Multimodal Workshop Research Articles

Addressing Firearm Safety Counseling: Integration of a Multidisciplinary Workshop in a Pediatric Residency Program.

Firearm-related injuries are the second leading cause of death among US children. Given this, firearm injury prevention should be a key aspect of pediatric anticipatory guidance. We assessed the impact of a firearm safety counseling workshop on pediatric resident knowledge, self-efficacy, and self-reported practice patterns. Sixty of 80 residents (75%) participated in a 2-hour multimodal workshop, including video, didactics with experts, and role-play scenarios. Participants were invited to complete pre-workshop, immediate post-workshop, and 3- and 6-month post-workshop self-reported questionnaires evaluating knowledge, comfort, perceived barriers, and reported practice patterns. Data comparing pre- and 6-month post-workshop practice patterns were analyzed via Fischer's exact test. Remaining statistical analysis utilized a one-sided, unpaired Mann-Whitney U test. A binomial exact proportions test was used for open-ended responses. After the workshop, the percentage of participants with perceived concern regarding parental barriers decreased significantly (24% to 7%, P = .001). Participants 6 months post-workshop were 5.14 times more likely to counsel their patients on firearms during more than 75% of their well visits than prior to the intervention (P = .010). Participants reported greater comfort asking patients about firearms, with mean Likert scores increasing from 3.81 pre to 4.33 post (P = .022), which was similar to 3-month (4.39, P = .06) and 6-month evaluations (4.54, P = .003). Education on firearm safety counseling improved pediatric resident comfort level in discussing the topic. This impact persisted 6 months after the workshop, implying a sustained change in attitudes and behaviors.

28. AN APPROACH TO DIFFICULT CONVERSATIONS FOR PEDIATRIC RESIDENTS: CHILD MALTREATMENT

Background Identifying and managing suspected child maltreatment is an unfortunate part of every pediatrician's job. Many pediatric trainees feel uncomfortable with multiple aspects of suspected child maltreatment cases including introducing concerns with caregivers, asking follow-up questions, documentation, requirements for mandated reporters, and available resources. Just like medical knowledge, communicating with patients and families in difficult situations is a skill that can be taught but may be lacking in the formal medical curriculum. Objectives: To teach a skill set that will increase resident comfort level in the setting of suspected child maltreatment, specifically: introducing the concern with caregivers, follow up questions, reviewing requirements as mandated reporters, and practical skills regarding physical examination and documentation. Methods A three-hour multi-modal workshop was developed for pediatric trainees at the beginning of their intern year to teach a skill set that would increase resident comfort level in the setting of suspected child maltreatment cases. Interns experienced a didactic session covering an approach to difficult conversations (SPIKES and HARD protocols) as well as practical knowledge regarding their role as mandated reporter, history taking, physical exam, and documentation. After the didactic session, residents experienced a role play session where they could practice the skills they just learned. Pre- and post- workshop surveys were obtained from trainees to evaluate both prior experience with child maltreatment cases as well as their comfort level with future child maltreatment scenarios before and after the workshop. Results A total of 28 Pediatric and Medicine/Pediatrics interns completed this workshop over the course of 3 academic years. Compared to pre-workshop data, interns felt more comfortable discussing concerns for child maltreatment with parents or caregivers (p Conclusions A three-hour multi-modal workshop improved interns’ comfort level regarding suspected child maltreatment cases including raising concerns with caregivers, communication with other team members, and documentation related to these cases. References “Practical Plans for Difficult Conversations in Medicine: Strategies That Work to Break Bad News.” Robert Buckman, MD PhD.

AN EVALUATION OF THE VA RURAL INTERDISCIPLINARY TEAM TRAINING PROGRAM: OUTCOMES AND IMPLICATIONS

The rural interdisciplinary team training (RITT) program has provided in-person training for almost 2000 VA providers and staff at 125 rural clinics since 2011. The multi-modal workshop, accredited for 6.5 hours for a number of disciplines, focuses on the recognition of common issues facing older Veterans, red flags prompting further assessment, how to administer screening instruments and team-based approaches for improving patient outcomes. Participants develop an improvement action plan improvement project based on common challenges faced by clinic patients. A program evaluation found an increase in geriatrics knowledge and a modest improvement in teamwork after the education program. It also found that participants self-identified an enhanced ability on average to use red flags after the 6.5 hour training in areas such as polypharmacy, falls and caregiver stress. The action plans were often not implemented at follow-up. The evaluation results will be discussed, as well as challenges, limitations, and implications.

Self-Efficacy in Multimodal Narrative Educational Activities: Explorative Study in a Multicultural and Multilingual Italian Primary School

The international migration changed the situation in the Italian school system: it is asked to update educational practices with new pedagogical models of narration and expression (multiliteracies and multimodality) and to promote digital skills from childhood. Self-efficacy, more than the actual performance, influences the will to try again and not give up. Few studies are available on how narrative self-efficacy affects expressive development, especially in school contexts characterized by multilingualism and multiculturalism. This exploratory survey aims to investigate the narrative self-efficacy of eighteen 8-year-old children attending primary school, with a significant presence of international migrant children (two out of three). For three months, these students were involved in multimodal narrative learning activities through gestural/mime languages (theatre), visual languages (drawings), verbal languages (oral and written) and digital languages (digital video narration). The research questions were: (1) Does the multimodal workshop influence the self-efficacy beliefs of the narrative skills perceived by Italian students (L1) and international migrant students (L2)? (2) Does the most influence come from the mime/gestural, the digital video or the entire multimodal narrative activities? (3) In which aspects of the narrative is the self-efficacy most influenced by the multimodal workshop for L1 and L2 groups?

An Introduction to Research Work, Scholarship, and Paving a Way to a Career in Academic Medicine.

Despite high faculty attrition and challenges to expanding the number of clinician-researchers, career development to heighten trainees' pursuit of an academic research career remains a relatively understudied topic. Completing peer-reviewed publications during medical school increases a trainee's likelihood of becoming a future faculty member. There is a lack of educational content to guide trainees in selecting research activities, publishing, and gaining self-efficacy to pave a path towards a clinician-researcher track. The Kern model was applied to create a multimodal workshop that would heighten trainee awareness of various research opportunities, skills for conducting research, best practices in publishing, and also help them develop a personal plan to pursue research. The workshop included a presentation, reflection exercises, and a case scenario. The workshop was implemented among trainees attending professional development conferences at nine medical schools. A questionnaire assessed participants' change in self-efficacy in completing research scholarship and pursuing an academic research career. Sixty medical students and seven residents participated in the workshops. Paired-sample t tests indicated a statistically significant increase in participants' perception that academic medicine would allow them to engage in research work, and in their self-efficacy to publish and succeed along a clinician-researcher track. The workshop not only exposed participants to a variety of research activities but also provided a sense that all research types are valid, aiding some participants to identify new research opportunities. In addition, participants gained clarity on how to publish and develop a research path, which may help maintain interest in a clinician-researcher track.

Providing Trainees With an Introduction and Decision-Making Framework for Pursuing an Academic Residency Position.

Medical students are a significant source of the future academic medicine workforce, but surprisingly little is typically done to promote academic medicine career awareness during the early stages of medical education. To raise awareness among medical students of the critical role an academic residency plays in pursuing a future academic career, we developed a workshop that describes what an academic residency entails and what to consider when selecting such a program. The six-step Kern model was applied to develop a multimodal workshop to help trainees understand characteristics of and explore their interest in an academic residency program. The 60-minute workshop consists of a PowerPoint presentation, reflection exercise, and case scenarios to help trainees learn and apply new skills in selecting a residency program. The workshop was offered to diverse medical students at nine different medical schools across the country between July 2016 and May 2017. Of the 115 workshop participants who completed the evaluation form, over 95% agreed or strongly agreed that each of the learning objectives was met. A paired t test of learner responses pre- and postworkshop demonstrated significantly increased confidence in finding an academic residency position. This workshop fills an important gap in raising medical students' awareness of how to pursue an academic medicine career by highlighting the critical role of an academic residency program. Participants liked the use of vignettes and small-group discussion to better prepare them in exploring and benefiting from an academic residency position.

Influence of an Educational Intervention on Pre-Allied Health Students' Attitudes Toward Older Adults

The purpose of this study was to determine the influence of an educational intervention on the knowledge and attitudes of pre-allied health students toward older adults. The subjects were 41 pre-allied health students assigned to an intervention (n = 19) or comparison group (n = 22). The intervention group participated in a six-hour multi-modal workshop consisting of didactic lecture, group activities, and simulation activities. A posttest only quasi-experimental design over time was used. Palmore's FACTS on Aging Quiz and Kogan's Old People Scale were used to measure knowledge and attitude towards older adults one week and 10 weeks following the workshop. The intervention significantly improved knowledge in the short term (p = 0.031). No significant difference was noted between the two groups on the attitudinal surveys.

A new approach to developing cross-cultural communication skills

The need for cross-cultural training (CCT) increases as physicians encounter more culturally diverse patients. However, most medical schools relegate this topic to non-clinical years, hindering skills development. Some residency programs have successfully addressed this deficit by teaching cross-cultural communication skills in a teaching objective structured clinical examination (tOSCE) context. The authors developed and evaluated a CCT workshop designed to teach cross-cultural communication skills to third-year medical students using a tOSCE approach. A 1½-day workshop incorporating didactic, group discussion and tOSCE components taught medical students cross-cultural awareness, interviewing skills, working with an interpreter, attention to complementary treatments, and consideration of culture in treatment and prevention. Six standardized patient cases introduced various clinical scenarios and the practical and ethical aspects of cross-cultural care. Student evaluation of the workshop was positive concerning educational value, skills advancement and pertinence to their clinical activities. Survey of students before and after the workshop demonstrated improvement in students’ abilities to assess the culture and health beliefs of patients and negotiate issues regarding treatment. CCT in the context of medical student clinical training can be carried out effectively and efficiently using a dedicated multi-modal workshop including standardized patients.

Effects of a Workshop on Mental Health Practitioners' Attitudes Toward Homosexuality and Counseling Effectiveness

The effects of a training workshop on mental health practitioners' attitudes toward homosexuality and counseling behavior were compared with the effects of no intervention. Treated subjects (n = 21) were enrolled in a 3‐day multimodal workshop about gay/lesbian counseling, and no‐treatment comparison subjects (n = 31) were enrolled in other counselor education coursework. Before and after the workshop, subjects completed homosexuality attitude questionnaires and a quasibehavioral gay/lesbian counseling effectiveness measure. Treated subjects improved significantly more than comparison subjects on all measures, and the gains remained in evidence at an 8‐week follow‐up. The multimodal training workshop thus appears encouraging as a possible means of instilling needed attitudes and skills in counselors of gay and lesbian clients.