectations (1–2 points). School C used an analytic rubric that allotted points for each component required for credit. Each component was worth 1 point and the total number of points were summed for each question. Study questions completed by MS1s were scored by content experts, who were considered the gold standard. Each site recruited noncontent experts and fourth-year medical students (MS4s) to independently score the questions. Intraclass correlation coefficient (ICC) was used to determine IRR with absolute score agreement and categorical determination (schools A and B). Results/Outcomes: Student responses to the 3 exam questions at school A (N = 54), B (N = 50), and C (N = 54) were randomly selected to be scored by noncontent experts and MS4s. Agreement between the content expert and the noncontent expert scorers at school A was in the fair/good range (ICC = 0.40, 0.47) and at school C was in the excellent range (ICC = 0.74, 0.76). Similar patterns were observed when examining each question individually. Agreement between the content expert and the student scorers at school A was in the fair/good range (ICC = 0.55, 0.66) and at school C was in the excellent range (ICC = 0.80, 0.82). At school A, agreement on the categorical determination was generally better than exact agreement for the student scorers (in the upper end of the fair/good range) but did not change substantially for noncontent experts. Data from school B are currently being analyzed. Discussion: IRR of scoring OEQs was variable among schools but trended toward good/excellent. IRR with content experts was higher when using the analytic rubric compared with the holistic rubric. Furthermore, MS4s were more reliable scorers than noncontent experts. We conclude that reliability among faculty and student scorers is achievable. Significance: Some of the major concerns associated with OEQ-based assessment can be circumvented by scoring by noncontent experts. Each school must determine what type of rubric works best within their assessment culture. Regardless of what type of rubric is used, reliability among scorers is achievable. Acknowledgments: The authors wish to thank the content experts who worked diligently together to create a common set of exam questions, and the noncontent experts and students who scored the study questions.

Design and assessment of a penile fracture simulation model

ObjectiveTo design and assess a novel penile fracture simulation model for teaching penile fracture repair. MethodsWe used a validated circumcision simulator to create a model. Foreskin for a circumcision was divided into two halves. A transverse slit (“simulated fracture”) was created on one part of the first half of the foreskin (mimicking “tunica”) and was applied over the penile model. A red jelly tablet (“clot”) was placed underneath the cut. A second full-length of foreskin was applied over it to cover the defect. The model was assessed by participants and expert faculty at the Urology Simulation Boot Camp. Evaluation was performed using a 5-point Likert Scale questionnaire. Data was analysed using Microsoft Excel and IBM SPSS Statistics V25. The intra-class correlation was calculated using a “One-way random model”. ResultsTwenty-two urology trainees and four experts participated in the evaluation. The majority of trainees strongly agreed (59%, n = 13) the model is useful for training with experts similarly agreeing in 75% of cases. The appearance of penile fracture was considered good by both trainees (68%, n = 14) and faculty (75%). Overall, the ability of the model to represent a realistic simulation of the task was considered excellent by 23% of participants and good by 64%. Personal confidence after simulation in managing a similar situation was considered high among trainees. The main difficulties reported were related to fascial planes and urethra. ConclusionThis is the first simulation model for penile fracture repair and has demonstrated face validity at a national urology bootcamp.

The Virtual Team Member: Remote Engagement of Medical Students in COVID-19 Care.

BackgroundMedical education abruptly changed in the setting of the COVID-19 pandemic, impacting experiential learning in clinical clerkship as medical students were removed from direct patient interactions and care team participation. Re-configuring a hospital clinical rotation using virtual care platforms allowed students to re-engage in the clinical environment and actively participate in patient care.MethodsDuring the height of the pandemic, we implemented a 4-week “virtual team member” (VTM) inpatient medicine elective for medical students in their second year and above to participate in acute patient care during the height of the COVID-19 pandemic. Tasks included providing daily updates to patients and family members along and care coordination. Faculty experts in infectious disease, mental health, ethics, and patient safety incorporated weekly didactic video talks throughout the elective. Student feedback was obtained anonymously through pre-, mid-, and post-elective questionnaires.ResultsA total of 26 students enrolled in the two 4-week blocks, with 85% in the 2nd year. Survey response rates for the pre, mid, and post-rotation questionnaires were 96%, 77%, 58% respectively. Of the 15 students who completed the post-survey, the majority strongly and somewhat agreed that the elective met expectations (12/15, 80%), was worthwhile (14/15, 93%) and met goals (12/15, 80%). Best parts of the elective most frequently cited by students were patient care and teamwork. Working remotely was the greatest challenge.ConclusionsDesigning a virtual role for students successfully allowed students to re-engage in the acute care setting and connect with patients and participate in COVID-19 care.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40670-021-01422-8.

SMI Adviser to Offer Virtual Learning Collaboratives

Back to table of contents Previous article Next article ProfessionalFull AccessSMI Adviser to Offer Virtual Learning CollaborativesMark MoranMark MoranSearch for more papers by this authorPublished Online:14 Oct 2021https://doi.org/10.1176/appi.pn.2021.11.17AbstractSMI Adviser offers free CME/CE-certified education, expert consultations, and resources to help frontline clinicians and staff provide evidence-based care to individuals who have serious mentaI illness.SMI Adviser, APA’s Clinical Support System for Serious Mental Illness, will offer 10 free virtual learning collaboratives beginning in February 2022. These 12-week courses provide in-depth information on specific topics related to caring for patients with serious mental illness (SMI). Each course is guided by experts in SMI.SMI Adviser was funded in July 2018 by a five-year, $14.2 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). It offers free CME/CE-certified education, expert consultations, and resources to help frontline clinicians and staff—including physicians, nurses, psychologists, social workers, counselors, and peer recovery specialists—provide evidence-based care to individuals who have SMI, including those living with schizophrenia, bipolar disorder, or major depressive disorder.The virtual learning collaboratives that launch in the spring include the following:Getting Started Building Your Clozapine PracticeProtocol-Driven System to Manage Efficacy and Side Effects of ClozapineGetting Started with Telehealth for Serious Mental IllnessGetting More From Telehealth: Increasing Engagement and Supporting Remote Diagnostics and InterventionsMotivational Interviewing for People With Serious Mental IllnessImplementing Tools for Symptom and Functional Assessment of Individuals With SMIBuilding and Using a Comprehensive Psychiatric Mental Health Nursing AssessmentTreating the Whole Patient: Addressing the Physical Health Needs of Populations With SMIThese learning collaboratives are an ideal opportunity to build skills using an intensive, real-world, evidence-based approach. Clinicians can consult with faculty experts and get real-time feedback during virtual office hours, participate in group calls with colleagues, complete skills-based assignments, and share ideas on interactive discussion boards. The time invested in these courses helps translate skills directly from concept into actionable care for individuals with SMI.SMI Adviser offers a wealth of information in addition to its virtual learning collaboratives. It is free and accessible via website and a smartphone app. This allows clinicians to easily obtain consultation from experts, access tools that support care, and earn CME/CE credits. SMI Adviser’s online education catalog includes more than 200 webinars and interactive modules on a wide range of subjects on SMI—among them, the interface between SMI and the criminal justice system, the use of telepsychiatry for treating patients with SMI, engagement of patients and families in treatment planning, strategies for successful use of clozapine, use of psychiatric advance directives, and chronic physical health management for individuals with SMI.Last year SMI Adviser released My Mental Health Crisis Plan, a mobile app that includes a step-by-step guide for people with SMI to create a psychiatric advance directive (PAD) and share their treatment preferences in advance of a mental health crisis. A PAD is a legal document that details an individual’s treatment preferences in the event they are unable to make decisions due to worsening illness.SMI Adviser also operates two Centers of Excellence (CoEs) to promote best practices in psychopharmacology—the Clozapine Center of Excellence and Long-Acting Injectable Center of Excellence. Each is dedicated to providing free CME/CE-certified education, consultations, resources, and other evidence-based tools.The CoEs host a community listserv and monthly virtual forums for moderated peer-to-peer discussions on trending topics on either clozapine or long-acting injectable medications. Clinicians can engage with colleagues and share challenges and questions on the month’s trending topic. Virtual forums are held from 4 p.m. to 4:45 p.m. ET on the first Wednesday of every month. Those interested in participating may sign up to receive email invitations at the Clozapine Center of Excellence or Long-Acting Injectable Center of Excellence.APA CEO and Medical Director Saul Levin, M.D., M.P.A., said that SMI Adviser breaks new ground in using technology to bring expert advice on SMI to clinicians who need it.“I urge our members and mental health professionals to visit the SMI Adviser website and download the app and explore this remarkable resource,” he said. “It’s a huge step in realizing the vision of the SAMHSA grant to bring customized, evidence-based information to those caring for patients with SMI.” ■ ISSUES NewArchived

Improving management of heart failure with reduced ejection fraction with sglt2i's using the latest clinical data: an online education intervention

Abstract Background Heart Failure (HF) is a leading and increasing cause of morbidity and mortality worldwide. In the last 20 years, a strong emphasis has been placed on improving survival and quality of life in patients with HF. However, despite substantial therapeutic advances, morbidity, mortality, and hospitalization rates remain high. Purpose To determine if an online continuing professional development (CPD) intervention could improve knowledge and confidence of cardiologists and primary care physicians related to: reviewing the latest clinical data on the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors in the management of patients with heart failure with reduced ejection fraction (HFrEF) and exploring the safety profile of SGLT2 inhibitors in HFrEF patients. Methods Cardiologists and primary care physicians electively participated in a 30-minute, video-based activity comprising of 4 mini lectures with synchronized slides by expert faculty on the review of clinical data on the use of SGLT2 inhibitors in the management of patients with HFrEF and exploring the safety profile of SGLT2 inhibitors in HFrEF patients. The effects of education were assessed using a repeated pair, pre-assessment/post-assessment study design. For all questions combined, a chi-square test assessed differences from pre- to post-assessment. P-values &amp;lt;0.05 are statistically significant. Cramer's V was used to assess level of educational effect using the range of &amp;lt;0.06 (modest), 0.06–0.15 (noticeable), 0.16–0.26 (considerable), and &amp;gt;0.26 (extensive). The activity launched on November 2, 2020 and data were collected through to December 22, 2020. Results Overall significant improvements were seen after education for both cardiologists (N=124; P&amp;lt;0.001; noticeable educational effect, V=0.129) and primary care physicians (N=207; P&amp;lt;0.0001; noticeable educational effect, V=0.113). Pre-assessment, the average correct response rate was 40% for cardiologists and 32% for primary care physicians, while post-assessment average correct response rates increased to 53% and 43%, respectively. Significant improvements were observed in cardiologists' and primary care physicians' knowledge related to the dissemination of the latest clinical data of novel therapies and the mechanistic effects of SGLT2 inhibitors in patients with HFrEF (Table 1). As a result of the education, 24% of cardiologists and 30% of primary care physicians had a measurable improvement in confidence in their ability to appropriately select patients with HFrEF who could benefit from initiation of SGLT2 inhibitor therapy. Conclusion The statistically significant improvements observed in this intervention demonstrate the benefits of using a video-based mini lectures with synchronized slides to increase knowledge and confidence of cardiologists and primary care physicians on SGLT2i's and how these therapies could positively impact the quality of life and clinical outcomes of patients with HFrEF. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boehringer Ingelheim &amp; Lilly Table 1

Flexible Bronchoscopy Simulation as a Tool to Improve Surgical Skills in Otolaryngology Residency.

ObjectiveTo evaluate the benefits of simulation to teach flexible bronchoscopy.Study DesignA prospective cohort study to assess the bronchoscopic skills of residents in an otolaryngology training program using a commercially available bronchoscopy simulator.SettingTertiary care otolaryngology residency program.MethodsThirty-two otolaryngology residents and 4 expert faculty across 2 academic institutions were assessed on 3 flexible bronchoscopy tasks: diagnostic bronchoscopy, foreign body removal, and tracheal lesion biopsy. Performance was evaluated with a modified version of the validated Bronchoscopy Skills and Tasks Assessment Tool. At 1 of the 2 academic institutions, an additional tool was implemented to evaluate the simulator.ResultsThere was a correlation between postgraduate training year and time taken to complete tasks, including bronchoscopy, foreign body extraction, and passing through the glottis (P < .001, P = .04, and P < .01, respectively). There was a significant difference between residents and faculty laryngologists for a range of skills and tasks, including percentage of time in middle lumen, contact with bronchial walls, inadvertent esophagus entry, and biopsy of healthy tissue (P < .001, P = .003, P < .001, and P < .001). Additionally, increasing postgraduate level was correlated with a higher percentage of time in the center of the lumen and reduced time to task completion (P = .05 and P < .001). Of 32 residents, 20 evaluated the simulator on its realism, with an average score of 4.1 of 5.ConclusionThe commercially available flexible bronchoscopy simulator provides a valid assessment of bronchoscopic skill and is a useful tool for practicing bronchoscopy in a safe, controlled environment.Level of EvidenceIndividual cohort study.

Guide to Social Work Intervention for Community Re-entry of Offenders With a History of Violence Against Individuals

Objective: The re-entry of offenders to the community after their imprisonment is a sensitive and important stage and should always be considered by governmental and non-governmental organizations. The proper transition from prison to the community occurs when rehabilitation and social reintegration programs are developed and implemented based on the real needs of individuals. Social work is one of the professions that can help the judicial system with this issue. Many graduates of this profession provide social work services to prisoners and their families. Therefore, it is necessary to identify effective operational solutions in accordance with the conditions of the country and formulate a specific framework. This study aims to prepare a guideline for specialized social work intervention for community re-entry of offenders with a history of violence against individuals. Materials &amp; Methods: In this study, a qualitative approach was used to prepare the specialized guideline. First, the initial barriers and facilitators of successful community re-entry for offenders with a history of violence against individuals were prepared using thematic analysis. Then, based on the protocols of the social work process, the initial draft was developed. Next, at a focus group discussion session with faculty members and experts, the draft was reviewed and improved. To assess its applicability, we used the Appraisal of Guidelines for Research and Evaluation (AGREE) tool. Results: Intertwined concerns, protective shields, welfare/economic security, social support, and achieving relative independence were identified as the five dimensions of successful community re-entry. The specialized social work interventions were presented after approval in four main stages: preparation for the case plan, development of the case plan, interventions and actions, and monitoring and review of interventions. The results of evaluation by AGREE tool showed an overall acceptable average of 58.7% (82.9% for scope and purpose, 88.1% for stakeholder involvement, 85.6% for rigor of development, 83% for clarity of presentation, 84.9% for applicability, and 89.8% for editorial independence). The users of this guideline are social workers and other professions related to prisons and training and security organizations, especially after-release care centers. Conclusion: Investing in rehabilitation programs for prisoners is one of the best and most cost-effective ways to prevent the reoccurrence of violence, which not only has beneficial effects on those concerned but also promotes public safety. This issue becomes important when social reintegration and rehabilitation programs are developed based on scientific approaches and perspectives. Future studies on the effectiveness of the developed guideline, considering the local conditions, can help identify the effective factors of re-entry to the community in newly released prisoners. The skills and capabilities of social workers in presenting specialized interventions and establishing professional and inter-organizational communication, supporting rules and programs, motivation, and enthusiasm of the offender to change can all contribute to the success of this guideline in achieving the defined goals.

Learnings from a multiphase, mixed-methods lung cancer quality initiative in U.S. community cancer centers.

254 Background: Quality improvement (QI) in cancer care delivery requires understanding the setting, clearly defining problem(s), and identifying targeted solutions. The Association of Community Cancer Centers (ACCC) conducted a national project to identify and provide guidance on key issues in care for patients with stage III/IV non-small cell lung cancer (NSCLC). We report the problems and solutions identified after a mixed-methods baseline data evaluation. Methods: The multi-phase ACCC QI initiative was guided by an expert steering committee. A request for applications was advertised to all ACCC programs, with committee members ranking each site in pre-specified categories (ex., replicability, practice champion engagement). After selection of sites, baseline data assessed programs’ patient populations, current care delivery practices, processes of care, and biomarker testing rates. A full-day workshop was conducted with multidisciplinary team members and expert faculty to review baseline data, refine problem statements, and identify site-specific QI solutions. Results: The 6 participating US sites were regionally diverse with a rural/urban mix. In baseline data, median patient ages were 65-72 years and patients treated were 50% stage III/50% stage IV. Biomarker testing practices, use of multidisciplinary tumor board, and clinical care pathways varied across sites. Five key QI areas were identified: 1.Management of immune related adverse events (irAE), 2.Biomarker testing, 3.Emergency visit management (EVM), 4.Access to clinical trials, and 5.Smoking cessation. Two sites identified problems with irAE management during immunotherapy (IT). The first identified needs for proactive symptom identification, assessment, and management. Solutions included: 1. a patient questionnaire to identify early signs of irAEs and 2. pilot testing a nurse-administered questionnaire. A second site identified that front-line clinicians may not be properly identifying possible irAEs. Solutions included: 1. form an IT toxicity working group and 2. educate front-line clinicians about irAEs. Two sites focused on biomarker testing. The first problem identified was inefficient tracking of testing results. Solutions were: 1. assign a nurse navigator to track, enter, and communicate test results and 2. proactively coordinate appointments for patients with positive test results. The second site identified delayed care when inadequate tissue was obtained. Solutions included: 1. pathology-driven reflex testing and 2. liquid biopsy order at diagnosis. Similar problems/solutions were developed for EVM, clinical trial access, and smoking cessation. Conclusions: Challenges in lung cancer care delivery can be identified and addressed using an intentional QI approach. Clearly defining the problem and identifying potential solution(s) are critical steps and should occur before implementation.