Medicine and Health Sciences Commons^™

An Innovative Approach For Integrating Mandatory, Longitudinal Spirituality Training Into The Medical School Curriculum, David W. Fleenor, Holly G. Atkinson, Reena Karani, Susan Lerner, Staci Leisman, Deborah Marin

Publications and Research

Problem:

Most Americans indicate they are religious and/or spiritual and wish to have their beliefs taken into account when engaging with health care providers, yet gaps in medical education and health care practice remain. To underscore the importance of spirituality as a significant social determinant of health, a team at the Icahn School of Medicine at Mount Sinai in New York developed mandatory spirituality and health training for students integrated into all 4 years of the undergraduate medical education curriculum.

Approach:

From 2014 to 2020, a small group of faculty took an innovative approach, launching the initiative and expanding the …

It Could Be So Much Worse, Alexandra Juhasz, Pato Hebert

Publications and Research

Conversation between longtime AIDS activists about longhauling with COVID-19, disclosure, shame, and the possibilities of COVID politics with photographs of the "COVID Body."

Improving Dental Hygiene Students' Journal Writing, Susan Davide

Publications and Research

During the introductory semester of treating patients, students are in need of assistance and guidance throughout the assessment and treatment phases of patient care. As novice learners, there is little to no prior knowledge on writing a patient case study presentation. To assist and improve dental hygiene student writing of patient case journals, a scaffold assignment was created. Over the course of the semester students were required to submit five patient case studies in the form of a journal. Each journal had a writing focus with specific directions for each along with a detailed rubric; the final journal encompassing all …

Covid-19 Impact On Radiology Students’ Distance Learning, Mary Lee, Fahameda Hassan, Zoya Vinokur

Publications and Research

Distance learning (DL) is a teaching tool that offers education to students remotely in various locations (Ruiz, 2006). The increase in distance learning education is evident in all types of educational programs including those in Radiologic Sciences. DL education programs are expected to comply with all standards just as traditional programs are (Aaron, 2015). With a traditional class setting, knowledge is taught at a given time and day, which is structured in terms of course development and attendance. It does not factor in the domestic and familial responsibilities of the students outside the classroom walls. What happens when a pandemic …

Twenty-Seven Questions For Writers & Journalists To Consider When Writing About Covid-19 & Hiv/Aids, Alexandra Juhasz, Pato Hebert, Theodore Kerr, Diana Cage

Publications and Research

The desire to compare COVID-19 and HIV/AIDS is understandable. The response to HIV provides an inspiring road map for how to save lives. For over four decades, starting in the early 1980s, activists, scientists, politicians and cultural producers have been working alongside one another resulting in life saving developments—and goals not yet achieved. Since the late 1990s, HIV has become a manageable chronic illness for those with access to life saving medicine, housing, food, and social support. Meanwhile, stigma, discrimination, and criminalization directed at people living with HIV continue, based on social difference, access to resources and community, and an …

Inequities Faced By Female Doctors Serving Communities Of Need, Ana Motta-Moss, Zainab Hussain

Publications and Research

The reasons for sex inequity in medicine are complex and partly interface ethnic background, specialty choice, and practice location. Multiple factors influence career choices including cultural values, balancing family responsibilities with professional growth, and career mentoring and support. Over the last 40 years, the Sophie Davis/CUNY School of Medicine (CSOM) has pursued a mission to increase diversity in medicine at the same time in which it has fostered the importance of primary care and service in underserved areas of New York State. Data from 1524 CSOM graduates show an increase in the number of women and underrepresented groups, with about …

What Would A Covid 19 Doula Do Zine, Alexandra Juhasz, Theodore Kerr, Pato Hebert, Jih-Fei Cheng

Publications and Research

This zine is a snapshot of a time from the WHAT WOULD AN HIV DOULA DO? (WWHIVDD) community, responding in words, actions and images to the unfolding, unprecedented, global crisis of the COVID-19 pandemic. The first half of the zine is rooted in the exhibition, Metanoia: Transformation through AIDS Archives and Activism curated by WWHIVDD for the ONE Archives Foundation (ONE) . The second half are responses from our Metanoia and WWHIVDD communities responding to the prompt: What Does a COVID-19 Doula Do? Many of the entries were submitted the second week of March as people in the US were …

Motivation To Access Laparoscopic Skills Training: Results Of A National Survey Of Obstetric And Gynaecology Residents, Jocelyn Stairs, Bradley W. Bergey, Finlay Maguire, Stephanie Scott

Publications and Research

Objective

Competency based medical education (CBME) requires novel approaches to surgical education. Significant investment has been made in laparoscopic simulation, which has been shown to foster skill development prior to patient encounters. However, research suggests variable voluntary use of these resources by residents, and little is known about the motivational factors that influence their utilization. The purpose of this study was to characterize factors that motivate residents to seek laparoscopic simulation experience outside of the formal curriculum.

Design

We developed a questionnaire grounded in Expectancy Value Theory, an established psychological theory of motivation, by adapting validated measures to fit the …

Public Health Research Priorities To Address Female Genital Mutilation Or Cutting In The United States, Holly G. Atkinson, Deborah Ottenheimer, Ranit Mishori

Publications and Research

Female genital mutilation or cut- ting (FGM/C), an age-old tradition that is still widely practiced around the world, is gaining recognition as an important public health issue in the United States. Increasingly, because of migration, women and girls affected by FGM/C have become members of host communities where the practice is not culturally acceptable.

According to recent conservative estimates, more than 513 000 immigrant women and girls living in the United States have undergone or are at risk for FGM/C, a significant increase from the 1990 estimate of 168 000. The arrests of physicians in Michigan in 2017 for performing …

Developing Physician Educational Competencies For The Management Of Female Genital Cutting: A Call To Action, Holly G. Atkinson, Amaris Geisler

Publications and Research

Female genital cutting (FGC), also called female genital mutilation, is defined as “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious, or other nontherapeutic reasons.” FGC can have significant health consequences, including multiple physical and psychological complications, throughout the life course. Despite violating numerous human rights and existing legal prohibitions, the practice continues. In the United States, FGC is becoming increasingly prevalent, however, physicians are not routinely trained to care for these patients. Despite the evidence of the need, there is a woeful lack of …

Preparing Physicians To Contend With The Problem Of Dual Loyalty, Holly G. Atkinson

Publications and Research

Dual loyalty is defined as, particularly as it pertains to the field of medicine, a conflict or potential conflict between a healthcare professional’s simul- taneous obligations–expressed or implied–to a patient and to a third party. Dual loyalty situations often compromise physicians’ ethical behavior, lead- ing them to participate, either knowingly or unknowingly, in human rights violations perpetrated by a third party, often the state. Classic dual loyalty situations include the participation of physicians in state-sanctioned torture or the death penalty. However, there are a number of other dual loyalty scenarios that arise routinely in clinical practice in both closed institutions …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Case Presentation On Congestive Heart Failure And Pulmonary Edema, Tetiana Soloviova, Denise Aris

Publications and Research

No abstract provided.

A Writing Assignment To Address Gaps In The Nursing Curriculum Regarding Health Issues Of Lgbt+ Populations., Bridget Maley, Randy Gross

Publications and Research

Background: LGBT+ populations account for 4% of the US population, yet health disparities persist, which are considered a priority in health care systems. In nursing education programs, the allotment in time to cover LGBT+ health content is not mandated thus ranges from zero to several hours total in nursing curricula. Therefore, nursing students’ education regarding LGBT+ health issues remains minimal and inconsistent throughout the nation’s nursing programs.

Aim: To provide associate degree nursing students with exposure to the health disparities in LGBT+ populations through a reflective writing assignment.

Methods: The essays were culled from both sections of an established core …

Exploring The Characteristics And Context That Allow Master Adaptive Learners To Thrive, William B. Cutrer, Holly G. Atkinson, Erica Friedman, Nicole Deiorio, Larry D. Gruppen, Michael Dekhtyar, Martin Pusic

Publications and Research

Because change is ubiquitous in healthcare, clinicians must constantly make adaptations to their practice to provide the highest quality care to patients. In a previous article, Cutrer et al. described a metacognitive approach to learning based on self-regulation, which facilitates the development of the Master Adaptive Learner (MAL). The MAL process helps individuals to cultivate and demonstrate adaptive expertise, allowing them to investigate new concepts (learn) and create new solu- tions (innovate). An individual’s ability to learn in this manner is driven by several internal characteristics and is also impacted by numerous aspects of their context. In this article, the …

Factors Associated With Perceived Accuracy Of The Undetectable = Untransmittable Slogan Among Men Who Have Sex With Men: Implications For Messaging Scale-Up And Implementation, H Jonathon Rendina, J T. Parsons

Publications and Research

Introduction: Recent research has shown high efficacy of HIV treatment for reducing the risk of HIV transmission to sexual partners. As the efficacy of treatment as prevention (TasP) has proliferated, a new messaging campaign, Undetectable = Untransmittable, has been gaining popularity. The purpose of this paper was to assess factors associated with the perceived accuracy of this TasP messaging strategy among a large and diverse sample of gay, bisexual, and other men who have sex with men (GBMSM) in order to inform subsequent efforts at large-scale and implementation of the HIV prevention message.

Methods: We conducted a nationwide survey of …

Teaching Third-Year Medical Students To Address Patients’ Spiritual Needs In The Surgery/Anesthesiology Clerkship, Holly G. Atkinson, David Fleenor, Susan M. Lerner, Edward Poliandro, Joseph Truglio

Publications and Research

Introduction: Despite many patients wanting physicians to inquire about their religious/spiritual beliefs, most physicians do not make such inquiries. Among physicians who do, surgeons are less likely than family and general practitioners and psychiatrists to do so.

Methods: To address this gap, we developed a 60-minute curriculum that follows the Kolb cycle of experiential learning for third-year medical students on their surgery/anesthesiology clerkship. The session includes definitions of religion/spirituality, an overview of the literature on spirituality in surgery, a review of the FICA Spiritual History Tool, discussion of the role of the chaplain and the process of initiating a chaplain …

Home-Based Pre-Exposure Prophylaxis (Prep) Services For Gay And Bisexual Men: An Opportunity To Address Barriers To Prep Uptake And Persistence, Steven A. John, H Jonathon Rendina, Christina Grov, Jeffrey T. Parsons

Publications and Research

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting …

Development And Validation Of Measures To Evaluate Adolescents' Knowledge About Human Papillomavirus (Hpv), Involvement In Hpv Vaccine Decision-Making, Self-Efficacy To Receive The Vaccine And Fear And Anxiety, A. S. Forster, K. A. Mcbride, C. Davies, T. Stoney, H. Marshall, K. Mcgeechan, Spring C. Cooper, S. R. Skinner

Publications and Research

Objectives: We describe the development and validation of measures of human papillomavirus (HPV)/HPV vaccination knowledge, fear/anxiety about vaccination, involvement in HPV vaccine decision-making, and self-efficacy with regard to getting the vaccine, designed to evaluate the efficacy of an intervention to affect these domains (collectively termed the HAVIQ: HPV Adolescent Vaccine Intervention Questionnaire). Study design: Literature search, cognitive interviews and cross-sectional survey.

Methods: A literature search identified existing items that were modified for the present measures. Experts reviewed draft measures for face and content validity. Cognitive interviews with adolescents were also used to assess content validity. Adolescents completed the measures and …

A Place-Based Community Health Worker Program: Feasibility And Early Outcomes, New York City, 2015, Priscilla M. Lopez, Nadia Islam, Alexis Feinberg, Christa Myers, Lois Seidl, Elizabeth Drackett, Lindsay Riley, Andreas Mata, Juan Pinzon, Elisabeth Benjamin, Katarzyna Wyka, Rachel Dannefer, Javier Lopez, Chau Trinh-Shevrin, Karen Aletha Maybank, Lorna E. Thorpe

Publications and Research

Introduction: This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes.

Methods: This intervention was informed by a mixed-method needs assessment performed December 2014–January 2015 (representative telephone survey, n¼1,663; six focus groups, n¼55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February–December 2015 (follow-up response rate, 93%) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease …

Awareness And Knowledge Among Internal Medicine House-Staff For Dose Adjustment Of Commonly Used Medications In Patients With Ckd, Sikander Surana, Neeru Kumar, Amita Vasudeva, Gulvahid Shaikh, Kenar D. Jhaveri, Hitesh Shah, Deepa Malieckal, Joshua Fogel, Gurwinder Sidhu, Sofia Rubinstein

Publications and Research

Background: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD. Methods: A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted. Results: The overall pattern …

Principles And Practices Fostering Inclusive Excellence: Lessons From The Howard Hughes Medical Institute’S Capstone Institutions, Patricia Marten Dibartolo, Leslie Gregg-Jolly, Deborah Gross, Cathryn A. Manduca, Ellen Iverson, David B. Cooke Iii, Gregory K. Davis, Cameron Davidson, Paul E. Hertz, Lisa Hibbard, Shubha K. Ireland, Catherine Mader, Aditi Pai, Shirley Raps, Kathleen Siwicki, Jim E. Swartz

Publications and Research

Best-practices pedagogy in science, technology, engineering, and mathematics (STEM) aims for inclusive excellence that fosters student persistence. This paper describes principles of inclusivity across 11 primarily undergraduate institutions designated as Capstone Awardees in Howard Hughes Medical Institute’s (HHMI) 2012 competition. The Capstones represent a range of institutional missions, student profiles, and geographical locations. Each successfully directed activities toward persistence of STEM students, especially those from traditionally underrepresented groups, through a set of common elements: mentoring programs to build community; research experiences to strengthen scientific skill/ identity; attention to quantitative skills; and outreach/bridge programs to broaden the student pool. This paper …

Reorienting Adolescent Sexual And Reproductive Health Research: Reflections From An International Conference, Kristien Michielsen, Sara De Meyer, Olena Ivanova, Ragnar Anderson, Peter Decat, Céline Herbiet, Caroline W. Kabiru, Evert Ketting, James Lees, Caroline Moreau, Deborah L. Tolman, Ine Vanwesenbeeck, Bernardo Vega, Elizabeth Verhetsel, Venkatraman Chandra-Mouli

Publications and Research

On December 4th 2014, the International Centre for Reproductive Health (ICRH) at Ghent University organized an international conference on adolescent sexual and reproductive health (ASRH) and well-being. This viewpoint highlights two key messages of the conference - 1) ASRH promotion is broadening on different levels and 2) this broadening has important implications for research and interventions – that can guide this research field into the next decade. Adolescent sexuality has long been equated with risk and danger. However, throughout the presentations, it became clear that ASRH and related promotion efforts are broadening on different levels: from risk to well-being, from …

Burnout And Depression In Psychiatric Residents, Irvin Sam Schonfeld, Eric Laurent, Pierre Vandel, Renzo Bianchi

Publications and Research

Kealy et al. (2016) found that 21% of psychiatric residents were suffering symptoms of burnout. A number of problems call that finding into question. First, the writers used a one-item measure to assess burnout. Second, mounting evidence suggests that burnout is a depressive syndrome. Third, unresolvable job stress is related to depression. Given burnout's overlap with depression and the diagnostic blur around burnout, research on the impact of job stress should connect with depression, which is nosologically well characterized and diagnosable using clinically validated instruments.

Toward A Deeper Understanding Of Disability: Physical Therapy Educators’ Reflections, Clarence Chan, Debra Engel, Jacqueline Ross

Publications and Research

This article describes the unique journey both of a blind student in our Physical Therapist Assistant (PTA) Program and of the faculty who taught him as they all navigated through uncharted territories. Despite the fact that the physical therapy profession trains practitioners to help clients with disabilities to maximize their physical function and teaches them how to adapt to the challenges of daily activity, we initially assumed that a blind student would not be able to complete the program or be able to become a self-sufficient practitioner. We were very wrong. This article describes our learning process over the course …

The Human Rights And Social Justice Scholars Program: A Collaborative Model For Preclinical Training In Social Medicine, Salina Bakshi, Aisha James, Marie Oliva Hennelly, Reena Karani, Ann-Gel Palermo, Andrea Jakubowski, Chloe Ciccariello, Holly G. Atkinson

Publications and Research

BACKGROUND:
Despite the importance of the role social justice takes in medical professionalism, the need to train health professionals to address social determinants of health, and medical trainees' desire to eliminate health disparities, undergraduate medical education offers few opportunities for comprehensive training in social justice. The Human Rights and Social Justice (HRSJ) Scholars Program at the Icahn School of Medicine at Mount Sinai is a preclinical training program in social medicine consisting of 5 components: a didactic course, faculty and student mentorship, research projects in social justice, longitudinal policy and advocacy service projects, and a career seminar series.

OBJECTIVES:
The …

Saludableomaha: Improving Readiness To Address Obesity Through Healthy Lifestyle In A Midwestern Latino Community, 2011–2013, Leah Frerichs, Jeri Brittin, Regina Robbins, Sharalyn Steenson, Catherine Stewart, Christopher Fisher, Terry T-K Huang

Publications and Research

Background A community’s readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities.

Community Context This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles.

Methods SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning …

Case Study: Sick On A South American Sugarcane Plantation, Kevin M. Bonney

Publications and Research

A case study is presented that was designed to be used in high school and college level courses to familiarize students with chagas disease, its transmission, and effects in Central and South America. Noted objectives of the lesson include evaluating disease symptoms, examining socioeconomic factors related to the epidemiology, and creating visual aids with public health information. Questions are provided for discussing the a case of chagas disease at a Brazilian sugarcane plantation.

A Randomised-Controlled Trial Of Two Educational Modes For Undergraduate Evidence-Based Medicine Learning In Asia, Janice M. Johnston, Mary Schooling, Gabriel M. Leung

Publications and Research

Background
As the overall evidence for the effectiveness of teaching of evidence based medicine (EBM) is not strong, and the impact of cultural and societal influences on teaching method is poorly understood, we undertook a randomised-controlled trial to test the effectiveness and learning satisfaction with two different EBM teaching methods (usual teaching vs. problem based learning (PBL)) for undergraduate medical students.

Methods
A mixed methods study that included a randomised-controlled crossover trial with two intervention arms (usual teaching and PBL) and a nested qualitative study with focus groups to explore student perceptions of learning and to assess the effectiveness and …

Prostitution And Hiv Infection: Women, Aids, & Activism, Polly Thistlethwaite, Zoe Leonard

Publications and Research

This "Prostitution and HIV Infection" chapter of the ACT UP/NY Women & AIDS Book Group's Women, AIDS & Activism reflects the scientific, feminist, gay, lesbian, HIV-community work that informed ACT UP/NY's activism and analysis on women and HIV infection up to 1990. Book Group members: Marion Banzhaf, Cynthia Chris, Kim Christensen, Alexis Danzig, Risa Denenberg, Zoe Leonard, Deb Levine, Samuel Lurie, Monica Pearl, Catherine Gund, Polly Thistlethwaite, Judith Walker, and Brigitte Weil. Additional members of the original Women and AIDS Handbook Group included Jamie Bauer, Heidi Dorow, Maria Maggenti, Ellen Neipris, Ann Northrop, Sydney Pokorney, Karen Ramspacher, Maxine Wolfe, and …