Small Group Sessions Research Articles

Developing Faith-Based Messaging and Materials for Colorectal Cancer Screening: Application of Boot Camp Translation Within the African Methodist Episcopal Church

Purpose of the study: Colorectal cancer (CRC) is the 2nd leading cause of cancer-related death in Black and African American people in the United States. We created culturally appropriate and locally relevant faith-based CRC screening messages and materials for African Methodist Episcopal (AME) church communities in Atlanta, Georgia. Methods: We used boot camp translation (BCT), a validated community based participatory strategy, to elicit input from AME congregants to 1) develop faith-based CRC screening messages that resonate with the AME community and 2) identify the role of the church in bringing CRC information to the AME community. Eligible participants were members of the AME Atlanta East District churches, ages 45 to 75 years, and willing to participate in one 5-hour in-person meeting and two follow-up video-conferencing calls. The in-person session, conducted in the church sanctuary and fellowship hall, consisted of expert presentations by a national leader on colorectal cancer and screening, a local leader well-versed in barriers to screening and community resources, and a prominent figure within the church clergy. Additionally, we held interactive small group sessions to create messages and identify dissemination methods. Results: A total of 27 adults participated in the in-person session (17 women and 10 men). Participants preferred CRC screening messages that incorporated faith-based concepts including “honoring God by taking care of one's body”_ and “choosing faith over fear of screening.”_ Other key themes focused on increasing awareness and knowledge of CRC screening, taking control of one's own health, and sharing personal stories with one's community to reduce stigma and inspire action. Favored dissemination channels within the church were Sunday service, print (e.g., flyers, pamphlets, message cards) distributed at church, and digital materials (e.g., videos) shown during service. Desired community channels included cancer awareness events and social media platforms. Conclusions: Churches serve as key partners in delivering health information as they are among the most trusted institutions within the Black and African American community. Using BCT, we successfully incorporated participant feedback to create faith-based CRC screening messages and identified appropriate channels for sharing information within the AME community.

Facilitated Study Groups for Undergraduate Organic Chemistry: Experience from a Large Public Canadian University

Undergraduate organic chemistry courses have a reputation for being difficult among students in biological and physical sciences programs. Due to the extensive problem-solving, visualization, and depiction of chemical structures/reactions required, students may perceive learning such content as similar to learning a new language. Several interventions such as course-integrated tutorials or discussion sessions have aimed to assist students. Another effective approach that chemistry educators might consider is Supplemental Instruction (SI), a well-established program that emphasizes student-driven learning whereby student SI leaders facilitate discussions to help students arrive at solutions while also developing effective communication and study skills. A type of SI, Facilitated Study Groups (FSG), established by the Centre for Teaching and Learning at the University of Toronto Scarborough (UTSC) in 2009, were introduced regularly into organic chemistry courses in 2012. This program provides semester-long optional small-group peer learning sessions, each of which corresponds to a course lecture. The aim of this paper is to provide comprehensive coverage detailing the structure of the organic chemistry FSG program, peer facilitation strategies employed, quantitative/qualitative synthesis of student outcomes indicating program uptake. We consistently find significantly higher grades and significantly lower attrition rates for students who regularly attend FSG sessions in comparison to those who do not (n=16 semesters). Given the growing diversity of undergraduate classes in terms of approaches to learning, language, and cultural barriers (international students, English second-language learners, learning and psychosocial disabilities), our FSG sessions seek to foster inclusion amongst our heterogeneous pool of attendees. Here, we describe strategies that tailored FSG sessions to a diverse group of undergraduate students as suggested by a sizable percentage of the class availing themselves of this resource and by a narrative synthesis of end-of-term surveys. Together, we demonstrate successful adoption of an SI-based model for organic chemistry and present a practical framework that includes pedagogically informed session strategies and cost estimates to guide design of similar programs for post-secondary students at other institutions.

Three-year evaluation of a program teaching social determinants of health in community-based medical education: a general inductive approach for qualitative data analysis

BackgroundSocial determinants of health (SDH) are intricately intertwined with various social and economic factors. Reflection is essential for learning about SDH. However, only a few reports have focused on reflection in SDH programs; most were cross-sectional studies. We aimed to longitudinally evaluate a SDH program in a community-based medical education (CBME) curriculum that we introduced in 2018 based on the level of reflection and content on SDH in students’ reports.MethodsStudy design: General inductive approach for qualitative data analysis. Education program: A 4-week mandatory clinical clerkship in general medicine and primary care at the University of Tsukuba School of Medicine in Japan was provided to all fifth- and sixth-year medical students. Students underwent a 3-week rotation in community clinics and hospitals in suburban and rural areas of Ibaraki Prefecture. After a lecture on SDH on the first day, students were instructed to prepare a structural case description based on encounters during the curriculum. On the final day, students shared their experiences in a small group session and submitted a report on SDH. The program was continuously improved and faculty development was provided. Study participants: Students who completed the program during October 2018–June 2021. Analysis: Levels of reflection were categorized as reflective, analytical, or descriptive. The content was analyzed based on the Solid Facts framework.ResultsWe analyzed 118 reports from 2018–19, 101 reports from 2019–20, and 142 reports from 2020–21. There were 2 (1.7%), 6 (5.9%), and 7 (4.8%) reflective reports; 9 (7.6%), 24 (23.8%), and 52 (35.9%) analytical reports; and 36 (30.5%), 48 (47.5%), and 79 (54.5%) descriptive reports, respectively. The others were not evaluable. The number of Solid Facts framework items in reports were 2.0 ± 1.2, 2.6 ± 1.3, and 3.3 ± 1.4, respectively.ConclusionsStudents’ understanding of SDH deepened as the SDH program in the CBME curriculum improved. Faculty development might have contributed to the results. Reflective understanding of SDH might require more faculty development and integrated education of social science and medicine.

School partner perspectives on the implementation of the Your Voice Your View sexual assault prevention program for high school students.

Despite the high risk for sexual assault among adolescents, few sexual assault prevention programs designed for implementation in high schools have sustained rigorous evaluation. The present study sought to better understand the factors that influenced the implementation of Your Voice Your View (YVYV), a four-session sexual assault prevention program for 10th grade students, which includes a teacher "Lunch and Learn" training as well as a 4-week school-specific social norms poster campaign. Following program implementation, eight school partners (i.e., health teachers, guidance counselors, teachers, and principals) participated in an interview to provide feedback on the process of program implementation. The Consolidated Framework for Implementation Research was utilized to examine site-specific determinants of program implementation. Participants discussed the importance of the design quality and packaging of the program, as well as the relative advantage of offering students a violence prevention program led by an outside team, as opposed to teachers in the school. School partners highlighted the importance of intensive preplanning before implementation, clear communication between staff, the utility of engaging a specific champion to coordinate programming, and the utility of offering incentives for participation. Having resources to support implementation, a desire to address sexual violence in the school, and a positive classroom climate in which to administer the small-group sessions were seen as school-specific facilitators of program implementation. These findings can help to support the subsequent implementation of the YVYV program, as well as other sexual assault prevention programs in high schools.

GRADE concept 4: rating the certainty of evidence when study interventions or comparators differ from PICO targets

ObjectivesThis Grading of Recommendations Assessment, Development and Evaluation (GRADE) concept article offers systematic reviewers, guideline authors, and other users of evidence assistance in addressing randomized trial situations in which interventions or comparators differ from those in the target people, interventions, comparators, and outcomes. To clarify what GRADE considers under indirectness of interventions and comparators, we focus on a particular example: when comparator arm participants receive some or all aspects of the intervention management strategy (treatment switching). Study Design and SettingAn interdisciplinary panel of the GRADE working group members developed this concept article through an iterative review of examples in multiple teleconferences, small group sessions, and e-mail correspondence. After presentation at a GRADE working group meeting in November 2022, attendees approved the final concept paper, which we support with examples from systematic reviews and individual trials. ResultsIn the presence of safeguards against risk of bias, trials provide unbiased estimates of the effect of an intervention on the people as enrolled, the interventions as implemented, the comparators as implemented, and the outcomes as measured. Within the GRADE framework, differences in the people, interventions, comparators, and outcomes elements between the review or guideline recommendation targets and the trials as implemented constitute issues of indirectness. The intervention or comparator group management strategy as implemented, when it differs from the target comparator, constitutes one potential source of indirectness: Indirectness of interventions and comparators—comparator group receipt of the intervention constitutes a specific subcategory of said indirectness. The proportion of comparator arm participants that received the intervention and the apparent magnitude of effect bear on whether one should rate down, and if one does, to what extent. ConclusionTreatment switching and other differences between review or guideline recommendation target interventions and comparators vs. interventions and comparators as implemented in otherwise relevant trials are best considered issues of indirectness.

Stay Home, Stay Connected: Providing Supplemental Education and Psychosocial Support for Pregnant People [ID: 1375777

INTRODUCTION: The traditional medical model of prenatal care may miss opportunities for anticipatory guidance and psychosocial support for pregnant people. We describe Stay Home, Stay Connected (SHSC), a virtual, service-learning, pregnancy support group that supplements routine prenatal care. METHODS: Stay Home, Stay Connected was implemented during the acute COVID-19 pandemic and updated in January 2022 in keeping with relaxation of COVID-19 restrictions. The program consists of monthly small-group sessions with 8–10 pregnant people at similar gestational age, led by an obstetric provider (eg, physician, midwife) and medical, midwifery, and social work students. Recorded group classes on mental health and wellness are available on-demand. In our IRB-exempt assessment of SHSC patients from January 2022 to October 2022, we obtained consent and collected surveys at enrollment and after sessions to assess participants' reasons for joining and overall satisfaction. RESULTS: Since program updates, 80 patients have participated in 5 small groups, led by 4 providers and 8 students. Of the 80 patients registered for SHSC, 65 (81%) completed the enrollment survey. The top reasons for joining SHSC were desire for extra support, more information about pregnancy, and connection with other patients. The majority of participants who completed satisfaction surveys, reported sessions were helpful to their learning (32/34, 94%) and feeling supported (25/26, 96%). All participants surveyed reported they would recommend SHSC to other pregnant patients. CONCLUSION: A virtual service-learning pregnancy support group remains feasible and acceptable for participants after the acute COVID-19 pandemic. We are continuing to expand and develop SHSC to fulfill unmet needs in pregnancy.

Hurricane Ida Emergency Medicine Resident Disaster Response

Introduction:This report describes the response, action plan, and after-action changes adopted by the Louisiana State University New Orleans (LSU-NO)–Emergency Medicine (EM) Residency Program in response to Hurricane Ida, which occurred in New Orleans, Louisiana in late August through early September 2021. Summarized are the redistribution of emergency department (ED) residents within the primary clinical site, University Medical Center New Orleans (UMCNO); the daily communication flow from chief residents and program leadership; and discussions pertaining to procedural revisions instituted following investigation of pre- and post-hurricane operations.Method:Small-group debrief sessions and after-action reports were conducted post-storm to discuss perceived deficiencies from a resident stand-point. Debriefing occurred between chief residents and individual classes through standardized residency forums. Additionally, an after-action committee, comprised of senior residents, academic faculty, and ancillary personnel, convened a separate counsel with hospital administration-level leadership to analyze retrospective limitations that occurred both during, and immediately following, Code Grey activation.Results:Following data collection and analysis from the various feedback channels, several changes were made to the residency’s Code Grey activation plan going into the 2022-2023 academic residency year. The information obtained was used to develop a more formalized Code Grey process, and to create more robust orientation and education materials for residents.Conclusion:Throughout the events of Hurricane Ida, the LSU-NO Emergency Medicine Department at University Medical Center New Orleans managed a substantial intensification in daily emergency medical activity, while contending with a near-immediate reduction in available resources. Consequently, our program has formalized a more durable residency response to future disasters, including real-time, evolving evacuation correspondence and modernized protocols for rapid re-distribution of resident-power. These procedures are now distributed and practiced throughout each residency year and reinforced on an ad hoc basis in advance of any major weather-related events predicted to impact the greater New Orleans metropolitan area.

Investigating the Impact of Virtual Versus In-Person Small Group Discussion on Academic Performance in a First-Year Medical Neuroscience Course (S10.003)

<h3>Objective:</h3> We aimed to determine if academic performance was different in students who self-selected to participate in virtual small group discussions, compared to students who engaged in traditional in-person small group discussions, in a first-year medical school neuroscience course. <h3>Background:</h3> Incorporating virtual instruction into the medical curriculum has been a longstanding subject of study and has increasingly been required due to the COVID-19 pandemic. Previous literature suggests that exchange and communication patterns during learning may be stunted on virtual platforms. In 2021, for the pre-clinical neuroscience course, the Mayo Clinic Alix School of Medicine gave students the choice to engage in small group sessions either in-person or virtually. These sessions have been used to facilitate case discussions to reinforce course material. <h3>Design/Methods:</h3> This is a retrospective analysis of academic performance in the 2021 neuroscience course. Students self-selected to participate either in-person or virtually for small group discussions. Academic performance was measured by scores on the National Board of Medical Examiners (NBME) shelf exam and professor-written final exam, as well as weighted final course grades. Unpaired t-tests were used to compare data from the two cohorts. <h3>Results:</h3> Of the 51 students, 23 chose the in-person cohort and 27 chose the virtual cohort. One student switched cohorts part way through the course and was excluded from analysis. Overall, when comparing the in-person and virtual cohorts, there was no difference in scores for the NBME shelf exam (87.13% vs 85.33%, p = 0.48), professor-written final exam (87.13% vs 86.22%, p = 0.55), or weighted course grades (87.56% vs 87.09%, p = 0.71). <h3>Conclusions:</h3> Students who self-selected to engage in virtual discussions of neuroscience course material performed comparably to their in-person counterparts. This suggests that virtual platforms may be appropriate for holding small group discussions within the medical curriculum. <b>Disclosure:</b> Dr. Vanood has nothing to disclose. Dr. Chhabra has nothing to disclose. Dr. Hoerth has a non-compensated relationship as a Epilepsy.com Editorial Board member with the Epilepsy Foundation of America that is relevant to AAN interests or activities.

Development and Optimization of a Remote Pediatric Cardiac Critical Care Bootcamp Using Telesimulation

AbstractWe developed a novel cardiac critical care bootcamp consisting of didactic, small group, and simulation sessions. The bootcamp was remote due to the COVID-19 pandemic and included telesimulation. We aimed to assess learners' reactions to the bootcamp and their perception of telesimulation. Paired anonymous surveys were administered before and after participation. Surveys assessed participants' comfort in independently managing cardiac critical care scenarios, perceptions of telesimulation, barriers to its effectiveness, and specific feedback on course components. Forty-three fellows from 10 institutions joined the bootcamp over 2 years. Thirty-eight pre- and 28 postcourse surveys were completed. The course was rated good or excellent by all respondents, and 27/28 rated the material as appropriate to their level of training. Based on feedback from 2020, the electrophysiology sessions were converted to a small group format in 2021; positive assessment of these sessions improved from 65 to 90–100%. The telesimulations were highly rated, with 83–94% of participants in 2020 and 90–100% in 2021 rating them as good or excellent. Participants' views on telesimulation improved following the course, with 78% (14/18) post- versus 50% preparticipation agreeing that telesimulation is an effective educational tool (p = 0.06) and 56% (10/18) post- versus 67% (12/18) pre-rating telesimulation as less effective than in person simulation (p = 0.04). Identified limitations of telesimulation were limited active participation, lack of realism, impaired flow of conversation, and audiovisual and technical concerns. Telesimulation is feasible in cardiac critical care education and was an acceptable alternative to in person simulation for course participants.

Targeted Intervention for Elementary Students With Internalizing Behaviors: A Pilot Evaluation

The Calm Cat Program was developed in response to the need for intervention approaches that target internalizing symptoms, are developmentally appropriate for early elementary students, and are feasible for school-based implementation by staff without specialized training. The Calm Cat Program is a brief Tier 2 intervention combining behavioral skills training and mentor-based coaching. In this initial study, the Calm Cat Program was evaluated in a cluster-randomized controlled trial of 72 student participants in nine elementary schools. Over a 5-week period, school counselors implemented small-group skills training sessions, and classroom teachers provided daily coaching on targeted relaxation skills. Overall, program participation was associated with small- to medium-sized gains in relaxation skill knowledge and reductions in self-reported anxiety symptoms. In addition, both staff implementers and student participants reported generally positive perceptions of the program’s usability. Additional research is needed to ensure the program’s efficiency and effectiveness as an early intervention approach within multitiered frameworks. Impact Statement School-based interventions are needed to support young students at risk for developing emotional disorders. The Calm Cat Program is an intervention that combines behavioral skills training and mentor-based coaching. In this pilot study, the Calm Cat Program demonstrated small- to medium-sized effects in increasing students’ knowledge of relaxation skills and decreasing their self-reported anxiety symptoms.

A thematic analysis of students' discussions on death and body donation in international online focus groups.

Historically, Anatomy education is an in-person discipline involving exposure to human body donors that facilitates personal and professional growth through, in part, the initiation of reflection on the topic of death. However, during the COVID-19 pandemic the decreased exposure to cadaveric anatomy for many health professions students may have influenced the depth of their individual reflections on this topic. Accordingly, this study aimed to investigate the effect of an alternate approach - focus group discussions between peers with varying degrees of exposure to cadaveric material - that may offer one strategy to stimulate deep reflection on the topic of death. A programmatic intervention was introduced, wherein students (n=221) from 13 international universities discussed differences in their anatomy courses during small focus group sessions as part of an online exchange program. An inductive semantic thematic analysis was conducted on responses to an open-ended text-response question on how the activity influenced students' reflections about death. Resulting themes were organized into categories that described the content and topics of the students' discussions as they grappled with this sensitive topic. The students reportedly engaged in deep reflection and expressed an increased sense of connectedness with their peers, despite their disparate exposure levels to cadaveric anatomy and being physically distanced. This demonstrates that focus groups with students experiencing different laboratory contexts can be used to help all students reflect on the topic of death, and that interchanges between dissecting and non-dissecting students can initiate thoughts about death and body donation among non-dissecting students.

An integrated pre-clerkship curriculum to build cognitive medical schema: It's not just about the content.

Both physiology and pathophysiology are essential disciplines in health professional education however, clinicians do not use this knowledge in isolation. Instead, physicians use inter-disciplinary concepts embedded within integrated cognitive schema (illness scripts) established through experience/knowledge that manifest as expert-level thinking. Our goal was to develop a pre-clerkship curriculum devoid of disciplinary boundaries (akin to the physician's illness script) and enhance learners' clerkship and early clinical performance. As well as developing curricular content, the model considered non-content design elements such as learner characteristics and values, faculty and resources and the impact of curricular and pedagogical changes. The goals of the trans-disciplinary integration were to develop deep learning behaviors through, 1) developing of integrated, cognitive schema to support the transition to expert-level thinking, 2) authentic, contextualization to promote knowledge transfer to the clinical realm 3) allowing autonomous, independent learning, and 4) harnessing the benefits of social learning. The final curricular model was a case-based approach with independent learning of basic concepts, differential diagnosis and illness scripting writing, and concept mapping. Small-group classroom sessions were team-taught with basic scientists and physicians facilitating learners' self-reflection and development of clinical reasoning. Specifications grading was used to assess the products (written illness scripts and concept maps) as well as process (group dynamics) while allowing a greater degree of learner autonomy. Although the model we adopted could be transferred to other program settings, we suggest it is critical to consider both content and non-content elements that are specific to the environment and learner.

Scaffolding children’s participation during teacher–child interaction in second language classrooms

ABSTRACT This study investigates the nature of teacher–child interaction and teacher scaffolding in Finnish second language (L2) classrooms. Although previous research on classroom interaction has highlighted the importance of scaffolding in language learning, much less is known about the importance of scaffolding for younger children's L2 learning. Utilising a sociocultural approach, this study aims to fill this gap. The data were collected from seven pre-primary/early primary L2 classrooms, with four teachers and 205 children through video recording (56 h) and observational field notes. The interaction analysis focused on the communicative functions of teacher–child interaction, teacher and student initiations, and teachers’ scaffolding children's participation during whole-class and small-group sessions. The results show how teacher–child interaction during small-group sessions supported the children’s active participation in L2 interaction and learning. The results also suggest how changing from teacher-centred modes of classroom interaction to child-centred and playful interaction is challenging and requires strong teacher professionalism.

Assessing Self-Reported Readiness of Medical Students transitioning to Clinical Clerkship at the University of Ottawa

Introduction: The transition from pre-clerkship to clinical clerkship is a pivotal moment for medical students. Curricular improvements can be made to better prepare students for clerkship. We collected student feedback to generate recommendations for improvement with regard to clerkship preparedness at the University of Ottawa Faculty of Medicine.&#x0D; Methods: We created a pre- and post-clerkship transition survey for medical students at the University of Ottawa Faculty of Medicine. The groups assessed were from different cohorts. Likert-type and open ended questions were used. The survey was open from October 10 to October 31, 2020. Microsoft Excel 2016 was used for data analysis.&#x0D; Results: We obtained 176 respondents (37% response rate), of which 158 provided consent and completed the survey. Students in the post-transition group were less anxious about the transition to clerkship, compared to their pre-transition colleagues, with the most significant difference being completing a thorough history and physical examination (2.9/5.0 vs. 3.3/5.0, p&lt;0.05). The two main stressors for incoming clerks were inadequate clinical skills training in pre-clerkship and lack of clarity around clerkship roles, responsibilities, and expectations.&#x0D; Conclusion: Improvements can be made in pre-clerkship through the integration of small-group orientation sessions, formative OSCEs, accelerated review of pre-clerkship material, and clerkship simulation sessions to facilitate a seamless transition to clerkship at the University of Ottawa.

Understanding the barriers and enablers for postgraduate medical trainees becoming simulation educators: a qualitative study

Introduction There is increasing evidence that Simulation-based learning (SBL) is an effective teaching method for healthcare professionals. However, SBL requires a large number of faculty to facilitate small group sessions. Like many other African contexts, Mbarara University of Science and Technology (MUST) in Uganda has large numbers of medical students, but limited resources, including limited simulation trained teaching faculty. Postgraduate medical trainees (PGs) are often involved in clinical teaching of undergraduates. To establish sustainable SBL in undergraduate medical education (UME), the support of PGs is crucial, making it critical to understand the enablers and barriers of PGs to become simulation educators.MethodsWe used purposive sampling and conducted in-depth interviews (IDIs) with the PGs, key informant interviews (KIIs) with university staff, and focus group discussions (FGDs) with the PGs in groups of 5–10 participants. Data collection tools were developed using the Consolidated framework for implementation research (CFIR) tool. Data were analyzed using the rigorous and accelerated data reduction (RADaR) technique.ResultsWe conducted seven IDIs, seven KIIs and four focus group discussions. The barriers identified included: competing time demands, negative attitude towards transferability of simulation learning, inadequacy of medical simulation equipment, and that medical simulation facilitation is not integrated in the PGs curriculum. The enablers included: perceived benefits of medical simulation to medical students plus PGs and in-practice health personnel, favorable departmental attitude, enthusiasm of PGs to be simulation educators, and improved awareness of the duties of a simulation educator. Participants recommended sensitization of key stakeholders to simulation, training and motivation of PG educators, and evaluation of the impact of a medical simulation program that involves PGs as educators.ConclusionIn the context of a low resource setting with large undergraduate classes and limited faculty members, SBL can assist in clinical skill acquisition. Training of PGs as simulation educators should address perceived barriers and integration of SBL into UME. Involvement of departmental leadership and obtaining their approval is critical in the involvement of PGs as simulation educators.

Eating pace instruction is effective in slowing eating rate in women with overweight and obesity

Slow eating is associated with lower body mass index (BMI), enhanced satiety, and reduced food intake in laboratory settings. This study developed and tested a 5-week slow-eating intervention, delivered either through individual or small group weekly meetings, in women with overweight and obesity. Women (n = 65; 20.5 ± 3.6 years; BMI 31.3 ± 2.7 kg/m2) were assigned to experimental or parallel non-treatment control. Main outcomes, measured pre- and post-intervention, included eating rate, meal duration, and energy intake during a standardized meal served on a universal eating monitor. Exploratory outcomes included Weight Related Eating Questionnaire (WREQ), Intuitive Eating Scale (IES), and Mindful Eating Questionnaire (MEQ) scores. All women in the experimental group underwent the same slow-eating intervention, but half had individual sessions while the other half had small group sessions. No differences were seen for any outcomes between session modalities, so experimental data were pooled (n = 25) and compared to control data (n = 25). Time-by-group interactions showed reduced eating rate (F(1,48df) = 13.04, η2 = 0.214, p = .001) and increased meal duration (F(1,48df) = 7.949, η2 = 0.142, p = .007) in the experimental group compared to the control group but change in energy intake was not significant (F(1,48df) = 3.298, η2 = 0.064, p = .076). Experimental within-group changes for WREQ subscale scores External Cues (t(23) = 3.779, p = .001) and Emotional Eating (t(23) = 2.282, p = .032) decreased over time, along with increased total and summary IES (t(23) = 2.6330, p = .015) and MEQ (t(23) = 2.663, p = .014) scores. Promising findings of reduced eating rate, increased meal duration, and improved WREQ, IES, and MEQ scores should be followed up in larger more diverse samples for longer durations.

A core outcome set for studies on vasa previa (COVasP): an international consensus study

There is little consistency in how outcomes are measured and reported across screening, diagnostic, and management studies of Vasa Previa (VP). Our objective was to develop a core outcome set for diagnostic and management studies of VP. This was an international Delphi consensus study, a part of the Core Outcome set for studies on Vasa Previa (COVasP) project. Previously, 67 outcomes were identified from interviews and literature reviews. Health service users (HSUs) and healthcare professionals (HCPs) from around the world were asked to participate in 2 rounds of online Delphi surveys, virtual small group meetings, and a virtual consensus meeting to finalize the core outcome set. A total of 115 HSUs and 89 HCPs from 23 countries participated in the Delphi survey, while 8 HSUs and 11 HCPs participated in virtual small group sessions. From these discussions, core outcomes were identified for all VP studies, such as fetal/neonatal survival, fetal/neonatal blood loss from rupture of fetal vessels, gestational age at birth, and severe neonatal morbidity. Others were deemed relevant only where screening was routinely performed (time interval between antepartum bleeding and birth) or not performed (mode of birth, neonatal intensive care unit admission and rupture of membranes). Process measures, intermediary events, and outcomes not specific to VP studies were excluded. Following a final consensus meeting, the number of core outcomes and categorizations were ratified. Outcomes not identified as core were assigned categories such as: important but not core, minimal data items, and clinical practice recommendations. This international consensus study identified core outcomes to be measured and reported in published studies on VP, in addition to other important data items to be incorporated into future research and clinical practice. This will enable harmonization of outcome reporting and measurement, facilitating appropriate meta-analyses and the drawing of meaningful conclusions to inform clinical practice and health policy.

Proceedings from the 2022 Consensus Conference to Implement Optimal Venous Thromboembolism Prophylaxis in Trauma.

On May 4 and 5, 2022, a meeting of multidisciplinary stakeholders in the prevention and treatment of venous thromboembolism (VTE) after trauma was convened by the Coalition for National Trauma Research, funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health, and hosted by the American College of Surgeons in Chicago, Illinois. This consensus conference gathered more than 40 in-person and 80 virtual attendees, including trauma surgeons, other physicians, thrombosis experts, nurses, pharmacists, researchers, and patient advocates. The objectives of the meeting were twofold: (1) to review and summarize the present state of the scientific evidence regarding VTE prevention strategies in injured patients and (2) to develop consensus on future priorities in VTE prevention implementation and research gaps.To achieve these objectives, the first part of the conference consisted of talks from physician leaders, researchers, clinical champions, and patient advocates to summarize the current state of knowledge of VTE pathogenesis and prevention in patients with major injury. Video recordings of all talks and accompanying slides are freely available on the conference website ( https://www.nattrauma.org/research/research-policies-templates-guidelines/vte-conference/ ). Following this curriculum, the second part of the conference consisted of a series of small-group breakout sessions on topics potentially requiring future study. Through this process, research priorities were identified, and plans of action to develop and undertake future studies were defined.The 2022 Consensus Conference to Implement Optimal VTE Prophylaxis in Trauma answered the National Trauma Research Action Plan call to define a course for future research into preventing thromboembolism after trauma. A multidisciplinary group of clinical champions, physicians, scientists, and patients delineated clear objectives for future investigation to address important, persistent key knowledge gaps. The series of papers from the conference outlines the consensus based on the current literature and a roadmap for research to answer these unanswered questions.

TEAMwork! An Innovative Hospital Medicine Teaching Program to Enhance Learners' Educational Experience.

Workplace-based learning and assessment are dependent on frequent observations, feedback, teaching, and evaluations. Yet high physician workload and multiple learners limit these efforts. A local needs assessment demonstrated insufficient direct observations, small-group teaching, and high-quality evaluations for learners. In response, the authors developed and implemented Teaching Excellence Among Medical providers (TEAM), a teaching program to enhance the educational experience of learners in pediatric hospital medicine (PHM). The TEAM program, grounded in a self-regulated learning framework, launched in 2019. The University of Colorado Department of Pediatrics provided salary support. TEAM hospitalists completed professional development for teaching and feedback skills. During their TEAM shifts, they observed, provided feedback, completed evaluations, and led teaching sessions for learners on PHM rotations. The program's impact was evaluated by using an electronic work tracking form and surveying learners, attending hospitalists, and TEAM hospitalists, leading to iterative program improvements. Over an 18-month period, TEAM hospitalists completed 1,573 direct observations, 265 teaching sessions attended by 1,921 learners, and more than 497 learner evaluations. Survey results showed that 95% of learners indicated TEAM was "very effective" or "somewhat effective" in helping achieve individualized learning goals, and a similar percentage "strongly agreed" or "agreed" that TEAM hospitalists were effective educators. Eighty-four percent of attending hospitalist survey respondents reported TEAM contributed "very much" or "somewhat" to learner education. Attending hospitalists particularly appreciated TEAM's ability to focus on learners identified as struggling, while TEAM hospitalists rated observation of rounds and small-group teaching sessions as the most valuable TEAM activities. The TEAM program employed concepts of self-regulated learning to enhance education in PHM through direct observation, feedback, written evaluations, and teaching efforts. This program can mitigate many challenges facing attending physicians and can serve as a model for other institutions. Next steps include evaluation of higher-level learning outcomes.

1798. Impact and Sustainability of Antibiotic Prescribing Feedback with Peer Comparison to Hospitalists in a Community Hospital

Abstract Background Antibiotic prescribing feedback with peer comparison has been shown to reduce antibiotic prescription rates in the outpatient setting, but data regarding its impact in community hospitals are lacking. We previously developed novel denominator metrics to control for differences between physician practices such as patient volume or workload. Using these metrics, we provided regular antibiotic prescribing feedback with peer comparison to hospitalists in a community hospital over four years and evaluated its impact on targeted antibiotic prescribing. Methods Antibiotic days of therapy (DOT) for all antibacterials and targeted agents (aztreonam, antipseudomonal beta-lactams, vancomycin, and the fluoroquinolones (FQ)) were obtained from electronic medication administration records and linked to the ordering hospitalist. Physician-specific shifts worked data by month were calculated from local administrative datasets. De-identified data were presented in DOT/shifts worked, and trends in facility-wide and hospitalist-specific antibiotic prescribing were evaluated. Results A total of 37,938 antibiotic DOTs were prescribed by hospitalists from January 2018 to March 2022. De-identified feedback was shared in-person (4/2018, 4/2019, 3/2020, 11/2021) or virtually (9/2020) in small group sessions, and education, including local antibiogram data and recommended alternatives, was provided for targeted agents. Of the 31 hospitalists that received feedback, trends in FQ use for 7 hospitalists with longitudinal data are shown (Figure 1). In the month following feedback sessions, hospitalist antibiotic use data demonstrated substantial reductions in FQ prescribing, and similar trends were observed among all targeted agents. A single hospitalist’s prescribing trend for targeted agents is shown in Figure 2. Facility-wide, targeted agent use decreased 31% from 2017 to 2021 and was primarily driven by reductions in use by hospitalists. Conclusion Regular antibiotic prescribing feedback with peer comparison and education was associated with a reduction in targeted agent prescribing by hospitalists at a community hospital. Disclosures All Authors: No reported disclosures.