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2018 Conference on Medical Student Education

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PR1 FMIG Faculty Advisor Summit

Ashley Bentley, MBA

02/1/18 10:00 AM - 5:00 PM Room: 415A-B

Family medicine interest group (FMIG) faculty advisors have both the opportunity and the calling to build and support medical student awareness, understanding, and commitment to family medicine at their institutions with the end goal of contributing to a more robust family medicine workforce. This goes far beyond simply helping a group of students reserve a conference room for a lunch lecture—it's about giving students the opportunity to follow their passion for primary care and spread it among their peers in a meaningful way, engaging students in reform, giving them crucial experiences that their curriculum leaves behind, and ultimately leading more of them to find their fit in family medicine. FMIG faculty and staff advisors from across the country come together in this biennial workshop to work together to share successful strategies and get reenergized for this vital work. At its foundation, the workshop provides dedicated space to explore with peers the role FMIGs play in developing the primary care workforce of the future and identify opportunities to make the programs, activities, and initiatives of FMIGs more effective and successful. The 2018 workshop will bring in current issues in new and emerging research on the role of FMIGs, models for FMIG engagement and management, and leadership skill development for faculty and staff.

Upon completion of this session, participants should be able to:

  1. Leverage new leadership skills to identify and harness shared goals with partners both within and outside of the institution to design new initiatives to increase student choice of family medicine.

  2. Develop a goal-oriented workplan for your FMIG that builds on best practices learned from peers, current research on student choice and FMIG impact, tools and resources provided by the AAFP and others, and unique opportunities at your institution or within your community, that connects the initiatives of your FMIG to larger medical school and primary care workforce goals.

  3. Activate a network of peers and stakeholders, including the FMIG Network and the AAFP Medical Education Division, to advise, problem-solve, and support your FMIG efforts.

PR2 Teaching in the Clinical Setting: Skills for Today’s Family Physician

Tomoko Sairenji, MD, MSc; Nehman Andry, MD; Laurie Belknap, DO, MS.MedL; Michele Birch, MD; Kirby Clark, MD; Ronald Cook, DO, MBA; Joanna Drowos, DO, MPH, MBA; William Hay, MD; Matthew Holley, PhD; Kristen Hood Watson, MD; David Kelley, MD; Peter Koopman, MD; Peter Lewis, MD; Mary Lindholm, MD; Erika Schillinger, MD; Martha Seagrave, BSN, PA-C; Mandi Sehgal, MD; Freya Spielberg, MD, MPH; Anne Walsh, PAC, MMSc; Srikala Yedavally-Yellayi, DO

02/1/18 1:00 PM - 5:00 PM Room: 417A-B

Family medicine physicians and other primary care health care professionals are critical to the success of teaching programs for medical trainees in both academic and community medical centers. Increasingly these teaching programs are implementing and emphasizing team-based care, interprofessional education (IPE), and longitudinal integrated clerkships (LICs). This preconference will focus on the related challenges that clinical teachers are likely to encounter, and prepare them for evolving trends, innovations, and requirements in medical education. Learners benefit from participating in patient care, but preceptors face challenges including limitations in preparation/faculty development, administrative/institutional support, and time. Additional challenges to the clinician-educator include providing appropriate patient selection and variation, meeting clinical and educational productivity and documentation expectations, and integration of a single learner or multiple learners (of varying levels, abilities, and/or professions) into the clinical encounter/environment. If these challenges are not constructively and repeatedly addressed then patient and learner satisfaction, as well as that of the preceptor, is likely to suffer.

Upon completion of this session, participants should be able to:

  1. Identify methods of teaching-including those pertaining to health systems that encourage medical trainees to participate in self-directed learning such as goal/educational-agenda setting.
  2. Utilize innovative documentation and information management tools (e.g. clinical decision support tools that may be accessed from the electronic health record-EHR-or point-of-care clinical references).
  3. Identify and incorporate successful methods and teaching strategies when working with learners and peer educators from diverse and complementary healthcare professions. Representative situations that combine clinical work and medical education include working with a single health profession student (e.g., medical student, PA student, NP student, Pharmacy student, nursing student, or other) and simultaneously precepting learners from different health professions-including learners within a given profession at different levels of training, and co-precepting (co-located or distant).

P01 Improving Off-Site and On-Site Medical Students' Engagement and Discussions During Family Medicine Clerkship Didactics Using Technology (STU)

Magdalena Pasarica

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

The purpose of this study was to use advanced innovative interactive technology in order to ensure equivalent training opportunities across all clinical sites for learners physically or virtually participating in didactic session. We found that using the audience response system technology improved learner participation, but not discussions and supported only multiple choice questions. Using the chat technology was effective in improving participation, discussions and engagement of both off-site and on-site learners and supported free text responses for open-ended questions. Other institutions seeking to improve participation and discussions in didactic sessions for clerkship students located off-site, but also on-site, may want to consider using a combination of an audience response system and chat.

Upon completion of this session, participants should be able to:

  1. On completion of this session, learners would be able to implement chat technology to improve on-site and off-site learner’s participation in didactic session.
  2. On completion of this session, learners would be able to implement an interactive audience response system technology to improve on-site and off-site learner’s participation in didactic session.
  3. On completion of this session, learners would be able to study the use of technology to improve on-site and off-site learner’s participation in didactic session.

P02 Quick and Meaningful: An Innovative Resource for the Use of Clinical Expert Time Establishing OSCE Cutoff Scores

Magdalena Pasarica; Leslie Marchand

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Establishing OSCE cutoff scores using the modified Angoff method is traditionally done using pen and paper and lasts for at least 4 hours for a three-station OSCE. As time is precious for all faculty, we created an innovative, meaningful, and efficient way of running the meeting required for establishing cutoff scores for OSCE. We developed a process that lasted 1.5 hours with four clinical raters for a three-station OSCE. More than this, the process was characterized as efficient and meaningful by the other raters, who also expressed interest in using this process for their meetings where the cutoff scores for OSCEs are established.

Upon completion of this session, participants should be able to:

  1. On completion of this session, learners would be able to implement the modified Angoff method for establishing OSCE cut-off scores.
  2. On completion of this session, learners would be able to implement an efficient process for establishing OSCE cut-off scores.
  3. On completion of this session, learners would be able to defend the reasons for using standardize setting for establishing OSCE cut-off scores.

P03 Medical Students Teaching Peer Athletes: An Innovative Way of Instructing the Physiology of Exercise, Nutrition and Sleep as Fundamentals for Lifestyle Medicine (STU)

Magdalena Pasarica; Ashley Franklin; David Harris

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

This is a presentation of an innovative instructional voluntary program called Lifestyle for Athletic Performance, in which preclinical medical students coached peer football athletes on making lifestyle changes for peak athletic performance. The purpose of this study was to determine if the LAP program was a successful pilot study by determining the medical students' buy-in and perception of the program. The LAP program was a successful pilot for introducing an innovative outside-the-box teaching intervention designed to educate medical students in lifestyle medicine. Further studies could be designed for the application of nutrition, exercise, and sleep physiology in the education of other health care professional trainees.

Upon completion of this session, participants should be able to:

  1. On completion of this session, the participant should be able to discuss the importance of integrating physiology of nutrition, exercise and sleep into the application of lifestyle medicine for disease prevention and athletic performance
  2. On completion of this session, the participant should be able to design an innovative educational approach for integrating preclinical physiology concepts in clinical lifestyle medicine education
  3. On completion of this session, the participant should be able to develop collaborations with other university departments for the education of medical students

P04 Faculty and Student LGBTQIA Curricular Development in Undergraduate Medical Education: A Place for Family Medicine

Madeleine Lipshie; Daniel Myers, MSW; Mollie Nisen; Zoe Ginsburg; Olivia Low; Kara Stoever; Pablo Joo, MD

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

In 2014, the Association of American Medical Colleges documented the need for undergraduate medical education reform concerning LGBTQIA health, part of a national trend of medical, educational, and patient-advocate organizations working to improve care for LGBTQIA populations. At Albert Einstein/Montefiore Medical Center, we began a project of longitudinal curricular development led by an interdisciplinary committee of medical students, physicians, administrators, social workers and psychologists. The LGBTQIA working group extensively reviewed educational materials and competencies regarding LGBTQIA content proposed by several national societies in order to create an LGBTQIA educational framework at Einstein. We used this research to create our own focused learning objectives tied to educational domains. To ensure the curricula was not only specific to our learning environment but also executable, we designed a needs assessment for all students and faculty based on these competencies. This was intended to assess student comfort with each competency as well as faculty ability to teach each competency. Preliminary data show that among both students and faculty there is strong interest in expanding curricula in LGBTQIA health, but there is lower confidence in abilities to either preform or teach competencies. Simultaneous to developing and implementing the needs assessment, we also mapped current LGBTQIA curricula. We did this to assess our baseline and to consider where we may be able to add newly designed educational activities. The curricular map showed that almost all LGBTQIA education currently happens in the preclinical years, and the only instance of clinical curriculum occurs in family medicine. From the outset, this has been a project of longitudinal curricula creation. Because family medicine already has an advantage of integrating population health-based curriculum into its undergraduate clinical teaching, the department has appropriate experience to use this as an opportunity to expand its preclinical teaching.

Upon completion of this session, participants should be able to:

  1. Attendees will be able to describe the process of developing needs-based LGBTQIA medical curriculum.
  2. Attendees will be able to apply principles of curricular development to their own schools, clinics or practice.
  3. Attendees will be able to articulate the specific role family medicine can play in delivering LGBTQIA medical education.

P05 Mandatory Community Engagement Experience in Year 2

Andrea Nazar, DO; Shaun Raganyi, MA

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

As part of the West Virginia School of Medicine (WVSOM) Year 2 curriculum, Clinical Skills 2–a 24-week experiential course in activities of patient care and other physician responsibilities–there is a requirement for a health-related presentation in the local community. A small group of 8 to 10 students and one faculty facilitator receive their assignment for a presentation to occur the following week in a community setting such as school, senior center, assisted living/skilled residential facility or other civic group. The group is tasked with creating an age and situation appropriate presentation. Following the activity, there is a facilitated discussion of pre- and postreflections on the unique needs of that group in terms of socioeconomic well-being, health literacy and personal views of health. The value of this experience from the students’ perspective is tracked with an immediate postexperience evaluation form and again in a distant recall measure at exit interviews for graduation. Scores indicate that approximately two-thirds of the students recalled and used the skills from this lab in the 2 years following, and the majority of students rated the lab as "useful" or "highly useful" immediately following the experience. The community audiences’ evaluations have been consistently positive and all have remained engaged in the program. In keeping with the WVSOM mission statement, this offers a positive and sustaining educational program in this rural Appalachian community.

Upon completion of this session, participants should be able to:

  1. Evaluate a mandatory Year 2 community engagement experience at WVSOM
  2. Review the format for measuring the value of this experience including survey metrics and personal comments submitted.
  3. Stimulate discussion regarding pertinent requirements to facilitate genuine student reflection on their role in promoting a culture of health in their community, with the goal of promoting life long commitment to this cause.

P06 Parental Perspectives of Pediatric Dental Health and Fluoride Varnishes

Amy Buchanan, MD; Eda Akyar, MPH

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Pediatric dental health is an important part of well child care, and is instrumental to the overall health of a growing child. The American Academy of Pediatric Dentistry recommends that children have their first dental visit by age one; however, many children do not see the dentist this early. An effective first step at promoting pediatric dental health is the use of fluoride varnishes to protect primary teeth. This can be especially effective in protecting those children who may not have access to or insurance coverage for traditional dental care. Trained primary care physicians can easily apply these varnishes during well child visits. Our study focuses on ascertaining parental perceptions of pediatric dental health and fluoride dental varnishes during well child visits with their family physician. Parents of children 5 years of age and younger have been surveyed to assess their knowledge of pediatric dental health, gauge their perception of dental varnishes applied in the family medicine practice, and to learn about general dental practices in our socioeconomically diverse urban-suburban population.

Upon completion of this session, participants should be able to:

  1. Describe and counsel patients on current guidelines regarding pediatric dental care, especially those recommendations pertinent to well child visits done by primary care physicians.
  2. Review the results of our multi-site, survey-based study on parental perceptions of pediatric dental care, exploring the differences reported by parents with different education levels, incomes, and insurance plans.
  3. Make plans to adopt fluoride varnish application in family medical practice.

P07 Effective Learning in an Ambulatory Family Medicine Clerkship: A Qualitative Study

Melissa Bradner, MD, MSHA; Sharon Flores, MS; Judy Gary, M Ed; Sharon Zumbrunn, PhD

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

There is substantial research on the effectiveness of ambulatory medical preceptors’ teaching skills, but less is known about the student perspective: What do students say contributes most to effective learning in a busy clinical practice? Methods: As part of a formative midpoint assessment during the third-year clerkship in family medicine, students were asked to respond to the following open-ended reflective prompt: "My preceptor contributed to my learning by..." A qualitative assessment of student responses was conducted to identify themes describing effective learning in the ambulatory setting. Responses for all clerkship students from the years 2012-2014 were examined (N=314). Results: The most common characteristic of effective learning identified by respondents was autonomy in practice. Other prominent themes included stimulating critical thinking and feedback.

Upon completion of this session, participants should be able to:

  1. Appraise the most common and valued learning attributes of community clerkships as described by medical students
  2. Hypothesize how to encourage community preceptors to use effective learning skills such as thinking out loud and stimulating critical thinking.
  3. Create ambulatory learning experiences that maximize medical student learning

P08 The Interprofessional Care Clinic: Learning While Providing Care for Medically Underserved at High Risk for Preventable Hospitalization

Bruce Britton, MD; Jamie Holland; Karen Kott, PhD, PT

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

A challenge for interprofessional education is to provide education in a setting where meaningful team-based integrative care is provided to patients in a way that student learners know that they have contributed to better outcomes for patients. The Eastern Virginia Medical School (EVMS) and Old Dominion University (ODU) have partnered with Sentara Ambulatory Care Clinic (ACC) to address the medical, behavioral, socioeconomic and environmental barriers to help patients at high risk avoid preventable emergency room and hospital utilization through an interprofessional care clinic (IPC) of students and primary care residents.

Upon completion of this session, participants should be able to:

  1. Describe how at risk patients are referred to the Interprofessional Care Clinic (IPC).
  2. Describe IPC patient flow.
  3. Describe IPC team flow.

P09 Comprehensive Head to Toe Exam vs Core Physical Exam: Is There a Better Way? (STU)

Brandy Deffenbacher, MD

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Traditionally, the physical exam has been taught following a body systems head-to-toe (HTT) approach during the preclinical years of medical school. The physical exam curriculum for our program has followed this HTT model. Previously, our students were taught a body-system comprehensive exam during the fall semester of first year. This material was covered during seven small group sessions divided into body areas (vital signs, cardio, pulmonary, head/ears/nose/throat (HENT), abdomen, upper musculoskeletal (MSK), and lower MSK). The small groups were taught by Standardized Physical Exam Teaching Associates (SPETAs). As part of an ongoing effort to improve our students' performance on USMLE CS, as well as performance in clinical clerkships, we rolled out a revised physical exam skills curriculum during the academic year 2015-16, going from the comprehensive exam to a core plus additional elements approach. This poster will compare the old physical exam curriculum with the new physical exam curriculum by looking at the results of a physical exam assessment that tests students' abilities to perform physical exam skills from three of the seven body areas.

Upon completion of this session, participants should be able to:

  1. 1) Discuss the reasons our program decided to change from teaching physical exam skills using the comprehensive head to toe approach to a core + additional physical exam approach.

  2. Explain the differences between the comprehensive head to toe physical exam and the core + additional physical exam.
  3. Discuss the results of our students' assessment performance comparing the old vs new physical exam curriculum.

P10 Finding Resources and Developing Partnerships for Mental Health Through a School-Based Clinic for At-Risk Children (STU)

Susan Lajoie, DrPH, ARN; Amber Farrington

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Children living in poverty are at relatively greater risk for experiencing anxiety, depression, and behavioral issues. School-based health clinics provide a safety net for vulnerable children. Pediatric patients are seen at school with their parents' permission and with minimal disruption to the school day and their education. The benefits are real; parents do not miss work and attendance for school and mental health sessions increase, thus potentially decreasing family stress levels. Multidisciplinary teams address the biopsychosocial needs of the child. School-based services in Gadsden County, Florida are funded by the Florida State University Dance Marathon proceeds, allowing medical and psychological services to be free of charge. Dance marathon is a national organization with over 300 programs through the Children's Miracle Network and underwrites many pediatric health programs. Clinicians and medical students partner with doctoral level counselors to address the mental health needs of elementary and middle schoolers. The Gadsden clinic program has funded a mental health counselor two days per week for 5 years and has demonstrated positive results for children who would otherwise not obtain services. Psychology students benefited as they were afforded required practicum hours for future licensure. This model offers a unique potential funding stream for pediatric patients residing in financially stressed communities and underscores the importance of cross-discipline collaborative relations to provide quality mental health services to students at risk.

Upon completion of this session, participants should be able to:

  1. Demonstrate an understanding of the importance of providing mental health resources utilizing a multidisciplinary team approach for at risk pediatric patients.
  2. Identify common mental health diagnoses seen in a vulnerable pediatric population.
  3. Identify potential funding resources for pediatric mental health programs in a school based clinic setting.

P11 Students as Peer Educators: A Needs Analysis and Results of a Pilot Teaching Skills Workshop

Leslie Smebak; Hunter Eason

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Nearly all medical schools across the United States, including the Pritzker School of Medicine, employ medical student peer educators (PEs) in preclinical medical education. However, fewer than half of medical schools provide teaching skills or other types of training. We conducted a needs analysis of PEs and preclinical basic science course directors to determine the potential benefit of and priorities for a teaching skills curriculum for PEs. A focus group of fourth-year PEs and an anonymous survey of peer educators and course directors were conducted. Qualitative analysis of the focus group and descriptive statistics of the survey results were performed. The peer educator survey (RR=40.4%) demonstrated that only 22% of PEs received teaching skills training; however, 72% said they would benefit from training focused on actionable skills, like teaching in unstructured environments and engaging struggling learners. Only one out of 12 course directors surveyed provides training to PEs, but all course directors agreed that a curriculum would be beneficial to PE performance. Overall, the needs analysis demonstrated that PEs would benefit from a teaching skills curriculum. Our continued work involves building a PE teaching skills curriculum, with a pilot course planned for Fall 2017.

Upon completion of this session, participants should be able to:

  1. List the roles and benefits of peer educators in undergraduate medical education.
  2. Enumerate the skills required for success as a peer educator.
  3. Understand the preferences of students, peer educators, and faculty for a peer educator skills workshop.

P12 Burden of Chronic Conditions Among Patients From Free Clinics

Yeshuwa Mayers; Shikerria Green; Sayeef Mirza; Laurie Woodard, MD

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Data about uninsured patients that visit free clinics has been limited. This study investigated the prevalence of chronic disease, comorbidity, and associated factors among patients who visited free clinics in Florida. We conducted a retrospective chart review of uninsured adult patients in four free clinics. The data on socio-demographics and chronic diseases were collected. Each patient was given a disease burden index (DBI), a score representing the total number of chronic conditions diagnosed or managed at the free clinic. Between January 2015 and December 2015, a total of 3,196 medical patients were included in this study. Demographic data showed: women (60.8%), Hispanics (44.7%), with a mean age of 47.9 years (SD=14.1) and a median income of $14,400. The top five highly prevalent conditions were hypertension (33.6%), hyperlipidemia (20.7%), diabetes (14%), depression (11.7%), and arthritis (8.7%). Approximately 55.6% of the patients had at least one chronic condition, 22.9% only one condition, 15.9% two, and 10.2% three conditions. The multivariate analysis, clinic site, age, marital status, employment status and household size were associated with the DBI. The data demonstrated relationships between socioeconomic variables and the prevalence of disease. Uninsured patients are unaccounted for due to their absence from medical systems. By assisting resource-poor charitable clinics with epidemiological research, we can paint a more accurate picture of American health care.

Upon completion of this session, participants should be able to:

  1. Recognize that the disparity in insurance coverage leads to increased prevalence of disease in uninsured.
  2. recognize that the lack of consistent healthcare can lead to increased burden of chronic disease/co-morbidity.
  3. recognize the role of free clinics as a "safety net" for uninsured.

P13 Create an Interactive and Engaging Clerkship Orientation Using Audience Response System Technology

Nehman Andry, MD

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Clerkship orientation is an essential time to engage students with course content and introduce them to one's specialty. Despite this, most orientations last several hours and are full of dry content that is passively delivered to the audience. In an effort to make our clerkship orientation more interactive and engaging, we have incorporated the use of an audience response system. Audience response systems allow students to answer questions discretely and provide real-time assessment. Though literature regarding the use of audience response systems in clerkship orientations is lacking, their use in medical school didactics has been studied extensively. They have been found to augment student interaction and engagement. TurningPoint is the audience response system we use in our clerkship, and is one of many easy-to-use engagement and assessment solutions available on the market. TurningPoint helps equip PowerPoint presentations with polling slides and allows our students to answer questions during orientation about clerkship expectations, policies, and procedures using response clickers. Based on the student responses, we are able to tailor content delivery to meet their needs. The incorporation of this audience response system into our family medicine clerkship orientation has allowed for more effective content delivery. This has resulted in increased audience attention, enhanced interest, mandatory participation, more successful knowledge transfer, more efficient use of time, and greater student and administration satisfaction.

Upon completion of this session, participants should be able to:

  1. Discuss the importance of actively engaging learners during clerkship orientation.
  2. Describe how to incorporate an audience response system into one's clerkship orientation.
  3. Use TurningPoint audience response system technology to answer questions and receive real-time feedback.

P14 Understanding the NRMP Match: Professional Development for Third-Year Medical Students (STU)

Luke Ernstberger, MD

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Medical students experience great anxiety over the National Resident Match Program (NRMP) Match. Concerns over matching with one’s top residency choice mirror concerns experienced during the medical school application process, and the anxiety associated with these critical medical training turning points can be reduced when physician faculty demystify the process. This poster outlines a formal professional development session focused on key questions medical students have about the Electronic Residency Application Service (ERAS) and the NRMP Match. The interactive session occurs during the third-year family medicine clerkship and addresses medical students’ concerns before uncertainty evolves into unprepared panic in the fourth year. Feedback from past medical student participants has identified this session as one of the top educational experiences in the clerkship. This poster outlines strategies for helping medical students navigate the Match process as well as common questions and concerns voiced by students. Interested attendees will receive facilitation and resource information for implementing this session at their training site.

Upon completion of this session, participants should be able to:

  1. Assess medical students’ understanding of the Match process.
  2. List key elements of a professional development session designed to help medical students navigate the Match process.
  3. Identify resources available to assist medical students with the Match process.

P15 Student Performance on Step 2 Clinical Skills After Family Medicine Crash Course

Ellen Hampsten, MD; Aarthi Kasilingam; Fahmida Musharof; Jessica Putheparampil; Elizabeth Tu, DO

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Step 2 Clinical Skills (CS) is a significant component of medical students' residency application that is often found to be a stressful test to prepare for. The Family Medicine Interest Group suggested a review course for third-year students. The students submitted questions and topics for review. Faculty and residents from the FM department held a review course in small groups. The students' perceptions of the course were assessed after taking Step 2 CS via an online survey.

Upon completion of this session, participants should be able to:

  1. Address students' concerns about Step 2 CS.
  2. formulate a review course for students prior to taking Step 2 CS.
  3. improve students' preparedness for Step 2 CS.

P16 The Utilization of Farmers' Markets in Low Income Areas From the Perspective of Patients and Physicians: A Qualitative Study (STU)

Christopher Stoming; Leslie Ruffalo, PhD; Zachary Carlson; Rebecca Bernstein, MD; Melissa DeNomie; Meg Kilkenny; Allison McCurdy

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Several studies have quantitatively demonstrated the effectiveness of fruit and vegetable prescription programs in low income areas. While clinic-based nutrition programs such as these have great potential to reduce risks and mortality associated with chronic diseases, farmers' markets remain an underutilized resource. There is also a lack of knowledge that Supplemental Nutrition Assistance Program(SNAP) and Women, Infants, Children (WIC) benefits can be redeemed for produce at farmers markets. In order to create and sustain more effective programs, qualitative data on fruit and vegetable prescriptions may be of value. In a follow-up study to a fruit and vegetable prescription pilot program conducted in the Midwest, we will conduct focus groups with the prescription users (ie, patients) and physicians or members of the clinical care team. There will be two focus groups with each group to glean insight on the effectiveness, feasibility, and usability of the program from each group's perspective. Focus groups will be audio recorded, transcribed, and analyzed in NVivo software using open coding techniques. Analysis will focus on identifying barriers and assets to implementing nutrition programs that are coconducted by primary care clinics and farmers' markets. We will also examine patient-physician dynamics as they relate to these programs. Ultimately, this study may provide opportunities for improved implementation of fruit and vegetable prescription programs, more effective ways to engage patients, and positive health behavior changes.

Upon completion of this session, participants should be able to:

  1. Describe perspectives on the impact, feasibility, and usability of fruit and vegetable prescription programs from the lens of physicians, members of the clinical care team, and patients.

  2. Identify barriers and assets to implementing nutrition programs that are jointly run by clinics and community-based organizations.
  3. Incorporate lessons learned into future iterations of the Fruit and Vegetable Prescription Program.

P17 Benefits and Pitfalls During the Implementation of a Longitudinal Shadowing Experience for a High School Student in the Department of Family Medicine

Michael Malone, MD; Rafay Nasir

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

For many years, high school students had been rotating with specialists as part of a longitudinal experience at our institution, but high school students had not previously shadowed family medicine physicians longitudinally. This session describes the experience for the first high school student to rotate through a longitudinal shadowing experience in the department of family medicine at Penn State. Based on a mixed-methods research approach, we collected both quantitative and qualitative data from the student and physicians during the 12-week longitudinal experience. We identify some of the positives and negatives of this type of rotation and how this experience can be used by other institutions to increase career interest in family medicine.

Upon completion of this session, participants should be able to:

  1. Describe some of the positive and negative aspects of having a high-school student shadow Family Medicine physicians longitudinally.
  2. Design and implement a shadowing experience for high school students at his or her institution.
  3. Identify barriers to an ideal shadowing experience for high school student

P19 The Lake Wobegon Effect: Are All Our Students Above Average?

David Sperling, MD; Stacey Gardner, PhD

02/2/18 9:30 AM - 10:30 AM Austin Grand Ballroom J-K

Narrative comments regarding student performance are essential for student success. Ideally, these comments allow students to receive specific written feedback regarding areas of strength and areas for continued improvement (aka "negative comments"). These comments are often also used to help compose various "high stakes" documents, including the Medical Student Performance Evaluation (MSPE) and the Department of Medicine Summary Letter. Despite the fact that balanced feedback, including areas for improvement, are often included in the prompt for these comments, many times only areas of strength are included. Are evaluators reluctant to include areas for continued improvement, fearing this might jeopardize their student's success on residency applications? We are beginning to explore this idea, presenting data from our institution and quantifying the frequency with which areas for continued improvement are included in clerkship summary comments. We will also present information from a review of the literature summarizing guidelines for writing summative comments focusing on the medical setting.

Upon completion of this session, participants should be able to:

  1. Review quantitative data regarding "negative" comments from NEOMED's M3 clerkship evaluations.
  2. Consider if and how prompts for comments might change the content of the comments.
  3. Reflect how evaluators might incorporate constructive comments in evaluations at their institutions.

Copyright 2018 by Society of Teachers of Family Medicine