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39th Annual STFM Conference on Medical Student Education

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PR1 Hot Topics in Family Medicine Education

Vincent WinklerPrins, MD; Joel J. Heidelbaugh, MD, FAAFP, FACG; David Victor Power, MD, MPH; Juliann Binienda, PhD; Richard Colgan, MD; Aaron Michelfelder, MD; Mari E. Egan, MD, MHPE; Mozella Williams, MD; Jennifer C. Molokwu, MD, MPH; Katye Conniff, MD

01/24/13 1:00 PM - 2:00 PM

For family medicine educators there are many themes in their work that often don’t find an appropriate forum for discussion at their home institutions. The Group on Medical Student Education proposes a 4-hour preconference workshop that will address three common themes that all family Medicine educators face. The themes include (1) Technology in Medical Education, (2) Developing Your Teaching Portfolio and Promotion Packet, (3) Curriculum Development and Evaluation. The format of this workshop will consist of three 15-minute presentations meant to frame each topic. This will be followed by three consecutive 45-minute small-group break-out sessions for in-depth discussion of each topic, facilitated by the presenters. Best practices for each theme will be reviewed, summarized, and given to participants at the end of the session.

P1 Medical Students in the Exam Room: Help or Hindrance? Patient's Perspective

Lara Mor-Zilberstein, MD; Sharon Kim

01/25/13 9:45 AM - 10:45 AM

Medical students are often the first clinical staff to evaluate a patient in the clinic, and student participation in these cases is part of the office visit. It has not been well researched how patients perceive being seen by a medical student and what the patients’ knowledge and opinion of this practice is. In fact, some patients may not want to be seen by students during the clinic visit. As physicians who have been in the role of medical student a few years ago, the aspiration is to have both the students and the patients benefit from the student-patient encounter. This study will help us understand how to achieve this goal. The aim of our study, which is patients’ survey, is to determine whether patients are satisfied with the presence of medical students in the office of PMD, and if this is not the case, to understand the reason(s).

P1 Medical Students in the Exam Room: Help or Hindrance? Patient's Perspective

Lara Mor-Zilberstein, MD; Sharon Kim

01/25/13 9:45 AM - 10:45 AM

Medical students are often the first clinical staff to evaluate a patient in the clinic, and student participation in these cases is part of the office visit. It has not been well researched how patients perceive being seen by a medical student and what the patients’ knowledge and opinion of this practice is. In fact, some patients may not want to be seen by students during the clinic visit. As physicians who have been in the role of medical student a few years ago, the aspiration is to have both the students and the patients benefit from the student-patient encounter. This study will help us understand how to achieve this goal. The aim of our study, which is patients’ survey, is to determine whether patients are satisfied with the presence of medical students in the office of PMD, and if this is not the case, to understand the reason(s).

P10 Step-wise Competency-based Mix of Fun, Stress, and Ultimate Success

Dale W. Quest, PhD FNP

01/25/13 9:45 AM - 10:45 AM

Intent: Step-wise competency-directed mix of fun, stress, and ultimate success. Concept: Given foundational concepts, rational approach, basic tools, and clinical scenario, trainees quickly experience competence and confidence to proceed to supervised care of common presentations (newly Dx DM1, fatigue, irritable bowel syndrome, severe atopic rx, falls in elderly, N&V in pregnancy). Context: Newly diagnosed type-1 diabetes mellitus in "honeymoon" phase. Methods: Each trainee plays role of both physician and patient, uses an approach and tools to calculate and self-administer their first basal-bolus injection (placebo). Exercise draws on concepts of progression to beta cell failure, distinguishing clinical manifestations of hyper- ans hypo-glycemia, ketosis, clinical nutrition, lab medicine, and insulin kinetics to bear on patient's requirement for exogenous carbohydrate and insulin to achieve effective safe glycemic control.

P10 Step-wise Competency-based Mix of Fun, Stress, and Ultimate Success

Dale W. Quest, PhD FNP

01/25/13 9:45 AM - 10:45 AM

Intent: Step-wise competency-directed mix of fun, stress, and ultimate success. Concept: Given foundational concepts, rational approach, basic tools, and clinical scenario, trainees quickly experience competence and confidence to proceed to supervised care of common presentations (newly Dx DM1, fatigue, irritable bowel syndrome, severe atopic rx, falls in elderly, N&V in pregnancy). Context: Newly diagnosed type-1 diabetes mellitus in "honeymoon" phase. Methods: Each trainee plays role of both physician and patient, uses an approach and tools to calculate and self-administer their first basal-bolus injection (placebo). Exercise draws on concepts of progression to beta cell failure, distinguishing clinical manifestations of hyper- ans hypo-glycemia, ketosis, clinical nutrition, lab medicine, and insulin kinetics to bear on patient's requirement for exogenous carbohydrate and insulin to achieve effective safe glycemic control.

P11 Increase in Residency Scholarly Activity as a Result of a Resident-Led Initiative

Kyle Hoedebecke, MD; Caitlyn Rerucha, MD

01/25/13 9:45 AM - 10:45 AM

Scholarly activity is a fundamental component of medical education at all levels; however, the output of national-level presentations and publications by residents has remained low despite the numerous possible methods of completing these tasks. We have implemented a resident-driven progress improvement project involving increased resident-to-resident mentoring for academic year 2012-2013 with the goal of doubling the scholarly activity footprint among our residents. By increasing awareness of conferences for scholarly submission, assignment of a research resident, and the pairing of interns/students with senior resident mentors, we have successfully started eight new scholarly projects for potential publication and presentation. Goal: Double last academic year’s total number of publications and national/international presentations. Results: The academic year has just begun and we are on track to meet our publication goal and far exceed our presentation goal. If successful, this project can be emulated by other residencies and medical schools.

P11 Increase in Residency Scholarly Activity as a Result of a Resident-Led Initiative

Kyle Hoedebecke, MD; Caitlyn Rerucha, MD

01/25/13 9:45 AM - 10:45 AM

Scholarly activity is a fundamental component of medical education at all levels; however, the output of national-level presentations and publications by residents has remained low despite the numerous possible methods of completing these tasks. We have implemented a resident-driven progress improvement project involving increased resident-to-resident mentoring for academic year 2012-2013 with the goal of doubling the scholarly activity footprint among our residents. By increasing awareness of conferences for scholarly submission, assignment of a research resident, and the pairing of interns/students with senior resident mentors, we have successfully started eight new scholarly projects for potential publication and presentation. Goal: Double last academic year’s total number of publications and national/international presentations. Results: The academic year has just begun and we are on track to meet our publication goal and far exceed our presentation goal. If successful, this project can be emulated by other residencies and medical schools.

P12 Does Clerkship Student Performance on the NBME and fmCASES Exams Correlate?

Howard R. Sussman, MD, FAAFP

01/25/13 9:45 AM - 10:45 AM

Background: Several knowledge assessments exist for Family Medicine Clerkships, including the NBME subject examination and the fmCASES examination. Little is known about how closely performance on these two assessments correlates. Objective: To determine the degree to which M3 performance on the fmCASES comprehensive examination and the NBME Subject Examination in Family Medicine correlates. Methods: 130 third-year medical students completed one of six 4-week Family Medicine Clerkships during the 2011-2012 academic year. At the completion of each block, all students were required to take the fmCASES examination on the penultimate day of the course followed by the NBME examination on the final day. Scores on both exams were analyzed on a per-clerkship and annual basis. All statistical analyses were conducted with SPSS (v19, 2010). Results: Percent correct on the fmCASES (mean 73.37 [+/- 7.37]) and NBME (mean 76.75 [+/- 7.85%]) examinations were highly correlated. Pearson correlation coefficient = 0.607. Using linear regression, performance on the fmCASES exam was a very strong positive predictor of subsequent NMBE score (p=.00000000000002). Conclusion: The percentage of questions a student answers correctly on either test is remarkably similar.

P12 Does Clerkship Student Performance on the NBME and fmCASES Exams Correlate?

Howard R. Sussman, MD, FAAFP

01/25/13 9:45 AM - 10:45 AM

Background: Several knowledge assessments exist for Family Medicine Clerkships, including the NBME subject examination and the fmCASES examination. Little is known about how closely performance on these two assessments correlates. Objective: To determine the degree to which M3 performance on the fmCASES comprehensive examination and the NBME Subject Examination in Family Medicine correlates. Methods: 130 third-year medical students completed one of six 4-week Family Medicine Clerkships during the 2011-2012 academic year. At the completion of each block, all students were required to take the fmCASES examination on the penultimate day of the course followed by the NBME examination on the final day. Scores on both exams were analyzed on a per-clerkship and annual basis. All statistical analyses were conducted with SPSS (v19, 2010). Results: Percent correct on the fmCASES (mean 73.37 [+/- 7.37]) and NBME (mean 76.75 [+/- 7.85%]) examinations were highly correlated. Pearson correlation coefficient = 0.607. Using linear regression, performance on the fmCASES exam was a very strong positive predictor of subsequent NMBE score (p=.00000000000002). Conclusion: The percentage of questions a student answers correctly on either test is remarkably similar.

P13 Incentives and Barriers of Military Medicine: Increasing Medical Student Awareness

Kyle Hoedebecke, MD; Blake Busey, DO

01/25/13 9:45 AM - 10:45 AM

Military medicine is full of opportunities for providers, but the number of uniformed doctors rarely meets the needs of the armed forces. The complexities of joining this community are due to the abundant potential barriers and incentives. We aim to improve medical student awareness of both the pros and cons of military service so as to potentially generate more interest in the uniformed services. A survey evaluating baseline medical student interest in military medical service will be given. Then a presentation on the pros and cons of military service outlining career progression, obligations, financial incentives, training opportunities, leadership opportunities, and deployment opportunities will occur. Afterwards the same survey will be repeated to observe any change in appeal due the improved knowledge gained from the aforementioned presentation. An increased interest is expected after comparison of the full spectrum of benefits and drawbacks of military medicine.

P13 Incentives and Barriers of Military Medicine: Increasing Medical Student Awareness

Kyle Hoedebecke, MD; Blake Busey, DO

01/25/13 9:45 AM - 10:45 AM

Military medicine is full of opportunities for providers, but the number of uniformed doctors rarely meets the needs of the armed forces. The complexities of joining this community are due to the abundant potential barriers and incentives. We aim to improve medical student awareness of both the pros and cons of military service so as to potentially generate more interest in the uniformed services. A survey evaluating baseline medical student interest in military medical service will be given. Then a presentation on the pros and cons of military service outlining career progression, obligations, financial incentives, training opportunities, leadership opportunities, and deployment opportunities will occur. Afterwards the same survey will be repeated to observe any change in appeal due the improved knowledge gained from the aforementioned presentation. An increased interest is expected after comparison of the full spectrum of benefits and drawbacks of military medicine.

P14 Student Feedback on a New Curriculum on the Patient- Centered Medical Home

Tamara K Oser, MD; Paul Haidet, MD; Shou Ling Leong, MD

01/25/13 9:45 AM - 10:45 AM

The patient-centered medical home (PCMH) addresses the challenge of rising health care costs and the exponential growth of chronic disease. We introduced a PCMH curriculum for clinical year medical students to teach population management, team-based care, medication safety, transition of care, and self-management. During this clerkship, students attend a continuity clinic one-half day weekly for 6 months, managing a panel of their own patients. At the conclusion of the curriculum, we conducted a focus group to explore the students’ experiences. The unique continuity experience of this clerkship allowed students to grow along a number of relational dimensions, including confidence and responsibility. Students identified an important obstacle in ancillary health care team members’ failure to view them as more than learners, as often occurs on more traditional clerkships. Nevertheless, their preceptors viewed them as primary care providers, fostering students’ transitions from observer to practitioner.

P14 Student Feedback on a New Curriculum on the Patient- Centered Medical Home

Tamara K Oser, MD; Paul Haidet, MD; Shou Ling Leong, MD

01/25/13 9:45 AM - 10:45 AM

The patient-centered medical home (PCMH) addresses the challenge of rising health care costs and the exponential growth of chronic disease. We introduced a PCMH curriculum for clinical year medical students to teach population management, team-based care, medication safety, transition of care, and self-management. During this clerkship, students attend a continuity clinic one-half day weekly for 6 months, managing a panel of their own patients. At the conclusion of the curriculum, we conducted a focus group to explore the students’ experiences. The unique continuity experience of this clerkship allowed students to grow along a number of relational dimensions, including confidence and responsibility. Students identified an important obstacle in ancillary health care team members’ failure to view them as more than learners, as often occurs on more traditional clerkships. Nevertheless, their preceptors viewed them as primary care providers, fostering students’ transitions from observer to practitioner.

P15 Survey Development to Assess Electronic Health Record Usage Impact on Teachers of Outpatient Family Medicine

Sean M Oser, MD; Tamara K Oser, MD

01/25/13 9:45 AM - 10:45 AM

There is little data on the effects of electronic health record (EHR) use on medical student educators and especially on teachers of outpatient family medicine. What little research exists notes a distressingly frequent perception by educators that their teaching efforts and enthusiasm are diminished by EHR use. Anecdotal experience at our institution has been similar. Nonetheless, EHR use is a vital element of the patient-centered medical home (PCMH), which is increasingly being taught to medical students. Faculty development initiatives for incorporating the EHR into medical student education are needed. To develop effective programs, better understanding of teachers’ experiences of EHR impact on their teaching efforts is needed first. To help assess these effects accurately, a well designed survey is an essential starting point, and a proposed survey tool is presented here for feedback from experts in medical student teaching of outpatient family medicine.

P15 Survey Development to Assess Electronic Health Record Usage Impact on Teachers of Outpatient Family Medicine

Sean M Oser, MD; Tamara K Oser, MD

01/25/13 9:45 AM - 10:45 AM

There is little data on the effects of electronic health record (EHR) use on medical student educators and especially on teachers of outpatient family medicine. What little research exists notes a distressingly frequent perception by educators that their teaching efforts and enthusiasm are diminished by EHR use. Anecdotal experience at our institution has been similar. Nonetheless, EHR use is a vital element of the patient-centered medical home (PCMH), which is increasingly being taught to medical students. Faculty development initiatives for incorporating the EHR into medical student education are needed. To develop effective programs, better understanding of teachers’ experiences of EHR impact on their teaching efforts is needed first. To help assess these effects accurately, a well designed survey is an essential starting point, and a proposed survey tool is presented here for feedback from experts in medical student teaching of outpatient family medicine.

P16 Evaluation of the Extent and Methods of Public Health Instruction in US Medical Schools

Jacob P. Prunuske, MD, MSPH; Ranit Mishori, MD, MHS; Linda Chang, PharmD, MPH, BCPS; Christopher P. Morley, PhD, MA, CAS

01/25/13 9:45 AM - 10:45 AM

Context: Family physicians address health concerns related to lifestyle, social disparities, and global factors. The IOM and AAMC promote increased public health instruction in medical education. The extent and methods of public health instruction in medical schools are incompletely understood. Objective: To assess public health instruction in medical schools. Design: CERA survey questions designed to identify extent and methods of public health instruction in US medical schools. Participants: Family medicine clerkship directors at US allopathic medical schools. Main outcome measures: Time devoted to each content area, and methods of delivery, will be modeled via multivariate regression techniques as a result of school characteristics. Expected Results: Estimates of characteristics that predict, promote, or detract from public health instruction in medical schools. Conclusions: Results of this project will assist: (1) Family medicine educators in curriculum development, (2) curricular deans in resource allocation and curricular design, and (3) government agencies in resource allocation.

P16 Evaluation of the Extent and Methods of Public Health Instruction in US Medical Schools

Jacob P. Prunuske, MD, MSPH; Ranit Mishori, MD, MHS; Linda Chang, PharmD, MPH, BCPS; Christopher P. Morley, PhD, MA, CAS

01/25/13 9:45 AM - 10:45 AM

Context: Family physicians address health concerns related to lifestyle, social disparities, and global factors. The IOM and AAMC promote increased public health instruction in medical education. The extent and methods of public health instruction in medical schools are incompletely understood. Objective: To assess public health instruction in medical schools. Design: CERA survey questions designed to identify extent and methods of public health instruction in US medical schools. Participants: Family medicine clerkship directors at US allopathic medical schools. Main outcome measures: Time devoted to each content area, and methods of delivery, will be modeled via multivariate regression techniques as a result of school characteristics. Expected Results: Estimates of characteristics that predict, promote, or detract from public health instruction in medical schools. Conclusions: Results of this project will assist: (1) Family medicine educators in curriculum development, (2) curricular deans in resource allocation and curricular design, and (3) government agencies in resource allocation.

P17 Checking the Ingredients: A Quality Assessment of Clinical Education Using Accreditation Standards

Stephanie L White, DO

01/25/13 9:45 AM - 10:45 AM

This session will highlight accreditation standards relevant to clinical education and compare allopathic and osteopathic requirements. This method of a self-assessment will serve as an example process for other institutions. Current Commission on Osteopathic College Accreditation (COCA) and Liaison Committee on Medical Education (LCME) accreditation standards were reviewed and selected based on relevance to the third- and fourth-year medical school curriculum. These standards were grouped into five categories. A gap analysis was performed that compared each standard to our college’s current practices. Effort was made to identify themes and suggest interventions for each identified gap. Significant gaps in achievement were identified for both sets of accreditation requirements. Proposed interventions were reported for each unmet gap.

P17 Checking the Ingredients: A Quality Assessment of Clinical Education Using Accreditation Standards

Stephanie L White, DO

01/25/13 9:45 AM - 10:45 AM

This session will highlight accreditation standards relevant to clinical education and compare allopathic and osteopathic requirements. This method of a self-assessment will serve as an example process for other institutions. Current Commission on Osteopathic College Accreditation (COCA) and Liaison Committee on Medical Education (LCME) accreditation standards were reviewed and selected based on relevance to the third- and fourth-year medical school curriculum. These standards were grouped into five categories. A gap analysis was performed that compared each standard to our college’s current practices. Effort was made to identify themes and suggest interventions for each identified gap. Significant gaps in achievement were identified for both sets of accreditation requirements. Proposed interventions were reported for each unmet gap.

P18 R U 4 PC?: Texting and Feedback on Primary Care During Medical School

Andrea Wudyka, MD; Andrea L. Wendling, MD; Christopher P. Morley, PhD, MA, CAS; Julie P. Phillips, MD, MPH; Anne Victoria Neale, PhD, MPH; Diane Levine, MD, MPH; Elie Mulhem, MD

01/25/13 9:45 AM - 10:45 AM

Medical students are often asked about their planned choice of specialty, and teaching physicians routinely offer feedback on this complex and important decision. Additional data regarding this aspect of the “hidden curriculum” are needed to better understand how to attract student interest in primary care. This poster presents an ongoing multicenter observational prospective trial designed to estimate the balance of positive/negative feedback on primary care as a career choice and secondarily, to determine efficacy of texting as a data collection method. Medical students from four universities will collect data for two 30-day periods by sending a text message whenever a comment regarding primary care is heard in the context of educational activities and will complete pre/post surveys regarding demographics, career plans, content of comments heard, and attitudes toward primary care. Our poster will describe current multi-institutional study and will present data from the completed single-institution pilot study.


Copyright 2017 by Society of Teachers of Family Medicine