Medical Education Commons^™

Perspectives On A Recently Merged Family Medicine Residency Program: A Post-Match Survey Of Ranked, Unmatched Applicants, John E. Snellings, Karo G. Ohanian, Ismail El Moudden

Eastern Virginia Medical Journal

Introduction: Residency program mergers are a topic of much consternation and relatively little scholarly investigation in graduate medical education. After undergoing a residency merger in July 2020, the newly formed Eastern Virginia Medical School (EVMS) Family Medicine Residency Program investigated the effects of the merger on the perspectives of the applicant pool for the subsequent 2020–2021 recruiting season. Methods: We conducted an anonymous survey of EVMS Family Medicine applicants during the 2020– 2021 recruiting season. Students who interviewed with the residency and were subsequently placed on the program’s National Residency Matching Program (NRMP) rank order list (ROL) but did not …

Influence Of Faculty-Derived Concept Maps On Student Study Strategies, Kaitlin P. Hardy, Amanda K. Burbage, Julie A. Kerry

EVMS School of Health Professions Faculty Publications

Background

Concept mapping is a well-established tool for students to actively organize information into a visual and spatial framework. However, some students are resistant to adopting concept mapping as a study strategy due to the time and effort involved in generating the maps. In this study, we explored student perceptions of faculty-derived concept maps (FD-maps) developed to accompany content within a Foundational Science module in a medical school curriculum. We subsequently investigated whether student use of FD-maps helped overcome resistance to adoption of concept mapping.

Methods

Student evaluation data was analyzed using a mixed methods approach to explore student perceptions …

Practice Patterns In Pediatric And Adult Dysphagia: Implications For Clinical Training, Jane Grothaus, Kaitlyn Hill, Marlee Nebesniak, Anastasia Raymer

Speech-Language Pathology Faculty Publications

Objective: Most speech language pathologists (SLPs) receive training to work with patients with swallowing disorders in graduate school, focusing primarily on adult dysphagia. Although SLPs share common foundational knowledge and skills for adult and pediatric dysphagia populations, there are considerable differences in these two specialized areas of practice. We aimed to query SLPs’ practice patterns for dysphagia assessment and management for adults and pediatric populations to consider differences and guide training efforts.

Methods: We distributed two comprehensive anonymous surveys to explore practice patterns of SLPs who provide assessment and management of dysphagia for adult or pediatric populations. The 118 respondents, …

Lost In Transition: The Need For Research On Immersive Clinical Experiences In Athletic Training Education, Julie M. Cavallario, Stephanie M. Singe

Rehabilitation Sciences Faculty Publications

Context

Immersive clinical experiences (ICEs) were integrated into athletic training education to enhance student learning. However, their structure and effect remain poorly understood.

Objective

To highlight the lack of research on ICEs and the need for data-driven improvements in athletic training education.

Background

Since the transition to graduate-level education, ICEs have been required to provide students with uninterrupted exposure to professional practice. Despite this requirement, little evidence exists regarding their effectiveness or best implementation practices.

Synthesis

Authors of recent studies have revealed inconsistencies in implementation, limited placement diversity, and inadequate preceptor training. Despite widespread adoption, little evidence supports how ICEs …

Behavioral Health Training For Integrated Behavioral Health: A Delphi Study, Nicholas Schmoyer, Lisa Corbin, Jessica Huffman, Gülşah Kemer

Counseling & Human Services Faculty Publications

Using a classical Delphi design, the authors used an interdisciplinary panel of behavioral health experts in integrated behavioral health (IBH) to identify foundational skills and knowledge counselor educators need to teach clinical mental health counselors for IBH practice. Eighty-eight statements were identified. Implications are provided for counseling and other behavioral health educators.

Engaging The Community, Providing Hopes, Mackenzie Peeke, Margaret West, Alyssa Wilkinson, Matthew Serrata, Michael Baroody, Conner Tembe, Chrisney Yerena

HOPES Free Clinic Publications

Founded in the 1970s as a grassroots effort to provide care to the underserved population of Hampton Roads, Eastern Virginia Medical School (EVMS) has long been committed to community-centered care. The HOPES Free Clinic is a manifestation of that mission. Launched in 2011 as a student-run phone triage service, the Health Outreach Partnership of EVMS Students (HOPES) later transitioned to provide direct clinical services—becoming the first student-run free clinic in the Commonwealth of Virginia. In 2014, HOPES integrated into Community Engaged Learning to enhance and solidify its efforts. Since its inception, medical and health professions students have partnered with volunteer …

Strategies To Enhance Gme Program Coordinator Job Satisfaction And Well-Being, Stuart Slavin, Julie Beckerdale, April L. Mcguire, Linda Ortiz Morrison, Melanie Pigott, Carrie L. Racsumberger, Evangelina Rangel, Bret Stevens, Ramona Tirado, Cynthia D. Thompson, Latoya Wright

Department Dermatology Faculty Publications

[Introduction] Program and institutional coordinators in graduate medical education (GME) have very complex jobs that are often highly pressured and demanding, requiring a diverse skill set to manage effectively. While these positions can be immensely gratifying, the demands and pressures inherent in the roles pose threats to job satisfaction as well as risks to mental health and well-being. A national survey of 6372 coordinators found that 20.4% reported being dissatisfied or very dissatisfied with work, and 27.9% reported being likely or very likely to leave their job in the next year. ¹ Of the coordinators surveyed 36.3% screened positive for …

Otolaryngology Applicants' Preferences For Virtual Vs. In-Person Interviews During The 2023-2024 Application Cycle, Taylor S. Erickson, Robert Frederick, Steven D. Pletcher, Aileen Dowden, Dana Dunleavy, Eric J. Dobratz

Department of Otolaryngology (ENT) Faculty Publications

Background Since the shift to virtual residency interviews, applicants and programs have reported difficulty distinguishing themselves in a virtual format, reduced exposure to medical campuses, and limited opportunity to establish personal connections. The 2023-2024 application cycle was the first time virtual and in-person interview formats were available in otolaryngology–head and neck surgery (OHNS). Programs offered one or both formats, and in some cases, applicants were given the choice between the 2.

Objective To assess the perceptions of OHNS applicants regarding virtual versus in-person interviews during the 2023-2024 application cycle.

Methods A 20-question survey was distributed via email through the Association …

Letter Of Concern From The Association Of Academic Chairs Of Emergency Medicine Regarding Acgme Proposed Changes, Richard J. Hamilton, Lance B. Becker, Richard E. Wolfe, D. Adam Algren, Arnold Thomas, Michael Baumann, Ross P. Berkeley, Terrell S. Caffery, Chad Cannon, Theodore J. Corbin, Michael E. Chansky, Harinder S. Dhindsa, Charles L. Emerman, David A. Farcy, Chris Fox, Michael A. Gibbs, Christopher S. Goode, Steven "Andy" Godwin, Dietrich Jehle, David Johnson, Samuel M. Keim, Babak Khazaeni, Barry J. Knapp, Clint Hawthorne, John D. Hoyle Jr., Michael Christopher Kurz, Evan Leibner, Robert Mcnamara, Robert F. Mccormack, Edward A. Michelson, Chadwick Miller, Ashley Norse, Andrew Nugent, Brian J. O'Neil, David T. Overton, Edward A. Panacek, William F. Paolo, Denis R. Pauzé, Amanda L. Perez, Ralph J. Riviello, Scott W. Rodi, Peter S. Pang, Juan A. Gonzalez Sanchez, David P. Sklar, Ben C. Smith, Jeffrey R. Stowell, Marc D. Squillante, J. Jeremy Thomas, Terry Vanden Hoek, Gregory A. Volturo, E. Lea Walters, Thomas E. Wyatt, Donald M. Yealy

Department of Emergency Medicine Faculty Publications

This letter, signed by over 50 academic chairs of emergency medicine, urges the ACGME to reconsider a proposed mandate requiring all emergency medicine residency programs to adopt a four-year training model. The authors argue that current three-year programs are supported by data demonstrating equivalent educational and clinical outcomes compared to four-year formats. They criticize the flawed survey methodology underpinning the proposal, note the loss of milestone-based training flexibility, and highlight the lack of added scholarly or clinical value in the fourth year. The letter also outlines negative consequences for fellowship participation, workforce development, trainee debt, and diversity. The signatories advocate …

"They Just Don't Have The "Doctor" In Front Of Their Name:" Dimensions Of Trust In Physician Assistants, Staci Defibaugh, Leah Onosato

English Faculty Publications

Physician assistants play a major role in healthcare delivery in the United States, yet what we know about how patients perceive the care they receive from PAs is limited. Prior research on patients’ impressions of PAs has focused primarily on survey data, limiting the scope of what we can learn about patient impressions to predetermined, quantifiable categories, and has focused on post-visit impressions of a single encounter. In an attempt to better understand patient impressions, we conducted open-ended, semi-structured interviews with 30 participants prior to their medical visit, focusing on general impressions of PAs. Through an analytic process of reflexive …

Virtual Learning In Emergency Medicine Residency Programs, Ashley Rider, Laura Oh, Rahul Bhat, Michael Gottlieb, Bruce Lo, Ulemu Luhanga, Shayne Gue, Jason Laenngfeld, Sarah Greenberger, Jeffery Hill, Jonathan Heidt

Department of Emergency Medicine Faculty Publications

During the COVID-19 pandemic, educational systems worldwide faced significant disruptions as in-person learning became unfeasible. In response, many institutions, including graduate medical education programs, swiftly transitioned to virtual learning platforms to adapt to these challenges. The rapid and unplanned pivot in learning format resulted in temporary negative impacts on residency training. Conversely, the experience of the rapid shift may have resulted in some long-term benefits while also preparing programs for future disruptions. This review aimed to discuss the advantages and disadvantages of virtual learning, potential mitigation strategies for the realized disadvantages, and potential areas of future research.

Using Virtual Reality To Assist Students At Academic Risk In Human Anatomy, Michael Foley, Lauren T. Lilley, Lindsay Meyers, Robert Armstrong, Lisa Fore-Arcand, Kelly Mccoy, Chad Eitel, Tod R. Clapp, Natascha Heise

Department of Pathology & Anatomy Faculty Publications

Learning human anatomy presents a significant challenge for health profession students due to the difficulty in visualizing structures in three dimensions. Virtual reality (VR) has been reported to aid in understanding these relationships. In this study, students at academic risk attended VR sessions alongside their gross anatomy course. Data from post-surveys, observations, and examinations indicated VR participants performed similarly to peers, except in head/neck and pelvis/lower limb exams where performance was lower. Students valued VR for enhancing confidence and understanding. VR shows promise in supplementing anatomy education, particularly for less complex regions, and bridging gaps in traditional learning methods.

Athletic Training Students' Use Of Health Information Technology Professional Behaviors During Clinical Experiences: A Report From The Aate Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, R. Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context:

As an essential core competency for high-quality healthcare, health information technology (HIT) leverages the use of technology, such as electronic record systems, to collect and use patient care information to make informed clinical decisions. There is a dearth of information regarding professional athletic training students' (ATSs') use of HIT professional behaviors during clinical experiences.

Objective:

To assess HIT professional behaviors ATSs engage with during clinical experience patient encounters (PEs). DESIGN: Multisite panel design.

Setting:

12 professional athletic training programs.

Participants:

363 ATSs enrolled across the participating professional athletic training programs entered patient encounter information within E*Value during their scheduled …

Newly Credentialed Athletic Trainers' Onboarding Process During The Transition To Practice, Ashley B. Thrasher, Stacy E. Walker, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: As new athletic trainers (ATs) transition into their roles, some employers provide orientation and onboarding to assist with the transition to practice. Research in which authors outline the ideal onboarding process for new ATs transitioning to practice is lacking.

Objective: To examine the onboarding process for new ATs.

Design: Grounded theory.

Setting: College or university, secondary school, and hospital or clinic.

Patients or other participants: Seventeen newly credentialed, employed ATs who recently graduated from professional masters' programs (11 female, 6 male; 25.6 ± 2.2 years) and 12 employers (6 female, 6 male; years in role supervising new ATs: 8.5 …

Perceptions Of Leadership Opportunities And Effectiveness Among Athletic Trainers: A Comparison Across Racial And Ethnic Groups, Nicolette A. Harris, Americus H. Williams, Julie M. Cavallario, Cailee E. Welch Bacon

Rehabilitation Sciences Faculty Publications

Context

Diverse representation in athletic training leadership is essential for fostering inclusion and innovation in the profession. Despite efforts to enhance leadership diversity, disparities persist, underscoring the need to explore barriers to leadership and the effectiveness of leadership in meeting the needs of athletic trainers (ATs).

Objective

To examine racial and ethnic differences in ATs' desire, pursuit, and attainment of leadership positions in the profession in addition to perceptions of current leadership effectiveness.

Design

Cross-sectional, web-based survey.

Participants

A purposeful sample of 1,173 racially and ethnically diverse ATs from an organized professional network followed by a random sample of 6,000 …

Comparing Immersive And Nonimmersive Clinical Experiences In Athletic Training Education: Effects On Student Engagement And Confidence, Julie M. Cavallario, Shana Pribesh, S. E. Walker

Rehabilitation Sciences Faculty Publications

Context

With the shift to a graduate-level professional degree in athletic training, it was hypothesized that immersive clinical experiences (ICEs) would be more effectively integrated into curricula than non-ICEs (N-ICEs) and better prepare students for practice.

Objective

To longitudinally compare clinical engagement opportunities in ICEs versus N-ICEs and assess if these opportunities are associated with changes in student confidence in performing related tasks.

Design

Prospective, longitudinal, time-diary study using a Web-based survey. Patients or Other Participants: Fifty-three first-year, master’s-level athletic training students from 21 programs.

Main Outcome Measure(s)

Participants reported their type of clinical experience (ICE, N-ICE, or none), the …

Clarification Of Public Health Pathways Toward Clinical Careers: A Pilot Study Describing A Benchmark Analysis Project, Elizabeth A. Brown, Melissa Feliciano, Daniel Martinez

Health Behavior, Policy & Management Faculty Publications

Introduction: Undergraduate public health programs have adapted the required basic sciences based on medical and technological advances and the needs of the public health workforce. We aim to demonstrate how a benchmark analysis project was used to improve curriculum and develop a model where basic sciences in public health can be used to build pathways to clinical graduate programs like medicine, pharmacy, physician assistant, etc.

Methods: Authors conducted a benchmark analysis of Bachelor of Science in Public Health (BSPH) Degrees (or public health-related degrees) in the southern region of the United States (US) to explore required basic sciences. Authors searched …

Increasing Serious Illness Conversations In Patients At High Risk Of One-Year Mortality Using Improvement Science: A Quality Improvement Study, Kanishk D. Sharma, Sandip A. Godambe, Prachi P. Chavan, Agatha Parks-Savage, Marissa Galicia-Castillo

Department of Family and Community Medicine Faculty Publications

Background: Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores. Methods: This was a quality improvement study with data collected pre- and post-intervention at a large urban level one trauma center in Virginia, which also serves as a primary teaching hospital to …

The Influence Of The Residency Interview Format On Future Interviewing Models And Use Of Preference Signals, John E. Snellings, Hanwen Miao, Daniel L. Meyer, Miranda A. Moore

Department of Family and Community Medicine Faculty Publications

Background and Objectives: The COVID-19 pandemic dramatically altered the format of residency recruitment, leading to the widespread adoption of virtual interviews, followed by the adoption of preference signaling. This study examines how the structure of the 2023-2024 interview season influenced family medicine residency program directors' intentions for future interview formats and their preferences regarding the number of preference signals.

Methods: A Council of Academic Family Medicine Educational Research Alliance survey, including demographic questions, was distributed to all family medicine residency program directors in the United States in spring 2024. Data analysis included descriptive statistics, cross-tabulations, χ² tests, and multivariable logistic …

Is It Getting Better? An Evaluation Of Two Successive Generations Of Chatgpt In Answering Specialized Vascular Surgery Questions, Dongjin Suh, Quang Le, Leana Dogbe, Kedar Lavingia, Michael Amendola

Department Surgery Faculty Publications

Purpose: Large language models (LLMs) can generate clinically relevant text; however, their performance in highly specialized medical domains remains uncertain. This study evaluated ChatGPT-3.5 and ChatGPT-4 (OpenAI) using vascular surgery board–style questions from the Vascular Education and Self-Assessment Program, version 4 (VESAP4) and compared the two public model versions (June and November 2023).

Materials and Methods: All non-image VESAP4 questions (n=384) were presented independently three times to each model version (ChatGPT-3.5 June/November; ChatGPT-4, June/November). Outcomes included accuracy (proportion correct), consistency (same option letter across all three attempts and “consistently correct”), explanation length (word count), and modes of failure classified for …

Exploring Institutional Stratification: Minority-Serving Institutional Pathways To Medical School Acceptance In The United States, Amanda K. Burbage, Eushekia Y. Hewitt

EVMS School of Health Professions Faculty Publications

Introduction

Recruiting and training a diverse pool of physicians from historically excluded groups is vital to solving complex scientific problems and increasing access to patient care. Disparate educational and health outcomes of COVID-19 amplified this need. In stratified higher education systems, underfunded institutions that serve greater numbers of underrepresented in medicine (URM) students face unique barriers to entering physician training. However, pathways from historically underfunded minority-serving institutions (MSIs) in the United States to medical school (MD) are not well understood.

Method

A hierarchical logistic regression analysis of 328 488 de-identified applicants to US MD-granting medical schools for academic years 2017-2018 …

Team Science In Interdisciplinary Health Professions Education Research: A Multi-Institutional Case Study, Peggy Gesing, Joni Tornwall, Violet Kulo, Sarah Mcbrien, Thuha Hoang, Hyun-Jin Jun, Amanda Burbage, Yuane Jia, Christina Cestone

EVMS School of Health Professions Faculty Publications

The interdisciplinary nature of health professions education requires exploration of problems by interdisciplinary research teams. Drawing on the Dynamics of Cross-disciplinary Research Development conceptual framework, this study explores the processes and experiences of an interdisciplinary research team, identifying elements of successful collaboration. Case study data were collected from a team of nine researchers from six universities. Data included meeting minutes and researcher reflections. Researcher reflection and meeting minute themes converged within the framework constructs: Contexts and inputs, social learning processes, social capital outcomes, and knowledge and human capital outcomes. This study provides a blueprint for interdisciplinary researchers indicating that successful …

Clinical Pharmacology And Medication Safety: A Remote Learning Elective Designed For Senior Medical Students, Elizabeth B. Graham, William T. Wightkin, Curt R. Bay, Uzoma S. Ikonne

Department of Biomedical and Translational Sciences Faculty Publications

In the United States, medical educators have expressed concern that an integrated and condensed pre-clerkship curriculum risks leaving gaps in student pharmacology knowledge. This study evaluates a remote-learning clinical pharmacology elective that integrates fundamental pharmacology concepts and principles of medication safety and explores how the course impacts senior medical students' self-reported readiness for residency. Clinical Pharmacology and Medication Safety is a remote elective course for senior medical students. The course integrates a review of basic pharmacology with clinical pharmacology topics through case-based learning sessions led by clinical pharmacists and physicians. To evaluate the elective's effectiveness, students in the fall and …

Medical Students' Attitudes Towards Research Participation After The United States Medical Licensing Examination Step 1 Scoring Change, Danxun Li, Nina Li, Curt Bay, Uzoma Ikonne

Department of Medicine Faculty Publications

Background

The recent transition of scoring for the United States Medical Licensing Examination (USMLE) Step 1 exam from a numerical grading system to pass/fail system has significant implications for residency applicants. It is anticipated that research productivity will gain greater importance in the evaluation process. To understand how medical institutions can best support students, we seek to understand medical students' motivations and experience conducting research in medical school after the USMLE Step 1 scoring change.

Methods

This is a mixed-methods, cross-sectional study that examines the motivations and barriers that medical students face in conducting academic or clinical research. A survey …

A Case Study Using The Transparency Framework And Artificial Intelligence To Promote Effective Writing And Student Success In A Writing-Intensive Course, Elizabeth A. Brown, Maria Kronenburg, Ashlee Steeley, Diana Tagbor

Health Behavior, Policy & Management Faculty Publications

Program evaluation data suggest that undergraduate students struggle with writing in a clear and concise manner and appropriately citing. Faculty implemented the plan-do study-act cycle to pilot the Transparency in Learning and Teaching (TILT) project framework and to explore the use of artificial intelligence (AI) and discuss approaches to using AI, along with the TILT framework, in a writing-intensive course to identify the pros and cons of using ChatGPT in an online classroom. The TILT framework reinforces adult learning by helping students clearly understand the assignment's purpose and establish a clear relationship between assignment and students' professional lives. Faculty encouraged …

A Worker's Struggle, Sakan Binte Imran, Shadman Mahmood Khan Pathan

Electrical & Computer Engineering Faculty Publications

[Introduction] The casualty department at Sir Salimullah Medical College Mitford Hospital was crowded, as it always was. The air smelled of antiseptics, and hurried footsteps echoed through the narrow corridors. It was another day of internship, and I had just finished checking on a patient when a nurse called me over.

“There’s a new case in Trauma. Factory worker. Severe hand injury.”

I hurried over and found a man sitting on the examination table. His face was pale, and his forehead was glistening with sweat. His right hand was wrapped in a blood-soaked cloth. His left hand trembled as he …

The Shared Experiences Of Novice, Full-Time Allied Dental Community College Educators, Misty L. Mesimer

Educational Leadership & Workforce Development Theses & Dissertations

A well-prepared oral healthcare workforce is essential to the overall health of the general population. A knowledgeable and qualified workforce would be non-existent without strong academic programs and faculty to prepare oral health professionals. For over 20 years, the dental and allied dental educator workforce has been a concern for the oral health professions. Since most allied dental education programs are based in community and technical colleges, it is crucial to thoroughly understand the transition experiences of faculty teaching at these institutions. It is only through application and use of this knowledge that these faculty can be recruited, supported, and …

Advanced Practice Nursing Initiatives In Africa, Moving Towards The Nurse Practitioner Role: Experiences From The Field, Deborah C. Gray, Melanie Rogers, Minna K. Miller

Ellmer School of Nursing Faculty Publications

AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa.

BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue.

SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects.

DISCUSSION: Four African countries have …

Discussing Systemic Racism And Racial Privilege At A Large, Academic Health Center Using A Modified Privilege Walk, Elizabeth A. Brown, Rosemarie Jones

Community & Environmental Health Faculty Publications

Background: There is a motivation for organizations to understand race and racism from the perspective of minoritized individuals. Academic health centers (AHC) are ideal organizations to have these conversations as they educate healthcare providers, support research in health disparities, and care for diverse patients.

Methods: We piloted and evaluated a virtual Modified Privilege Walk (MPW) with faculty, staff, and students at an AHC in July 2020 to promote difficult conversations about race/racism, social class, and privilege. Each MPW session was voluntary, held virtually over Zoom, and lasted one hour and thirty minutes. Before attending, participants answered questions based on their …

The Nature And Validity Of Implicit Bias Training For Health Care Providers And Trainees: A Systematic Review, Nao Hagiwara, Conor Duffy, John Cyrus, Nadia Harika, Ginger S. Watson, Tiffany L. Green

VMASC Publications

The number of health care educational institutions/organizations adopting implicit bias training is growing. Our systematic review of 77 studies (published 1 January 2003 through 21 September 2022) investigated how implicit bias training in health care is designed/delivered and whether gaps in knowledge translation compromised the reliability and validity of the training. The primary training target was race/ethnicity (49.3%); trainings commonly lack specificity on addressing implicit prejudice or stereotyping (67.5%). They involved a combination of hands-on and didactic approaches, lasting an average of 343.15 min, often delivered in a single day (53.2%). Trainings also exhibit translational gaps, diverging from current literature …