Digital Commons Network^™

Immersion In Physiology Bolsters Bedside Mechanistic Thinking, Rebecca Miller

Health Sciences Education Symposium

Purpose and Background:

• Compression of education and training with other responsibilities into more limited work hours
• Shift towards algorithm-based teaching/practice
• Less time spent in practice of basic science
• Intellectual Curiosity/Mechanistic Thinking less emphasized
• Self-directed learning and intellectual curiosity a primary focus for improvement in 2017

Mission Statement:

Through science experimentation in applied physiology, housestaff will reconnect with basic physiology and apply learned principles to commonly encouraged clinical scenarios.

Housestaff will participate in experiments to stimulate intellectual curiosity among participants and encourage appreciate and incorporation of physiology into their clinical and teaching roles.

Nursing Students Behind Bars, Mary L. Falk

Health Sciences Education Symposium

Virginia Commonwealth University (VCU) School of Nursing and Virginia Commonwealth University Health System (VCUHS) have created a unique partnership in which brand new undergraduate baccalaureate nursing students are completing their first clinical rotation on VCUHS’s Secure Care Unit (SCU). The VCU School of Nursing has had a total of 50 beginner nursing students rotate through a semester long clinical on the SCU over the past three years.

Effect Of Suction Assisted Laryngoscopy Airway Decontamination (Salad) Training On Intubation Quality Metrics, Benjamin Barmaan

Health Sciences Education Symposium

Introduction:

• VCU Health Critical Care Transport Network paramedics and nurses provide emergency scene response and interfacility transport through Virginia
• Pre-hospital RSI is a high-risk procedure employed by these providers
• A quality assurance review of pre-hospital intubations determined issues with suction to be a key area for improvement
• SALAD technique has been shown to improve trainee’s confidence in managing airway of vomiting patient

Association Between Workplace-Based Assessments And Self-Assessment Of Entrustment, Lelia Brinegar

Health Sciences Education Symposium

Purpose:

Optimal implementation of Entrustable Professional Activities (EPA)-based curriculum requires direct observation using workplace-based assessments (WBA) coupled with a longitudinal coaching relationship between learners and faculty. Students should be engaged and considered an active participant in the entrustment decision. As part of our engagement with the AAMC Core EPA pilot, we implemented both a WBA using the Otawa Clinic Assessment Tool (OCAT) and a coaching program for our medical students in 2018-2019. We measured the association between WBAs collected during the clinical clerkships and student self-assessment.

Coaches were selected from currently designated small group advisors and trained on the EPAs …

Cardiac Arrest Simulation: Complementary Approaches For Undergraduate And Graduate Medical Education, Nathan Lewis

Health Sciences Education Symposium

Background:

• Cardiac arrests require critical thinking and leadership skills
• Two simulation models—medical student and resident—were designed to enhance training for cardiac arrest
• Medical students focused on the individual resuscitation components
• Residents focused on team-related tasks

• Enhance the understanding of team roles and dynamics for medical students
• Improve residents’ performance of components of a cardiac arrest simulation

How Does Usmle Step 1 Examination Performance Predict Short-Term Wellness And Perceived Stress?, Nicole Deiorio

Health Sciences Education Symposium

Purpose

Wellbeing and stress are areas of increasing concern in medicine. The three steps of the USMLE exam were originally developed as pass-fail requirements toward MD licensure, but their use has evolved to include eligibility for residency programs. There is increasing student distress around USMLE Step 1 performance, yet little is known about how Step 1 performance immediately impacts wellness. We examined the relationship between step 1 performance with perceived stress and wellbeing. We hypothesized that higher Step 1 scores would correlate with lower subsequent stress and improved wellbeing.

Peer Observations: Enhancing Teaching Behaviors, Carolyn Marcelo

Health Sciences Education Symposium

Purpose and Background:

Academic hospitalists have varying degrees of experience and training on being an effective clinical educator (1,2).Teaching attendings typically receive feedback through learner evaluations, but to provide anonymity to the learner, these evaluations are aggregated and given to the teacher months later, limiting timely improvements. Learners may also lack the framework to give effective feedback on teaching (3). Peer observation with feedback is a solution to the drawbacks of learner evaluation of teaching attendings. The Stanford Faculty Development Program (SFDP) describes seven domains of effective clinical teaching (4) that have been used to create teaching evaluation tools (3,5,6). …

Is There A Relationship Between Profession And Assessment Of Interprofessional Collaboration In Ipe?, Kelly Lockeman

Health Sciences Education Symposium

Purpose: Interprofessional education (IPE) seeks to train students to collaborate across professions, but assessing interprofessional competency is challenging (Blue, 2015). Because faculty variation may be one barrier, this study explores grading patterns to determine whether there is variation between faculty and whether professional differences impact this variation.

Development And Implementation Of A Resident Training Tracking Tool Targeted To Documentation Of Milestone Fulfillment, Caleb King

Health Sciences Education Symposium

Purpose and Background:

Despite adoption of the 2015 Accreditation Council for Graduate Medical Education (ACGME) and American Board of Pathology (ABP) Milestones for assessment of resident education, no tool is available to organize longitudinal collection of residency program trainee tracking data relevant to the milestones. With the goal of being able to efficiently and accurately convert resident accomplishment data into milestone scores during biannual resident evaluations, we devised a user-friendly tracking tool to collect, display and map this data to relevant ACGME milestones.

Improving The Confidence Of First-Year Pharmacy Students On Drug-Utilization Review (Dur) Through An Online Choose-Your-Adventure Activity, Apryl N. Anderson

Health Sciences Education Symposium

Drug utilization review (DUR) is an essential pharmacist responsibility to ensure safe, effective medication use. DUR is a systematic review of medications to screen for medication-related problems (MRPs), such as drug interactions, duplications in therapy, inappropriate drug usage, etc.1,2Most pharmacies have computerized systems that alert for drug interactions, however, the systems’ accuracy and specificity vary widely.3 Therefore, pharmacists must use their clinical judgment to make decisions on medication appropriateness.

Previous studies show that innovative active learning activities may be successful in developing student pharmacists’ clinical decision-making skills associated with DURs. Castillo et al utilized “Brown Bag” simulations to improve students’ …

Incorporation Of The Ottawa Clinical Assessment Tool Scale (Ocat) To Measure Entrustability In Clinical Clerkships, Fidelma Rigby

Health Sciences Education Symposium

Purpose and Background:

Assessment of the Core Entrustable Professional Activities for entering residency (CEPAs) requires direct observation in the workplace to render ad hoc entrustment decisions.1 In recent years, two “entrustability” scales have been proposed as instruments for collecting entrustment data in the context of workplace-based assessments.2,3 One of these scales, the Ottawa Clinic Assessment Tool (OCAT), has been demonstrated validity evidence when used in graduate medical programs in surgery and internal medicine.4,5 As a component of our involvement in the CEPA pilot program, we incorporated OCAT across all core clerkships within our institution using a mobile-friendly workplace-based assessment (WBA) …

Onboarding Residents In The Vcu Obstetric Anesthesia Service, Fatoumata Kromah

Health Sciences Education Symposium

Purpose and Background:

Onboarding is commonly utilized in the corporate world. It is a process that begins before an employee starts a new position. During the process, the employee is welcomed to their new role, and provided tools and knowledge to be successfully assimilated into his or her position with a quicker ramp-up to productivity1. A structured onboarding process in post graduate training generally occurs before the start of residency2. Once residency is underway there is a wide variety of pre-rotation information that is passed on to the residents. There no published data on onboarding of anesthesia residents prior to …

The Relationship Between Active Learning And Workload During Clinically Relevant Simulations, Moshe Feldman

Health Sciences Education Symposium

Purpose:

Active learning through medical simulation has been shown to improve learning outcomes when used appropriately. However, simulation can inhibit learning outcomes and learner engagement when the simulation scenario context requires a high level of workload (perceived or actual) that is inappropriate for the level of learner (Curtis 2012). This study examines the relationship between individual learner engagement, team problem solving, and perceived workload during a Simulation Based Orientation to Clinical Medicine (SBOC).

Resident Perceptions And Habits Following Implementation Of A Resilience Skills Curriculum, Rebecca Miller

Health Sciences Education Symposium

Purpose and Background:

Health professionals and medical educators have identified resilience, or the ability to overcome adversity, as a characteristic which may be protective against professional burnout.1-4 At Virginia Commonwealth University, we sought to foster resilience among residents in Internal Medicine by implementing formal training for all residents. During the 2015-2016 academic year (AY), residents participated in training-level specific skill development workshops. However, the workshop format lacked a longitudinal component which may be necessary to reinforce and practice the use of these skills to develop consistent behaviors.

Setting Foundations For Pediatric Fellowship Core Curriculum Training, Ashlie Tseng

Health Sciences Education Symposium

Purpose and background:

The American Board of Pediatrics (ABP) and the Accreditation Council for Graduate Medical Education (ACGME) require pediatric subspecialty fellows to learn a core curriculum of scholarly topics including biostatistics, research methodology, teaching, quality improvement and leadership. Traditionally, each fellowship would develop such curricula for their own fellows –leading to variable experiences for fellows in different disciplines. Nationally, many fellowships are working to provide a common core curriculum which is available across disciplines with an aim towards improving training and transitioning to academic careers.1,2,3 To address this, we have developed a core curriculum which aims to provide all …

Local Outcomes Of A National Pilot To Enhance Ambulatory Precepting, Mark Ryan

Health Sciences Education Symposium

Recruiting and retaining effective ambulatory preceptors in Family Medicine is a national priority (1), and the American Board of Family Medicine (ABFM) and the Society of Teachers of Family Medicine (STFM) have developed a collaborative program to enhance Family Medicine Precepting (2). As one of the first cohort of pilot sites participating in the Preceptor Improvement Project (PIP), VCU's Department of Family Medicine and Population Health developed a faculty development program to enhance clinical teaching at the Hayes E. Willis Health Center, one of the Department's key teaching locations. The PIP content was based on the learning needs identified by …

Knowing Their Limits: Assessing The Discernment Of Pre-Clinical Medical Students, Elizabeth P. Marlowe

Health Sciences Education Symposium

Introduction:

Discernment, or awareness of one’s limitations, is one of the qualities fundamental to entrustment (ten Cate et al., 2015). The AAMC Entrustable Professional Activities (EPA) pilot project lists discernment as an expectation of medical students entering residency (AAMC, 2014).

Our institution, Virginia Commonwealth University School of Medicine (VCU SOM), was selected to participate in the EPA pilot. Prior to implementing a pilot curriculum on discernment, our institution gathered data on the current practice of discernment among our pre-clinical medical students.

The Practice of Clinical Medicine (PCM) at VCU SOM is a pre-clinical longitudinal course which teaches the core skills …

Longitudinal Changes In Psychological Resilience And Wellness During Clinical Clerkship, Moshe Feldman

Health Sciences Education Symposium

Purpose: An individual’s capacity to monitor, anticipate, react, and recover from stressful events defines their resilience. Resilient coping strategies have been shown to reduce stress, burnout, and improve performance in medical students (Erschans 2018, Thompson 2016, Wetzel 2018), but less is known on how resiliency changes over time across different phases of medical school or whether it is a trait. Ideally, educators would understand the periods in the curriculum where resilience building and stress reduction interventions are most needed, and most effective. The purpose of this study was to assess longitudinal changes in resiliency and the association between resiliency and …

Loneliness In Later Life, Edward F. Ansello

Director's Editorials from Age in Action

The National Social Life, Health and Aging Project (NSHAP) at the University of Chicago notes that persistent loneliness in later life is the exception rather than the rule. When it occurs, it’s most likely to be a transient condition and remediable.

Blue Zones And Longevity, Edward F. Ansello

Director's Editorials from Age in Action

We can embrace the generalizable characteristics of Blue Zones: a plant-based diet, friendships, spiritual or religious grounding, awareness of and immersion in our community, physical activity as a regular, normalized part of our daily routine, and, more philosophically, an opening up to our own sense of place and purpose.

Dementia-Friendly Resources, Edward F. Ansello

Director's Editorials from Age in Action

While dementia caregiving challenges continue for individual caregivers and communities, Alzpossible.org and Dementia Friendly America (dfamerica.org) can offer immediate support and a hopeful vision.

Interprofessional Geriatrics: Improving The Health Of Older Adults, Edward F. Ansello

Director's Editorials from Age in Action

We have received a five-year award (2019-2024) from the federal Health Resources and Services Administration (HRSA) to grow our Virginia Geriatric Education Center (VGEC) project, which aims to improve health outcomes across Virginia for older adults by developing a healthcare workforce that maximizes patient and family engagement, integrating geriatrics and primary care, and demonstrating measurable impact.

The Mason Music & Memory Initiative (M3i), Catherine J. Tompkins, Emily S. Ihara, Megumi Inoue, Christi Clark, Kristen Suthers Rumrill

Case Studies from Age in Action

Educational Objectives

1. Explain the benefits of a nonpharmacological intervention, such as the M3I, for persons with dementia.

2. Describe the work of M3I and its collaboration with students and faculty throughout the state.

3.Highlight lessons learned and future directions for the M3I.

Virginianavigator/Gwep Community Outreach Training For Older Adults, Caregivers, And Service Programs, Adrienne Johnson, Kim Tarantino

Case Studies from Age in Action

Educational Objectives

1. Demonstrate how VirginiaNavigator (VN) can support self-care and connecting with community resources.

2. Discuss how VN can assist service providers who work with older adults and their families.

3. Explain how VN relates to six focus areas of the Geriatrics Workforce Enhancement Program (GWEP) to improve the well-being of older adults.

The Senior Mentoring Program At Vcu’S School Of Medicine, Leland H. Waters, Madeline Mcintyre

Case Studies from Age in Action

Educational Objectives

1. To demonstrate the value of senior mentoring in geriatrics education for medical students.

2. To provide a framework for positively influencing student attitudes toward older adults.

3. To describe the underlying human relationships that contribute to patient-centered care.

4. To describe effective verbal and non-verbal skills to establish and build relationships.

Care Transitions: Empowering Older Adults With Post-Hospital Interventions, Karen Moeller

Case Studies from Age in Action

Educational Objectives

1. Understand how Care Transitions Interventions® (CTI®) can decrease hospital readmission rates among older adults, ages 60 and over.

2. Recognize how CTI® services assist older adults to stay in their homes after hospitalization for 30 days or more without unnecessary readmissions.

3. Appreciate examples of ways Senior Connections, The Capital Area Agency on Aging, collaborates with community partners.

4. Identify how Senior Connections refers older adults and caregivers to community resources for effective utilization and outcomes.

To Repair Or Replace: That Is The Restorative Question, Juhstin M. Brown, Clement S. Augustus

Dental Hygiene Student Scholarship

Objective/Aims: During dental visits, patients spend the majority of their time with their dental hygienist. At these recall appointments the patient’s face-to-face time with the dentist may be short. At this part of the appointment the dentist may diagnose the need for restorative treatment for the patient. Part of the hygienist’s responsibility is to explain treatment options for teeth with restorative needs. The purpose of this review of literature is to provide both options for restoration of dentition to a functional/aesthetic state.

Methods: Studies pertaining to the topic were searched using PubMed database. Keywords used in the search were amalgam, …

Puberty: Is Your Gingiva Having Mood Swings?, Gabrielle R. Salvatore, Kendall A. Connerley

Dental Hygiene Student Scholarship

Objectives/aim: The purpose of this paper is to explore the effects on the different pathological changes in the oral cavity due to puberty, in both males and females. Hormonal changes caused by menstrual cycles, ovulation, the use contraceptives, and increased testosterone and estrogen levels.

Methods: This topic will be analyzed by thoroughly reviewing research on articles that relate to the oral health of individuals specifically between the ages of 12-18 years old.

Results: Research presents significant evidence that supports changes occurring in the oral cavity during an individual’s stage of puberty. These stages include ovulation, pre-menstruation, menstruation and males transitioning …

Food Access In Petersburg, Virginia: Final Report And Recommendations, Ursp 666 (Commercial Revitalization), Logan Ashby, Chesley De Leon, Shekinah Mitchell, Michael Nixon-Garrison, Gabriella Pino-Mareno, Elizabeth Roderick, Jeff Smith

Urban and Regional Studies and Planning Reports

The City of Petersburg has long suffered with issues of limited access to food and food insecurity. Food deserts, or areas underserved by retail food options, are prevalent throughout the City. As a result, the Robert Wood Johnson Foundation has ranked the city last of Virginia's 133 counties in their annual health rankings.

For the Fall 2019 semester, students from Virginia Commonwealth University's L. Douglas Wilder School of Government and Public Affairs, through Dr. John Accordino's Urban Commercial Revitalization course, focused on planning solutions to address food deserts in commercial areas, with the City of Petersburg being one of their …

Increasing Access To Food: A Comprehensive Report On Food Supply Options, Ursp 666 (Commercial Revitalization), Logan Ashby, Chesley De Leon, Vegas Krane, Eric Mai, Shekinah Mitchell, Michael Nixon-Garrison, Gabriella Pino-Moreno, Elizabeth Roderick, Chloe Rote, Jeff Smith, Charlie Wilson, Will Wilson, Hunter Wood

Urban and Regional Studies and Planning Reports

Access to food is one of the most important aspects of a healthy, sustainable community. Grocery stores and other suppliers can serve as an economic anchor to provide social benefits to communities. Unfortunately, many communities do not have convenient and/or affordable access to grocery items, particularly fresh produce.

As part of Virginia Commonwealth University's Fall 2019 graduate course on Urban Commercial Revitalization, class members researched 13 retail and other food access options, which are described in this report. Each chapter covers a food access option and provides basic information that will be useful to individuals, organizations, or government agencies that …