Pre-and Post-surveys Research Articles

Gynecologic Simulation Training Increases Medical Student Confidence and Interest in Women's Health

Background: Exposure to commonly performed gynecologic procedures via simulation has potential to improve medical student knowledge and foster confidence with procedures. Purposes: To implement and evaluate a gynecologic simulation curriculum for 3rd-year medical students during their obstetrics and gynecology core clerkship. Methods: A gynecologic simulation curriculum was implemented for medical students during their obstetrics and gynecology clerkship. Participants completed pre-and postsurveys to assess learner confidence; effect on interest in a surgical field, women's health, and obstetrics and gynecology as a career; and whether the session met their learning needs. Results: Fifty-nine students participated. Improved confidence in performing the procedures was noted when comparing mean survey scores before and after the simulation for IUD insertion and removal (1.9 pre, 4.3 post, p < .0001), for dilatation and curettage (1.7 pre, 3.8 post, p < .0001), and basic laparoscopy skills (2.1 pre, 4.3 post, p < .0001). An increase in pursuing a surgical field (3.3 pre, 3.6 post, p < .003) and interest in women's health (3.7 pre, 4.9 post, p < .004) was noted among students after the simulation session. The curriculum strongly met the students learning needs with a mean score of 4.54 on the 5-point scale. Conclusions: Gynecologic simulation training for medical students can increase confidence in procedures, interest in pursuing a surgical field and women's health, and was highly effective in meeting student learning needs.

The Magic Questions: A Qualitative Review of a Simple Communication Tool for Person-Centered Advance Care Planning (S708)

Objectives 1. Understand the significance for teaching residents how to initiate advance care planning conversations for patients with complex medical illness for the outpatients. 2. Describe the methods used for the GOCARE educational intervention. Background. Good communication with a trusted physician is central to the practice of medicine, particularly for advance care planning (ACP) discussions. Medical residents frequently have these conversations in the inpatient setting but unfortunately, patients in the hospital are often too ill to participate in decision making. Although it would be preferable to have these discussions earlier, few residents conduct goals of care discussions with their patients during outpatient visits. This pilot project aims to promote the quality and quantity of these discussions by giving residents the knowledge and skills to engage in advance care planning in the outpatient setting. Research Objectives. 1) Describe the concept of advance care planning and a framework for having these conversations. 2) Depict ways to respond to patients’ emotions and emotional concerns. 3) Improve confidence in initiating and leading ACP discussions as well as eliciting patient preferences and responding to emotions. Methods. We developed a curriculum for Internal Medicine residents during their 4-week rotation in the ambulatory clinic. The course included short didactics, role-playing, and communication labs where residents could practice their communication skills in a safe and controlled environment with standardized patients. Additionally, residents had the opportunity to practice these skills after each lesson with their own continuity patients. We evaluated the objectives for the course by using preand post-surveys. Results. 45 second year residents were recruited. Residents overall enjoyed the course and believed that it was ‘‘very useful.’’ Compared to before the course, residents felt more prepared and more confident in topics such as giving bad news, discussing treatment options, and eliciting goals (p<0.0005, effect size 0.6). Conclusions. Overall,participantsdemonstrated a substantial increase in confidence and preparedness for ACP discussions for both inpatient and outpatient settings. This study however, did not evaluate residents’ overall improvement in skill level and the next phase of the intervention is to observe resident skills before and after the intervention. Implications for research, policy, or practice. We believe by teaching residents the fundamentals of ACP communication increasing their confidence in these discussions, residents will not only increase the frequency of these conversations in the outpatient setting but will able to match their patient’s goals with the treatments they offer.

EPISTEMIC PERSISTENCE: A SIMULATION-BASED APPROACH TO INCREASING PARTICIPATION OF WOMEN IN ENGINEERING

Educational institutions have historically struggled with retaining women in engineering. A significant drop occurs in the first year of undergraduate studies. In response, some universities have modified firstyear curricula to include more teamwork and collaboration. Using epistemic frame theory, we hypothesize that more women would remain in the field if they had authentic experiences of the engineering profession early in their undergraduate career. To test this hypothesis, we designed and implemented an epistemic game, Nephrotex in which students engage in authentic engineering design in teams. We collected two sources of data from students in Nephrotex (experimental condition): (1) students’ preand post-survey responses about attitudes toward engineering and (2) students’ online discourse. We collected preand post-surveys from the comparison group (control condition), students who participated in a non-designbased introductory engineering course in which they researched global engineering problems and solutions in teams. We conducted a principal components analysis on the survey data and an epistemic network analysis on the discourse data. Our controlled study suggests that (1) women in the experimental condition had a greater increase in confidence in and commitment to engineering than women in the control condition, and (2) students in the experimental condition who focused mostly on engineering design instead of collaboration were more committed to engineering. While the sample sizes are not large for this experiment and the gender distribution is not equal between groups (experimental, 63 female 75 male; control, 35 female 95 male), our results suggest that an authentic engineering simulation can increase women’s motivation to persist in engineering. Interestingly, this was not the finding for men. Of the male and female students who participated in Nephrotex, those who focused on engineering design talk in collaborative discussions reported that they were more committed and confident afterward, suggesting that design is a motivating element in authentic engineering simulations for both men and women.

Evaluating a promotor training to prevent obesity among Latino preschoolers

The food and social environment play an important role in influencing obesity prevalence during the preschool years (2–5 years old). Approximately 25% of US preschoolers are overweight or obese. The prevalence of overweight Latino preschoolers is almost 50% higher than White preschoolers. Using a promotor approach is a promising strategy to address obesigenic factors in home and neighborhood settings. There is a need for systematic evaluation of promotor training curricula. The authors pilot‐tested a two‐phase Latino toddler obesity prevention curriculum designed to build promotor capacity to create healthier home and neighborhood environments. The first phase of the curriculum provided 19 promotores with group facilitation skills, while the second phase focused on improving knowledge, perceived relevance and self‐efficacy in order to implement home and neighborhood strategies. Pre‐and post‐surveys were administered before and after each phase and process evaluation data was collected. The phase one curriculum resulted in significant gains in self‐efficacy and group facilitation. Phase two results showed significant gains in knowledge and positive shifts in self‐efficacy. By assessing the learning gains of participating promotores, this project addressed the lack of field‐tested promotor training curricula.Funded by LLU Center for Health Research and LLU Office of Public Health Practice.

Changing Medical Students' Attitudes Toward Older Adults

Given the growth in the number of older adults and the ageist attitudes many in the health care profession hold, interventions aimed at improving health professionals' attitudes toward older adults are imperative. Vital Visionaries is an intergenerational art program designed to improve medical students' attitudes toward older adults. Participants met for four 2-hour sessions at local art museums to create and discuss art. Three hundred and twenty-eight individuals (112 treatment group, 96 comparison, 120 older adults) in eight cities participated in the program and evaluation. Participants completed pre-and postsurveys that captured their attitude toward older adults, perception of commonality with older adults, and career plans. Findings suggest that medical students' attitudes toward old adults were positive at pretest. However, Vital Visionary students became more positive in their attitudes toward older adults at posttest (p < .001), with a moderate effect size, G = .60, and they felt they had more in common with older adults at posttest (p < .001), with a moderate effect size, G = .64. The program did not influence their career plans (p = .35). Findings from this demonstration project suggest that socializing medical students with healthy older adults through art programs can foster positive attitudes and enhance their sense of commonality with older adults.

What Older Adults Know about HIV/AIDS: Lessons from an HIV/AIDS Education Program

Despite being one of the fastest growing segments of the HIV/AIDS caseload, persons age 50 and older have been largely neglected in terms of HIV/AIDS education. This study describes a project involving HIV-related health education for persons ≥50 in an urban area of Ohio. Data from 50 persons age ≥50 were collected. Pre-and postsurveys were used in the completion of repeated measures ANOVA, and focus groups provided qualitative data. Despite a paucity of available educational materials addressing HIV/AIDS, older adults are willing to participate in sessions about HIV/AIDS. Findings suggest the need for alternative approaches to providing HIV/AIDS education.

Giftedness Perceptions and Practices of Teachers in Lithuania

This article reports on two of the first studies of post-Soviet reforms of gifted education in Lithuania. After a professional development (PD) programme was provided Lithuanian teachers to help them develop a list of characteristics of gifted children, define giftedness, and design a procedure for gifted identification, two qualitative studies examined: a) how teachers’ perceptions of giftedness changed as a result of a Western professional development programme in gifted education that introduced the Renzulli Three-Ring Conception of Giftedness; and b) what gifted educational practices do teachers in an urban basic school know, practice, and recommend after the implementation of a systematic gifted identification process. Evidence for change in teachers’ perceptions was gathered via pre-and post-surveys. In the follow-up case study at a basic school, the Screening Committee identified 19% or 84 of 450 pupils as ’gifted.’ Observational and interview data from the case study school indicated that teachers from the PD programme felt more empowered to differentiate the curriculum for identified gifted pupils.(1) How have the Lithuanian teachers’ perceptions of giftedness changed as a result of a Western professional development programme in gifted education that introduced the Renzulli Three-Ring Conception of Giftedness Model?(2) What gifted educational practices do Lithuanian teachers in an urban basic school know, practice, and recommend after the implementation of a systematic gifted identification process?

Longitudinal Effects of Informal Language in Formal L2 Instruction

This study investigates the longitudinal effects of informal language contact on formally instructed L2 learners through multiple approaches which include quantitative and qualitative data sources. It focuses on the use of the aspect markers –te iru and –te ru (the reduced form of –te iru) in Japanese oral discourse by Chinese exchange students (NNSs). The quantitative data for conversational tasks was transcribed and analyzed by Child Language Data Exchange System (CHILDES), and the frequency of occurrence and variation of aspect markers were compared with those of Japanese university students (NSs). Qualitative data from follow-up interviews and pre- and postsurveys was also analyzed. The findings were that: a) NSs used –te ru far more frequently and with more variation than –te iru; and b) NNSs used –te ru less than –te iru over a period of one year. However, the use of –te ru steadily increased with longer stays in Japan. The implications of the results for sociolinguistic theories are also discussed. 本研究は、言語接触の観点から、本国でのフォーマルな日本語学習から日本というインフォーマルな日本語環境に接触した外国人留学生を対象に、アスペクト変化について、縦断的に調査したものである。具体的には、談話資料、フォローアップ・インタビューおよびサーベイの結果を複合アプローチを用いて分析した。談話分析に関しては、CHILDESを使用し、同世代の日本人大学生と比較した。その結果、明らかになったことは、次の通りである。 ⑴母語話者の発話では、頻度および領域の両面において、「テル」が「テイル」を凌駕している。⑵非母語話者の発話では、「テル」より「テイル」が多用されているが、滞日期間が長くなるにつれて、「テル」の使用が増える傾向にある。

Integrated teaching programme with student-centred case-based learning

were considered statistically significant at P £ 0AE05. Epi info 6 and SPSS statistical packages were used for the analysis. Evaluation of results and impact A statistically significant increase in students’ self-reported knowledge, skills and attitudes regarding EBM was found. Mean scores for their understanding of the EBM concepts increased from 2AE20 ± 0AE85 to 3AE17 ± 0AE80 on a 4-point rating scale (P < 0AE001). Student knowledge of the EBM process also increased significantly (P < 0AE05). Mean scores for student knowledge about the need for effective literature search processes in EBM practice were similar and relatively high in the preand post-surveys: 3AE24 ± 0AE71 and 3AE33 ± 0AE89, respectively. Although textbooks remained their major source of evidence, increased use of the Internet (P 1⁄4 0AE0003), Cochrane database (P 1⁄4 0AE0001) and secondary EBM resources (P 1⁄4 0AE045) was reported. Students’ use of EBM resources for questions related to patient care increased (P 1⁄4 0AE0001). Student-perceived limitations to EBM practice included lack of training (77AE8%) and lack of role models among teachers (60AE9%). The EBM course was perceived by students to have enhanced their learning (74AE1%) and provided lifelong learning skills (90AE7%). A positive correlation was found between knowledge about EBM, the use of EBM resources and application of EBM concepts to patient care questions, while a negative correlation was noted between knowledge and misconceptions about EBM. Students strongly supported the inclusion of the EBM course in the undergraduate curriculum (90AE7%). An EBM course, even with resource constraints, is a feasible, beneficial and desirable educational programme for medical students that is associated with significant self-perceived benefits that include enhancement of learning, provision of lifelong learning skills and increased use of EBM resources.

Comparing the effectiveness of different presentation formats for workshops on introductory library skills

Internet access to library electronic databases significantly increased user demand for library instruction. As the supplier of user education services, there has been rising interest among librarians in the cost and effectiveness of alternative presentation formats. This article describes our experiment to compare the difference in effectiveness between a real-time hands-on lecture/demonstration with a high active learning component, and an eclectic format that combines the traditional “passive” lecture format with an “active” hands-on component. We administer pre-and postsurveys to the different classes and find that the eclectic format is associated with significantly higher student retention of material.

The Effect of the Cost and Perceived Cost of Special Low Protein Foods on their Utilization and Dietary Compliance in Phenylketonuria

The parents of children with phenylketonuria (PKU) often cite the high cost of special low protein products as a reason for their not using many of these products and for poor dietary compliance in their children. We assessed the actual utilization of special low protein products in 42 PKU children between the ages of 3–8 from three-day diet records that were part of their nutritional assessment at a semi-annual clinic appointment. The cost of these items was prorated per serving from the most up-to-date price lists from the manufacturers. The cost of these items was compared to both the cost of their higher protein counterparts (regular bread, pasta, etc) and to the cost of high protein items (meat, dairy, etc) not allowed on the PKU diet. It was found that the amount of money needed to purchase special low protein foods was significantly less than the amount the USDA estimates it costs to provide high protein items to an average 3-8 year old. This amount was also considerably lower than the amount of money parents estimated that they spend per month for special low protein foods. This suggests that there is either food wastage or the special low protein foods are being consumed by non-PKU family members. A three-month supply of special low protein items was provided to 6 PKU children who had not been completely compliant with the diet and whose families were receiving public assistance. Parents were given recipes, baking pans and menu planning assistance to allow them to make maximum use of the products. Pre-and post-surveys were given to the parents to see how the special products changed the way the children's diets were managed. Further assessment was done using blood phenylalanine levels to see if the provision of the low protein foods made a difference in compliance. The results of this study indicated that the provision of low protein foods to this small group of PKU children, whose families cited cost as a barrier to their utilization did not make a significant difference in dietary compliance.

Appreciative Inquiry as a Team-Development Intervention: A Controlled Experiment

In a controlled laboratory experiment, the effects of a team-development intervention based on the theory of appreciative inquiry were compared with task-oriented team development (TOTD) and lectures on group processes, outcomes, and performance. Undergraduate students (96) in two semesters of an introductory organization behavior course participated in four-person teams and had 13 weeks to complete a task worth 25% of each member's final grade. One third of the teams received an appreciative inquiry intervention, another third received a TOTD intervention, and the final third received a lecture on group dynamics (placebo). Pre-and postsurveys assessed group process and outcomes; project grades were used to assess task performance. ANOVAs and ANCOVAs on each of the process and outcome measures showed groups receiving appreciative inquiry, and TOTD scored significantly higher than those receiving the placebo on almost all measures, including task performance. Teams receiving TOTD scored significantly higher than appreciative inquiry on task performance. Implications for organization development and directions for future research are discussed.