Medical Education Environment Research Articles

Assessment of mental health and various strategies among Health Professions' (HP) students: A cross sectional study in King Saud Bin Abdulaziz University for Health Sciences.

The education environment of medical colleges is known to have a burdensome effect on the overall mental health of the students. This study aimed to investigate the immediate impact of the medical education environment on mental health and quality of life among Health Profession students and to identify various coping strategies used by students to mitigate the stress. An online survey was conducted between April 1 and May 10, 2021, using a validated questionnaire based on DASS-42, employing a snowball sampling technique. A total of 338 students filled the questionnaire. The respondents had a high level of depression and anxiety scores, categorized as very severe which were significantly different among level of education (P < .05), for example, 88.9% of sixth year students had very severe depression compared to just 37% of first year ones. Gender-wise very severe scores varied from lowest 45.8% to 70.3% with comparable results for both males and females. Additionally, more than 30% of the students listed that the amount of material to be covered, lack of time to study the material to be tested, heavy demand to study, concern about trying to learn all the content, and competitiveness among students to be the top reason which affect their mental state of mental health. This study identifies the need to provide the free professional and psychological services to help cope with stress to the health profession students.

Teaching Future Teachers: Development of a Students-as-Teachers Advanced Elective for Post-Clerkship Medical Students.

Although teaching is an essential part of Graduate Medical Education and the practice of medicine, it is not often formally taught in Undergraduate Medical Education. Vanderbilt University School of Medicine (VUSM) has addressed this gap by creating a year-long Students-as-Teachers elective for post-clerkship medical students. The elective utilizes diverse activities to emphasize core tenets of medical education theory while simultaneously providing authentic teaching opportunities. The success of the elective is primarily attributable to its structure and design, the collaborative and supportive medical education environment, and student initiative and engagement. This manuscript describes the implementation and outcomes of the Students-as-Teachers elective.

Medical education environment perception and learning engagement in undergraduate nursing students: The mediating effect of self-regulated learning ability

AimTo investigate the interrelationships of medical education environment perception, learning engagement and self-regulated learning ability among Chinese undergraduate nursing students. BackgroundAfter the outbreak of COVID-19, great changes have taken place in the medical education environment, many offline teaching and academic activities have been replaced by online activities. Students’ learning engagement influences the efficiency of online learning. However, the mediating effect of self-regulated learning (SRL) ability between medical education environment perception and learning engagement is unclear. DesignThis study involved a cross-sectional descriptive correlational research. MethodsA total of 228 undergraduatenursing students who were attending online learning were included in this study.This investigation adopted Dundee Ready Educational Environment Measure scale (DREEM), Motivated Strategies for Learning Questionnaire (MSLQ) and Utrecht Work Engagement Scale-Student scale (UWES-S) to respectively know about the levels of medical education environment perception, self-regulating and learning engagement. The structural equation model and bootstrap method were used to clarify the association and interaction among the three variables. ResultsThe scores of nursing students' medical education environment perception, SRL ability and learning engagement were 135.64 ± 15.12, 161.39 ± 22.57 and 68.01 ± 11.77, respectively. Perception of medical education environment directly affects learning engagement (β = 0.556, P < 0.001). SRL ability partially mediated the effect of medical environment perception on learning engagement (x2/df = 1.427, RMSEA = 0.043, GFI = 0.962, NFI = 0.954, TLI = 0.980, CFI = 0.986), and the variance was 30.8 %. ConclusionSRL ability plays a mediating role between medical education environment perception and learning engagement. Nursing educators should continuously optimize the online education environment, such as designing intelligent teaching platform or software, adopting interactive teaching methods, strengthening professional value education and encouraging peer learning, so as to meet the requirements of nursing students' learning engagement in the new medical education environment.

Development and validation of Digi-MEE Instrument measuring online learning environments in medical education

Objectives: To develop and validate Digital Medical Education Environment (Digi-MEE) Instrument for measuring online learning environment in medical education.&#x0D; Methods: This series of studies involved 696 participants from May 2022 to December 2022. Following scoping review, invited modified e-Delphi experts developed consensus on the components and related items for measuring online learning environments. A panel of content experts and a group of medical students carried out content and response-process validation to determine Content Validity Index (CVI) and Face Validity Index (FVI) respectively. This was followed by exploratory and confirmatory factor analysis and reliability analysis to determine Digi-MEE’s factorial structure and internal consistency using SPSS version 26.0 and AMOS 26.0.&#x0D; Results: Delphi experts agreed upon nine components with 73 items of initial Digi-MEE version. CVI of Digi-MEE 2.0 was more than 0.90. with FVI of Digi-MEE 3.0 of 0.87. Exploratory factor analysis yielded 46 items with 57.18% variance. Confirmatory factor analysis led to the final Digi-MEE version containing 28 items within nine components with acceptable levels of goodness of fit indices. Overall Cronbach alpha of the final Digi-MEE was more than 0.90, and for the nine components ranged between 0.62 and 0.76.&#x0D; Conclusion: Digi-MEE is a promising valid and reliable instrument to evaluate online education environment in medical education. Content, response-process, factorial structure, and internal consistency evidence support the validity of Digi-MEE. Medical schools can use Digi-MEE as an evaluation tool for the continuous quality improvement of online learning environments.&#x0D; doi: https://doi.org/10.12669/pjms.39.6.8430&#x0D; How to cite this: Naeem NK, Hadie SNH, Ismail IM, Yusoff MSB. Development and validation of Digi-MEE Instrument measuring online learning environments in medical education. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.8430&#x0D; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Strategies to Create a More Gender Identity Inclusive Learning Environment in Preclinical and Clinical Medical Education.

Recognition of the spectrum of gender identities has been a recent phenomenon in the medical profession. Over the past 20 years, medical literature related to gender identity diversity has increased several-fold, yet it more commonly addresses clinical care rather than aspects related to medical education. Medical educators continue to struggle with appropriate language and inclusive approaches when discussing gender-based aspects of medical education. Reproductive health education, including obstetrics and gynecology clerkships, is particularly vulnerable to missteps and anachronisms regarding gender identity.This article aims to provide preclinical and clinical medical educators with strategies to identify and predict situations where missteps related to gender identity inclusivity may occur in their curriculum or learning environment, and to develop approaches to improve gender identity inclusivity within medical education. The authors explore 3 areas that commonly pose challenges for medical educators: inclusive language and terminology, anatomy education, and reproductive genetics and genetic counseling. They hope the tools and strategies provided here will be useful to reproductive health medical educators across specialties to enable the realization of a more inclusive learning environment in reproductive health.

Validity Evidence of A Screening Tool for Early Detection of Clinical Crisis-Related Anxiety Amongst Medical Students

Construct: Psychological distress among students is a growing concern in medical education, even more so with the advent of COVID-19 pandemic. Anxiety is among students’ mental health issues. High and persistent anxiety has many negative impacts on students’ academic and personal life. Early detection is essential for timely intervention. Background: Currently, medical student anxiety is assessed using tools primarily designed for psychiatric purposes. Despite their excellent validity evidence, these tools contain sensitive items and do not explore stressors related to clinical activities. There is a need for contextualized tools to better identify anxiety-provoking factors specific to the medical education environment. Approach: We previously developed the Crisis Experience Rating Scale (CERS-7), a short screening tool to identify early on anxious students participating in clinical activities during the first wave of the COVID-19 pandemic. The present study sought to produce further validity evidence for the CERS-7. Medical students in their clinical years at two Swiss and one French medical school, all involved in COVID-19 clinical activity during the second wave of the pandemic, completed the CERS-7 and the State Anxiety Inventory (STAI-A), the best known and widely used tool to measure for general anxiety. We evaluated internal structure using confirmatory factor analysis (CFA) and relation to other variables using linear regression (LR) and receiver operating characteristic (ROC) curves with thresholds defined using the Youden index. Findings: There were 372 participants. CFA confirmed the two-factor structure of the CERS-7 scale from first-wave dataset. The CERS-7 total scale and subscales demonstrated validity evidence in relationship to the STAI-A scores and categories. A CERS-7 total scale score < 27.5 identified 93% of severely anxious students. Conclusion: The CERS-7 produces reliable scores to use for monitoring anxiety status when assigning students to clinical settings as well as for improving training conditions during clinical crisis.

Novel 3D Custom-Made Silicone Tumor Model as a Support for Teaching Surgical Oncology Principles.

Alternative laboratory teaching methods are becoming increasingly desirable and effective in medical education environments. While ethical concerns associated with the use of live animals in terminal surgery laboratories have been reduced with cadaveric models, availability, and lack of pathology can limit their ability to adequately convey surgical principles and replicate clinical training. We have developed a three-dimensional (3D) custom-made silicone soft tissue tumor model using 3D-printed molds derived from canine soft tissue sarcoma computed tomography images. This novel teaching model allows users to apply surgical oncology principles and perform basic technical tasks such as incisional biopsy, margin demarcation, marginal and wide surgical excision, and inking of surgical margins. A large cohort of students in addition to a small number of professional veterinarians at different levels of specialty training followed the laboratory guidelines and evaluated the simulated tumor model based on a qualitative survey. All participants were able to successfully complete the practical training. The model also allowed the students to identify and correct technical errors associated with biopsy sampling and margin dissection, and to understand the clinical impacts related to those errors. Face and content validity of the model were assessed using Likert-style questionnaires with overall average instructors' scores of 3.8/5 and 4.6/5, respectively. Content validity assessment of the model by the students approximated instructors' evaluation with an overall average score of 4.4/5. This model development emphasizes the efficacy of alternative non-cadaveric laboratory teaching tools and could become a valuable aid in the veterinary curricula.

Intelligent Avatars, Holographic Tools, Digitized Objects: An Extended Reality Simulation Demonstration

How can we design engaging and effective medical education both online and on site? Extended reality (XR) is a term referring to all real-and-virtual combined environments and human-machine interactions generated by computer technology and wearables. It includes representative forms such as AR, VR, and MR, and the areas interpolated among them. MR is a domain of particular interest today: It takes place not only in the physical world or in the virtual world, but is a mix of the real and the virtual. Metaverses can be enabled by MR wearable augments. Glasses-free MR is another very interesting dimension: e-REALâ, as a MR environment for hybrid simulation and medical education in general, can be a stand-alone solution or even networked between multiple places through a link to a special videoconferencing system. Digital humans and human-sized holograms are part of the e-REAL scenarios, making this solution unique, rich, and diversified.

Developing a Conceptual Model of Self-Directed Learning in Virtual Environments for Medical Sciences Students

Identification of key factors affecting the self-directed learning process in the virtual environment of medical education is vital. In this article, we designed a model that describes the self-directed learning process in the virtual learning environment for post graduate students of medical sciences in Iran. This study was carried out in two steps: first, using a qualitative study, we explored the formation of a self-directed learning process in the virtual environment. Second, a review of the literature was conducted to identify the conceptual models. Finally, based on the results, a self-directed learning model for virtual learning was developed. A total of 25 people were research participants in the qualitative part, and individual interviews were conducted with both faculty members and students. There were 1,049 codes, 80 subcategories, 15 categories, and 5 themes extracted from the interviews and through analysis. The themes included (a) backgrounds and requirements, (b) support, discipline, and coordination of the educational system, (c) students’ effort to manage to learn, (d) efficiency, attractiveness, and organization of educational environments and context, and (e) personal excellence, growth, and development. The self-directed learning process in virtual environments consists of some elements and structures, and a description of the relationship between these elements can be the basis of educational planning to develop and compile an effective evaluation of this skill.

The “Intern” Label: Introducing Unnecessary Confusion and Bias?

The Oxford English Dictionary defines "intern" as "a student or trainee who works, sometimes without pay, at a trade or occupation in order to gain work experience." In the medical realm, the label "intern" may introduce confusion as well as implicit and explicit bias. In this study, we sought to examine the general public's perception of the label "intern" compared to the more accurate label "first-year resident." We developed 2 forms of a 9-item survey that assessed an individual's level of comfort with surgical trainees' participation in various aspects of surgical care and knowledge of medical education and work environment. One form used the label "intern" and the other used "first-year resident." San Antonio, TX. A total of 148 adults in the general population at 3 local parks on 3 separate occasions. A total of 148 individuals completed the survey (74 per form). Respondents who did not work in the medical field reported less comfort with interns vs first-year residents participating in various aspects of their care. Only 36% of respondents were able to correctly identify which surgical team members have completed a medical degree. Directly assessing perceptual incongruity between the labels "intern" and "first-year resident," 43% of respondents said interns have a medical degree compared to 59% for first-year residents (p = 0.008), 88% stated that interns work full-time in the hospital compared to 100% for first-year residents (p = 0.041), and 82% stated that interns get paid for their work in the hospital compared to 97% for first-year residents (p = 0.047). The label "intern" may confuse patients, family members, and perhaps other healthcare professionals regarding the level of experience and knowledge of first-year residents. We advocate for abolishing the term "intern" and replacing it with "first-year resident" or simply "resident."

Valoración del instrumento modificado Dundee Ready Educational Environment Measure, versión peruana, durante la pandemia COVID-19

IntroductionTo validate a modification of the Peruvian version of the Dundee Ready Educational Environment Measure (DREEM) instrument to assess the distance learning environment during the COVID-19 pandemic. MethodsInstrumental, analytical, cross-sectional, prospective study. A 50-item Google Forms questionnaire was applied to 527 medical students with modifications in the domain of perception of teaching (02) and perception of the atmosphere of the educational environment (03). The sampling was non-probabilistic and by convenience. ResultsThe average age of the students was 20.4 (±2.74) years. 63% were women, 88% used a personal computer and 62.6% described the quality of their Internet connection as regular. The adequacy of the sample was pertinent (Kaiser-Meyer-Olkin sampling coefficient 0.96 and Bartlett's sphericity test with Chi-square 13,976.1; p < 0.05 and df 1,225). The extraction of factors through the analysis of the main components and Varimax rotation, yielded 10 primary factors that explain the accumulated 62.54% of the total variance. The reliability analysis had Cronbach's alpha of 0.95. This result is considered to be very adequate. The students rated the remote educational environment "with many problems", the mean global score was 87.7 (±1.18), with a confidence interval of 95% (85.4 - 89.9), range 134 between 24 and 158 points. ConclusionThe proposal to modify the DREEM instrument of the Peruvian version to assess the remote or distance educational environment in medical education is adequate during the COVID-19 pandemic.

Understanding the Functional Components of Technology-Enhanced Learning Environment in Medical Education: A Scoping Review.

The online version contains supplementary material available at 10.1007/s40670-023-01747-6.

Fostering a Health-Promoting Learning Environment in Medical Education: Adapting the Okanagan Charter for Administrators and Medical Educators.

Medical students enter medical school with similar or even better well-being than their age-matched peers in other educational programs, but there is predictable erosion of their well-being following matriculation. Interventions to counter this erosion predominantly focus on the individual level; however, significant systemic issues persist that thwart meaningful change. Effectively reforming the learning environment and more broadly targeting problematic aspects of the culture of medical education are essential steps to advance efforts to improve medical learner well-being. Although a healthy environment may allow learners to be well in the educational setting, a health-promoting learning environment strives to promote and embed well-being across all aspects of the learner's experience. Health-promoting learning environments operate by infusing health principles into all aspects of operations, practices, mandates, and businesses. The Okanagan Charter is a widely adopted international framework with principles for best practices of adoption. This charter has the recent endorsement of the Association of Faculties of Medicine of Canada, representing all faculties of medicine in Canada, and serves as a framework for reassessing work on well-being in medical education. In response to this endorsement, the authors have adapted the 5 strategies from the charter for pragmatic integration into the medical education environment and added a sixth strategy: (1) embed health in all policies; (2) develop sustainable, supportive spaces; (3) create thriving medical communities and culture; (4) encourage, support, and sustain meaningful personal development; (5) review, develop, and strengthen faculty-level health services; and (6) collaborate and invest in continuous improvement and evaluation. For each of these 6 strategic directions, actionable steps for implementation in academic medicine are provided to create sustainable and meaningful change.

Perceived Workplace Bullying and Mental Health Status among Medical Residents in Iran

Background: The prevalence of negative act behaviors among medical residents has not yet been assessed in our country. Present study aimed at evaluating the prevalence and impact of negative act behaviors among residents of four academic hospitals in Iran.&#x0D; Methods: This cross-sectional survey was conducted on medical residents in two educational hospitals affiliated to Iran University of Medical Sciences. An online electronic questionnaire was distributed to all clinical residents in these hospitals via WhatsApp. We used an online electronic four-part questionnaire including demographic data, Negative Act Questionnaire-Revised (NAQ-R), some questions on negative behaviors causes and effects, and General Health Questionnaire 12 (GHQ-12).&#x0D; Results: In total, 254 completed questionnaires were received, with an overall response rate of 71%. Ninety five percent of participants had experienced negative act behaviors once or more during the last six months, whereas 91% of responders had witnessed negative act behaviors during this time. The most common source of these behaviors were senior residents (73.8% of those bullied, n=178). There was a significant positive correlation between the GHQ score and the NAQ-R score assays.&#x0D; Conclusion: This study, as the first study on the prevalence of bullying and negative acts in Iranian medical residents, showed that the medical education atmosphere in residency is not optimal. Therefore, there is a need for certain interventions in the medical education environment. We recommend better education of residents and faculty members, strong policy making, situation assessment and feedback regulations as essential steps towards diminishing bullying and negative behaviors in resident training centers.

Assessing the readiness of medical students for blended learning model using virtual reality

Background: Assessing students’ learning readiness has become more important to establish on-target learning and teaching environments, particularly since blended learning and online learning are widely implemented in medical education. This study aims (1) to examine the reliability and validity of Online Learning Readiness Scale (OLRS) and (2) to identify the levels of online learning readiness for blended learning methods using virtual reality and its associations. Methods: A cross-sectional study with 102 fifthyear medical students was conducted. The data were analyzed through exploratory factor analysis and confirmatory factor analysis. Pearson correlation analysis was utilized to investigate the relationships among dimensions of OLRS. Results: The VN-version of the OLRS scale consists of 16 items in four dimensions, namely Self-directed learning - SDL, Motivation for learning - MFL, Computer &amp; Internet self-efficacy - CIS, Online communication self-efficacy - OCS. Confirmatory factor analysis indicates the model fit of the OLRS scale in a blended learning course context. The composite reliability and construct validity of the scale was found to be within the acceptable range. Students showed high readiness for blended learning course, of which SDL was the dimension having the highest score of readiness, followed by MFL and CIS dimensions. There were positive correlations across all dimensions of OLRS (p&lt;0.001). Statistically significant associations were found between gender, health professional orientation, computer self-efficacy and their experience of medical education environment and dimensions of OLRS. Conclusion: The results indicate that the OLRS is a reliable and valid measurement tool in the assessment of online learning readiness levels of blended learning course using virtual reality. It is recommended to develop a reliable scale to assess the perceptions and readiness of instructors undertaking the move to blended teaching. Key words: confirmatory factor analysis, blended learning, Online Learning Readiness Scale, virtual reality, medical education

Challenges for International Medical Graduates in the US Graduate Medical Education and Health Care System Environment: A Narrative Review.

International medical graduates (IMGs) have become a vital part of the US graduate medical education (GME) and health care system (HCS) workforce; they contribute to essential diversity that relieves cultural and linguistic barriers to health care. The number of IMGs looking for medical training in the United States. has constantly been increasing in the last decades. The challenges they meet begin long before residency application, continue during their transition to residency programs, through early medical training, and eventually subside in senior years. IMGs' hurdles permeate the themes of navigating the US GME and HCS, adaptation to the US culture, communication skills, racial discrimination, emotional distress, and finances. This article aims to comprehensively review available information concerning the challenges encountered by IMGs in their transition to the US GME and HCS environments.

Application of 3D Printing in Training Health Care Providers; the Development of Diverse Facial Overlays for Simulation-Based Medical Training.

The medical simulation manikins used by healthcare learners provide the training of numerous clinical skills but often lack diversity with respect to race, ethnicity, age, and sex. Having a diverse medical education environment is imperative for exposing learners to the diverse population of patients they may encounter when in practice. In this technical report, the development of diverse and cost-effective facial overlays produced using 3D scanning, 3D printing, and silicone to be used on top of the current medical manikins at Lakeridge Health Hospital (Oshawa, Ontario, Canada) is described. To obtain consistent feedback throughout the development process, an advisory committee was consulted monthly at Lakeridge Health Hospital. The process began by determining that two facial overlays would be developed based on the two groups that represent the highest percentage of visible minorities in the Durham Region (Ontario, Canada). Facial overlays representing the South Asian (31.8%) and Black (29.6%) races were chosen. To prevent the generalizability of the facial features of these two races, volunteers who identified as specific ethnicities (East Indian and Jamaican) within each race were selected. To add variation in age for the facial overlays, the East Indian facial overlay was edited to represent an adolescent teenager (15 to 17 years old) and the Jamaican overlay was edited to represent an elderly citizen (over 60 years old). The facial overlays were developed from the 3D scans of the two volunteers and were used to create the design of 3D printed molds, in which silicone was poured in. Pigments were added to the silicone to match the skin tones of the two volunteers, and these specific tones were used as the base color for each facial overlay. Details, such as wrinkles, eyebrows, and lip color, were painted on top of the base using additional pigmented silicone. Additionally, neck overlays were created to provide continuity of the skin tone of the facial overlay. To retain the functionality of the medical manikins, the eyes of the facial overlays were cut out, and the mouth was cut open to allow for intubation training. For stability purposes, Velcro attachments were added to the facial and neck overlays so that they could be secured onto the medical manikins. Overall, the costs to manufacture both facial overlays resulted in CAD 235.65, including local taxes. Once manufactured, both facial overlays were tested by medical students (n=18) during two separate advanced cardiovascular life support (ACLS) training sessions in the local, hospital-based simulation laboratory at Lakeridge Health Hospital. The feedback obtained suggested a need to improve the functionality of the facial overlays by making the mouths bigger and less stiff for easier intubation. However, the overlays were accepted overall as a means to add diversity to the current medical manikins. In the end, cost-effective and diverse facial overlays were created to be used on top of the medical manikins that are currently being used by healthcare learners at Lakeridge Health Hospital.

Innovation and Missed Opportunities in Internal Medicine Undergraduate Education During COVID-19: Results from a National Survey.

BackgroundCOVID-19 disrupted undergraduate clinical education when medical schools removed students from clinical rotations following AAMC recommendations. Clerkship directors (CDs) had to adapt rapidly and modify clerkship curricula. However, the scope and effects of these modifications are unknown.ObjectiveTo examine the effects of the initial phase of COVID-19 on the internal medicine (IM) undergraduate clinical education.DesignA nationally representative web survey.ParticipantsIM CDs from 137 LCME-accredited US medical schools in 2020.Main MeasuresItems (80) assessed clerkship structure and curriculum, assessment in clerkships, post-clerkship IM clinical experiences, and CD roles and support. The framework of Understanding Crisis Response (Royal Society for Encouragement of Arts, Manufactures, and Commerce) was used to determine whether curricular modifications were “amplified,” “restarted,” “let go,” or “ended.”Key ResultsResponse rate was 74%. In response to COVID-19, 32% (32/101) of clerkships suspended all clinical activities and 66% (67/101) only in-person. Prior to clinical disruption, students spent a median of 8.0 weeks (IQR: 2) on inpatient and 2.0 weeks (IQR: 4) on ambulatory rotations; during clinical re-entry, students were spending 5.0 (IQR: 3) and 1.0 (IQR: 2) weeks, respectively. Bedside teaching and physical exam instruction were “let go” during the early phase. Students were removed from direct patient care for a median of 85.5 days. The sub-internship curriculum remained largely unaffected. Before the pandemic, 11% of schools were using a pass/fail grading system; at clinical re-entry 47% and during the survey period 23% were using it. Due to the pandemic, 78.2% of CDs assumed new roles or had expanded responsibilities; 51% reported decreased scholarly productivity.ConclusionsCurricular adaptations occurred in IM clerkships across US medical schools as a result of COVID-19. More research is needed to explore the long-term implications of these changes on medical student education and clinical learning environments.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-022-07490-9.

A Consideration for Intersectional Framing Within Physiological Training

ObjectivesPrevious scholars have identified the need to increase diversity in medical education in terms of diversifying the student base, cultural competency curricula, and increasing health equity (Awosogba et al 2015; Sharma 2019; Hordjik 2019; Muntinga et al 2016). Establishing an intersectional theoretical framework, and other feminist theoretical frameworks, within medical education has been put forth, however literature indicates there are many obstacles in optimizing this implementation (Sharma 2019). In line with Bentabos et al (2014), we argue that much can be gained from addressing health equity at the biomedical undergraduate level, as healthcare is an institution of workers beyond the medical field (e.g. clinical research). Further, we posit that, given AAMC data points (AAMC Diversity in Medicine: Facts and Figures 2019), addressing diversity at the medical education level addresses the problem too late. Finally, the traditional medical education environment likely does not provide space to adequately develop a critical framing of cultural competency (Moore 2007; Muntinga et al 2016). As such, the purpose is to demonstrate how intersectional framing embedded within the Health Disparities track of a Biomedical Research Certificate provides a multidimensional analytical tool able to equip health &amp; care workers, including future medical students to: (1) Increase a diversity minded environment in medical education. (2) Apply reflective and reflexive tools to professional and graduate biomedical aimed curricula thus impacting the organizational discourse overall.MethodsThematic analysis applied to Intersectional Methodology to identify the interaction of curricula content and scaffolded collaborative learning through the Research‐Intensive Community (RIC) Model (Desai et al 2008). The major themes we seek to identify and reflect upon are the Guideposts of Intersectionality laid out by Collins and Bilge (2016). The research question we seek to answer is: how does intersectional curricula within the RIC model interact to create a reflexive lens that can identify and act on inequity at the micro, macro and meso level. Practical Implications:The framework provided here can supply a starting point of implementation that goes beyond an additive framework or simple gesture to intercategorization.

Students' Perception of the Anatomy Educational Environment at Regional Medical Campuses (RMC) and Main Campus

IntroductionIn 2006, the Association of American Medical Colleges (AAMC) recommended to increase medical school enrollment to address an anticipated physician shortage in the future. To accommodate this increase, medical schools not only increased students enrolled at existing medical schools, but also opened new regional medical campuses (RMCs). However, the Liaison Committee on Medical Education (LCME) has standards for medical schools with more than one geographically separate campus; specifically, the curriculum should have comparable educational experiences, equivalent methods of assessment, and uniform graduation standards across all locations. Thus, RMCs have the unique task of maintaining an autonomous identity with their own strengths and resources, all the while remaining consistent and comparable to the central campus. Indiana University School of Medicine has eight RMCs and a main campus in Indianapolis. The first‐year Human Structure course integrates gross anatomy, histology, and embryology and utilizes identical learning objectives, assessment, and state‐wide pre‐recorded lectures. This instructional design leaves the local educational team, cohort of students (75% fewer students at RMCs), and the campus climate among the differences in learning environment. The goal of this study is to explore the differences in medical students’ perceptions of the anatomy environment at RMCs versus the central campus despite comparability in formal curriculum.MethodsThis IRB‐approved study used a modified version of the Dundee Ready Educational Environment Measure, that included a 40‐item Likert survey and six free response questions to gather more information about the medical education environment. First‐year medical students were recruited from three RMCs and main academic campus. A Mann Whitney U test was used to compare survey responses of participants at RMCs and main campus (α ≤ .05) and free responses comments were analyzed using thematic analysis.ResultsA total of 15 RMC (21%) and 12 main campus students (9%) completed the survey. Students at the main campus reported significantly lower scores on 10 items compared to RMC participants (p ≤ 0.035). These items related to stimulating learning, providing student‐centered instruction, offering constructive feedback, and having a relaxed laboratory learning environment. Thematic analysis of free responses was consistent with survey results and demonstrated that students at RMCs appreciate the smaller number of students which provides more opportunity for one‐on‐one instruction, support, and camaraderie among peers.DiscussionIn considering the learning experience of students, the contributions of factors beyond the formal curriculum need to be explored. Thus, the interaction of instructor and student, through empathy, support, communication, and the learning environment as a whole need to be considered and developed. Allowing the unique qualities and identities of the RMC and central campus to flourish can improve the learning environment while maintaining comparable curriculum standards.