Preclinical Medical Education Research Articles

Pilot Implementation of a Multidisciplinary Tumor Board Seminar Series to Foster Increased Understanding of and Interest in Oncologic Care Among Medical Students

Background Prior work has demonstrated a need for educational curricula to increase medical student understanding of how to care for a growing population of patients with cancer, particularly in a multidisciplinary setting. Tumor boards (TBs) foster both high quality complex care for patients with cancer and continued education for oncologists. While TBs are critical components of oncologic practice, medical students have minimal exposure to TBs. We designed a TB seminar series for preclinical medical students with the primary aim of promoting a multidisciplinary lens towards cancer care and a secondary aim of increasing exposure to radiation oncology (RO). Methods Seminars were developed in collaboration with a resident-led RO Education Committee and a medical student-led Oncology Interest Group (OIG) at a single academic institution. Each seminar comprised of a 30-minute RO resident-led didactic session followed by a 60-minute institutional TB meeting and concluded with a 15-minute resident-led debrief. The didactics were used to provide a scaffold for observing the TB by describing the specialists' roles, commonly encountered diseases, treatment paradigms, and clinical challenges frequently addressed in this venue. In the resident-led didactic, special emphasis was placed on describing RO approaches and considerations. The post-TB debrief offered an opportunity for consolidation by providing a forum to address questions, highlight learning points, provide closure to challenging scenarios, and explore opportunities for engagement in research. Results The first seminar series piloted was Stereotactic Radiosurgery TB. An email inviting participation was sent via the OIG to all first-year medical students at our institution. Six students pre-registered for the seminar and subsequently participated in the seminar. Three students expressed interest in writing a case report on a patient treated with radiosurgery following the seminar experience. Participating students and program leadership expressed interest in continued seminar programming; the second seminar in the series will expose students to a breast TB. Discussion Pilot implementation of a multidisciplinary TB seminar series for medical students is feasible and may spark clinical and scholarly interest in RO. Future directions include formal integration of TB opportunities into longitudinal oncology curricula in preclinical medical education and promoting sustainability of the seminar series through institutional support. We plan to conduct a longitudinal mixed-methods study among students who attend at least one TB seminar in the series to assess the impact of the seminar series on familiarity with multidisciplinary care, interest in a career in RO, and participation in RO-focused scholarship. Prior work has demonstrated a need for educational curricula to increase medical student understanding of how to care for a growing population of patients with cancer, particularly in a multidisciplinary setting. Tumor boards (TBs) foster both high quality complex care for patients with cancer and continued education for oncologists. While TBs are critical components of oncologic practice, medical students have minimal exposure to TBs. We designed a TB seminar series for preclinical medical students with the primary aim of promoting a multidisciplinary lens towards cancer care and a secondary aim of increasing exposure to radiation oncology (RO). Seminars were developed in collaboration with a resident-led RO Education Committee and a medical student-led Oncology Interest Group (OIG) at a single academic institution. Each seminar comprised of a 30-minute RO resident-led didactic session followed by a 60-minute institutional TB meeting and concluded with a 15-minute resident-led debrief. The didactics were used to provide a scaffold for observing the TB by describing the specialists' roles, commonly encountered diseases, treatment paradigms, and clinical challenges frequently addressed in this venue. In the resident-led didactic, special emphasis was placed on describing RO approaches and considerations. The post-TB debrief offered an opportunity for consolidation by providing a forum to address questions, highlight learning points, provide closure to challenging scenarios, and explore opportunities for engagement in research. The first seminar series piloted was Stereotactic Radiosurgery TB. An email inviting participation was sent via the OIG to all first-year medical students at our institution. Six students pre-registered for the seminar and subsequently participated in the seminar. Three students expressed interest in writing a case report on a patient treated with radiosurgery following the seminar experience. Participating students and program leadership expressed interest in continued seminar programming; the second seminar in the series will expose students to a breast TB. Pilot implementation of a multidisciplinary TB seminar series for medical students is feasible and may spark clinical and scholarly interest in RO. Future directions include formal integration of TB opportunities into longitudinal oncology curricula in preclinical medical education and promoting sustainability of the seminar series through institutional support. We plan to conduct a longitudinal mixed-methods study among students who attend at least one TB seminar in the series to assess the impact of the seminar series on familiarity with multidisciplinary care, interest in a career in RO, and participation in RO-focused scholarship.

Pursuing Quality Education in Physical and Rehabilitation Medicine in Japan.

In Japan, medical education and training are the combined responsibility of two ministries namely Ministry of Education, Culture, Sports, Science and Technology, and the Ministry of Health, Labor and Welfare. The medical education system underwent a major transformation in August 2021 making it a seamless clinical education blending pre-graduation and post-graduation training. Not all universities offer rehabilitation medicine curriculum. Furthermore, where rehabilitation medicine is taught, the curriculum content is not standardized. All medical students sit for a common national medical practitioner qualifying examination. However, only a few questions on Rehabilitation Medicine are included. The personal experience of the author's teachings in rehabilitation medicine at Saga University medical school is described. Emphasis is placed on experiential learning on subjects that are current and state-of-the-art in Japan including robotics. It is aimed at promoting inspired motivation for the students to pursue specialized training in rehabilitation medicine. Japan can take lessons from the European Union's white book on Physical Medicine and Rehabilitation as well as the International Society of Physical and Rehabilitation Medicine core curriculum. In addition, the Rehabilitation Medicine education system can be further improved through a well-coordinated preclinical and clinical medical education. There is also a need to expand the rehabilitation medicine field and address the gaps with other specialties.

Effective and Time-Efficient Implementation of a Flipped-Classroom in Preclinical Medical Education.

The flipped classroom (FC) model of instruction has inherent barriers to implementation in medical education due to amount of content taught versus time allotted, the widespread adoption of interdisciplinary course structure causing a plethora of instructors responsible for content delivery, and trends to reduce the number of weeks to teach preclinical foundational science. Here we report on a FC model executed in an interdisciplinary endocrinology block in a time-saving manner, while preserving student preferences and satisfaction and improving written assessment performance. In this study, traditional lectures were 100% replaced with pre-session assignments (custom video modules) resulting in less time (- 9h) spent on first pass learning. In-person, active-learning, case-based sessions were created (+ 8h) to complete the FC model and achieve higher level understanding. Written assessment performance in the endocrinology block was compared between two cohorts: the FC model and traditional lecture model. The FC model cohort outperformed the traditional lecture cohort on written, multiple-choice assessments (both in-house and NBME assessments). Furthermore, a measured (survey data) student preference for the FC model was observed.

INSIGHT: Evaluation of the Year Four Psychological Medicine Student Placements at HMP Berwyn, North Wales

AimsBackground: Although social determinants of health (SDOH) are to some extent incorporated within preclinical medical education, little validated educational methodology exists to provide guidance on how to integrate teaching about SDOH within the competency-based training of medical students’ clinical years. This is potentially important. The COVID-19 pandemic has highlighted the importance of SDOH, and social determinants have become topical, with increasing discussion in journals about equity, inequality, and sustainability. Sir Michael Marmot's 2020 review has highlighted these issues. Consequently, the evaluation of medical students’ experience of prison placements is an interesting area to investigate. This will help us to explore their understanding of SDOH, and implications of gained knowledge for their future practice. Aims: This study explores changes in year four psychological medicine students’ knowledge and attitude towards SDOH during prison placements.MethodsA mixed-methods study between Sep 2021 to Apr 2022 recruiting all year four medical students on their psychiatry placement in North Wales. Data collection involves baseline and mid-placement questionnaires and end-of-placement individual interviews to explore their understanding of SDOH.Thematic analysis will be used to describe students’ reflection on placement satisfaction; explore impacts on trainee doctors and supporting staff; make suggestions to improve placement structure in the future; and evaluate the utility of placements in prison.ResultsData collection is in progress. However, early indications suggest that students view these placements favourably and find them a helpful learning experience. Preliminary results will be reported at the conference.ConclusionWe are hopeful that this evaluation will suggest a way forward to raise awareness about SDOH during clinical placements and will give these students confidence in working with socially excluded populations in the future.Implication for practise, policy and researchFindings of this study may provide exploration of means of capacity building and training with improved knowledge of the SDOH in partnership between the medical school, the local health board and the prison.We have developed systems and processes to raise awareness of social factors to be considered by medical students in their future practice. These can guide further development of such placements at HMP Berwyn and in other prisons.This research was funded by Betsi Cadwaladr University Health Board and sponsored by Bangor University in North Wales, UK.

The Use of Race, Ethnicity, and Region Associations in a USMLE Step 1 Resource

Phenomenon : Mental shortcuts are commonly used in medical education to facilitate the learning and application of a large volume of information. However, the use of demographic identifiers such as race, ethnicity, region, and descent from one of these groups as mental shortcuts in association with disease can perpetuate misconceptions about the construction of these identities and reinforce stereotypes. The United States Medical Licensing Exam (USMLE) Step 1 is a major driver of pre-clinical undergraduate medical education that requires memorization of a large volume of information and application of this information to clinical vignettes. This study assesses how demographic identifiers have been used in a nearly universally used study resource for this exam. Approach : The authors analyzed First Aid for the USMLE Step 1 2020, Thirtieth Edition, a resource that contains “high yield facts” and was built and maintained based on experiences with the USMLE Step 1 for references to race, ethnicity, region, and descent from one of these groups and the distribution of skin tones used in photos. These findings were subsequently compared to the changes made in the 2021 edition of the resource. Findings : The authors found 50 references in the 2020 edition to race, ethnicity, region, and descent from one of these groups, all in relation to disease. More than half of these references had an associated heritable component. Black or African American race was disproportionately represented, comprising more than half of all racial associations (13/24). Additionally, light skin tone was used in 170/204 photos (84.2%) in the 2020 edition. In the 2021 edition, only 12/209 photos (5.7%) were new or changed. Insights : These findings highlight the trend to associate race with disease while also furthering the misconception that there are innate, heritable differences between socially constructed groups and establishing light skin tone as the norm. While some favorable changes were made to the 2021 text, further work within this resource and across medical education is required to avoid further misuse of race and challenge existing implicit biases.

Randomised controlled monocentric trial to compare the impact of using professional actors or peers for communication training in a competency-based inverted biochemistry classroom in preclinical medical education

ObjectiveIn medical education, biochemistry topics are usually knowledge based, and students often are unaware of their clinical relevance. To improve students’ awareness of the relevance, we integrated communication skills training...

Enhanced confidence and ultrasound‐performance skills of medical students: A comparative study with and without prior videographic ultrasound exposure

INTRODUCTIONPoint‐of‐care ultrasonography (POCUS) is commonly used in many modalities of medicine. However, there is a lack of standardized protocol for integrating POCUS into preclinical medical education. Previous literature has detailed the benefits of POCUS in clinical diagnoses and reasoning, but many medical students still lack exposure to POCUS. At California University of Science and Medicine (CUSM), medical students will be exposed to POCUS in their preclinical years. We aim to compare the confidence levels and ultrasound‐performance skills of medical students with and without prior videographic ultrasound exposure.HypothesisPrior videographic ultrasound exposure will improve the confidence and ultrasound‐performance skills of medical students during a live ultrasound workshop compared to those without videographic exposure.MethodsParticipants will be divided into two groups. One group will watch a 5–10‐minute procedural video about ultrasound‐guided peripheral intravenous (IV) access prior to ultrasound training, while the other group will be ultrasound‐naive prior to ultrasound training. Ultrasound training will be led by three other medical students who are trained and approved by ultrasound physicians. After demonstrations, participants will practice ultrasound‐guided IV access on a practice pad. Instructors will grade students on the spot on their ability to perform ultrasound‐guided IV access correctly. The parameters measured will be proper positioning of the ultrasound probe, insertion of the needle, ultrasound probe movement, puncturing of the vein, and overall technique. The two study groups will then take surveys on their perceived performance and overall confidence levels.ResultsResults from participants will be scored using two measures. Firstly, their self‐reflection surveys will measure their level of confidence and perceived ultrasound‐performance skills. Secondly, on‐the‐spot grading by instructors will provide information on participants’ actual ultrasound‐performance skills. A standardized grading scheme will ensure fairness among different instructors and participants.ConclusionComparison of the effectiveness of an additional videographic ultrasound component prior to live demonstration will be elucidated. This study will help create elements within existing ultrasound curriculae that will enhance the confidence and ultrasound‐performance skills of preclinical medical students.

Perception and attitude of pre‐clinical medical students towards obese donors: Should obesity sessions be incorporated in gross anatomy labs?

IntroductionThe prevalence of obesity in the United States has grown to over 40% and is a major cause of morbidity and mortality. With the advent of integrated curriculum, many medical schools across the US have incorporated obesity education programs. However, gaps still exist within preclinical medical education including specific training that addresses obesity and long‐term studies showing that such training is needed (Butsch et al., 2020). In a medical student’s career, dissection labs are a place where students first encounter human bodies in a medical capacity. The donor is a great resource that can help medical students’ perception and bias about obesity. During dissection, students navigate through different regions of the body, totally inattentive to the distribution of fat in specific regions such as the vital organs & their clinical implications. To ensure medical students are supported throughout their education about obesity and its impact on health, we at OUWB, through an innovative curriculum initiative incorporated an obesity session using donors and imaging in the endocrine systems clinical integrated lab (CIL).MethodsIn this study, a survey (pre‐session) was developed and sent to medical students to assess students' clinical knowledge and perceptions regarding fat distribution in donors before the endocrine systems anatomy CIL.ResultsThirty‐six medical students responded to the pre‐session anatomy of fat survey. Only 11.4% of respondents felt they could “learn and observe a lot from an obese donor,” whereas 45.7% felt that obese donors “don’t make any difference” to their learning and 28.6% felt that an obese donor “will take a long time to dissect.” 85.9% of respondents reported never having discussed the distribution of fat with their lab‐mates (Fig.1). In order to assess student knowledge regarding fat distribution in several organs with clinical implications, 36.5% and 27.0% of respondents acknowledged the presence of fat around the heart and kidneys (respectively), less than 10% of students recognized the fat around the lungs, bones, spinal cord, or orbit (Fig. 2). Additionally, only 17.1% of respondents reported routinely looking for the “clinical relevance of fat while identifying structures on the donor.”ConclusionsBased on our survey results it is clear that many students do not see the utility of learning from obese donors. Furthermore, they seem to be unaware of the need to consider fat distribution through a clinical lens and failed to recognize key organs where fat distribution may have clinical implications. We hope that by incorporating anatomy of fat education using donors and imaging early‐on in the curriculum within a lab setting, will make students more attentive and aware of the clinical implications about fat. This will enhance their perceptions of obese patients and be well prepared for the clinical years.ReferencesButsch WS, Kushner RF, Alford S, Smolarz BG. Low priority of obesity education leads to lack of medical students' preparedness to effectively treat patients with obesity: results from the U.S. medical school obesity education curriculum benchmark study. BMC Med Educ. 2020;20(1):23. Published 2020 Jan 28. doi:10.1186/s12909‐020‐1925‐z

Antiviral Pharmacology: A Standardized Patient Case for Preclinical Medical Students.

IntroductionPharmacology is an important learning topic in preclinical medical education. Simulated patient encounters allow students to apply basic science knowledge in a clinical setting and have been useful in previous studies of pharmacology education. We developed a standardized patient (SP) encounter to reinforce antiviral pharmacology content for first-year medical students.MethodsStudents were instructed to recommend a medication for shingles during an SP encounter and to answer questions from the SP on mechanism of action and adverse effects. Students then attended a large-group debrief session. Following the activity, students evaluated the exercise through a voluntary survey. For knowledge assessment, students were randomized into two groups to complete three multiple-choice questions either before or after the learning activity.ResultsIn 2020 and 2021, 144 and 145 students, respectively, participated. In 2020, there was no significant difference in the proportion of correct answers between the pre- and postsimulation groups (p > .05). In 2021, the postsimulation group significantly outperformed the presimulation group in knowledge of mechanism of action (p < .01) and adverse effects (p < .01), but no difference was seen between the groups regarding medication selection (p = .27). Most learners assessed the instructional design as effective for the tasks assigned.DiscussionThis SP activity provided an opportunity for early medical students to practice integrating antiviral pharmacology knowledge into a patient encounter and was well received by learners. The instructional method offers a clinically relevant approach for reinforcing pharmacology knowledge for preclinical medical students.

The implementation of scribing within a medical school\u2019s pre-clinical curriculum: pilot study

BackgroundMedical students matriculating from their preclinical curriculum into clinical clerkships face a significant learning curve when using an electronic medical record (EMR) system for clinical documentation. With the trend toward reduction in preclinical medical education, students now have fewer opportunities to optimize their note-writing and overall clinical skills before transitioning to patient-care settings.MethodsThis study sought to investigate how a structured medical scribing program in an outpatient clinic helps bridge the gap between traditional preclinical and clinical curricula in medical education. A small cohort of medical students were trained in medical scribing within our institutions’ existing preclinical preceptorship program. We surveyed students, preceptors, and patients during the project to better understand confidence around documentation, the EMR, and the impact of the scribing program on workflow efficiency and patient satisfaction.ResultsThere was no significant difference between the scribe and non- scribe students in their confidence documenting a patient encounter or navigating EMR (all p > .05). Our study demonstrated that preceptors for scribe students reported a significant decrease in documentation time compared to non-scribes (Mdiff = − 5.75, p = .02), with no negative impact on patient satisfaction.ConclusionsMedical scribing can be a tool to further develop medical trainees in clinical documentation and help prepare them for the responsibilities during clinical years. When summing the per encounter time savings over the course of a half or full clinic day, scribing can return a significant amount of time back to preceptors. The time saved by the preceptor needs to be further investigated to determine if the time can lend itself towards better patient care, student-specific feedback, focused teaching, or even mentoring.

The Current Status of Preclinical Endocrine Education in U.S. Medical Schools

ObjectiveTo characterize the current landscape of preclinical medical endocrine education in U.S. allopathic medical schools. MethodsU.S. endocrine curriculum directors were asked to voluntarily complete a 16-question email survey surveying the status of endocrine preclinical education at their medical school. ResultsSixty-nine of 155 (45%) endocrine block director respondents completed the online survey between July 2021 and September 2021. A larger incoming class, a longer duration of the endocrine curriculum, and the offering of a separate endocrine curriculum (ie apart from the teaching of other organ systems) were each independently associated with an increased number of faculty teaching the course. Schools that used a gland-/organ-based curriculum only and those that used a combination of gland-/organ-based curriculum with topic-based curriculum differed significantly in their use of large lectures, small groups, and several curriculum components, including point of care glucose testing, continuous glucose monitoring, and insulin pumps. ConclusionThis survey study reports the current landscape of preclinical endocrine education in the United States and describes opportunities to improve interest in pursuing endocrinology as a career.

44. Expansion and Integration of a Novel LGBTQ+ Curriculum into the Pre-clinical Medical Education at a Midwestern School

An estimated 4.5% of the US population identifies as LGBTQ+, and significant health disparities exist due to discrimination. Despite high prevalence, there is limited training in medical schools in LGBTQ+ healthcare. To address this educational gap, a curriculum, which was previously piloted with volunteer students (N=29), was integrated into the second year clinical skills course in order to increase knowledge of LGBTQ+ health issues and improve comfort with taking an inclusive sexual history. This study examines the impact of the now mandatory curriculum on the students’ knowledge, attitude, and perspective regarding the LGBTQ+ population.

A structured approach to Shared Decision Making training and assessment of knowledge, attitudes and perception of second year medical students

ABSTRACT Shared decision making (SDM) has been acknowledged in the last decade. Literature has shown that when physicians are engaged in SDM and form a relationship with their patients, there is higher patient satisfaction of care. Moreover, SDM has been reported to improve patient outcomes and clinical measures. Despite this clear benefit of implementing SDM into clinical practice, there is little evidence for including SDM learning into preclinical medical education. We integrated an exercise for second year medical students to practice the steps of shared decision making. In this paper, the quantitative and qualitative results from a survey of medical students following the SDM learning exercise will be discussed. Students were more educated regarding SDM after this exercise and were motivated to use it in their future clinical careers. They also expressed overall positive attitudes towards SDM tools such as decision aids. Feedback to improve this SDM learning experience included the use of standardized patients, and to expand such education to the clinical environment training. This research provides a model of SDM practice integration into medical education. Similar programs can be beneficial for the development of SDM and other interpersonal skills.

Evaluation of Preclinical Task Based Learning program in Medical Education.

The conventional curriculum in preclinical medical education has a need for early clinical exposure programs that help in correlation of basic science data with clinical skills. This is helpful to develop clinical reasoning skills, problem-solving abilities, team work, communication skills and overall attitudes and behaviour relevant for a healthcare provider. Preclinical task based learning (TskBL) is an active learning strategy in which the focus for the first year medical student is a real task done by a doctor. In this strategy the student-doctors undergo a standardized patient encounter and discuss the learning issues related to the task in the first year of medical school. The current study is focussed on the student perception of the effectiveness of task based learning module.The TskBL was conducted among first year medical students for nine topics that are commonly encountered in the clinics. After TskBL was planned and implemented the evaluation of the modules was done using focus group discussions. The students highlighted the importance of standardized patients in the TskBL strategy in providing early clinical exposure in preclinical medical education. They reported its usefulness gaining essential knowledge, skills and attitudes for medical learning. They reported positive outcomes of module design and processes and activities in TskBL. Based on the negative aspects of the modules, future improvement was suggested in improving the usefulness of standardized patient encounter. This study showed the novice learners' outlook of the potency of TskBL for several other topics of clinical relevance to provide early clinical exposure in medical schools.

Shift to emergency remote preclinical medical education amidst the Covid-19 pandemic: A single-institution study.

The Covid‐19 pandemic disrupted medical education, shifting it towards emergency remote delivery. This cross‐sectional study aimed to assess the impact of the pandemic on preclinical medical education and identify predictors of the virtual learning experience and perceived stress. An anonymous survey was delivered electronically to the students of the authors' medical school that attended either histology or pathology. This survey contained two scales, the virtual learning experience (VLE) and the perceived stress scale‐10 (PSS‐10). A total of 173/255 (68%) responded, showing a positive perception towards the remote delivery of both courses. An exploratory factor analysis was performed on the VLE scale items and four new dimensions were formed: “course quality and learning outcomes”, “student motivation”, virtual against F2F learning”, and “virtual laboratory sessions”. The following significant predictors of enhanced VLE, in at least one dimension, were identified: female gender, pathology course, final examination grade >80%, lower perceived stress levels, studying in home country, and holding of another degree before medical school. In addition, the following predictors were significantly associated with higher levels of student perceived stress: female gender, pathology course, studying away from home, and suboptimal internet connection. Notably, the quality of internet connection was significantly associated with the students' final examination performance. Concerning the best mode for future delivery of both courses, most students proposed a blended, rather than an entirely on‐campus or online approach. In conclusion, despite its problems, a high‐quality remote preclinical medical education was possible in the authors' school and offered tremendous opportunities for future improvement.

Vertical integration of anatomy curriculum in the undergraduate clinical education period: medical students’ perspectives

Objectives: The adaptation of the knowledge and skills acquired in preclinical medical education to the clinics by vertical integration would be more permanent when combined with clinical skills. The aim of the study was to determine the needs of the students in clinical internship education on anatomy and to plan the relevant anatomy subjects before clinical internships by rearranging the curriculum as needed. Methods: The study was carried out on a questionnaire form applied to 4th, 5th, and 6th-grade students of Bursa Uludağ University Faculty of Medicine. In addition to demographic information, 16 multiple-choice and open-ended evaluation questions were asked in the questionnaire. Results: 335 students participated in the study. 84.4% of the participants reported that they had needed basic anatomy knowledge and they had to study again before the clinical internship. 69.59% of the participants stated that among the courses taken in the basic sciences education period, anatomy should be integrated into the clinical internships. 88.24% of the participants stated that anatomy education should be integrated before starting clinical internships in the surgical departments. Conclusion: As a result of the feedback received from the students with the current study, it was seen that some of the anatomy information obtained during the preclinical basic sciences period was forgotten until the clinical internship period and they should be remembered again. We support that integrated clinical anatomy lessons should be taken into the clinical education period.

Student Perspectives on Indigenous Health Content in Pre-Clinical Medical Education

Introduction: In 2015, the Truth and Reconciliation Commission of Canada released 94 calls to action. These calls were intended to redress harms inflicted on Indigenous peoples as a result of the Indian Residential School system and to advance the process of reconciliation of Canada. Several of these calls to action are directed specifically toward educating health-care providers as a means to actively eliminate racism in health-care experiences for Indigenous peoples. Objectives : To identify the learning needs of pre-clerkship medical students with respect to Indigenous health content and curriculum, and to explore the perspectives of pre-clerkship medical students on existing gaps in the medical curriculum regarding Indigenous health. Methods: This study involved semi-structured interviews with 14 first- and second-year (pre-clinical/pre-clerkship) medical students at one medical school. Thematic analysis was performed using NVivo data management software to identify common themes, and then considered within the context of the existing literature. Results: Three main themes were identified: (a) Familiarity with Indigenous culture prior to medical school, (b) constructive criticism about Indigenous education in medical school, and (c) pervasive lack of education about Indigenous health issues in the program. Discussion: Participants felt they needed more time devoted to learning about Indigenous peoples’ health, as there are many topics to explore. Most participants felt that their understanding of health issues impacting Indigenous peoples has not been sufficient in their primary, secondary, and post-secondary education to date and offered suggestions for improving the Indigenous health content in the medical school curriculum. These suggestions included providing the education earlier in the program, having Indigenous peoples involved in content creation and delivery, and ensuring all learners have sufficient opportunity to learn more about Indigenous peoples and their health. Conclusion: Through this research we gain a glimpse of how future medical providers are interpreting Indigenous health curriculum, and whether and how they intend to apply this education to their own future practice. NOTE: While the term Aboriginal has been used in Canada and Australia, the term Indigenous is used in this paper as an all-encompassing term to speak of the diverse cultures and peoples who are the original inhabitants of Canada, as it is used globally (Indigenous Foundations, 2009).

Histology education in an integrated, time-restricted medical curriculum: Academic outcomes and students' study adaptations.

In an ever-changing medical curricular environment, time dedicated for anatomical education has been progressively reduced. This happened at the University of Michigan Medical School starting in 2016-2017 when preclinical medical education was condensed to one year. Histology instruction remained integrated in organ system courses but reduced to a lecture-only format without scheduling time for laboratory exercises, requiring students to study virtual histology slides on their own time. In accordance with the shortened instructional time, the number of histology examination questions was reduced more than twofold. This study analyzed students' histology examination results and assessed their motivation to learn histology and use of educational opportunities before and after these curricular changes were implemented. Students' motivation to learn histology and their evaluation of histology lectures increased in the new curriculum. However, students devoted less study time to studying histology. Students' cumulative histology examination scores were significantly lower in the new curriculum and the number of students with overall scores <75%, defined as a substandard performance, increased more than 15-fold. Academically weaker students' histology scores were disproportionately more affected. As medical educational strategies, priorities, and curricular frameworks continue to evolve, traditional didactic topics like histology will need to adapt to continue providing educational value to future health care providers.

Tell Me Your Story: Experiential learning using in-home interviews of healthy older adults.

To create a curriculum innovation for early preclinical medical students to explore personal perspectives by listening to and learning from the lived experience of community-living older adults. Tell Me Your Story (TMYS) paired first-year medical students (MS1s) with community-dwelling older adult partners (OAPs) residing in the independent living portion of a continuing care retirement community (CCRC) for a half-day educational experience. MS1s conducted 1-hour semi-structured interviews with their OAP and then formed small groups with geriatric faculty members to explore experiences and views that were either reinforced or challenged. The authors evaluated the effectiveness of this exercise using post-activity surveys. A mixed-methods analysis of 7 years of data (2013-2019) was conducted. TMYS had 1251 MS1 participants from 2013 to 2019. Students completed 1052 surveys for a response rate of 84%. During the semi-structured interview with OAP, the frequency of issues discussed included relationships (94%), professionalism/art of medicine (91%), healthcare accessibility (83%), death/dying/grieving/loss (72%), nutrition (69%), ethics (64%), and cultural competence (61%). Exactly 97% (n=1023) responded that the overall organization was "good, very good or excellent." The most prominent themes identified by student responses highlighted person-centered care, patient perspective, life experience/personal stories, and doctor-patient relationship. Fifty-three faculty members completed the post-program survey. Exactly 100% (53/53) rated the quality of this exercise as an educational experience high. TMYS was highly valued by students and provided an important experiential learning activity in preclinical medical education. Themes related to person-centered care emerged from the intervention.

Skin of Color in Preclinical Medical Education: A Cross-Institutional Comparison and A Call to Action.

Disease presentations can vary between different skin phototypes, at times requiring distinct management and therapies. Medical education curricula have yet to be updated to better reflect and address the dermatologic needs of an increasingly diverse population. The objective of this study was to determine if the preclinical dermatology curriculum at 3 US medical schools provided adequate representation of skin of color patients in their didactic presentation slides. Three US medical schools-all members of the American Medical Association (AMA) Accelerating Change in Medical Education consortium-were included in the study. The institutions were a blend of private and public schools located across different geographic boundaries. The main outcome measures included the proportion of total skin of color photographs for each institution, the number of priority conditions for skin of color patients, and the discussion of differences between skin types. The results strongly suggested that skin of color is underrepresented in the preclinical dermatology curriculum at all 3 institutions. Efforts should be made to increase images and discussion of skin of color in preclinical didactics.