Postcurriculum Surveys Research Articles

Beyond the symptoms: Team‐based learning for social determinants in emergency medicine training

AbstractBackgroundEmergency departments serve as the front line for individuals facing acute health needs, often compounded by social determinants of health (SDoH). Integrating SDoH into emergency medicine care is vital for promptly addressing health concerns and averting future crises. This curriculum adopts a team‐based approach to train emergency medicine residents in identifying and addressing SDoH, thereby delivering comprehensive and equitable care.MethodsThe curriculum employs various educational strategies, including presession readings, SDoH introductions, case simulations, debriefing sessions, panel discussions, and collaboration with other health care professionals. Evaluation via pre‐ and postcurriculum surveys revealed substantial enhancements in residents' comprehension, identification, and familiarity with local resources related to SDoH.ResultsFindings indicated an uptick in residents' grasp and acknowledgment of SDoH, alongside their capacity to address these factors. Posttraining Likert scores exhibited notable improvements across all domains, underscoring an augmented ability to manage SDoH in clinical practice. This curriculum amplifies residents' capability to deliver patient‐centric care and advocate for health equity.ConclusionsContinuous refinement and assessment are paramount for ensuring residents' readiness to navigate the intricate social determinants affecting patients' well‐being. Ultimately, this curriculum heralds a pivotal stride toward fostering health equity and refining patient care standards within emergency medicine.

Enhancing an Experience-Based Patient-Initiated Mistreatment Training.

Mistreatment of health care workers and learners by patients and their families is prevalent at all levels of training. This mistreatment has negative consequences and disproportionately affects women and historically marginalized and excluded groups. The authors designed and piloted a preliminary practice-based curriculum consisting of a discussion of literature, a framework for responding to mistreatment in the moment, and interactive simulated mistreatment encounters with trained patient actors. Feedback was generally positive, but participants consistently requested greater diversity in the representation of mistreatment. Using funds from the Josiah Macy Jr. Foundation Catalyst Award for Transformation in Graduate Medical Education, the authors expanded and improved the curriculum to meet the needs of a diverse population of learners. Effectiveness of the curriculum was measured using pre- and post-curriculum surveys. The curriculum was delivered over multiple sessions from January 2022 to March 2024 with grant-funded interventions starting in January 2024. Participants included medical students, house officers, and faculty, and 678 participants completed pre-curriculum surveys. Upon implementation of grant-funded interventions, post-curriculum surveys showed improvements in respondents' self-reported plan to use skills demonstrated in the session (4.76 to 4.85, P = .006) and plan to address mistreatment with their teams moving forward (4.75 to 4.81, P = .045). All health care workers and learners deserve to feel safe, respected, and welcome in their work and in training. The foundation of this curriculum will support expansion to meet the needs of all patient-facing health care workers and learners at the pilot institution and beyond.

Integrating an Interventional Pain Management Curriculum in Hospice and Palliative Medicine Fellowship Training: A Feasibility Study.

Pain is a common symptom for patients with cancer. Hospice and Palliative Medicine (HPM) physicians are expected to be experts in both pharmacologic and non-pharmacologic treatment of pain for this patient population. Insufficient knowledge of non-pharmacologic, interventional approaches to pain management is a barrier to providing optimal care. This study assesses the feasibility and effectiveness of an interventional pain management curriculum on HPM fellow knowledge at a single institution. The primary objective was to implement an interventional pain management curriculum for HPM fellows' and secondly to measure its effects on their knowledge and confidence in interventional pain management approaches. We executed an interventional pain management curriculum for HPM fellows. The curriculum consisted of 6 fifty-minute virtual lectures. Anonymous pre- and post-curriculum surveys were used to assess curricular impact. Post-course surveys showed a significant increase in HPM fellows' knowledge and confidence in interventional pain management techniques. An interventional pain management curriculum for HPM fellows is a feasible and promising intervention to significantly impact fellows' knowledge and confidence in non-pharmacologic treatment of cancer pain.

Evaluating a web-based training curriculum for disseminating best practices for the care of newborns with neonatal opioid withdrawal syndrome in a rural hospital, the NOWS-NM Program

BackgroundThe incidence of neonatal opiate withdrawal syndrome (NOWS) in the US has grown dramatically over the past two decades. Many rural hospitals not equipped to manage these patients transfer them to hospitals in bigger cities.MethodsWe created a curriculum, the NOWS-NM Program, a web-based curriculum training in best practices. To evaluate the curriculum, we conducted pre- and post-surveys of NOWS knowledge, attitudes, and care practices, plus post-curriculum interviews and focus groups.ResultsFourteen participants completed both pre- and post-curriculum surveys. They indicated an increase in knowledge and care practices. A small number of respondents expressed negative attitudes about parents of infants with NOWS at pre-test, the training curriculum appeared to have no impact on such attitudes at post-test. Sixteen participants participated in focus groups or interviews. Qualitative data reinforced the positive quantitative results and contradicted the negative survey results, respondents reported that the program did reduce stigma and improve provider/staff interactions with patients.ConclusionsThis curriculum demonstrated positive impacts on NOWS knowledge and care practices. Incorporating focus on core concepts of trauma-informed care and self-regulation in future iterations of the curriculum may strengthen the opportunity to change attitudes and address the needs expressed by participants and improve care of families and babies with NOWS.

An Interactive Mapping and Case Discussion Seminar Introducing Medical Students to Climate Change, Environmental Justice, and Health.

Integrating climate change and health into a medical school curriculum is critical for future physicians who will manage health crises caused by a rapidly changing climate. Although medical schools have increasingly included climate change in the curriculum, there remains a need to address the link between the climate crisis, environmental justice, and historical policies that shape environmental health disparities in local communities. In academic years 2021-2022 (AY22) and 2022-2023 (AY23), second-year medical students participated in a 2.5-hour seminar utilizing didactic teaching and small breakout groups that included interactive mapping activities and case scenarios. Learner knowledge and attitudes were self-assessed using pre- and postcurriculum surveys and a quiz. Qualitative thematic and content analysis was used to evaluate short-answer quiz responses and feedback. Of 357 students who participated in the seminar, 208 (58%) completed both the precurriculum and postcurriculum surveys. Self-assessed ability increased significantly for all educational objectives across both years. Attitudes on the importance of climate change knowledge for patient health also improved from a mean of 3.5 precurriculum to 4.2 postcurriculum (difference = 0.7, p < .01) in AY22 and from 3.6 pre- to 4.3 postcurriculum (difference = 0.7, p < .01) in AY23 on a 5-point Likert scale. This climate change and health session highlighting the link between environmental policy and climate change health vulnerability in the local context was successful in improving students' self-assessed ability across all stated educational objectives. Students cited the interactive small-group sessions as a major strength.

A framework to integrate artificial intelligence training into radiology residency programs: preparing the future radiologist

ObjectivesTo present a framework to develop and implement a fast-track artificial intelligence (AI) curriculum into an existing radiology residency program, with the potential to prepare a new generation of AI conscious radiologists.MethodsThe AI-curriculum framework comprises five sequential steps: (1) forming a team of AI experts, (2) assessing the residents’ knowledge level and needs, (3) defining learning objectives, (4) matching these objectives with effective teaching strategies, and finally (5) implementing and evaluating the pilot. Following these steps, a multidisciplinary team of AI engineers, radiologists, and radiology residents designed a 3-day program, including didactic lectures, hands-on laboratory sessions, and group discussions with experts to enhance AI understanding. Pre- and post-curriculum surveys were conducted to assess participants’ expectations and progress and were analyzed using a Wilcoxon rank-sum test.ResultsThere was 100% response rate to the pre- and post-curriculum survey (17 and 12 respondents, respectively). Participants’ confidence in their knowledge and understanding of AI in radiology significantly increased after completing the program (pre-curriculum means 3.25 ± 1.48 (SD), post-curriculum means 6.5 ± 0.90 (SD), p-value = 0.002). A total of 75% confirmed that the course addressed topics that were applicable to their work in radiology. Lectures on the fundamentals of AI and group discussions with experts were deemed most useful.ConclusionDesigning an AI curriculum for radiology residents and implementing it into a radiology residency program is feasible using the framework presented. The 3-day AI curriculum effectively increased participants’ perception of knowledge and skills about AI in radiology and can serve as a starting point for further customization.Critical relevance statementThe framework provides guidance for developing and implementing an AI curriculum in radiology residency programs, educating residents on the application of AI in radiology and ultimately contributing to future high-quality, safe, and effective patient care.Key points• AI education is necessary to prepare a new generation of AI-conscious radiologists.• The AI curriculum increased participants’ perception of AI knowledge and skills in radiology.• This five-step framework can assist integrating AI education into radiology residency programs.Graphical

Abstract A072: Cancer health education in high schools: A qualitative analysis of student gains

Abstract Background. Cancer disparities are prevalent in Milwaukee, Wisconsin. Community member feedback highlighted the importance of cancer education in reducing these disparities. Extension into alternative venues, such as high schools, can provide an innovative way to promote and provide cancer health information. The Cancer Health Education Curriculum (CHEC) provides high school students with an overview of cancer biology, cancer risk factors, early detection and screening methods, cancer treatment, survivorship, and cancer disparities. To reinforce their learnings, students complete a group project focused on a particular topic of interest. Integrated into the curriculum is a Service-Learning project in which students disseminate the information they learn to the community via a booth at the class sponsored “Cancer Health Fair,” a 30-second public service announcement or sharing their information with five friends and/or family members. Previously we published the effects on knowledge, beliefs and behaviors. In this presentation, we examine if outcomes differ by type of Service-Learning project. We also explore students’ perceptions of anticipated and achieved gains before and after the curriculum, as well as community feedback on the Service-Learning component. Methods. Data was collected between 2017-2019 at a Milwaukee Public High School. Students completed surveys before and after completion of the CHEC that included measures of cancer health knowledge, a validated measure of cancer fear and fatalism and Behavior Risk Factor Survey Study items querying about fruit and vegetable consumption, physical activity, tobacco use and screen time. Pre-curriculum surveys also include the open-ended question, “What do you hope to gain from CHEC,” and post-curriculum surveys include the question, “What did you gain from CHEC.” Quantitative data pre-post were compared using paired t-tests. Qualitative analysis was completed by participants by semester who responded to both pre and post question through coding and theme creation. Results. 521 students with a mean age of 15 completed the curriculum. Quantitative results showed significant improvements in cancer-related knowledge (p &amp;lt; 0.0001), cancer fear and fatalism (p &amp;lt; 0.0001) and three of eight health behaviors assessed showed significant improvement. Qualitative data analyses showed the most predominate response themes from the “gains” question included 1) understanding cancer better, 2) decreasing fear, 3) wanting to make healthy behavioral changes, 4) gaining skills to talk with family and friends about cancer. Qualitative data suggests that the creation of seminal messaging through health education and Service-Learning contributed to change in perception and attitude. Qualitative data through gains analysis will be presented by Service-Learning type. Study results also support the feasibility of integrating cancer education, leveraging a Service-Learning requirement, and the potential for such programs to impact friend/family communications related to cancer. Citation Format: Kathleen O'Connell, Melinda Stolley, Dakota Berg, Abigail Kerschner. Cancer health education in high schools: A qualitative analysis of student gains [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A072.

Implementation of an Evidence-Based Medicine Curriculum for Postgraduate Emergency Medicine Physician Assistant and Nurse Practitioner Fellows.

Within physician assistant (PA) education, the inclusion of evidence-based medicine (EBM) is mandatory. Despite existing literature on EBM training methodologies for PA students and emergency medicine (EM) physician residents, there exists a dearth of published data concerning EBM instruction within postgraduate PA EM programs. A pilot study is described providing an overview of implementation of an EBM curriculum in a single-institution postgraduate physician assistant and nurse practitioner emergency medicine fellowship. Quantitative data using pre-curriculum and post-curriculum surveys were collected. The curriculum included statistical concept screencasts, required attendance at a journal club with assigned topics for discussion, and used a critical appraisal tool designed to help fellows better analyze and understand the articles being reviewed. Upon graduation, fellows participated in structured interviews to collect qualitative data about the curriculum and application of learned concepts to the clinical setting. There was a statistically significant improvement in fellows' reported confidence in discussing the medical literature with practicing providers ( P = .02). However, there was no difference in prescores and postscores on EBM knowledge questions or on fellows' feelings of importance of EBM to clinical practice. Qualitative data revealed several themes, including helpfulness of tools provided in the curriculum, appreciation of curricular changes made secondary to fellow suggestions, and reports of improvement in reviewing medical literature and comfort in participation in local journal clubs upon graduation from the fellowship program. Limitations, including small sample size and validity concerns, are discussed. Positive changes were made to the curriculum based on qualitative data collected. The authors advocate for subsequent investigations into this subject within a multi-institutional and multispecialty context, thereby enhancing the breadth of the findings. Nevertheless, this study furnishes the initial accessible substantiation of the viability of introducing an EBM curriculum within this specific demographic.

The effect of a point-of-care ultrasound curriculum on PAs in emergency medicine.

To address identified learning gaps among physician associates/assistants (PAs) working with point-of-care ultrasound (POCUS) in our ED, we designed and implemented a longitudinal POCUS curriculum. This curriculum introduced the 12 main POCUS applications for emergency medicine with presession educational assignments and in-person learning sessions. We used the Kirkpatrick framework of evaluation to develop our metrics of measurement. To examine the effect of the curriculum, pre- and postcurriculum surveys were completed and use of POCUS before, during, and after the curriculum period was monitored. Our results showed the curriculum increased confidence and knowledge of POCUS applications and significantly increased the use of POCUS clinically by PAs. Formal, on-the-job POCUS education for postgraduate PAs is a vital adjunct to informal clinical learning for PAs in emergency medicine to gain POCUS skills.

Emergency Medicine Obstetrics and Gynecology: A Case-Based Curriculum for Residents.

Millions of patients present to US emergency departments every year with OB/GYN concerns. Emergency medicine trainees must be adequately prepared to care for this population, regardless of how commonly they appear in the training environment. We used active learning and gamification principles in this curriculum to increase learner engagement and participation in the material. We chose OB/GYN topics based on review of Tintinalli's OB/GYN content and the American Board of Emergency Medicine's Model of Clinical Practice. Each session comprised a case-based lecture and review questions using the game-based Kahoot! online software. Pre- and postcurriculum surveys assessed residents' confidence in caring for emergent OB/GYN pathologies on a 5-point Likert scale. We designed survey questions assessing the first level of Kirkpatrick's levels of training evaluation; these questions were reviewed and revised by the department's Medical Education Scholarship Committee for validity. A mean of 18 residents attended each session. Seventy-six percent of residents (26 of 34) completed the precurriculum survey, 67% (23 of 34) completed the postcurriculum survey, and 44% (15 of 34) completed both. For all respondents, mean reported confidence with curriculum topics increased from 3.5 to 4.0 (p < .05). For residents completing both surveys, confidence increased from 3.4 to 4.0 (p < .01). Application of this curriculum significantly improved learner confidence in targeted OB/GYN topics. Future directions could include evaluating curricular impact at higher levels in the Kirkpatrick model, extending sessions to include more time for interaction, and adding suggested readings.

Promoting clinical reasoning with meta-memory techniques to teach broad differential diagnosis generation in a pediatric core clerkship.

Clinical reasoning with generation and prioritization of differential diagnoses (DDx) is a key skill for medical students, but no consensus exists on the best method to teach these skills. Meta-memory techniques (MMTs) may be useful, but the efficacy of individual MMTs is unclear. We designed a 3-part curriculum for pediatric clerkship students to teach one of 3 MMTs and provide practice in DDx generation through case-based sessions. Students submitted DDx lists during two sessions and completed pre- and post-curriculum surveys assessing self-reported confidence and perceived helpfulness of the curriculum. Results were analyzed using ANOVA with multiple linear regression. A total of 130 students participated in the curriculum, with 96 % (125/130) completing at least one DDx session, and 44 % (57/130) completing the post-curriculum survey. On average, 66 % of students rated all three sessions as "quite helpful" (4/5 on 5-point Likert scale) or "extremely helpful" (5/5) without difference between MMT groups. Students generated an average of 8.8, 7.1 and 6.4 diagnoses using the VINDICATES, Mental CT, and Constellations methods, respectively. When controlling for case, case order, and number of prior rotations, students using VINDICATES produced 2.8 more diagnoses than those using Constellations (95 % CI [1.1,4.5], p<0.001). There was no significant difference between VINDICATES and Mental CT (Δ=1.6, 95 % CI [-0.2,3.4], p=0.11) or Mental CT and Constellations (Δ=1.2, 95 % CI [-0.7,3.1], p=0.36). Medical education should include curricula focused on enhancing DDx development. Although VINDICATES helped students produce the most DDx, further research is needed to identify which MMT generates more accurate DDx.

Standardized Curriculum Improves Physician and Nurse Confidence and Competence in Brain Death (P12-2.005)

<h3>Objective:</h3> To study the impact of a standardized brain death curriculum on physician and nurse competence, confidence, and comfort. <h3>Background:</h3> There is decreased familiarity with and exposure to brain death amongst medical professionals when compared with cardiac death. Therefore, targeted education should be offered to multidisciplinary healthcare providers to impact competence and familiarity with this entity. <h3>Design/Methods:</h3> Brain death educational curricula were developed for and offered to (A) neurosciences and critical care physicians to effect accurate declaration and discussion of brain death, and (B) critical care nursing to improve confidence and competence in answering family questions about brain death at the bedside. Trainees and attending physicians underwent a formal didactic followed by simulation-based training incorporating examination and communication skills. Critical care nurses underwent formalized didactic followed by peer-based simulated conversations of frequently asked questions. All participants submitted pre-curriculum and post-curriculum surveys that included a combination of Likert, fill-in, and multiple-choice questions as well as a knowledge test. Wilcoxon signed-rank test and Kruskal-Wallis test were used for statistical analysis (P&lt;0.05). <h3>Results:</h3> 46 neurosciences and critical care physicians and 21 critical care nurses participated in their respective brain death curriculum. Mean scores on knowledge test improved from 5.3 to 6.9 out of 10 for physicians (p&lt;0.001) and from 4.2 to 6.2 out of 8 for nurses (p&lt;0.001). Mean physician confidence in performing independent brain death declaration increased from 3.6 to 7.7, out of 10 (p&lt;0.001). Mean physician comfort documenting a brain death assessment increased from 3.7 to 7.9, out of 10 (p&lt;0.001). Mean comfort in discussing brain death with patients’ family increased from 5.0 to 8.1 for physicians and from 5.3 to 7.8 for nurses (both out of 10, both p&lt;0.001). <h3>Conclusions:</h3> Formalized education on brain death improves confidence, comfort, and competence in brain death among physicians and nurses. <b>Disclosure:</b> Dr. Hodosevich has nothing to disclose. Dr. LaBuzetta has nothing to disclose.

An Advanced, Risk-Driven Sexual Health Curriculum for First-Year Internal Medicine Residents.

Despite recommendations for annual chlamydia screening for young, sexually active females, chlamydia rates continue to increase nationally. Medical school students often receive limited training in obtaining comprehensive, risk-based sexual histories, leading to less screening for sexually transmitted illnesses (STIs). Consequently, many internal medicine (IM) residents feel unprepared for advanced sexual history taking and site-specific STI testing based on sexual practices. We developed a case-based interactive didactic session for IM and med/peds residents. We focused on more advanced topics, such as comprehensive sexual history taking, secondary site testing for STIs, and patient counseling. Based on pre- and postcurriculum surveys, interns reported increases in comfort (scale: 1 = very low comfort, 5 = very high comfort) with counseling after positive STI results (Ms: pre = 2.9, post = 3.5, p < .01) and providing education on safe sex practices (Ms: pre = 3.0, post = 3.6, p < .01) and modest improvement in comfort with expedited partner therapy (EPT; Ms: pre = 2.1, post = 2.5, p = .06). An increase in self-reported confidence with collecting site-specific testing (composite Ms: pre = 2.7, post = 3.5, p < .01) was also seen. Percentage correct on knowledge questions increased from 48% to 78% postcurriculum (p = .01). This curriculum demonstrated improvement in knowledge and comfort with sexual history taking, STI screening, and counseling. Comfort also improved with EPT counseling, but not significantly, which could be addressed in future iterations of the curriculum.

Integrated behavioral health education using simulated patients for pediatric residents engaged in a primary care community of practice.

Novel teaching curricula using simulated patients (SP) and a team-based approach are needed to teach pediatric residents how to approach behavioral health (BH) conditions in an integrated care setting. This mixed-methods study evaluated a pilot curriculum on BH integration in pediatric primary care. Two 1-hour didactic sessions and 3 hours of SP encounters focused on attention-deficit/hyperactivity disorder (ADHD) and anxiety, followed by facilitated debriefings that included interdisciplinary team members. Residents completed pre- and postcurriculum surveys on self-efficacy in patient assessment and management. A subset of residents participated in semistructured interviews, reviewing video recordings of their SP encounters to facilitate reflection on their learning. We conducted qualitative analysis of interview transcripts until we reached thematic saturation. Residents (n = 31) reported significantly improved self-efficacy in the majority of BH skills (p ≤ .05 to p ≤ .0001), including assessing and discussing concerns with families, using screening tools, developing management plans, prescribing medications, and performing warm handoffs with BH clinicians. In analysis of 15 interviews, four themes emerged: shared experiences, mutual engagement, contextual meaning, and behavioral change, which aligned with the components of the communities of practice framework. Sharing experiences within an integrated BH-pediatric primary care learning community enhanced activated, self-reflective learning and consequent behavioral change that contributed to identity formation. Resident participation in the integrated BH-pediatric curriculum improved self-efficacy in patient care for anxiety and ADHD. Curricula implemented in integrated learning communities could help promote reflection and improve integrated pediatric-BH care, including warm handoffs from pediatric to BH providers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Training clinicians in culturally relevant care: a curriculum to improve knowledge and comfort with the transgender and gender diverse population.

To design a replicable simulation curriculum collaboratively with the transgender and gender diverse community to improve clinician knowledge and comfort with providing reproductive care to this population. This is a prospective, single arm pre-post analysis of obstetrics and gynecology residents at a single academic institution after completion of a novel simulation curriculum. The primary outcome was the change in resident comfort and knowledge in providing transgender and gender diverse patient care. A thematic analysis of learner and standardized patient free text responses was analyzed for insights on perceived learner experiences. This curriculum was created with iterative feedback from the transgender community and involved only transgender and gender diverse-identified standardized patients. Thirty residents participated, with 22 responding to both the pre-and post-curriculum surveys, and 11 responding to a 6-month post-curriculum survey. There were significant improvements in learner comfort and knowledge after participation that were found to persist at 6months. Qualitative analysis demonstrated that this was a positive and powerful learning experience for both residents and standardized patients. This simulation curriculum may be an effective and impactful tool to increase trainee comfort and knowledge of transgender and gender diverse patient care, which is important given the lack of physician training in the care for these individuals. By building the foundation with resident learners, the ultimate goal is to enhance the pool of clinicians confident and capable of caring for transgender and gender diverse patients, to increase access to care, and to improve health outcomes in this vulnerable population.

Abstract 11964: Implementation of a Near Peer ECG Didactic Curriculum in an Internal Medicine Residency Program

Introduction: Electrocardiogram (ECG) interpretation is a fundamental skill. Near-peer teaching improves knowledge acquisition and learner satisfaction. We previously demonstrated an improvement in resident comfort level in interpreting ECGs following structured didactics. Here, we aim to establish whether a longitudinal didactic curriculum objectively increases resident performance in ECG interpretation. Methods: This prospective cohort study surveyed Internal Medicine residents at University at Buffalo who participated in monthly ECG didactics over a 7-month period. Pre- and post-curriculum surveys were administered. Responses were anonymous and participation voluntary. Data collected included demographics, attendance, exposure to clinical cardiology, interest in cardiology, and number of sessions attended. Residents were asked to interpret sixteen unique ECGs, divided evenly among eight common rhythms into both surveys. Fall 2021 and Spring 2022 cohorts were compared using t-tests and chi-square analyses. Associations between attendance, comfort level in interpretation, and number of correct interpretations were analyzed using Pearson correlations. Multivariate linear regression determined the strongest predictor of the number of correct ECG interpretations. Results: Spring cohort correctly interpreted a significantly greater percentage of ECGs than Fall cohort (74.5% vs. 60.9% , p &lt; 0.001). Didactic attendance was significantly associated with comfort level in interpreting ECGs (r = .328, p = .018) and a showed trend towards increased number of correct interpretations (r = .248, p = .077). Attending three or more sessions resulted in a greater percentage of correct ECG interpretations compared to those who attended two or fewer sessions (80.0% vs. 71.1%, p = 0.48). Number of clinical cardiology blocks taken was significantly associated with correct interpretations (r = .310, p &lt; .001) and was the strongest predictor of accurately interpreting ECGs (β = 0.29, p = .037). Conclusions: Dedicated ECG didactics improve residents’ ability to interpret ECGs. A longitudinal curriculum which contains both didactic sessions and clinical exposure appears to offer the greatest benefit in improving ECG interpretation skills.

Pediatric Interfacility Transport Curriculum: Its Impact on the Pediatric Intensive Care and Emergency Medicine Fellows’ Performance and Confidence

ObjectivePediatric interfacility transports are frequent. Despite the absence of a formal pediatric transport curriculum in eastern Canada, directly managing patients during transport and medical direction of the referring center and transport team are part of the pediatric critical care medicine (PCCM) and pediatric emergency medicine (PEM) program requirements. The authors developed a pediatric interfacility transport curriculum and measured its impact on fellows’ confidence and performance. MethodsThis was a pilot interventional prospective study in Montreal, Canada. Postcurriculum surveys were used to measure confidence, and high-fidelity simulations were used to measure performance. A target threshold for confidence was defined before implementation, and pre- and post values were compared. The simulation scenario and assessment checklist were locally developed. ResultsThe participants were 11 PCCM and 3 PEM fellows. The content of the curriculum and educational methods were selected based on the literature and a needs assessment survey. All participants rated themselves as confident at the end of the curriculum. Eighty-three percent of the participants were deemed proficient with a perfect interrater agreement. ConclusionThe pediatric transport curriculum had a positive impact on PEM and PCCM fellows’ confidence and performance in transport. Further studies should look at the impact of such a curriculum on participants’ real-life performance and patient care.

Longitudinal Remote SBRT/SRS Training in Latin America: A Prospective Cohort Study.

BackgroundContinuing medical education in stereotactic technology are scarcely accessible in developing countries. We report the results of upscaling a longitudinal telehealth training course on stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS), after successfully developing a pilot course in Latin America.MethodsLongitudinal training on SBRT and SRS was provided to radiation oncology practitioners in Peru and Colombia at no cost. The program included sixteen weekly 1-hour live conferencing sessions with interactive didactics and a cloud-based platform for case-based learning. Participant-reported confidence was measured in 16 SBRT/SRS practical domains, based on a 1-to-5 Likert scale. Pre- and post-curriculum exams were required for participation credit. Knowledge-baseline, pre- and post-curriculum surveys, overall and single professional-group confidence changes, and exam results were assessed.ResultsOne hundred and seventy-three radiotherapy professionals participated. An average of 56 (SD ±18) attendees per session were registered. Fifty (29.7%) participants completed the pre- and post-curriculum surveys, of which 30% were radiation oncologists (RO), 26% radiation therapists (RTT), 20% residents, 18% medical physicists and 6% neurosurgeons. Significant improvements were found across all 16 domains with overall mean +0.55 (SD ±0.17, p<0.001) Likert-scale points. Significant improvements in individual competences were most common among medical physicists, RTT and residents. Pre- and post-curriculum exams yielded a mean 16.15/30 (53.8 ± 20.3%) and 23.6/30 (78.7 ± 19.3%) correct answers (p<0.001).ConclusionLongitudinal telehealth training is an effective method for improving confidence and knowledge on SBRT/SRS amongst professionals. Remote continuing medical education should be widely adopted in lower-middle income countries.

Addressing geographic disparities in dermatology through virtual educational outreach

Purpose: Rural areas face significant shortage of dermatologists. Rural origin is a strong indicator of eventual rural practice for physicians, however students of rural background account for less than 5% of all incoming medical students. Increasing representation of students with rural backgrounds is important to increase the supply of dermatologists in rural areas, which have higher skin cancer mortality rates compared to urban populations. We created a virtual educational outreach program for high school students in Maine, a predominately rural state, to create interest amongst high school students in pursuing a career in health care.&#x0D; Methods: We developed a virtual pipeline program called the Inside Medicine Program that provides monthly educational workshops to high school students in Maine. For one of the sessions, we conducted a dermatology workshop teaching various topics in Dermatology. Pre- and post-curriculum surveys were sent to 33 students, which used a 10-point Likert scale to rate interest and perceived knowledge levels in these topics.&#x0D; Results: After the workshop, 100% of respondents endorsed a greater understanding of the path to a dermatology career and 94.12% stated that they were interested in learning more about dermatology. Moreover, students endorsed greater interest in pursuing a career in dermatology and reported a significant increase in knowledge about various dermatologic topics.&#x0D; Conclusions: Our results suggest that our program has improved these students’ interest and perceived knowledge in dermatology. We hope that this will promote their subsequent entry into the medical field to address shortages in subspecialty care in rural areas.

Martial arts-based curriculum reduces stress, emotional, and behavioral problems in elementary schoolchildren during the COVID-19 pandemic: A pilot study.

This exploratory study examined the impact of Heroes Circle, a martial arts-based curriculum on stress, emotional, and behavioral problems in elementary school children. While students completed classroom surveys at baseline, post-curriculum surveys were collected from teachers, students, and parents/guardians two and five months after COVID-19-related school shutdowns. Satisfaction with the curriculum was high among those who received the intervention. Children reported increased mindfulness and decreased stress over the school year. Most children (77%) were still using the program's techniques and reporting benefits five months later, including lower internalizing symptoms and COVID-19-related fears. These patterns were not observed at the control school.