Second Year Of Medical School Research Articles

Assessing Student Engagement and Higher Order Skill Proficiency During the First and Second Year of Medical School – A Comparison Between the Legacy and Recently Reformed Active Learning Curricula

Background and Hypothesis: This study set-out to determine if: 
 
 students enrolled in Indiana University’s reformed curricula (RC) demonstrate higher levels of engagement (E) and higher order skill (HOS) proficiency than students prior to reform in the legacy curriculum (LC). 
 
 
 students increase E and HOS from first year of medical school (MS1) to second year (MS2). 
 students performing in lowest HOS quartile during MS1 will demonstrate greater gains in HOS by MS2 than students in higher quartiles. 
 
 Experimental Design or Project Methods: Determined E using a validated self-report survey (Ahlfeldt, 2007). Assessed HOS using the standardized Collegiate Learning Assessment (CLA+), professionally developed and validated by the Council for Aid to Education (https://cae.org/flagship-assessments-cla-cwra/cla/). Statistical analysis was preliminary; further analysis to be completed by statistician. Between group comparison of LC and RC via t test assuming unequal variance; paired t test for within group comparison MS1 to MS2 (significance p<0.05). 
 Results: Students in RC increased E significantly from MS1 (39.0±7.0) to MS2 (40.8±5.3) and demonstrate significantly higher E than LC MS2 students (36.3±5.3). There were no differences in HOS proficiency when comparing RC to LC, or MS1 to MS2. Students in RC in the lowest quartile for HOS during MS1 (1688.8±53.1) significantly increased when re-tested during MS2 (1809.5±86.8). 
 Conclusion and Potential Impact: Curricular reform resulted in higher E when compared to LC. Despite increased E, there were no related changes in HOS. Results from quartile analysis agreed with previous reports that active learning preferentially benefits lower performing students (Koles, 2010).

Differences in Medical Students' Academic Performance between a Pass/Fail and Tiered Grading System.

Medical school implementation of a pass/fail grading system offers the opportunity for a reduction in student stress and anxiety and the creation of a less competitive environment, leading to an improvement in overall well-being. Some critics of a pass/fail system have raised concerns of a decrement in academic performance. The purpose of this research project was to determine whether medical students at the Medical College of Georgia experienced a significant change in academic performance when graded using a pass/fail grading system rather than a tiered grading system in the year 1 curriculum. This retrospective cohort study included a convenience sample of two cohorts of students: the first had tiered grading in the first year of medical school (classes of 2015 and 2016; n = 389) and the second cohort had pass/fail grading in the first year of medical school (classes of 2017 and 2018; n=385). Students' undergraduate grade point average and Medical College Admission Test scores in the two cohorts were compared. The first- and second-year averages and comprehensive finals, and the US Medical Licensing Examination step 1 scores were compared. Mann-Whitney U tests were calculated to compare the cohorts' grades. Overall, both cohorts performed similarly in the first and second year of medical school and on US Medical Licensing Examination step 1; however, there were a few unimportant but statistically significant differences of 1 to 2 points on a 100-point scale. In a few instances, the pass/fail cohort performed slightly better and in others, slightly worse. Overall academic performance was similar. The potential for an enhanced learning environment associated with pass/fail grading does not create an important decrement in academic performance.

Encouraging Engagement with Students and Integrating Librarians into the Curriculum through a Personal Librarian Program

Five years ago, the Harriet F. Ginsburg Health Sciences Library created a Personal Librarian Program (PLP) to encourage librarian engagement with first- and second-year medical students and to promote awareness of library resources and services. Prior to the creation of the PLP, the library struggled with finding ways to connect with its medical students, especially because the library is 98% digital. The PLP was created to give students an individualized library experience and an easier way to interact with librarians. As a result, opportunities for librarian-student engagement increased, and Personal Librarian groups facilitated the integration of librarians into two first- and second-year medical school courses.

Joshua Mayourian: Rising to the Challenge.

Joshua Mayourian: Rising to the Challenge.

551 The stigma of psoriasis: Public and healthcare professional perceptions

Patients with psoriasis suffer from stigmatization which contributes to reduced quality of life. There is a research gap in understanding the general public and healthcare professionals perceptions of persons with psoriasis which is required to advance efforts to reduce stigma. We conducted a quasi-experimental survey through Amazon.com's Mechanical Turk and an online survey at the Perelman School of Medicine to quantitatively assess the public and medical students perceptions of people with psoriasis. Herein, we report the results from the medical students survey compared with the general public. All participants viewed images of adults with visible psoriatic lesions and rated their emotional responses and desire to avoid the people in the images. Participants also reported their agreement with psoriasis-related myths and stereotypes, preference for having psoriasis compared to other stigmatized diseases (e.g., HIV), and if they encountered psoriasis previously. Participants from the public were living in the US (n=198, 81.8% white, 58.6% male, mean age (SD) 33.4±9.9 years). Medical students (n=187, 59.4% white, 41.2% male, mean age (SD) 29.4±8.4 years) were mostly in their second year of medical school (31.6%) and had not completed a dermatology rotation (92.5%). Most medical students had heard of (95.7%) or knew someone with (51.3%) psoriasis, which was comparatively more than the public (OR=6.77 vs. 2.96, p<.001). The photos elicited more compassion in the female medical students than males (p=0.02). Significantly less of the student sample compared to the public sample 8.6% vs. 41.9% expressed a desire to avoid the pictured persons with psoriasis and 2.1% vs. 12.1% reported belief in psoriasis misconceptions. Compared to the medical student survey results, the public reported more contempt and blame toward people with psoriasis (p<.001). Medical students appear to have more knowledge about psoriasis and less stigmatizing attitudes and beliefs towards patients with psoriasis than the general public. Our results demonstrate that provide accurate information to the general public may help to reduce stigma.

Interprofessional Collaborative Practice: Use of Simulated Clinical Experiences in Medical Education.

Mastering the art of assessing interprofessional outcomes has been a topic of interest in academic research. Specifically, the Interprofessional Education Collaborative has been publishing thorough bodies of work that aim to strengthen teamwork among health professionals and reinforce competencies that will lead to better patient care. To determine osteopathic medical students' perceived effectiveness of simulated clinical experiences in cultivating interprofessional competencies with nursing students. Second-year osteopathic medical students (classes of 2016 and 2017) and nursing students participated in a simulated clinical experience using a simulated patient mannequin. Students were assessed on clinical and humanistic skills using graded evaluations performed by faculty and actors portraying family members and given feedback on their performance. Evaluation grades were not analyzed. Students were asked to complete an anonymous survey that assessed their attitudes toward the collaborative experience. A total of 743 medical students participated in the study-371 from the class of 2016 and 372 from the class of 2017. Incomplete surveys (1 from the class of 2016 and 3 from the class of 2017) were included in the analysis. Statistically significant differences were found between the 2 classes of medical students in their responses to 2 items. With regard to appropriate patient data collection, the ranked distribution of scores was significantly greater for the class of 2014-2015 than for the class of 2013-2014 (mean rank, 389.3 vs 354.64, respectively; U=75,445.50; P=.017). For the item on effective communication with family members, the ranked distribution of scores was significantly greater for the class of 2014-2015 than for the class of 2013-2014 (mean rank, 390.61 vs 353.34, respectively; U=75,928.50; P=.006). Overall, medical students reported feeling better prepared to care for real patients after the simulation. Simulated interprofessional experiences during the second year of medical school may help prepare students to collaborate with other health care professionals in a clinical setting, take care of patients, and communicate with patients' family members.

Establishing a medical student-run opt-out HIV testing initiative in an urban emergency department: Description of a pilot program

Since July 2012, a testing initiative implemented and staffed entirely by first and second year preclinical medical students has trained medical student volunteers to offer and perform OraQuick® rapid HIV-1/2 antibody tests (OrasureTechnologies, Inc., Bethlehem, PA) on an opt-out basis at a University hospital emergency department (ED) in the District of Columbia. This program is unique among current opt-out ED rapid HIV testing programs in the United States in that all logistics, staffing, and procurement of test kits are coordinated and operated solely by preclinical medical students (i.e, students in their first and second years of medical school). This paper will address the conception, development, and implementation of this pilot project. In addition, it will discuss several factors that were essential to its successful implementation and describe how key barriers were overcome.

Study Habits of Medical Students: An Analysis of which Study Habits Most Contribute to Success in the Preclinical Years.

This article was migrated. The article was marked as recommended. Academic performance during the first two years of medical school is an important predictor of success on the United States Medical Licensing Exam Step 1. Research is lacking into what study methods successful students use, with success being defined as achieving a grade point average of above 90% in all or in most of the courses in the preclinical years.This study sought to identify specific study habits that successful students use and to demonstrate an association between preclinical grades and Step 1 scores. In this study, an anonymous survey was sent to first, second, and third year medical students that included various questions about their study habits, as well as their course grades (A, B, C, or fail) and, if applicable, their Step 1 score. Results demonstrated statistically significant differences existed between Step 1 scores and grades in the second year of medical school, with A students earning higher scores. A students tended to attend class, limit use of online lectures, study for 6-8 hours a day, and review lectures the same day they were given significantly more than B and C students did. This study demonstrates that certain study habits are employed consistently by successful students. These study habits should be shared with medical students early in the preclinical years to help students reach maximum potential both in class and on Step 1, which in turn will allow students to match into their choice of residency.

Increasing Self-Awareness of Medical Students Through the Use of Ultrasonography.

Self-awareness is vital for the health and development of medical students, but few reported modalities successfully increase medical student self-awareness. To assess the effect of ultrasonography on medical student self-awareness and health status. In 2016, first- and second-year osteopathic medical students completed a 9-item survey, created specifically for the current study, which included questions about the use of ultrasonography, health status, and self-awareness after completing at least 1 ultrasonography course. Differences between student responses by class were analyzed using χ2 analysis for items assessing experience with ultrasonography and t tests for items assessing self-awareness. Of the 329 students surveyed, 192 (58.4%) reported using ultrasonography to explore or monitor their own health or body. Forty-nine students (14.9%) found out something about their health that they did not know before their exposure to ultrasonography. Significant differences were found in the use of ultrasonography between first-year and second-year students; more second-year students reported using ultrasonography outside of laboratory hours (P<.05) and discovering incidental findings (P<.05). The largest portions of students reported average health status for exercise (106 of 325 [32.6%]), stress management (174 of 324 [53.7%]), and sleep (137 of 326 [42.0%]). The largest portions of students reported very good health status for tobacco use (282 of 322 [87.6%]), alcohol use (138 of 323 [42.7%]), and healthy relationships (118 of 326 [36.2%]). Statistically significant differences existed in responses between first- and second-year students regarding exercise (P=.007) and alcohol use (P=.001). The majority of students agreed or strongly agreed (182 of 326 [55.8%]) that access to ultrasonography equipment and ultrasonography training during the first and second years of medical school increased their self-awareness. The results suggest that the incorporation of ultrasonography into medical education could potentially increase medical student health status and self-awareness.

Association Between Undergraduate Performance Predictors and Academic and Clinical Performance of Osteopathic Medical Students.

Medical schools use a variety of preadmission indices to select potential students. These indices generally include undergraduate grade point average (GPA), Medical College Admission Test (MCAT) scores, and preadmission interviews. To investigate whether the admission indices used by Midwestern University Arizona College of Osteopathic Medicine are associated with the academic and clinical performance of their students. Associations between the prematriculation variables of undergraduate science GPA, undergraduate total GPA, MCAT component scores, and interview scores and the academic and clinical variables of the first- and second-year medical school GPA, Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Cognitive Evaluation (CE) total and discipline scores, scores in clinical rotations for osteopathic competencies, COMLEX-USA Level 2-Performance Evaluation passage, and match status were evaluated. Two-tailed Pearson product-moment correlations with a Bonferroni adjustment were used to examine these relationships. The traditional predictors of science and total undergraduate GPA as well as total and component MCAT scores had small to moderate associations with first- and second-year GPA, as well as COMLEX-USA Level 1 and Level 2-CE total scores. Of all predictors, only the MCAT biological sciences score had a statistically significant correlation with failure of the COMLEX-USA Level 2-Performance Evaluation examination (P=.009). Average interview scores were associated only with the osteopathic competency of medical knowledge (r=0.233; n=209; P=.001), as assessed by clerkship preceptors. No predictors were associated with scores in objective structured clinical encounters or with failing to match to a residency position. The data indicate that traditional predictors of academic performance (undergraduate GPA, undergraduate science GPA, and MCAT scores) have small to moderate association with medical school grades and performance on COMLEX-USA Level 1 and Level 2-CE. This finding requires additional research into the value of the interview in the medical school admissions process and the availability of alternatives that allow better prediction and assessment of applicant performance.

System Changes Needed to Support Physicians Seeking Help

System Changes Needed to Support Physicians Seeking Help

Is the introduction of medical genetics course using Team-Based Learning session more effective in the first year or second year of medical school?

Is the introduction of medical genetics course using Team-Based Learning session more effective in the first year or second year of medical school?

Assessment of medical students’ leadership traits in a problem/case-based learning program

ABSTRACTBackground: Healthcare delivery is shifting to team-based care and physicians are increasingly relied upon to lead and participate in healthcare teams. Educational programs to foster the development of leadership qualities in medical students are needed to prepare future physicians for these roles.Objective: Evaluate the development of leadership attributes in medical students during their first 2 years of medical school while participating in leadership training integrated into a problem/case-based learning program utilizing the Leadership Traits Questionnaire assessment tool.Design: Ninety-eight students enrolled at Zucker School of Medicine participated in Patient-Centered Explorations in Active Reasoning, Learning and Synthesis (PEARLS), a hybrid problem/case-based learning program, during the first and second years of medical school. The Leadership Traits Questionnaire, designed to measure 14 distinct leadership traits, was utilized. It was administered to students, peers in students’ PEARLS groups and their faculty facilitators. Participants completed questionnaires at three-time points during the study. Likert scale data obtained from the questionnaire was analyzed using a two-level Hierarchal Linear Model.Results: Complete data sets were available for 84 students. Four traits, including self-assured, persistent, determined, and outgoing, significantly increased over time by measurements of both peer and facilitator-rated assessments. Six additional traits significantly increased over time by measurement of facilitator-rated assessment. By contrast, a majority of student self-rated assessments trended downward during the study.Conclusions: Medical students demonstrated development of several important leadership traits during the first 2 years of medical school. This was accomplished while participating in the PEARLS program and without the addition of curricular time. Future work will examine the impact of third year clerkships on leadership traits.

Comparison of the Impact of Wikipedia, UpToDate, and a Digital Textbook on Short-Term Knowledge Acquisition Among Medical Students: Randomized Controlled Trial of Three Web-Based Resources

BackgroundWeb-based resources are commonly used by medical students to supplement curricular material. Three commonly used resources are UpToDate (Wolters Kluwer Inc), digital textbooks, and Wikipedia; there are concerns, however, regarding Wikipedia’s reliability and accuracy.ObjectiveThe aim of this study was to evaluate the impact of Wikipedia use on medical students’ short-term knowledge acquisition compared with UpToDate and a digital textbook.MethodsThis was a prospective, nonblinded, three-arm randomized trial. The study was conducted from April 2014 to December 2016. Preclerkship medical students were recruited from four Canadian medical schools. Convenience sampling was used to recruit participants through word of mouth, social media, and email. Participants must have been enrolled in their first or second year of medical school at a Canadian medical school. After recruitment, participants were randomized to one of the three Web-based resources: Wikipedia, UpToDate, or a digital textbook. During testing, participants first completed a multiple-choice questionnaire (MCQ) of 25 questions emulating a Canadian medical licensing examination. During the MCQ, participants took notes on topics to research. Then, participants researched topics and took written notes using their assigned resource. They completed the same MCQ again while referencing their notes. Participants also rated the importance and availability of five factors pertinent to Web-based resources. The primary outcome measure was knowledge acquisition as measured by posttest scores. The secondary outcome measures were participants’ perceptions of importance and availability of each resource factor.ResultsA total of 116 medical students were recruited. Analysis of variance of the MCQ scores demonstrated a significant interaction between time and group effects (P<.001, ηg2=0.03), with the Wikipedia group scoring higher on the MCQ posttest compared with the textbook group (P<.001, d=0.86). Access to hyperlinks, search functions, and open-source editing were rated significantly higher by the Wikipedia group compared with the textbook group (P<.001). Additionally, the Wikipedia group rated open access editing significantly higher than the UpToDate group; expert editing and references were rated significantly higher by the UpToDate group compared with the Wikipedia group (P<.001).ConclusionsMedical students who used Wikipedia had superior short-term knowledge acquisition compared with those who used a digital textbook. Additionally, the Wikipedia group trended toward better posttest performance compared with the UpToDate group, though this difference was not significant. There were no significant differences between the UpToDate group and the digital textbook group. This study challenges the view that Wikipedia should be discouraged among medical students, instead suggesting a potential role in medical education.

A Crowdsourced System for Creating Practice Questions in a Clinical Presentation Medical Curriculum

Medical students must learn a large amount of information in their first 2 years of medical school. Question banks such as UWorld and COMBANK are a popular method of preparation for national board exams, but it is difficult to have a similar uniform resource to prepare for exams administered by individual medical schools because the curriculum varies from school to school. In order to help prepare for course exams, students from the Class of 2017 at A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) collaborated to create crowdsourced practice quizzes based on the specific material taught at their school. Google Drive was used to manage sign-up sheets and collect questions, and Blackboard was used to create automatically graded practice quizzes. Participants were given a survey at the end of their second year of medical school to assess their opinions of the project’s effectiveness. Students indicated that participation in the project helped them feel more confident on exams, improved their ability to write higher-order, clinically based questions, and improved their ability to predict what types of questions would be used on school-administered exams. Participants ranked the crowdsourced practice quizzes as more useful than textbook practice questions and as useful as faculty-written practice quizzes, board question banks, and verbal quizzing in study groups in preparing for school-administered exams. Comparison of study participant course grades and medical-school grade point average suggested the practice quizzes may benefit lower-performing students more than higher-performing students.

Fundamentals for an Osteopathic Obesity Designed Study: The Effects of Education on Osteopathic Medical Students' Attitudes Regarding Obesity.

Obesity is a major health concern in the United States, and its prevalence continues to rise. Although it is a common health issue, many people, including health care professionals, are biased against people with obesity. To determine whether a comprehensive obesity curriculum presented to students in medical school can positively influence their attitudes toward obesity. The study was designed around a comprehensive educational obesity curriculum at Touro University College of Osteopathic Medicine-CA, involving the classes of 2013 through 2018. A survey to assess student attitudes toward obesity was distributed to first-year students before the curriculum, directly after completion, and each year after until graduation (graduating classes of 2015 through 2018). Second- and third-year medical students in 2011 (graduating classes of 2014 and 2013), who did not complete the curriculum, were given an examination to establish baseline values and served as the control group. The obesity curriculum consisted of lectures delivered during the first and second year of medical school and case study simulations during the third year. Knowledge gained from the curriculum was assessed with a multiple-choice examination, and bias was assessed using the Fat Phobia Scale. A total of 718 first- through fourth-year students were included. Students who completed the first year of the obesity curriculum (n=528) showed significantly greater medical knowledge regarding obesity-related epidemiology, pathogenesis, biochemistry, pathophysiology, and metabolic factors; nutrition, diet, physical activity, self-control, and behavior modification; pharmacologic and nonpharmacologic interventions; and associated chronic disorders, based on their multiple-choice examination scores compared with the control group. The examination scores indicated significant increases in medical knowledge compared with the precurriculum cohort after the curriculum (OMS I students: 130 [72.4%]; 133 [92.6%]; 133 [91.1%]; 132 [89.0%]; vs control: 105 [47.2%]; 134 [52.6%], respectively [P<.01]). In all 4 years observed, there was a significant reduction in bias among first-year medical students after obesity curriculum (before: 3.65, 3.76, 3.57, 3.61, and after: 3.47, 3.38, 3.34, 3.37, respectively) (P<.05). The reduction in bias was also significantly sustained throughout the fourth year. A comprehensive obesity curriculum throughout medical school resulted in an improvement in students' attitudes toward and knowledge of obesity.

EQuality: a Process Model to Develop an Integrated, Comprehensive Medical Education Curriculum for LGBT, Gender Nonconforming, and DSD Health

Patients who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming (GNC), or born with differences of sex development (DSD) face significant health disparities. Many of these disparities originate from discrimination and systemic biases that decrease access to care and from inadequate provider knowledge that contributes to unmet medical needs. Provider training to deliver equitable care for these populations is thus critical, but such training is deficient at most medical institutions. The authors developed an integrated educational model, eQuality, that sought to drive educational and system innovation by teaching and assessing the acquisition of attitudes, knowledge, and skills needed to provide competent care for LGBT/GNC/DSD individuals. This paper outlines the process of its implementation for other programs to model. With input from an LGBT/GNC community advisory panel, eQuality incorporated new teaching sessions and revised existing content in 50.5 h of required curriculum. This curriculum involved 23 teaching faculty and included direct student-LGBT/GNC/DSD patient interactions for 320 students. The program was piloted in the first and second years of medical school and is being expanded into medical school years 3 and 4 with clinical assessments to ensure that curriculum translates into improved patient care. eQuality demonstrates that promoting healthcare equity for LGBT/GNC/DSD populations through medical education is feasible. Forthcoming baseline data will also enable future longitudinal comparisons as eQuality cultivates exceptional insight into the evolution of LGBT/GNC/DSD health knowledge and awareness among both students and faculty.

The Optimal Time to Institute Interprofessional Education in the Medical School Curriculum

Modern healthcare occurs in a dynamic and complex environment that requires providers to work together, collaborate, and quickly adapt to the continuously changing work environment. To prepare providers to meet these demands, practical healthcare and academia establish interprofessional education (IPE) opportunities for healthcare professions. Educational psychologists and philosophers who propone constructivism as a theory of learning argue that “each of us perceives the world through the prism of our own unique experience” (Jean Piaget, Lev Vygotsky, John Dewey, Jerome Bruner, and John Locke) that determines how ready we are to accept or reject given concepts or constructs. This makes the appropriate timing to institute IPE in healthcare curricula very important. No current literature in the realm of IPE collaboration has determined an ideal time to introduce IPE into health education (Curran et al. in J Interprof Care 24:41–52, 4). In our project, we have assessed where in the curriculum medical students had the most positive attitude toward IPE and, more importantly, when they were ready to learn from other healthcare professions, and when they were ready to teach the other professions. In addition, we examined potential confounding factors such as behavioral traits, medical specialty of preference, prior academic degree or working experience in another healthcare profession, amount of clinical experience, and previous IPE exposure. Since none of the existing instruments were suitable to achieve this goal, we developed a 27-item Academic Interprofessional Education Attitude Scale (AIPEAS) survey instrument. This instrument has been piloted and validated at the University of South Dakota Sanford School of Medicine (USD SSOM). At the time of the survey administration, there were 71 first-year, 61 second-year, 58 third-year, and 65 fourth-year students enrolled at USD SSOM. To enhance the response rate, the survey was administered in the last 2 weeks of November and first 2 weeks of December when students did not have major exams or clinical evaluations. One hundred thirty-five out of 254 students replied (135/254, 53.14% response rate), and their profiles closely represented the entire medical school student body. This study found that medical students younger than 25 years, who were females and were in the first or second year of medical school, had significantly more positive attitudes toward IPE. This discovery supported prior research findings conducted by other investigators (Pollard et al. Health Soc Care Community 12(4):346–58, 2004; Anderson and Thorpe J Interprof Care 22(3):263–82, 2008). Among all medical specialties, primary care and family medicine in particular, along with the group of undecided specialty, demonstrated the highest mean attitude toward IPE scores. These findings agree with the previous studies that showed correlation between medical specialties and personality traits (Borges and Osmon J Vocat Behav 58:22–35, 5). The University of South Dakota Sanford School of Medicine conducted a survey-based study to determine the best timing to institute interprofessional education in medical school curriculum. According to the obtained data, the majority of students responded that the first year of the medical school curriculum was the best time to initiate IPE. While the entire attitude toward IPE was positive, female students were more enthusiastic about it than their male counterparts. Also, students younger than 25 years had more positive attitudes toward IPE than their elder schoolmates. Since many healthcare accreditation agencies require students to be involved in the IPE activities throughout their educational curricula, this survey and its findings could be an important tool in designing such curricula (Dominguez et al. J Interprof Care 29:1–6, 2014).

Osteopathic Philosophy and Manipulation Enhancement Program: Influence on Osteopathic Medical Students' Interest in Osteopathic Manipulative Medicine.

Interest in osteopathic manipulative medicine (OMM) among first- and second-year osteopathic medical students typically declines toward the end of the second year of medical school. An osteopathic philosophy and manipulation enhancement (OPME) program was implemented for osteopathic medical students to gain additional exposure to OMM at the Touro College of Osteopathic Medicine in New York, New York. To assess how additional exposure to OMM through the OPME program influenced first- and second-year students' interest in using OMM. A survey of first- and second-year osteopathic medical students was conducted at the end of the school years to evaluate students' demographics, exposure to OMM before matriculation, reasons for participating in the OPME program, and level of interest in OMM before and after participating in the OPME program. Of 390 students, 204 returned the survey. Respondents reported that their exposure to OMM before enrollment was mostly from reading about OMM philosophy (112 [54.9%]). Respondents also gained exposure from learning about OMM from family members or friends who had been treated by an osteopathic physician (37 [18.1%]), shadowing an osteopathic physician before matriculation (33 [16.2%]), and being treated by an osteopathic physician themselves (22 [10.8%]). After the OPME sessions, respondents reported improved practical skills (98 of 170 [57.6%]) and increased level of confidence in applying OMM (87 of 170 [51.2%]). Nearly half of respondents reported that being treated by a faculty member (100 [49.0%]) was very likely to increase their level of interest in OMM, followed by treating other classmates (77 [37.7%]) and being treated by classmates (73 [35.8%]). The OPME program improved students' interest in OMM and can be modified and implemented in any college of osteopathic medicine.

HIV: A Socioecological Case Study.

New strategies are needed to lower health care costs and address the health care needs of communities, especially for marginalized persons and subpopulations. Improved education in health systems, which encompasses population, community, preventive, and public health, is one way to better train the future physician workforce to meet national and local health care needs. This resource was created as part of an 18-month science of health systems and navigation curriculum. The purpose of this resource is to use the socioecological model lens to analyze health disparities for marginalized persons and subpopulations. A medically and socially complex patient with HIV is presented as the initial case study that leads to identification of barriers and needs on individual, community, and public policy levels. This is an active-learning resource that includes both small- and large-group discussion driven by self-directed learners using the provided resources. This resource was successfully implemented as a required session for 150 medical students beginning the second year of medical school. A cohort of 21 students randomly selected to complete a standard online course evaluation for the session, rated their agreement (1 = strong disagreement, 5 = strong agreement) to the statement "Rate the extent to which the lecture supported your mastery of the learning objectives," as 4.4, on average. This curriculum has been implemented and evaluated for medical students, but it is broadly applicable to residents and interprofessional students in health-related fields. It is designed to give learners a practical medical context for the application of principles that may be taught within a health systems or population health course.