Post-session Surveys Research Articles

P-1547. Real-World Patient Insights Inform an Action-Oriented Healthcare Professional (HCP) Educational Initiative to Address Gaps in Uncomplicated Urinary Tract Infection (uUTI) Management

Abstract Background uUTIs are among the most common outpatient infections and reasons for antibiotic use. This project aimed to understand the real-world burden of UTIs on patients, uncover HCP challenges in uUTI management, and educate HCPs to improve knowledge of guidelines and align clinical practices with patient priorities.Table 1.Demographics of Women Who Experience UTIs Who Participated in the Patient Survey (N = 413). Methods Patient surveys were distributed nationwide to women who experience UTIs (Table 1). Baseline HCP surveys were administered in 6 clinics that treat UTIs in the southeast US (Table 2). Survey outcomes informed live education sessions with each clinic from 10/2023 – 2/2024, featuring pre-/post-session surveys and team-based action planning.Table 2.HCP Baseline Survey Participant Demographics (N = 94). Results Outcomes from the patient survey revealed the extensive burden of UTIs on quality of life (N = 413, Fig 1). Patients experienced 4 UTIs in the last year on average and reported the most difficult aspect of experiencing UTIs was fear of recurrence (49%), with 79% of patients seen in urology clinics and 66% of patients seen in infectious disease clinics agreeing they were frequently concerned about recurrence versus 58% of patients seen in other clinics (p < .001 and p = .217, respectively). HCPs (N = 94) also reported their top challenge in uUTI care was management of persistent or recurrent infections (54%) and felt they could most improve on antibiotic stewardship (47%) and aligning clinic protocols with the latest guidelines (42%). HCP education sessions led to improvements in knowledge and confidence in uUTI management. After sessions, more HCPs correctly selected 5 days of nitrofurantoin as a first-line uUTI treatment (85% vs 61%, p < .001) and reported high confidence in applying the latest guidelines (72% vs 40%, p < .001) than before. Patient survey data presented to HCPs during sessions showed patients thought their care teams could most improve on counseling about antibiotic side effects (50%) and education about risks of frequent antibiotic use (47%). In response, 93% of HCPs committed to counseling patients about antibiotic use and UTI prevention and clinic action plans included expansion of patient education efforts.Figure 1.Real-World Patient Insights on UTI Burden. Conclusion This initiative offers real-world insights on the burden of UTIs on patients and demonstrates the potential impact of patient-informed education on HCP knowledge and clinical practice in uUTI care. Disclosures Kalpana Gupta, MD MPH, GlaxoSmithKline: Advisor/Consultant|Iterum Therapeutics: Advisor/Consultant|PhenUtest Diagnostics: Advisor/Consultant|Qiagen: Advisor/Consultant|Up to Date: Royalties|Utility Therapeutics: Advisor/Consultant Kara Cossis, MPH, PA-C, Amgen: Honoraria|Astellas: Advisor/Consultant|AstraZeneca: Advisor/Consultant|Bayer: Advisor/Consultant|Janssen: Advisor/Consultant|Myriad: Advisor/Consultant|Tolmar: Advisor/Consultant

Innovations to the ECHO model to enhance reach and network-building among addiction clinicians in Western Canada

BackgroundBuilding capacity for evidence-based treatment and support for people with substance use disorders (SUD) is an urgent priority in the context of the toxic drug poisoning crisis. We implemented the first substance use-focused Project Extension for Community Healthcare Outcomes (ECHO) in Western Canada for health care providers, to enhance their clinical addiction skills and knowledge, facilitate practice change, and foster a supportive community of practice. The aims of this article are to describe our innovations to the Project ECHO model in British Columbia (BC) and Yukon, and present key program outcomes.MethodsA pragmatic multi-methods program evaluation employed observational records of BC ECHO on Substance Use session attendance, cross-sectional and longitudinal participant surveys, and qualitative interviews with participants to assess satisfaction, relevance, and preparation to use evidence-based approaches, practice change intentions, and actual behaviours.ResultsThe 52 ECHO sessions (from June 2019 to July 2022) attracted 2134 unique registrants with 5089 attendances (mean 124/session), 2132 newsletter subscribers, and 5842 podcast downloads. The evaluation included 844 post-session survey respondents and 53 interview participants. The program included ECHO sessions with rolling attendance; widely accessed supplemental formats (e.g., newsletter, podcast, clinical tools, archived presentation recordings); variable, regional hub representation; and evidence-based content developed by medical writers. These features contributed to broad geographic and discipline reach, high-quality program content, and high mean session satisfaction ratings (4.2/5). Key qualitative themes emerged, related to knowledge and skill acquisition, gaining confidence in providing SUD care, facilitating shared decision-making, increasing compassion for patients, consolidating learning and applying it to practice, and reducing isolation through expanded networks.ConclusionsThe ECHO model is an effective way to improve capacity in SUD care for physicians and nurse practitioners, while offering benefits for interprofessional attendees. Our findings can inform innovations in other ECHO programs to enhance reach, engagement, and impact.

Implementing and Assessing Climate Change Education in a Pediatrics Residency Curriculum.

Background For physicians to effectively combat the growing health crisis that is climate change, they should begin learning during medical training about its health implications. However, there is little data on residents' knowledge of the climate crisis, and even less data regarding the effectiveness and acceptability of climate change education in graduate medical training programs. Objective To incorporate a new educational session on the health implications of climate change into a residency curriculum and evaluate the acceptability of the session and its effects on residents' knowledge, attitudes, and perceptions of the topic. Methods In July 2021, a 90-minute, interactive, small-group format educational session on the health implications of climate change was incorporated into the first-year curriculum of a pediatric residency program. From July 2021 through June 2023, resident participants completed pre- and post-session surveys that assessed their knowledge, attitudes, and perceptions regarding health implications of climate change. Likert scale data were analyzed using Wilcoxon signed-rank tests. Results Of the 109 residents scheduled to participate, 50 (46%) completed both the pre- and post-session surveys. Session participation increased residents' self-reported knowledge of how climate change impacts health and how physicians can act as climate advocates. Ninety-eight percent of all post-session respondents (58 of 59) agreed that they would recommend the session to other residents. With 3 facilitators, the monthly session required ≤4 hours of preparation and ≤12 hours of direct teaching time per facilitator each academic year. Conclusions A single educational session improved residents' self-reported knowledge of the health implications of climate change and was well-received by participants.

A Longitudinal Pediatric Residency Climate Justice Curriculum.

Background Graduate medical education programs must prepare physicians to adapt their care for patients whose health equity and outcomes are being threatened by climate change. This article presents the implementation of a longitudinal climate justice curriculum within a pediatrics residency program. Objective To measure the self-reported changes in attitudes and intentions for change in behavior after implementation of a climate justice curriculum. Methods A longitudinal, 4-part, climate justice and health equity (CJHE) curriculum was implemented from 2023 to 2024 into the broader advocacy training of a pediatrics residency program. Resident participants completed pre- and post-session surveys that assessed their attitudes toward climate change and health, as well as their intentions to engage in climate advocacy. Paired deidentified responses were analyzed via Wilcoxon signed-rank test. Results Thus far, facilitators have conducted 4 introduction sessions, 4 narrative medicine sessions, and 3 health system sustainability sessions. Sixty-eight of 100 residents (68%) completed both pre- and post-session surveys. The curriculum was associated with increased self-reported understanding of how climate change impacts human health (CJHE 1: median of pairwise averages of pair-differences [MPA]=1.00, P<.001; CJHE 3-4: MPA=1.00, P<.001), increased agreement that health care providers can be effective climate advocates (CJHE 1: MPA=2.00, P<.001; CJHE 3-4: MPA=1.50, P<.001), and increased intention to discuss the health impacts of climate change in future patient encounters (CJHE 1: MPA=1.00, P<.001; CJHE 3-4: MPA=1.00, P<.001). Conclusions This longitudinal CJHE curriculum demonstrated acceptability and increased participants' self-reported understanding of how climate change impacts human health and the ways in which physicians can act as advocates.

Incorporating Climate Change Education Into Residency: A Focus on Community Risks and Resources.

Graduate medical education (GME) focused on climate change (CC) health effects is essential. However, few CC education evaluations exist to guide residency programs looking to implement CC content. To evaluate the effect of an education session on residents' self-reported knowledge of CC health effects and confidence utilizing local CC anticipatory guidance and community resources with patients. A CC session was integrated into the pediatric, family medicine, and social medicine curricula at an urban academic medical center in 2023. A convenience sample of residents participated in 1 of 4 nonrandomized case-based or lecture-based sessions. Pre- and post-session 5-question Likert-scale surveys were used for assessment and analyzed using paired t tests. Sixty-eight of 108 eligible residents completed the surveys (28 case-based, 40 lecture-based, 63% response rate). Residents' understanding and confidence to engage with patients on CC health effects after the educational session improved (Q1 mean difference 1.3, t 67=9.85, 95% CI 1.04-1.57, P<.001; Q2 1.5, t 67=9.98, 95% CI 1.20-1.82, P<.001; Q3 1.8, t 67=12.84, 95% QI 1.54-2.11, P<.001; Q4 2.1, t 67=16.25, 95% CI 1.84-2.36, P<.001; Q5 2.1, t 67=16.28, 95% CI 1.86-2.38, P<.001). Resident self-reported understanding of the health effects of CC and confidence utilizing local CC anticipatory guidance and resources with patients increased after a CC education session.

Focused anatomy workshops for clerkships and the USMLE Step 1 examination.

Anatomy is essential for understanding healthy and disease states as well as for the successful completion of clinical clerkships and board examinations. This project provided structured workshops aimed to review anatomical concepts for clerkships and Step 1 and provided a means for medical students to assess their anatomical knowledge. We provided six optional anatomy workshops, in which students (1) took a pre-session quiz, (2) faculty reviewed key anatomy of a particular system (e.g., musculoskeletal), (3) students worked through clinical cases in small groups, and (4) students took a post-session quiz and responded to a post-session survey to rate satisfaction of session content and delivery on a five-point Likert scale. One session was excluded due to small sample size (n = 2). Results from five workshops, including brachial plexus, musculoskeletal, pelvic, gastrointestinal, and head and neck anatomy, showed that students performed significantly (p ≤ 0.05) better on the post-session quizzes compared to pre-session quizzes in all sessions. Post-session survey results indicated that students were satisfied with session content and facilitation, would attend future workshops, and would use session materials to study for Step 1. Based on these short-term benefits of the sessions, we plan to continue offering monthly workshops to medical students to increase knowledge retention of key anatomical concepts and increase preparedness for clerkships and Step 1. Future studies will longitudinally follow up with students post-Step 1 and clerkships to determine the long-term benefits of offering these workshops.

Decreasing Perceived Moral Distress in Pediatrics Residents: A Pilot Study.

Pediatric residents experience ethical dilemmas and moral distress during training. Few studies have identified meaningful methods in reducing moral distress in pediatric trainees. The authors aimed to determine how residents perceive ethics case discussions, whether such a program affects trainee ethics knowledge and perceived moral distress, and if residents' perceived moral distress changes before, during, and after a discussion series. Participants included pediatric residents in a single residency program. Five separate 1-hour sessions were presented over a 5-month period. Each session consisted of a case presentation by a resident developed under the guidance of an ethicist. Multidisciplinary services and content experts were present during sessions. Baseline, postsession, and final surveys were distributed to resident attendees. Open-ended responses were recorded. When comparing baseline and final responses, the only significance was increased preparedness to navigate ethical decisions (p = 0.004). A 10.2% decline was observed in perceived moral distress. An increase in ethics knowledge was observed. Residents favored case-based, multidisciplinary discussions. Residents desire more sessions, time for small-group discussions, and legal insight. Satisfaction was high with 90.7% of respondents feeling better prepared to address ethical concerns. Pediatric trainees desire case-based ethics training that incorporates small-group discussions and insight from multidisciplinary topic experts.

Team-Based Learning & Point of Care Ultrasound (POCUS) to Augment a Preclinical Cardiovascular Physiology Course.

Introduction: There has been increasing interest in point of care ultrasound (POCUS) as a learning tool in preclinical medical anatomy and physiology courses. Few interventions have used team-based learning (TBL) to teach cardiac POCUS. This study investigates a novel TBL exercise designed to integrate cardiac anatomy, physiology, and cardiac POCUS education within a first-year cardiovascular (CV) course called Team-Based Learning - Ultrasound (TBL-US). Methods: The TBL-US exercise consisted of four phases: preparation, individual and team readiness assurance, image acquisition and application, and knowledge assessment. Six second-year students were trained to facilitate the session under physician supervision. Pre- and post-session knowledge assessments were administered to determine knowledge acquisition. Pre- and post-session surveys were administered to assess attitudes, beliefs, and confidence surrounding cardiac POCUS. Final exam scores were compared between participants and non-participants of TBL-US and stratified into high- and low-performing subgroups to account for pre-TBL baseline differences in ability between the groups. Results: A total of 54 first-year medical students completed TBL-US. Students showed significant improvement on the post-knowledge assessment compared to the pre-knowledge assessment (70.5% vs. 54.9% [p< 0.001]) and scored significantly higher on the final CV exam compared to non-participants (low-performing group: 85.92% vs. 81.02% [p=0.039], high-performing group: 89.22% vs. 85.95% [p=0.038]). Between 43.3-72.7% of students reported that TBL-US increased their understanding of CV anatomy, physiology, and cardiac POCUS. Discussion: Students found TBL-US to be a valuable teaching modality and improved student knowledge of CV anatomy, physiology, and cardiac POCUS. TBL-US effectively augments the learning of cardiac anatomy and physiology during the preclinical undergraduate medical curriculum.

An Active-Learning Framework for Educating Medical Students on SARS-CoV-2 Variants and COVID-19 Epidemiology

Background The emergence of multiple Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) variants presented an escalated risk to public health globally and prompted epidemiologic monitoring and classification. Health professionals are vital for patient education regarding Coronavirus Disease 2019 (COVID-19), discussing patient concerns, and providing guidance. Students enrolled in professional healthcare programs benefit from being adept with the evolution and spread of SARS-CoV-2 variants, and a team-based learning module can be helpful for applying foundational concepts to clinical problems. Methods This team-based learning (TBL) framework was developed in response to the COVID-19 pandemic and the emergence of viral variants. It was placed at the end of a hematology block within the first semester of year one of the medical school during the academic years 2021–2022. It consists of a 7-question readiness assurance process and a four-question application exercise. Results The average score increased from 58.8% (iRAT) to 85.9% (tRAT) (n=104). The post-session survey data showed an increase in students’ understanding of the classification of COVID-19 variants and the role of genetic mutations in viral pathogenesis. Qualitative data yielded positive feedback for the session, notably in students' ability to interpret phylogenetic trees and understand the role of variants. Conclusions This TBL framework cultivates higher-order thinking skills among medical students and effectively integrates virology, epidemiology, and pathology. Additionally, it provides a framework for developing a robust and up-to-date platform for the discussion of novel variants of COVID-19 or other infectious diseases.

EDI&amp;S SO02 The Aspire Initiative: A Community-Based Intervention to Champion Equality, Diversity and Inclusion in the Future Surgical Workforce

Abstract Background In March 2021, the Royal College of Surgeons of England published The Kennedy Report, an independent and powerful review addressing the critical issues surrounding equality, diversity and inclusion within the surgical profession. Chapter 5 of the review states that aspirations to become a surgeon can begin whilst at secondary school, yet students from diverse ethnic and social backgrounds felt discouraged by teachers who doubted their potential. We describe the development and implementation of a strategic careers outreach initiative across the state-funded secondary schools in our diverse community, aiming to engage and support aspiring surgeons early in their journey. Method In June 2023, The Aspire Initiative was launched as an independent entity supported by surgeons from the local Hepato-Pancreato-Biliary Unit and sponsorship from the Royal College of Surgeons of England. Targeting students aged 13 to 17, the initiative offers community open events, inspiring video content, surgical work experience for those over 16, and outreach careers assemblies. Between November 2023 and March 2024, 13 assemblies were delivered at various state-funded secondary schools across Leicester. These sessions were led by surgeons reflecting ethnic, gender, and socio-economic diversity. Students were invited to complete surveys before and after the assembly to assess their impact. Results The pre-session survey, completed by 874 students from Years 8-11, revealed that 149 aspired to be doctors or surgeons, while 243 were considering this (n=392). Of the 392 students, 57% reported that their parents had not attended university. Only 19% had a good understanding of the medical school application process, and 21% knew about the support available. Furthermore, 31% felt knowledgeable about the daily responsibilities and training pathways of medical professionals. The post-session survey, with 420 responses, showed significant improvements: 91% gained a better understanding of a surgical career and 52% felt more inspired and motivated to pursue their aspirations. Conclusion The Kennedy Report recommended that careers outreach to diverse communities should be planned for as a strategic priority. This study highlights the impact of such initiatives in state-funded secondary schools, showing how they provide students from diverse social backgrounds with crucial insights into surgical careers. These programs help students make informed decisions and inspire them to pursue their aspirations by connecting with relatable role models. We propose that engaging with students at the secondary school level offers an ideal opportunity for surgeons to foster and sustain professional relationships with a diverse future workforce, laying foundations for continued support and mentorship.

Assessing utility of a simple low-cost simulator model to improve direct ophthalmoscopy skills amongst medical students

BackgroundOphthalmoscopy is an essential skill for medical trainees, however, trainees commonly report feeling uncomfortable with this skill. The purpose of this study is to determine the utility of a low-cost simulator in improving medical student’s comfort and proficiency with direct ophthalmoscopy.MethodsAn easy to assemble simulator was constructed using low-cost materials. First and second year medical students at the University of British Columbia were recruited. Participants in the Simulator group completed a survey to rate their competency using a direct ophthalmoscope prior to a practice session with the simulator. The Control group had no simulator session. Both groups then took part in the regularly scheduled clinical session and were assessed by a preceptor on their proficiency using an evidence-based rubric. The Simulator Group completed a post session survey about their perceived proficiency with an ophthalmoscope.ResultsThe Simulator group had 14 participants and the Control group had 103 participants. Participants in the Simulator group self-reported significant increases (p < 0.05) in their perceived competence across all domains surveyed including overall comfort and visualizing the optic disc. There were no significant differences in proficiency rated by a preceptor between the Simulator and Control groups (7.21 vs 7.06 out of 10; p = 0.572).ConclusionsThis study demonstrates that a low-cost simulator is an accessible and valued method for improving student’s perceived competence and comfort in ophthalmoscopy. While this study did not show the simulator results in higher proficiency, rated by an evaluator, future studies can focus on more robust measures of skill acquisition and larger sample size.

Abstract 4144566: Building CPR/AED Confidence through Community Volunteer Prevention Screening Sessions: The Impact of the Eric Paredes Save A Life Foundation

Introduction: Sudden cardiac arrest (SCA) remains a leading cause of death among young individuals, often occurring without prior symptoms. Public confidence in recognizing SCA warning signs, understanding risk factors, and using cardiopulmonary resuscitation (CPR) and Automated External Defibrillators (AEDs) is generally low. The Eric Paredes Save A Life Foundation addresses this gap by offering free cardiac screenings and educational sessions. This abstract evaluates the foundation's impact on participants' confidence in these critical areas. Goals: The primary objectives were to enhance participants' confidence in identifying SCA warning signs and risk factors, performing CPR, using AEDs during cardiac emergencies, and communicating youth heart health concerns to healthcare providers. Methods: Volunteer-led prevention screening sessions were conducted, incorporating educational components on SCA warning signs, risk factors, and hands-only CPR and AED training. Post-session surveys were administered to 1,123 participants to assess their confidence levels in these areas. Results: The screening sessions significantly increased participants' confidence. Specifically, 96% of participants reported heightened confidence in recognizing SCA warning signs and understanding risk factors. Additionally, 94% felt more assured in discussing youth heart health with providers. Confidence in performing CPR during a cardiac emergency rose to 92%, while confidence in using an AED reached 89%. These results demonstrate the effectiveness of the sessions in empowering individuals with essential life-saving skills. Conclusions: The Eric Paredes Save A Life Foundation's prevention screening sessions are highly effective in improving participants' confidence in recognizing SCA warning signs, understanding risk factors, and using CPR and AEDs. The substantial increase in confidence levels underscores the importance of community-based education and training programs in reducing SCA-related fatalities among youth. These findings support the need for ongoing and expanded initiatives to further enhance public health outcomes and preparedness for cardiac emergencies.

Evaluating the Realism of a Task Trainer and the Impact on Residents' Confidence in Managing Massive Upper Gastrointestinal Bleeding Among Emergency Medicine Residents.

Objective Hemodynamically unstable upper gastrointestinal bleeding (UGIB) represents a life-threatening emergency that often lacks adequate high-fidelity training in the insertion of balloon tamponade devices. To address this gap, we developed an affordable task trainer that provides real-time feedback to enhance the training experience for emergency medicine residents. This study aims to evaluate the realism of the task trainer and its impact on residents' confidence in managing massive UGIB. Methods Constructed from low-cost, readily available materials, the task trainer was utilized in a training session attended by 28 emergency medicine residents. Following the review of an instructional video, participants were timed during the insertion of the balloon tamponade device. Subsequently, they completed a paper survey to assess their experiences and confidence levels. Results All 28 residents completed both the pre- and post-session surveys. The average time for inserting the balloon tamponade device was 3 minutes and 49 seconds. Sixteen participants strongly agreed, 11 agreed, and one felt neutral regarding the task trainer's realism in teaching the procedure. Additionally, all residents rated the simulation average or above average compared to previous educational experiences. Fourteen residents reported feeling significantly more confident in managing massive UGIB, while 13 felt slightly more confident, and one noted no change in confidence. Participants provided several positive remarks regarding the training session. Conclusions The balloon tamponade device task trainer proved beneficial in enhancing emergency medicine residents' confidence in managing patients with massive UGIB. Furthermore, the task trainer was perceived as realistic and superior to other educational modalities.

Empowering Medical Students to Address Patient-Initiated Mistreatment at the Transition to Residency: An Education Quality Improvement Study.

Mistreatment from patients is prevalent and has far-reaching negative consequences. To develop a practice-based curriculum on patient-initiated mistreatment and examine participant perceptions before and after the curriculum. Single medical school in the United States. 306 senior medical students from classes 2022 and 2023. A single patient-initiated mistreatment session delivered during specialty-specific residency preparation courses (RPCs) featuring a literature discussion, a response framework, and patient-actor skills practice. Between February 2022 and October 2023, 22 sessions occurred. Electronic surveys were delivered before, following, and approximately eight months after each session. A total of 257 (84.0%) and 174 (56.9%) participants completed pre- and post-session surveys, respectively. Significant increases in mean scores were noted for confidence in recognizing mistreatment (pre-session 4.25, post-session 4.68; p < 0.001) and comfort in addressing mistreatment personally (pre-session 2.86, post-session 4.30; p < 0.001) and as a bystander (pre-session 2.98, post-session 4.27; p < 0.001). In the follow-up survey, participants noted that the session was useful in preparing them for residency. A novel patient-initiated mistreatment curriculum empowered students, resulting in enhanced confidence in responding and sustained skill usage. Medical schools may consider including this training for all graduating students.

A Resident Narrative Medicine Curriculum to Promote Professional Identity Development: Story-Based Sessions Grounded in Narrative Learning Theory.

Empathy, reflection, and social connectedness are important skills for physician identity development and are increasingly challenged by burnout. Humanities-based interventions like narrative medicine (NM) are emerging in medical education to promote these skills. Only 17% of such initiatives target graduate medical learners. Furthermore, interventions are inconsistent in approach and theory representation. NM uses story-based learning to promote reflection and group discussion. Inspired by narrative learning theory, we developed NM sessions for residents to foster healthy identity development. Ninety-minute sessions were integrated into curricula for PGY 1-PGY 3 internal medicine-primary care residents at two large academic centers. Sessions involved engagement with a narrative source (stories, poems, art), personal reflection, and group discussion. Topics ranged from burnout to difficult patients. Participants completed anonymous postsession surveys assessing satisfaction, attitudes, and skills. Fifteen sessions occurred from 2021 to 2023, with three to 10 residents per session. Fifty residents completed between one and four sessions, with 68 survey responses (response rate: 88%). Over 95% ranked 4-5 out of 5 for overall impression (n = 67) and personal value (n = 65) of sessions. Sessions were highly enjoyable (M = 4.8), with mean scores of >4 out of 5 for impact on wellness, appreciation of work values, social connectedness, and patient care. NM sessions demonstrated measurable improvements in several domains of professional performance including wellness, job satisfaction, and patient care, while promoting camaraderie and emotion processing. Our materials offer tremendous potential for promoting healthy identity formation.

Managing Cancer and Living Meaningfully in adults with brain metastases: A NIH ORBIT model phase II feasibility and proof-of-concept trial

Abstract Background Managing Cancer and Living Meaningfully (CALM) is a brief, evidence-based psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study has systematically examined CALM in adults with brain metastases, despite the well-documented incidence of distress in this growing population. The primary aim of this trial was to assess the feasibility and acceptability of CALM in adults with brain metastases. Methods Patients with brain metastases (N = 13) and elevated symptoms of depression and/or death anxiety enrolled in this single-arm trial. CALM was administered in 6 biweekly sessions, with outcomes assessed at baseline and post-intervention. Feasibility was assessed based on established metrics including enrollment and retention rates. Acceptability was measured by post-session surveys and post-intervention interviews. Preliminary signal change on measures of psychological distress was explored. Results Of the 13 enrolled participants, 11 completed baseline assessments and initiated treatment: 73% female, Mage = 58 years (SD = 12.9; range = 37–75). Nine completed the study (81% retention rate). Overall, participants reported high perceived benefits and would recommend the program to others. Baseline to post-intervention assessments indicated improvements in depression, death anxiety, generalized anxiety, post-traumatic stress, suicidal ideation, and spiritual well-being. Life quality, substance use, and fear of cancer recurrence remained relatively stable. Conclusions CALM is feasible and acceptable and may improve psychological distress in adults with brain metastases. The findings of this study align with our previous trial of patients with malignant glioma and support a future National Institute of Health Obesity Related Behavioral Intervention Trials phase II randomized pilot trial of CALM in neuro-oncology. Trial Registration Number NCT05087095 registered on March 23, 2022.

The Body Advocacy Movement-Health: a pilot randomized trial of a novel intervention targeting weight stigma among health professional students

BackgroundWeight stigma among healthcare professionals is associated with negative health impacts on patients, yet there are few effective strategies to combat weight stigma among health professional learners. The Body Advocacy Movement-Health (BAM-Health) is a novel group-based, peer-led stigma reduction intervention for health professional students that targets weight stigma across intrapersonal, interpersonal, and structural levels. The present study (1) assesses short-term impacts of BAM-Health participation on intrapersonal and interpersonal weight bias compared to an informational brochure control condition and (2) explores the feasibility and acceptability of BAM-Health among a sample of health professional students.MethodsSixty-seven health professional students participated in BAM-Health (n = 34) or received an informational brochure about weight stigma (n = 33). Participants completed validated self-report surveys assessing internalized weight/ appearance concerns and interpersonal weight stigma prior to their assigned intervention (baseline), immediately following intervention (post-intervention), and four weeks after intervention (follow-up). Baseline to post-intervention and baseline to follow-up effect sizes on each measure were calculated. At post-intervention, participants completed feedback surveys for thematic assessment.ResultsBAM-Health participation had a large baseline to post-intervention effect on internalized weight/ appearance concerns that diminished slightly at follow-up (Cohen’s d = -0.88; d = -0.62). Receipt of the informational brochure had a small effect on internalized weight/ appearance concerns (d = -0.27); however, these changes were not sustained at follow-up (d = 0.04). BAM-Health participation resulted in reductions in interpersonal obesity stigma and anti-fatness with small effect sizes (d = -0.32; d = -0.31). The effect on obesity stigma was slightly amplified at follow-up (d = -0.43); however, decreases in anti-fatness were not sustained (d = -0.13). The brochure condition failed to demonstrate effects on anti-fatness (d = 0.13, d = 0.14) or obesity stigma (d = -0.12; d = -0.12) at either time point. Between-session attrition rates of 4.5%, favorable quantitative ratings on post-session acceptability surveys, and free responses demonstrating appreciation of the virtual group environment and session activities reflect feasibility and acceptability of BAM-Health.ConclusionsBAM-Health is a novel peer-led intervention that aims to reduce weight stigma among health professional students. BAM-Health met feasibility benchmarks and received positive feedback from participants, demonstrating acceptability and indicating interest among health professional students in analyzing and reducing weight stigma in their personal lives and careers. The intervention led to promising decreases in internalized and interpersonal weight stigma at post-intervention, some of which were sustained at follow-up. However, lack of effect on internalized weight/ appearance concerns measures may indicate that BAM-Health participants are more likely to reject weight stigma directed toward others following intervention, while maintaining thin ideals for themselves. Further investigation of BAM-Health with a larger sample and continued program development is warranted.

COVID Just-in-Time Extension for Community Health Outcomes: A Collaborative Information-Sharing Platform for a School Health Community.

The COVID-19 pandemic challenged school health professionals to navigate a dynamic public health emergency and to stay aware of changing recommendations. This study aimed to determine the value of the COVID Just-in-Time ECHO (Extension for Community Health Outcomes) Learning Series for Schools among participating school health personnel and to describe their ongoing information needs during the pandemic. School health, public health, and education professionals across Colorado participated in this ECHO series. Participants attended 1-hour sessions every 2 to 4 weeks from March 2020 through December 2021 for a total of 34 sessions. Data collection included postsession and postseries surveys assessing what participants found most valuable and what additional information they needed. School nurses represented 113 of 224 participants (50%). ECHO content noted as being the most valuable included epidemiology updates and special topics as chosen by participant input. Postseries surveys identified the value of experiencing shared knowledge among Just-in-Time ECHO participants. Participants identified ongoing needs for information about COVID-19 guidance and risk mitigation in schools throughout the sessions. In postseries surveys, participants reported additional ongoing information needs related to COVID-19 outside schools. This ECHO series delivered reliable and time-sensitive information for school health personnel and school leaders and may provide a useful model for information sharing among education and public health professionals.

Findings from a public engagement programme for school children aged 13-15 years about endocrinology.

To investigate the utility and effectiveness of a school outreach programme in areas of lower socioeconomic status to improve understanding of common endocrine topics and the medical profession. Two secondary school outreach sessions were conducted in July 2022. Students were invited to attend lectures delivered by medical professionals and engage in poster-making sessions using the knowledge they had gained throughout the day. Participants completed anonymised pre- and post-session surveys. Outcomes were identified using Kirkpatrick's training evaluation model. Self-reported perceptions and beliefs (Kirkpatrick's level 2a) were compared using chi-square tests. Thematic analysis of team-led poster presentations was performed. Of the 254 participants included, the response rates of pre- and post-session questionnaires were 75.6% and 56.2%, respectively. The outreach day increased students' understanding of obesity and diabetes, polycystic ovary syndrome, and Health Technology. The most well-received activities from the outreach day were voted to be the poster challenge (43.4%) and poster presentation (14.7%). Following the session, there was a trend towards an increased understanding of medical careers and interest in pursuing a medical career, although these did not reach statistical significance. Outreach programmes could be a practical and effective approach to engaging prospective medical applicants from areas of lower socioeconomic status. Further studies are required to expand outreach programmes and investigate the efficacy of school engagement programmes.

An Interactive, Case-Based Workshop on the Patient Experience for Internal Medicine Residents.

The technological revolution has narrowed the information gap between physician and patient. This has led to an evolution in medicine from paternalistic to patient-centric, with health care systems now prioritizing patient experience to achieve higher satisfaction scores. Therefore, it is imperative to start early in educating trainees on how to best address the holistic needs of the patient while also delivering high-quality care. We implemented a 1-hour workshop that was repeated weekly over 8 weeks to capture all internal medicine residents in our program. During the workshop, we reviewed the historical evolution of patient care from paternalistic to patient-centered, presented the Hospital Consumer Assessment of Healthcare Providers and Systems survey questions, and discussed evidence-based strategies for physicians to improve their patients' experience utilizing four case-based scenarios. Over the 8-week period, a total of 195 residents participated in the workshop. One hundred thirty-nine residents (71%) completed the pre- and postsession survey. Results demonstrated significant knowledge improvement (p < .001) in all of the topics discussed. Additionally, the majority of residents felt the workshop would be useful in their clinical practice and found the clinical scenarios useful. Given the evolution towards patient-centered care, it is important to take a proactive approach in providing residents with the tools to best address their patients' needs. Early understanding of patient satisfaction surveys and the impacts they have on hospital metrics can help trainees in their careers as practicing physicians.