Medical Education Commons^™

The Effect Of Reflection Rounds On Medical Students’ Empathy, Erica Westlake, Jennifer Desantis, Med, Fred Markham, Md

Phase 1

Background: A decline in empathy has been noted in medical students in medical education and training. This decline raises concerns because empathic physician-patient interactions positively impact health outcomes and patient satisfaction. We tested the hypothesis that Reflection Rounds would increase empathy scores of third-year medical students.

Methods: Third-year students entering their Family and Community Medicine (FCM) clerkship completed the Jefferson Physician Scale of Empathy – Student Version (JPSE-S) at the onset of their clerkship; students at the Jefferson Campus site were assigned to the experimental group and students at Affiliate Sites were assigned to the control group. The experimental group …

Sepsis Education And Training In Medical School, Shayan Ghiaee, Dimitrios Papanagnou, Md, David F. Gaieski, Md

Phase 1

Purpose: According to the National Institutes of Health, severe sepsis strikes more than one million Americans every year. Despite the extensive research that has gone into creating the different risk stratification tools for sepsis, there is still a fifteen to thirty percent mortality rate among patients diagnosed with sepsis. We believe this is due to a lack of robust education and training of medical students in sepsis identification, and thus, the purpose of this study was to determine the extent of training and education of medical students in the identification and treatment of sepsis.

Methods: This study is aimed at …

Simulation Of Status Epilepticus Is Effective Teaching For Junior Neurology Residents, Pankhuri Jha, Navya George, Jeffrey Ratliff

Phase 1

Purpose: Status Epilepticus (SE) represents a potentially fatal neurologic emergency. At Jefferson, acute management of SE falls to the inpatient neurologist, requiring early competency.

Methods: During a 2 week educational “bootcamp”, 9 PGY2 residents participated in a 2 hour simulation of acute SE with two clinical scenarios. Scenarios included a patient with SE requiring adequate benzodiazepine dosing and another with seizures requiring IV anticonvulsant therapy. Prior to and following the simulation, residents took a survey to gauge their knowledge and confidence in managing SE.

Results and Conclusions: There was an increase in the number of residents expressing confidence in their …

Simulating Status Epilepticus Management For Junior Neurology Trainees, Navya George, Pankhuri Jha, Frank Anzelmi, Md, Allyson Pickard, Md, Jeffrey Ratliff, Md

Phase 1

Purpose/Methods: Status Epilepticus (SE) represents a potentially fatal neurologic emergency. We aimed to create an educational simulation of SE for 9 PGY2 neurology residents. Scenarios included a patient with SE requiring adequate benzodiazepine dosing and another with seizures requiring IV anticonvulsant therapy. Subjects were dichotomized to groups who did and did not feel confident in clinical skills around SE. Knowledge was assessed with a multiple choice quiz. Confidence groups were analyzed with Fisher’s exact test. Quiz scores means were assessed with paired t-test.

Results: There was a trend towards significance in the proportion of residents expressing confidence in their ability …

A Module Based Method Of Teaching A Novel Approach To Electrocardiogram Interpretation, Emily Fishbein, Alexandra Koutsoubis, Jennifer White, Md, Dimitrios Papanagnou, Md

Phase 1

Purpose: The traditional approach to 12-lead electrocardiogram interpretation has limitations in the ED setting because it is tedious and does not emphasize pattern recognition for potentially fatal conditions that ED physicians must recognize. Additionally, while lecture-based learning is necessary, learning modules can help learners gain a better understanding of the material. The purpose of this study was to create and implement a self-paced learning module that teaches a novel way of ECG interpretation through the following steps: is it sinus? is it wide? is there ischemia? and does this herald sudden death?

Methods: The objective endpoint of this study was …

Motivational Interviewing For Cpap Adherence, Caitlin Green, Grayton Downing, Cindy Cheng, Md, Phd

Phase 1

Background: Continuous Positive Air Pressure (CPAP), is the gold standard for obstructive sleep apnea (OSA) treatment. If left untreated, patients with OSA can experience serious and potentially life-threatening consequences. However, patient CPAP adherence is an ongoing problem, as compliance rates are historically low (typically 30-60%). Engaging patients in motivational interviewing (MI) by trained providers could promote increased CPAP adherence.

Question/Purpose: Assess CPAP compliance in patients who receive motivational interviewing compared to a control attention intervention.

Methods: A team of medical students were trained in MI interviewing techniques through a novel training protocol. The training protocol includes reading articles and watching …

“Trauma To The Eye” – A Low Fidelity Module For Identifying Retrobulbar Hematoma And Practicing Lateral Canthotomy & Cantholysis, Jared Raikin, Dimitrios Papanagnou, Md, Ronald Hall, Md

Phase 1

Purpose: A retrobulbar hematoma (RH) can cause preventable blindness due to damage of the optic nerve. Due to its relative infrequency in the emergency department, Emergency Medecine (EM) residents have limited experience in recognizing and treating a RH. This paper outlines a simulated scenario that was developed to improve EM residents knowledge in diagnosing a RH and performing an emergent lateral canthotomy and cantholysis (LCC).

Methods: This module used a low fidelity task trainer and case vignette created for EM residents to practice recognizing a RH and perfroming a LCC. Participants took an assessment questionnaire before and after the teaching …

A Module-Based Novel Approach To Electrocardiogram Interpretation For Emergency Medicine Residents, Alexandra Koutsoubis, Emily Fishbein, Jennifer White, Md

Phase 1

Purpose: In the Emergency Department, accurate ECG interpretation is essential as many conduction abnormalities are treatable and can lead to death if inaccurately diagnosed. Learning how to read a 12-lead ECG is part of medical education, taught through the following approach: rate, rhythm, axis. In the ED, this tedious approach doesn’t relay important information that should be garnered from the ECG with accuracy. Currently, resources for residents to improve ECG interpretation skills are limited. The purpose of the study was to design a module that teaches an accurate way of interpreting an ECG, that allows for pragmatic, pattern recognition of …

Developing An Online Critical Care Electroencephalography Curriculum For Epilepsy And Neurophysiology Fellows, Anne Woehling, Brooke Hancock, Nathanael Lee, Md, Connie Tang, Md, Allyson Pickard, Md, Andres Fernandez, Md

Phase 1

Purpose: This project aims to create an Electroencephalography (EEG) curriculum that synthesizes the teachings of current publications and faculty expertise within a single digital platform. The goal is to remedy the unmet need for a centralized resource for learners to use when learning EEG interpretation.

Methods: The target learner population is epilepsy and neurophysiology fellows. The platform will be accessible from any computer, tablet, or phone, allowing for mobile, self-paced learning to take place. To date, the curriculum outline has been designed with extensive literature review and collaboration from other institutions, and two pilot modules have been completed using the …

The Effect Of The Surgery Rotation Sequence On Surgery And Emergency Medicine Nbme Scores, Anna Lin, Gerald Isenberg, Md, Chaiya Laoteppitaks, Md

Phase 1

Purpose: Within a school, the formerly fourth year emergency medicine clerkship was added to the third year curriculum in a sequence with general surgery and surgical subspecialty clerkships. Together, a student can be placed in any permutation of the three clerkships, but a student will take the Surgery and EM NBME exam after the completion of the respective clerkship regardless of the order of clerkships. The purpose of this project was to look to see if there was a significance difference in NBME scores between four different sequences of clerkships and to see if sequence of a third year student’s …

An Educational Workshop To Improve Neurology Resident Knowledge And Understanding Of Burnout, Substance Abuse, And Mood Disorders, Shiori Tomatsu, Ryan Donaghy, Patrick Kerns, Md, Phd, Courtney White, Md

Phase 1

Problem: Many medical residents are at risk for burnout, mood disorders, and substance abuse. We created an educational activity composed of an online module (OM), an interactive role-playing session (AL), and a video practicum (VP) to inform neurology residents on the aforementioned risks and available support resources. This project evaluates the efficacy of these tools.

Methods: PGY2 and PGY3 neurology residents were given OM. In addition, the PGY2 residents participated in AL. Three surveys were given to assess their knowledge about burnout before completing the module (Sur1), after AL session (Sur2), and after watching VP(Sur3).

Outcomes: More PGY2 residents scored …

Medical Student Knowledge Of Narcolepsy, Alyssa Sinko, Karl Doghramji, Md

Phase 1

Background: Narcolepsy is a sleep disorder, whose main symptoms include daytime sleepiness, cataplexy, sleep paralysis, disturbed sleep, and hypnagogic hallucinations. The disorder is poorly identified in medical settings. We hypothesized that lack of knowledge of narcolepsy and its hallmark symptoms are a cause for the low levels of identification of this disorder. This was a pilot study into medical student knowledge of narcolepsy at Sidney Kimmel Medical College of Thomas Jefferson University (SKMC).

Methods: Two groups of SKMC students, years 1 and 2 (before sleep medicine education) and years 3 and 4 (after sleep medicine education) were the subjects of …

A Comparison Of Homemade Phantoms For Ultrasound Guided Peripheral Intravenous Catheter Insertion, Saami Zakaria, Liam Hughes, Lauren Selame, Kelly Kehm, Resa E. Lewiss, Arthur Au, Zachary Risler

Phase 1

Purpose: U/S guided peripheral intravenous catheter (PIV) placement is implemented in many clinical settings. Commercially available U/S phantoms are expensive and difficult to alter from stock. Non-commercial phantoms have been described in published literature without data showing which type is more efficacious. The primary objective of this study was to determine efficacy of various non-commercial phantoms for U/S guided PIV placement, while secondary objectives were to characterize the cost and ease of production.

Methods: This prospective observational study trialed six unique phantom models: 1) Amini ballistics gel model, 2) Morrow ballistics gel model, 3) University of California San Diego (UCSD) …

Developing An Online Critical Care Electroencephalography Curriculum For Epilepsy And Neurophysiology Fellows, Brooke Hancock, Anne Woehling, Nathanael Lee, Md, Connie Tang, Md, Allyson Pickard, Md, Andres Fernandez, Md

Phase 1

Purpose: This project aims to create an Electroencephalography (EEG) curriculum that synthesizes the teachings of current publications and faculty expertise within a single digital platform. The goal is to remedy the unmet need for a centralized resource for learners to use when learning EEG interpretation.

Methods: The target learner population is epilepsy and neurophysiology fellows. The platform will be accessible from any computer, tablet, or phone, allowing for mobile, self-paced learning to take place. To date, the curriculum outline has been designed with extensive literature review and collaboration from other institutions, and two pilot modules have been completed using the …

Medical Student Attitudes Toward Cell Phone Use On Rounds, Jacob Garcia, Sarah E. Rosenberg, Md

Phase 1

Purpose: Mobile devices are ubiquitous and serve as an important resource for on-the-spot research about patient questions and conditions. However, even when a device is used to address patient needs, patients and members of the medical team may assume the student is using their phone for non-clinical activities and perceive the student as uninterested and disengaged. Medical students are aware of this potential for misperception, and as such, we designed a study to investigate the attitudes of third and fourth year medical students towards cell phone use on internal medicine rounds.

Methods: Our target learner population was third and fourth …

Assessing The Operative Log Data Of Traditional (5+2) Vs. Integrated (0+5) Vascular Training Programs, Ernest Gillan, Bs, Anthony Feghali, Md, Tuong Nguyen, Md, Dawn Salvatore, Md, Paul Dimuzio, Md, Babak Abai, Md

Phase 1

Introduction: In 2006, the Accreditation Council for Graduate Medical Education (ACGME) approved an integrated 5 year vascular surgery residency program. Operative experience can be used as a surrogate marker for success in the evolving field of vascular surgery training.

Objective: The purpose of this study is to compare the operative experience of those graduating from the traditional (5+2) vascular training program with the integrated (0+5) program.

Methods: National operative case log data supplied by the ACGME was gathered and organized for vascular surgery residents graduating between 2013 and 2018. Mean case numbers were compared between integrated vascular residents and traditional …

The Impact Of Mental Health On Cancer Preventative Screenings, Chelsea Edirisuriya, Amy Leader, Phd

Phase 1

Among the mental health population of the United States, overall preventative health services, such as cancer screening rates, are remarkably low. Additionally, there is a significant 30% higher mortality rate due to cancer in psychiatric patients. This project established if there are disparities in cancer screening rates between the general population and the mental health population of Southeastern Pennsylvania. The project analyzed and compared the differences in cancer screenings for colorectal, breast, and cervical cancer among those currently diagnosed with a mental condition and the general population. Through p-value and Pearson chi-square statistical analysis of the Community Health Data Base …

Patient Perceptions And Expectations About Postoperative Analgesia, Carrie Mok, Nirmal Shah, Do, Stephen F. Goldberg, Md, Amir C. Dayan, Md, Marc Torjman, Phd, Jaime L. Baratta, Md

Phase 1

Introduction

Opioid overdose deaths have nearly quadrupled since 1999. Nearly 2 out of 3 persons being prescribed medications are prescribed an opioid. Physicians may be prescribing opioids for more than what is required for postoperative pain control, leading to increased risk for opioid abuse and addiction. Patient perceptions of perioperative pain medications are poorly understood.

Objective

This survey aims to understand patient expectations of perioperative analgesics.

Methods

Following IRB approval, patients 18 years of age or older, were given a 13-question survey prior to their surgery at Thomas Jefferson University Hospital, to evaluate the perception of pain medications, medication efficacy, …

Common Practice For Behavioral Health Screening In Pediatric Primary Care Settings, Joseph A. Menand, Mario Cruz, Md

Phase 1

Mental health disorders in the United States are highly prevalent, affecting 14-20% of children yearly. Only 25-35% receive treatment after on average a six-plus year delay from symptom onset. Current recommendations suggest primary care physicians/providers (PCP) manage mental health conditions, however, PCPs are wary, citing lack of time, training and resources.This study evaluated pediatric/adolescent PCPs using a self-report questionnaire assessing knowledge/skill, clinical practice (e.g. screening tool) and perceived barriers when managing attention deficit hyperactivity disorder (ADHD), anxiety and depression (N = 11). Self-reported knowledge/skill diagnosing, treating and referring each disorder were recorded on a 5-point Likert scale and evaluated using …

Opioid-Prescribing Practices For Post-Operative Patients In Otolaryngology: A Multiphasic Quality Improvement Project In A Single Large Institution, Zachary Gandee, Sophia Dang, Alexander N. Duffy, Jonathan C. Li, Tanvi Rana, Brittany Gunville, Tingting Zhan, Elizabeth Cottrill, Md, David Cognetti, Md

Phase 1

Objectives:

In otolaryngology, postoperative pain management lacks evidence-based guidelines. We investigated opioid prescription and consumption for common procedures to develop prescribing guidelines at our institution.

Study Design:

Prospective, survey study.

Methods:

Patients who underwent surgery between July and September were given surveys upon discharge and at first follow-up visit. We assessed opioid usage and pain using the visual analog scale and opioid consumption throughout the postoperative period. Opioid prescriptions were converted to a standardized unit of 5 mg Oxycodone pills for reporting. Four procedures (transoral robotic surgery resection [TORS], sialendoscopy, parathyroidectomy/thyroidectomy, and parotidectomy) were selected for isolated analysis.

Results: …

A Comparison Of Screening, Prevention, And Management For Hepatitis B Patients Between The Us And Chinese Healthcare Systems, Thomas Chen, James D. Plumb, Md

Phase 1

Introduction: Hepatitis B (HBV) is a complex disease entity with potentially serious outcomes, including developing hepatocellular carcinoma (HCC). HBV is estimated to be responsible for about 50-80% of HCC cases worldwide, and 75-95% of HCC cases in HBV endemic regions.¹ HBV and HCC are great concerns especially in East Asian countries like China. In China, HCC ranks as the 2^nd most common cancer and 2^nd in cancer mortality, both behind only lung cancer.¹ China is considered an endemic HBV region, with about 100-150 million people infected. In comparison, only an estimated 550,000-2 million people are chronically …

Clinician Perspectives On Factors Affecting Shared Decision Making About Lung Cancer Screening, Mohammad Abubaker-Sharif, Melissa Dicarlo, Mph, Ms, Ronald E. Myers, Phd, Dsw

Phase 1

Background/Objective. In 2015, the Centers for Medicare and Medicaid Services (CMS) announced coverage for annual lung cancer screening (LCS) with low dose computed tomography (LDCT) for individuals who are 55 to 77 years of age, have > 30 pack years of smoking history, and undergo shared decision making (SDM) prior to screening. Most referrals for LCS are initiated in primary care. Currently, little is known about how primary care physicians view SDM and barriers in practice to SDM about LCS. This study aimed to gather information to help fill these knowledge gaps.

Methods. I worked with senior leadership in …

Pilot Study Of The Physiological Effects Of An Integrative Medicine Approach In Irritable Bowel Syndrome, Gigi Constable, Eleanor Lewis, Andrew B. Newberg, Md

Phase 1

Introduction: Irritable Bowel Syndrome (IBS) is the most common GI functional disease in the US, affecting 10-25% of the population and costing ~$1.6B in annual healthcare spending. Defined by varied GI symptoms, IBS is associated with gut inflammation from many factors, including diet, microbiome imbalances, and stress. However, the disease lacks a treatment algorithm, especially within integrative medicine.

Objective: This research explores integrative medicine approaches to IBS, including diet and supplements, to identify microbiome and symptom patterns before and after intervention.

Methods: Patients first complete surveys on diet and symptoms, the Beck depression inventory, the SF-36 questionnaire, PET-MRI imaging, and …

Total Body Skin Exams: Sensitivity, Specificity, And Number Needed To Screen, Shayan Waseh, Michael Bui, Audra Hugo, Alexander Sherban, Elizabeth Jones, Md

Phase 1

Introduction: Skin cancer, the most common form of cancer worldwide, has one of the highest cure rates among cancers if diagnosed and treated early in its course. The Total Body Skin Exam (TBSE) is the primary modality used to screen for skin cancers. Currently, few studies have characterized the effectiveness of the TBSE in contemporary populations.

Objective: Characterizing the number-needed-to-screen (NNS) to diagnose a case of skin cancer through TBSEs will make it possible to better understand its effectiveness as a screening modality and its utility in an increasingly population health-based healthcare system.

Methods: A retrospective chart review of 3155 …

Rethinking Emergency Response To Mass Casualty Incidents: Disaster Medicine Education And The Role Of Medical Students, Claire Zurlo, Edward Jasper, Md, Mph

Phase 1

Introduction: The threat of a mass casualty incident (MCI) is one that must be taken seriously and for which hospitals must be prepared. In the wake of a disaster, emergency departments are often taxed beyond their ability to handle the demands of incoming traumas. In response to this, Dr. Edward Jasper, an emergency physician at Thomas Jefferson Hospital, designed the Hospital Emergency Response Team (HERT) to alleviate the pressure on the ED during a MCI. The HERT is a team of nursing and medical students who are FEMA trained to respond in the event of a MCI.

Objective: The primary …