Undergraduate Medical Education Program Research Articles

Perception of 1 MBBS students about educational environment through ‘DREEM’ questionnaire

In an undergraduate (UG) medical education program, the educational environment is a critical factor of effective outcomes. Because it is a proven approach for this assessment in medical schools, the Dundee Ready Education Environment Measure (DREEM) was employed in this study.1. To assess the student’s perception of the educational environment using the Dundee Ready Educational Environment Measure (DREEM) questionnaire among 1st-year undergraduate medical students. 2. To identify the strengths and weaknesses in student’s educational environment.A cross-sectional study was carried out among first-year medical students. To obtain student perceptions of the educational environment, a widely accepted DREEM questionnaire was employed. The DREEM questionnaire is divided into five sections, each of which has 50 statements that are rated on a five-point Likert scale (0–4). The questionnaire was distributed to consented individuals (n=150) after receiving ethical approval. The filled questions were collected and statistically evaluated. The data were presented as mean and standard deviation, frequency, and percentages. The responses were analyzed and interpreted using McAleer and Roff's practical recommendations.There was a 100% response rate. The average DREEM score was 124.9 ± 50 (62.46%). Among the five DREEM dimensions, students' perceptions of learning received the highest score (65.63%), while students' perceptions of the environment received the lowest (59.31 %).Statements “I have good friends in this college”, “My social life is good” and “I am confident about passing this year” scored ≥ 3 of 4 points.“A more positive than negative perception,” according to the total mean DREEM score. Student confidence, social life, instructor knowledge, encouragement to participate in a teaching session, teacher preparedness, and having excellent friends on campus received the most positive answers. However, there is space for development in areas where there is a lack of expertise, such as student ennui and creative teaching.

Strategies for Developing an Inclusive Geriatric Physician Workforce for Older Adults in the U.S.

The “geriatric imperative” has been part of the aging discourse for more than 30 years but neither geriatric practice nor older adults are homogenous. As the U.S. population ages, elders will become more racially and ethnically diverse; and, their health outcomes will be shaped by lifetime experiences with systemic discrimination and racism. Already, COVID-19 has made clear that older adults and non-Whites, particularly African Americans and Hispanics, disproportionately bear the burden of disease and illness. Research suggests health disparities will continue unless there is change within the health care system. The Institute of Medicine (2001) reported on the problematic nature of the stark contrast between the diversity of patients and the physicians caring for them, including issues with patient trust and communication, yet no significant movement has been made to diversify the physician workforce. Despite being 13% and 16% of the U.S. population, respectively, African Americans and Hispanics make up just 5% and 6% of the practicing physician workforce. Further, practicing geriatricians represent less than 1% of physicians with very few physicians of color. There is a need for more African American and Hispanic geriatricians. In this systematic review, we examine recruitment and retention efforts targeting students of color, and curricula of geriatric medical programs in the U.S. We offer recommendations toward incentivizing physicians of color to enter geriatrics, strategies to support decolonization of geriatric medical curricula in undergraduate medical education programs, and the development of mentorship and pipeline programs to increase diversity in the geriatric physician workforce.

Are Canadian medicine librarians directly supporting medical student health and wellness? A nation-wide survey.

IntroductionStudents in Undergraduate Medical Education (UGME/UME) programs face a variety of stressors that can affect well-being. To address this, the Committee on Accreditation of Canadian Medical Schools (CACMS) mandates that medical schools offer support and programming that promotes student well-being. Academic librarians are accustomed to providing outreach that meets their faculties’ needs. Therefore, the goal of this study was to explore if Canadian undergraduate medical education librarians are supporting medical student wellness at their medical schools, and how.MethodsA bilingual, electronic survey containing multiple choice and open-ended questions was distributed across two Canadian health sciences library listservs during the summer of 2020. Librarians supporting UGME/UME programs now or within the last three years were invited to participate.Results22 Responses were received, and 17 complete datasets were included in the final results. The majority of respondents have encountered a medical student in distress (n=10) and have adjusted their teaching style or materials to help reduce stress in medical students (n=9). Other initiatives such as resource purchasing, wellness-themed displays, planning wellness-themed events and spaces, and partnerships on campus in support of medical student wellness were less common.DiscussionThe data in this study provides evidence that Canadian undergraduate medical education librarians are mindful of medical student well-being, and are taking steps to provide relevant support to this learner group. Librarians could adopt similar initiatives at their libraries to show support for learner wellness, and enhance their programs’ accreditation efforts in this area.

Language Interpreting in Undergraduate Medical Education: Developing a Framework for Educational Practice

Linguistic differences between patients and clinicians can result in ineffective and inequitable healthcare delivery. Medical students should therefore be facilitated to develop the requisite knowledge and skills to work effectively within language discordant clinical situations. This paper explores language interpreting processes in an undergraduate medical education programme. The study utilizes a constructivist paradigm incorporating an action research approach. Action Research Cycle 1 (ARC1) examines the use of interpreters during clinical examinations while Action Research Cycle 2 (ARC2) focuses on language translation technology. In Action Research Cycle 3 the data that was generated in ARC 1 and ARC 2 is reviewed in association with international literature to develop a framework for practice. This study demonstrates that language interpreting procedures should be based within a collaborative framework with students, interpreters and educators receiving appropriate educational preparation, predicated on a cross cultural approach to care.

A systematic scoping review of undergraduate medical ethics education programs from 1990 to 2020

Introduction Ensuring medical students are equipped with essential knowledge and portable skills to face complex ethical issues underlines the need for ethics education in medical school. Yet such training remains variable amidst evolving contextual, sociocultural, legal and financial considerations that inform training across different healthcare systems. This review aims to map how undergraduate medical schools teach and assess ethics. Methods Guided by the Systematic Evidence-Based Approach (SEBA), two concurrent systematic scoping reviews were carried out, one on ethics teaching and another on their assessment. Searches were conducted on PubMed, Embase, PsycINFO and ERIC between 1 January 1990 and 31 December 2020. Data was independently analysed using thematic and content analysis. Results Upon scrutinising the two sets of full-text articles, we identified 141 articles on ethics teaching and 102 articles on their assessments. 83 overlapped resulting in 160 distinct articles. Similar themes and categories were identified, these include teaching modalities, curriculum content, enablers and barriers to teaching, assessment methods, and their pros and cons. Conclusion This review reveals the importance of adopting an interactive, multimodal and interdisciplinary team-teaching approach to ethics education, involving community resource partners and faculty trained in ethics, law, communication, professionalism, and other intertwining healthcare professions. Conscientious effort should also be put into vertically and horizontally integrating ethics into formal medical curricula to ensure contextualisation and application of ethics knowledge, skills and attitudes, as well as protected time and adequate resources. A stage-based multimodal assessment approach should be used to appropriately evaluate knowledge acquisition, application and reflection across various practice settings. To scaffold personalised development plans and remediation efforts, multisource evaluations may be stored in a centralised portfolio. Whilst standardisation of curricula content ensures cross-speciality ethical proficiency, deliberative curriculum inquiry performed by faculty members using a Delphi approach may help to facilitate the narrowing of relevant topics.

To Assess Competency in Interpretation of Cardiac Arrhythmias among Emergency Medical Professionals in Pune, India

Introduction: The annual number of deaths from Cardiovascular Disease (CVD) in India is projected to rise from 2.26 over the past several decades and have ranged from 1.6% to 7.4% in rural populations and from 1% to 13.2% in urban populations.
 Electrocardiography (ECG) is a non-invasive tool which is extensively used to understand and analyze a patient’s cardiac condition. It provides information about cardiac condition and helps in diagnosing acute coronary syndromes and cardiac arrhythmias. Emergency Medical Professionals (EMP’s) handle numerous cases of medical as well as trauma emergencies daily and are the first responders prior to hospitalization and the only reliable resource to help in revival of the patient. As it is of high priority, to give the upmost necessary care to the patients, being able to interpret and honing the skills to interpret ECG is of utmost importance and necessary.
 Despite its immense clinical value, there continues to be a lack of a comprehensive ECG interpretation curriculum in medical education programs. The goal should be to encourage the development of organized curriculum in undergraduate and postgraduate medical education programs, and to ensure the acquisition of level-appropriate ECG interpretation skills while maintaining patient safety.
 Objective: To assess competency in interpretation of cardiac arrhythmias among Emergency Medical Professionals
 Study Design: 
 Place of Study: Symbiosis Centre for Health Skills (SCHS), Pune India in May 2021.
 Methodology: The present study was conducted in May 2021, amongst 200 Emergency Medical Professionals (EMPs) employed in various hospitals in the city of Pune, India. American Heart Association (AHA) – Pre-course Self-Assessment questions were utilized for the study to assess ECG interpretation competency among Emergency Medical Professionals.
 Conclusion: The present study highlights the poor ECG competence amongst EMP’s. and is limited by its small sample size and interpretation of only three kinds of cardiac rhythms. Yet the study offers, insight on the current gaps in competence and offers simple solutions to improve the scenario.

'The word that comes to mind is polymath': medical students' perceptions of rural postgraduate careers.

Physician shortages in rural and remote areas challenge accessibility and delivery of care to rural and remote communities, including within Scotland. Medical education is a reform priority to establish a sustainable medical workforce. Although there is evidence to support aspects of medical education that enhance the likelihood of practising rurally, the mechanism by which these educational initiatives work is not clearly understood. This study aimed to examine medical students' perceptions of rural and remote practice, how these perceptions motivate their interest to practise rurally, and what aspects of education are thought to influence these perceptions. This cross-sectional study utilised semistructured interviews with 10 University of St Andrews medical students enrolled in undergraduate or graduate-entry medical education programs. Feldman and Ng's theoretical framework was deductively applied. Interviews informed additional subthemes, which were integrated into the original framework. The final framework helped examine medical students' perceptions of rural medicine and mechanisms that shape these perceptions. Structural (countrywide) themes included geographical barriers affecting patients and physicians. Organisational themes included perceptions of inequitable allocation of resources between urban and rural areas, as well as limited staff and support in rural practices. Occupational themes included the perception of rural clinical generalists. Personal life themes included the perception of community in rural areas. Mechanisms shaping medical students' perceptions most profoundly were their experiences (educational, personal experience or working). Medical students' perceptions align with other professionals' reasons for staying in a particular job. Perceptions regarding rural careers included challenges due to geographical proximity to patients, resource allocation in rural areas, and the potential to subspecialise as a general rural practitioner. Identified mechanisms, which shape perceptions, can be addressed and strengthened by educators, policy-makers and governments to optimise medical education that promotes rural recruitment and retention.

Taking a Leap of Faith: A Study of Abruptly Transitioning an Undergraduate Medical Education Program to Distance-Learning Owing to the COVID-19 Pandemic.

The COVID-19 pandemic has forced universities worldwide to immediately transition to distance-learning. Although numerous studies have investigated the effect of the COVID-19 pandemic on universities in the Middle East, none have reflected on the process through which medical education programs for health professions underwent this transition. This study aimed to elucidate the rapid transition to distance-learning of an undergraduate medical program at the College of Medicine, Mohammad Bin Rashid University of Medicine and Health Sciences (Dubai, United Arab Emirates), owing to the COVID-19 pandemic. An action research approach constituted the foundation of this collaborative effort that involved investigations, reflections, and improvements of practice, through ongoing cycles of planning, acting, observing, and reflecting. Efforts of transitioning to distance-learning were grouped into four interrelated aspects: supporting faculty members in delivering the program content, managing curriculum changes, engaging with the students to facilitate distance-learning experiences, and conducting web-based assessments. Challenges included the high perceived uncertainty, need for making ad hoc decisions, lack of experiential learning and testing of clinical skills, and blurring of work-life boundaries. Our preliminary findings show the successful generation of a strong existing digital base, future prospects for innovation, and a cohesive team that was key to agility, rapid decision-making, and program implementation.

USMLE Step-1 is Going to Pass/Fail, Now What Do We Do?

The Winter 2021 Webinar Audio Series (WAS) of the International Association of Medical Science Educators (IAMSE), titled, “USMLE Step-1 is Going to Pass/Fail, Now what do we do?” was broadcast live to audiences at academic institutions worldwide in five weekly webinars from January 7, 2021, to February 4, 2021. Recognized experts from various stakeholder groups discussed the impact of the decision to score the United States Medical Licensing Examination (USMLE) Step 1 exam Pass/Fail (P/F). The speakers identified challenges to their respective programs and explored creative ways to address potential consequences. Sessions included the perspectives of allopathic and osteopathic residency program directors, basic science faculty, undergraduate medical education curriculum designers, clinical educators, and programs for international medical students matriculating to the United States. On February 25, 2021, a bonus session provided cutting-edge updates from a co-chair of the Coalition for Physician Accountability Undergraduate Medical Education (UME) to Graduate Medical Education (GME) Review Committee (UGRC).

Use of Patient Identifiers at the University of Washington School of Medicine: Building Institutional Consensus to Reduce Bias and Stigma.

Patient identifiers are used in the opening lines of case presentations and written documentation in health care and medical education settings. These identifiers can reflect physicians' implicit biases, which are known to impact patient care. Yet, no clear recommendations for the use of patient identifiers to reduce bias and stigma in patient care and medical education learning environments currently exist. We describe a process and outcomes for articulating such recommendations. The University of Washington School of Medicine convened a group of diverse stakeholders to create patient identifier recommendations for use in the undergraduate medical education program. After a literature review, 22 recommendations for the use of patient identifiers were articulated. These underwent public comment periods reaching 11,150 potential respondents across our 5-state institution. Feedback from 437 respondents informed modifications to the recommendations. We used consensus methodology with three rounds of surveys and an expert group of 27 stakeholders to adopt recommendations with an a priori threshold of 90% agreeing the recommendation should be used. We adopted 12 recommendations for patient identifiers for age, gender/sex, race/ethnicity, sexual orientation, ability, size, and stigma; nine in round one, three in round two, and none in the third round. Our institution vetted these patient identifier recommendations via public comment and consensus methodology. Next steps include implementation across the undergraduate medical education program, including classroom and clinical settings. Other institutions could consider similar processes as key steps to reduce bias and stigma in their medical education programs.

Curriculum Mapping and Alignment of the Neuroscience Block in an Undergraduate Medical Education Program: A Delphi Study.

BackgroundCurriculum mapping and alignment are complex processes essential for the improvement of curriculum and serve as guidelines for students, faculty, and college administrators. This project aims to map different components of the curriculum in a comprehensive manner to ensure smooth running of the curriculum for the end users.Materials and MethodsThe project addressed the neuroscience block of the undergraduate medicine program. Eight parameters were investigated: competencies (learning outcomes), curriculum themes, block objectives, weekly problems, and objectives of weekly problems, disciplines, delivery, and assessment. The Delphi method was used by ten experts to assess the importance of these parameters. Focus interviews were then conducted with faculty members.ResultsThe panel of ten experts reached consensus by agreeing that the eight parameters are important for aligning and mapping the neuroscience block and can be helpful for smooth operation of the curriculum. Mapping and alignment were performed electronically using eight parameters over 8 weeks. Majority of the faculty members appreciated the use of curriculum mapping.ConclusionCurriculum mapping using electronic software helps in identifying gaps and redundancies and facilitating alignment between learning and assessment and learning objectives and competencies (learning outcomes). Training programs for faculty members and encouragement from leaders are suggested.

P115 Students experiences of graduate attribute development, a qualitative study

Abstract Introduction Graduate attributes are recognised as the skills and values that should be acquired by all students in tertiary education, regardless of their field of study. Graduate attributes have significant relevance to employability and in enhancing students’ personal development. This research aimed to explore students’ lived experiences of developing two graduate attributes embedded within their undergraduate medical curriculum: communication and collaboration skills. Methods Phenomenology was the validated, qualitative research method most suited to address the research question. Phenomenology allows one to better understand peoples’ direct, lived experiences of a particular phenomenon; in this case, graduate attribute development. Purposefully sampled participants were chosen for semi-structured interviews, all of whom had completed the same undergraduate medical education programme. Semi-structured interviews were performed until thematic saturation occurred, at participant eight. The Braun and Clarke method of thematic analysis was utilised to identify recurring themes from the interview process. Results The five key themes that emerged were (1) the value placed on graduate attribute development, (2) the presence of graduate attribute learning opportunities, (3) the presence of barriers against graduate attribute development, (4) graduate attribute literacy and preconceptions and (5) the students’ transition into employment. Conclusions There is a need for improved graduate attribute assessment methods and the development of meaningful learning strategies that promote transformative learning opportunities. Barriers against communication and collaboration skills development exist and need to be addressed. Students need to better understand the relevance of communication and collaboration skills to their future professional careers before the student-to-doctor transition has occurred.

LIVE FM (lecture improvised with video elements in forensic medicine): does a video worth a thousand pictures? A comparative study in medical education*

Forensic education should be fully conversant with a scientific theory of how students learn. By and large, the traditional model of education is widely accepted. ‘Difficult-to-learn’ areas in forensic medicine are the challenges to students as well as teachers. An innovative modality ‘lectures improvised with video elements’ was used by authors in the undergraduate medical education program of Forensic Medicine in order to facilitate active learning. Evaluation of this approach has established a positive impact on student’s spatial ability, reasoning ability, and memory skills. Intrinsic cognitive load on working memory was reduced to a certain extent. With compare to the static pictures, video usage significantly helps to comprehend the difficult content of the learning. Students found the experience interesting and very ardent to use it again.

An equity-oriented admissions model for Indigenous student recruitment in an undergraduate medical education program.

BackgroundWith the 2015 publication of the Truth and Reconciliation Commission of Canada’s calls to action, health professional schools are left grappling with how to increase the recruitment and success of Indigenous learners. Efforts to diversify trainee pools have long looked to quota-based approaches to recruit students from underserved communities, though such approaches pose dilemmas around meaningfully dismantling structural barriers to health professional education. Lessons shared here from developing one multi-layered admissions strategy highlight the importance of equity—rather than equality—in any recruitment for learners from medically underserved communities.SummaryThe promotion of fairness in the recruitment of future practitioners is not just a question of equalizing access to, in this case, medical school; it involves recognizing the wider social and structural mechanisms that enable privileged access to the medical profession by members of dominant society. This recognition compels a shift in focus beyond merely giving the disadvantaged increased access to an unfair system, towards building tools to address deeper questions about what is meant by the kind of excellence expected of applicants, how it is to be measured, and to what extent these recruits may contribute to improved care for the communities from which they come.ConclusionEquity-based approaches to student recruitment move health professional schools beyond the dilemma of recruiting students from marginalized backgrounds who happen to be most similar to the dominant student population. Achieving this requires a complex view of the target population, recognizing that disadvantage is experienced in many diverse ways, that barriers are encountered along a spectrum of access, and that equity may only emerge when a critically, socially conscious approach is embedded throughout institutional practices.

Implementation experience on undergraduate medical education program of Dokuz Eylul Universıty Faculty of Medicine during the COVID-19 outbreak

Implementation experience on undergraduate medical education program of Dokuz Eylul Universıty Faculty of Medicine during the COVID-19 outbreak

Implementing a Real-time Workplace-based Assessment Data Collection System Across an Entire Medical School's Clinical Learning Environment.

This article was migrated. The article was marked as recommended. Background & Objectives: Workplace-based assessments (WBAs) are a vital aspect of medical student competency assessment for the core Entrustable Professional Activities (EPAs), but pose significant challenges since assessment must occur in real-time during the routine care of patients. We developed an online WBA system designed to overcome these challenges, and implemented it across an entire undergraduate medical education program to address the need for EPA competency assessment. We describe the development and implementation process, and present initial results from our inaugural medical student cohort. Methods: The WBA tool was designed to be student-driven, easy to use, and minimally disruptive to clinical care. Students trigger assessments by choosing the desired EPA to be assessed within a custom-built Qualtrics XM survey application. Their clinical assessor is prompted to select their level of involvement in the activity using the modified Ottawa co-activity scale and provide brief written feedback. Direct verbal feedback at time of discussion is encouraged. Results: 3,568 WBAs were completed. The mean number of assessments per student for all EPAs combined was 24.27 with a range of 1-103. All students completed at least one WBA. Over the course of 12 months, the mean number of EPAs recorded per student in this cohort was lowest for EPA 10 (Recognizing a Patient Requiring Urgent or Emergent Care and Initiate Evaluation and Management) (mean=0.36; range 0-4; n=53) and was highest for EPA 6 (Provide an Oral Presentation for a Clinical Encounter) (mean=5.46; range 1-17; n=803). The mean number of minutes it took to complete the assessments was 2.7 minutes with a standard deviation of 1.2 minutes (n=2,803). Conclusion: An electronic application-based survey collecting real-time WBAs to assess progress toward attaining competence in EPA performance resulted in increased assessment data within a medical school cohort.

Implementing longitudinal integrated curricula: Systematic review of barriers and facilitators.

The increase of longitudinal integrated curricula in medical schools worldwide represents the shift towards an outcome-oriented education. This novel model allows comprehensive student-patient interactions over time and integrates the educational content across disciplines. According to quantitative research, students, patients, doctors and communities benefit from this educational model in terms of participant satisfaction, learning outcomes and clinician recruitment. However, quantitative research does not provide detailed information on programme implementation processes. Therefore, this review aims to summarise facilitators and barriers of programme implementation reported in qualitative and mixed methods studies. The authors reviewed the literature about facilitators and barriers for the implementation of longitudinal integrated curricula in undergraduate medical education programmes. The systematic search was conducted in MEDLINE, Embase and PsycINFO on 2 December 2019. The authors used the CASP checklist for qualitative research for the critical appraisal and summarised the results across studies using thematic content analysis. The authors screened 1682 reports. Twenty studies examining 17 different curricula met the inclusion criteria. Most curricula were implemented in the United States (n=6/17), Australia (n=5/17) or Canada (n=4/17). Programme implementation is facilitated and hampered by its educational components (eg continuity of supervision, safe learning environments), organisational structures (eg community involvement) and participating students' and staff' motivation and personality. The critical appraisal revealed that several studies lacked transparent documentation and adequate reflection on the researcher-participant relationship (n=20/20), data collection instruments (n=12/20) and recruitment strategy (n=4/20). The authors derived practical recommendations for the implementation of undergraduate, patient-centred, integrated medical curricula. Programme managers need to define and communicate common objectives with all participants. They should clarify the implementation of the objectives in all processes in a transparent and structured manner. Considering reporting guidelines, future studies in this field should document more transparently the methods used to gain qualitative insights and the researchers' personal involvement.

A cross-sectional survey on academic librarian involvement in evidence-based medicine instruction within undergraduate medical education programs in Canada

Introduction: The purpose of this study was to determine the range of involvement of Canadian academic medical librarians in teaching evidence-based medicine (EBM) within the undergraduate medical education (UME) curriculum. This study articulates the various roles that Canadian librarians play in teaching EBM within the UME curriculum, and also highlights their teaching practices. Methods: An electronic survey was distributed to a targeted sample of academic librarians currently involved in UME programs in Canadian medical schools. Results: 12 respondents (including one duplicate response) representing ten schools responded to this survey. 7 of 10 respondents were involved in EBM instruction, 3 of 10 institutions had a dedicated EBM course. Librarians were involved in a variety of roles, and often co-created and co-delivered content along with medical school faculty, and were present on course committees. They used a variety of educational strategies, incorporated active learning, as well as online modules. Discussion/Conclusion: The data highlighted the embedded nature of EBM instruction in undergraduate medical education programs in Canada. It also showed that librarians are involved in EBM instruction beyond the second step of EBM; acquiring or searching the literature.

A Visiting Professorship in Undergraduate Medical Education at the University of Alberta: Reflections on possibilities for medical humanities in China, and elsewhere.

This article was migrated. The article was marked as recommended. Enhancing humanities in medical education is a pressing concern in China. Similar to other countries, medical education in China evolved over the past century to emphasize bioscience and technology in treating illness and disease. Increasing recognition of the limitations of biomedical technology led to emergence of the medical humanities in the West in the latter half of the 20 th century, an interdisciplinary area that has continued to expand and grow. In China and elsewhere, activity in this area developed somewhat later. Ongoing patient-doctor disputes and decline in public trust in the medical profession in China has led many to advocate for enhanced emphasis on humanism and medical humanities. In 2017, the Chinese government introduced new healthcare reforms which included an education and training plan that promotes medical humanities teaching. Global developments have led to a wide variety of models and approaches that may be considered in cultivating medical humanities and humanism in China. With the support of China Medical University in Shenyang, Liaoning Province, PRC, Professor Wei visited the Faculty of Medicine & Dentistry at the University of Alberta through the 2019/20 academic year. This article provides an overview of a wide array of medical humanities teaching and learning opportunities associated with the undergraduate medical education program at the University of Alberta. Professor Wei reflects on possibilities for medical humanities in medical education in China given all she learned and experienced as a visiting professor at the University of Alberta, which may be of interest to others who are also developing new approaches to introducing medical humanities as part of their health professions education program. Additional reflections regarding possibilities for global medical humanities are also offered.

Wright State University Boonshoft School of Medicine.

Wright State University Boonshoft School of Medicine.