Medical Education Research
This section includes Class of 2022 Embark Projects within the Medical Education field. These include educational research projects designed to improve the undergraduate and/or graduate medical education areas, as well as other areas of health education.
Effect of Success and Failure Motivations on Stress and Quality of Life Among Students
Allisen Nguyen1, Kanako Taku, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Oakland University, Rochester, Michigan
INTRODUCTION
The quadripolar model demonstrates how success and failure affect academic motivation. It places individuals into one of 4 categories: Optimist, Overstrivers, Self-protectors, and Failure-acceptors. This project aims at first determining the alignment of both medical and undergraduate students and the second is establishing if based on the model, there is an effect on quality of life and stress levels. Based on results the hope is using the information to tailor academic lessons aimed towards meeting students’ needs to address distress and quality of life.
METHODS
A 94-question online survey was given to both medical and undergraduate students from Oakland University in Rochester, MI. A total of 388 undergraduates and 213 medical students took the questionnaire. The medical students were recruited on a volunteer basis via email. The undergraduate students were recruited through Sona, a website that allows students to sign up and participate in psychology research and given 0.5 credits to be applied to their psychology class. After data collection, the data was analyzed using 3 tests: descriptive statistics, Fisher Exact P-value, and ANOVA.
RESULTS
When comparing the results for both gender and school status there was no statistical significance difference in quadripolar identity. However, in contrast there was statistical significance in the quality of life, and distress between the different quadripolar identities. Specifically, difference of quality of life in failure avoider/ over striver compared to optimists, and failure acceptor vs. failure avoider/ overstriver. For distress there was significant difference in failure acceptor vs overstriver, and failure avoider/ overstriver vs optimists.
CONCLUSIONS
The results demonstrate that success and fear of failures as motivators play a significant role in identity within the quadripolar model, but more significantly that these identities affect distress and quality of life.
Exploring the Effects of Mindfulness Based Stress Reduction on Pre-Clinical Medical Students: A Qualitative Methods, Longitudinal Pilot Study
Alyssa Heintschel, B.S.1, Scott Sabbagh, B.S.1, Patrick Herndon, B.S.1, Michael Moussa, B.S.1, Ruth Lerman, M.D.2,3
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Internal Medicine, Beaumont Health, Royal Oak, Michigan
3Beaumont Center for Mindfulness, Beaumont Health, Royal Oak, Michigan
INTRODUCTION
Mindfulness Based Stress Reduction has become an increasingly popular practice in healthcare-affiliated populations. MBSR is a course designed to promote mindfulness and awareness within oneself through a combination of formal and informal practices. Studies suggest healthcare workers are at higher risk of experiencing stress and burnout; this is prevalent among pre-clinical medical students due to the rigorous nature of medical school coursework. The primary objective of this study is to evaluate the effectiveness and feasibility of implementing an MBSR program to facilitate improvements in key areas of mental health among medical students throughout their training.
METHODS
23 first- and second-year medical students from OUWB School of Medicine participated in an on-campus MBSR course from October to December 2019. The course included 31 hours of contact time (weekly classes, one all-day session) and daily home practice. During each session, participants were invited to engage in mindfulness activities including body scan, meditation, yoga, and group discussions. Participants completed two in-class, narrative-based surveys regarding their experience, along with a 12-month follow-up assessment. A qualitative analysis using Grounded Theory was used to analyze the results of the surveys.
RESULTS
When asked in the endpoint assessment to describe what they learned from the course, participants reported themes such as ‘Recognition’ and ‘Acceptance’. At the 12-month interval, participants were asked to discuss the lasting impact of the MBSR course, and reported themes including ‘Non-Judgmental Awareness’ and ‘Appreciation’. ‘Relationships’ was a common theme among both assessments. Dropout and attendance rates were favorable for this rigorous, extra-curricular program.
CONCLUSIONS
The themes expressed support the hypothesis that MBSR may improve the students’ mental health and ability to manage stress and burnout. Offering an MBSR course as a voluntary, for-credit option within the OUWB curriculum could improve participation and retention rates and provide opportunities for further studies.
The Impact of Previous Healthcare Experience on the Practice of Medicine
Amy Cox, B.S.1, Stephen Loftus, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
There is a population of practicing physicians who worked in other patient care positions before becoming physicians such as nurse assistant, nurse, EMT, phlebotomist, etc. Healthcare experience is considered an important component of the development of future physicians and is weighted in the medical school admissions process, yet the effects of healthcare experience have not been studied in now practicing physicians. This study seeks to explore how prior healthcare employment experience influences how physicians perceive their practice of medicine.
METHODS
Seven practicing physicians from the Beaumont Health System were interviewed one-on-one in a semi-structured interview format encouraging participants to share their stories, perceptions, and reflections from their healthcare experiences. The interview transcriptions were evaluated by narrative analysis techniques with an inductive framework to identify significant themes.
RESULTS
Four themes were identified: (a) career insight, (b) communication style (c) empathy for patient experience, and (d) healthcare leadership. Additionally, all participants said they would repeat their early healthcare experiences and recommended such experience for future physicians.
CONCLUSIONS
These physicians found exceptional value in the lessons they learned from their previous healthcare experiences and perceived them to have a profound impact on their current practice of medicine. They expressed a commitment to the field of medicine, empathy for patients, and strong communications skills. Their insights into leadership showed that they understood, valued, recognized, and supported each member of the healthcare team. Given the growing crisis of burnout in the healthcare profession, the value of these experiences should be considered in future physicians’ path to medicine and considered within medical schools’ admissions process. We recommend continuation of this type of study to further benefit the medical education system. This study was limited by the number of participants and should be expanded to other health systems to identify more of these unique physicians.
The Influence of BLM and the Death of George Floyd on Medical and Pre-med Students and Their Views on Institutional Racism
Asia Susko, B.S.1, Jason Wasserman, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Foundational Medical studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Racial inequalities present in medical education in a multitude of ways, including basing disease prevalence on majority populations and using images that disproportionately represent white patients. George Floyd’s death was not only a sentinel event of police violence, but underscored broader systemic racism, including medicine’s potential for complicity. This study highlights the perspectives of premedical and medical students in light of George Floyd’s death and the Black Lives Matter movement. Their views help elaborate ways to better support students and staff of color in medical education.
METHODS
Key word searches identified prospective medical school applicants and medical students on Reddit forums. Data collected from these forums was analyzed using a process that moves from open coding to categorization to allow themes to emerge.
RESULTS
Four key themes were identified: Fear of future repercussions, concern about barriers to medical school and residency admission, the importance of representation in medicine, and the connection between medicine and protests. Students wanted to participate in protests, but were afraid of potential negative impact on their career. Discussion of events surrounding George Floyd and BLM lead into a conversation about systemic racism and how skin color and socioeconomic status played a role in admission to medical school or residencies. Representation in medicine benefits both patients and students. Students made connections between professional responsibilities of physicians as community leaders and addressing biases and inequalities within medicine.
CONCLUSIONS
This study hopes to bring light to the aspects of institutional racism in medicine and how it affects current and future medical students and it adds their voices to this important discourse. Future address of these concerns should include creating environments where students can safely express opinions and concerns, implicit bias training, and readdressing the financial burden placed upon students when applying to medical school or residency.
Imposter Syndrome and Depressive Symptoms in Medical Students
Christopher Gilbert, B.S.1, Varsha Karamchandani, M.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Psychiatry, Beaumont Health System, Royal Oak, Michigan
INTRODUCTION
Imposter syndrome (IS), characterized by chronic feelings of self-doubt as well as fear of being discovered as an intellectual fraud, has been reported to have a high prevalence among medical student populations. Many forms of psychological distress, such as depressive symptoms, have also been found to have a high prevalence among medical student populations. Combined, these can lead to poor scholastic performance and poor mental health. The object of this research is to gather data by survey about the prevalence of IS within the medical student community and explore its potential relation to depressive symptoms.
METHODS
A web-based survey was sent to all of the medical students at Oakland University William Beaumont School of Medicine (OUWB) that included questions on demographic information, including gender and year in school; the Young Imposter Scale, an 8-question survey assessing for the presence of IS in the respondent; and a modified PHQ-9 questionnaire to identify depressive symptoms in the respondent. All of the data collected was anonymous and self-reported.
RESULTS
74 students with representation from each class responded to the survey, with 54% of individuals screening positive for IS. This data was then compared to the individuals’ responses to the screening for depressive symptoms by a Fishers Exact Test. The only question from the PHQ-9 that was found to be correlated to the presence of IS was “Feeling bad about yourself – or that you are a failure or have let yourself or your family down” (p=0.029).
CONCLUSIONS
The results show a moderately high prevalence of IS among medical students, with a correlation of a positive IS screening to feeling bad about oneself or a failure. This displays a negative impact on this realm of mental health. With this affecting so many students, future studies should investigate any other possible deleterious effects of IS.
The Current State of Diagnostic Error Education in U.S. Medical Schools
Dakota Hall, B.S.1, Sandra LaBlance, Ph.D.1, Brett Todd, M.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Emergency Medicine, Beaumont Health, Royal Oak, Michigan
INTRODUCTION
Diagnostic error has been identified by the Institute of Medicine as a major cause of patient harm. Despite recent focus on the importance of diagnostic error, little is known about how medical schools are educating future physicians, specifically, the extent to which it is taught. We aimed to investigate the current state of diagnostic error education in U.S. medical schools.
METHODS
We conducted an anonymous survey of deans of medical education at U.S. M.D. and D.O. medical schools utilizing Qualtrics, which was distributed in February 2021 and resent on two occasions through a listserv known to reach U.S. medical school faculty. The survey asked questions concerning diagnostic error education at that school, including whether or not it was taught, details about the curriculum if taught, and questions about obstacles if not taught.
RESULTS
47 out of a potential 192 deans of medical education responded to the survey. Of those that responded, 93.6% were M.D. schools, and 6.4% were D.O. schools. 83.7% of schools teach diagnostic error, while 16.3% schools do not. 68.0% of schools teach diagnostic error during both the preclinical and clinical years, 28.0% teach it during only the preclinical years, and 4.0% teach it during only the clinical years. Small-group discussions are the most commonly used format for teaching diagnostic error, utilized by 87.5% of schools. Other teaching formats used include didactic lectures (79.2%), online educational modules (41.7%), workshops (33.3%), simulation (33.3%), and flipped classroom (29.2%).
CONCLUSIONS
To our knowledge, this is the first study investigating diagnostic error education in U.S. medical schools. The results suggest that the majority of U.S. medical schools do teach diagnostic error in their curriculum, and that it is more commonly taught in the preclinical years using small-group discussions. Future research should investigate the effects of diagnostic error education in medical school on patient outcomes.
Gauging the Impact of Interactions with Autistic Children Early in Medical Education
Emily W. Yuen, MPH1, Helen E. Huetteman, B.S.1, Jessica Korneder, Ph.D.2, Jason Adam Wasserman, Ph.D.3, Mary O. Dereski, Ph.D.3
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Oakland University Applied Behavior Analysis Autism Clinic, Rochester, Michigan
3Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
One in fifty-nine children in the United States are currently diagnosed with Autism Spectrum Disorder (ASD). Despite this high prevalence, medical students receive little training on this unique population. This project aims to determine the impact on first-year medical students’ attitudes toward treatment of children diagnosed with ASD following small group interactions in an Applied Behavior Analysis (ABA) clinic.
METHODS
Study participants (first-year medical students) were recruited from the Oakland University William Beaumont (OUWB) School of Medicine Pediatric Interest Group. Each student attended six 30-minute sessions in the ABA clinic, where they read songbooks to children (ages 2-8). Two or three medical students, three to four children with an ASD diagnosis, and children’s respective teacher aides were in each session. A pre- and post- video recorded interview was administered to the medical students. Responses were examined using a narrative coding technique with line-by-line codes grouped into categories, which, in turn, led to the identification of themes. Common themes related to perceptions and attitudes towards working with autistic children were compared and contrasted.
RESULTS
Four participants had substantial previous experience working with children with ASD and five had limited or no experience. All participants (n=9) viewed direct interaction as a valuable, and effective tool for preparing students for future treatment of autistic children. There was an overall positive change in the medical education categories of knowledge and attitudes, with no overall change in skills among the students. Additionally, hands-on experience was the most preferred learning modality among students to develop effective strategies for future patient encounters, followed by a combination of modalities (e.g. lectures, readings, and hands-on experience), and small group discussions.
CONCLUSIONS
Direct interactions early in their medical education with children having an ASD diagnosis is an effective teaching strategy and preferred learning modality among medical students.
Students’ Perception and Evaluation of a Computer Assisted Learning (CAL) Embryology Module
Hussam Mawari, B.S.1, Nicholas Schimmel, B.S.1, Varna Taranikanti, M.D./Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Computer Assisted Learning (CAL) involves the integration of animations, images, quizzes, and activities into a single online learning platform for students to access from home. Embryology is a subject that is taught at different periods of time in a curriculum by different disciplines making it difficult for students to understand the bigger picture. The integration of different disciplines, visual learning tools, and activities into a single CAL module may help students better understand embryology. The purpose of this study is to assess students’ attitude and perception of CAL in learning embryology to assess if CAL is effective in teaching embryology in medical school.
METHODS
Seven medical students at the Oakland University William Beaumont School were given a 25-question pre-test. Following the pretest, students were required to complete a 1 hour and 30-minute CAL module which contained multiple EKGs, imaging, animations, and audio recordings. Afterwards, students were required to complete the 25 questions minute post-test followed by a survey to assess their perception of the CAL module. Students were presented with their scores and answer explanations after each test. The survey included seven qualitative multiple-choice questions followed by answers choices on a Likert scale as well as one open ended question.
RESULTS
Student attitude towards the module was overall positive. Students reported that the module was helpful in reinforcing the material taught, reported feeling more confident about the material presented, would recommend the module to their classmates, and suggest similar modules be created for other subjects. The most common suggestion for improvement was to shorten the length of the module.
CONCLUSIONS
The results supported the hypothesis that medical students positively perceive the use of computer assisted learning to learn embryology. CAL could also be an engaging and effective tool to reinforce other subjects or difficult topics in medical school.
Using Board Games to Promote Collaboration and Communication in Healthcare Students: A Pilot Study
Kassy E. Kneen, M.S.1, Kyeorda Kemp, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Interprofessional collaboration in healthcare improves patient outcomes; however, there is not a definitive understanding of how to facilitate this in medical education. Board games have been used to improve attitudes toward collaboration among medical students in Germany, but it is unknown if this approach can be utilized in the U.S. We predicted that using games would improve students’ attitudes toward interprofessional collaboration and communication.
METHODS
Twenty-three healthcare students from Oakland University were recruited and divided into control and intervention groups. Before and after the study, participants filled out the Jefferson Scale of Attitudes toward Interprofessional Collaboration (JeffSATIC). The study consisted of the following: During the first activity, both groups participated in a collaborative activity to measure their baseline for communicating and collaborating. During the second activity, the intervention group played the game Pandemic. The control group watched a lecture about teamwork. During the third activity, both groups participated in a second collaborative activity. Participants were assessed by at least two observers using a Collaborative Skills Rubric developed by the researchers and perceptions of the usefulness of the activities were collected. A paired t-test was used to analyze the results.
RESULTS
In the overall participant and medical student cohorts, there was no significant difference between
the JeffSATIC scores. Observable communication skills improved in both the control and gaming intervention; however, only the gaming group had a statistically significant improvement in observed communication and collaboration. Moreover, students perceived the gaming intervention to be more beneficial than the control lecture activity.
CONCLUSIONS
Playing the board game Pandemic improved communication and collaborative skills of healthcare students in the short term. Students demonstrated an increase in these behaviors despite not having a significant improvement in their attitudes toward collaboration and communication. We will investigate using games at more institutions over longer periods of time.
Journal Club in the Pre-Clinical Years During Medical School
Kristen Cuadra, B.S.1, Steven Joseph, M.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
INTRODUCTION
Traditionally, journal clubs have been conducted within graduate medical programs to help integrate evidence-based learning. This study will be focused on beginning to integrate journal club into the pre-clinical years while implementing successful techniques used in past journal clubs. Our hypothesis is that, with a structured review instrument in place to help students analyze clinical articles, students will be able to benefit from monthly journal clubs and fully grasp concepts taught in these pre-clinical years. Overall, the results will contribute significantly in determining the efficacy of journal club and whether or not it can be a valuable tool in medical education.
METHODS
This was a prospective study that consisted of 14 2nd year medical students from August 2020 to April 2021. Each month, a one-hour journal club was held virtually over Zoom, where students used a structured review instrument to discuss and analyze journal articles. Journal club articles correlated with the pre-clinical curriculum at OUWB. At the end of April 2021, all 14 students were asked to complete a 10-question survey determining whether or not the monthly journal clubs were helpful in providing them with a better understanding of organ system material. Descriptive statistics was used to analyze the survey responses.
RESULTS
All 14 students either “strongly agreed” or “agreed somewhat” when asked if their pre-clinical education benefited from the monthly journal clubs as well as when asked if integrated journal clubs would benefit their future education in residency.
CONCLUSIONS
The results support the hypothesis that medical students would benefit from integrating journal club into the pre-clinical curriculum. Students felt that journal club positively impacted their education and was applicable in order to start practicing evidence-based medicine. Further studies may demonstrate whether journal club can improve clinical performance throughout medical school.
The Effect of Mentoring on Impostor Phenomenon
Monique Waltman, B.S.1, Kyeorda Kemp, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Impostor phenomenon (IP) is characterized by self-perceived feelings of fraud and self-doubt despite having achieved professional and academic successes. Recent publications indicate that medical students have high levels of IP, and this increases as students continue in their courses. Moreover, IP in medical students correlates with burnout. IP is also found in other high pressure programs, such as veterinary programs. Studies outside of academia indicate that the act of mentoring is beneficial to mentors in addition to mentees in terms of boosting confidence. Therefore, we asked if participating in a mentoring program, either as a mentor or mentee, reduces feelings of impostor phenomenon after one year of participating in a mentoring program in medical or veterinary students.
METHODS
First and second year medical students were recruited to complete The Clance Impostor Survey to measure IP at the start and end of the school year. Students recorded their mentoring status (mentor and/or mentee). Mentors and mentees were asked to complete additional questions about their experience in the program after one year of mentoring.
RESULTS
The pre- and post-survey responses were treated as independent groups and a two-sample T test was completed. Impostor Score – In the post time period the average score was lower than in the pre time period (29±32.4 vs 55.7±29.9 respectively; p=0.0017). Students also perceived the experience to be beneficial.
CONCLUSIONS
The results indicate that engaging in a mentoring program reduces imposter feelings among medical students.
The Interplay of Posttraumatic Growth, Motivation, and Burnout on the Journey to Becoming a Physician
Nicolas Baker, B.A.1, Katherine Fraus, B.A.2, Kanako Taku, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Psychology, Oakland University, Rochester, Michigan
INTRODUCTION
There are a wide range of potential motivations for people to embark on the challenge of becoming a physician. It is suspected that personal trauma can influence motivation. The research attempts to understand the extent to which Posttraumatic Growth (PTG) influences an individual’s path after experiencing trauma. This study aims to determine if a portion of students identify a traumatic event as a trigger for becoming a physician and to assess the relationship of burnout, PTG, and motivation in medical students.
METHODS
96 medical students completed an online survey. The participants were asked to identify a “most impactful event” from a list of common “potentially stressful life events”. They also completed inventories assessing variables of interest. Inclusion criteria was met if the participant experienced one of the stressful life events. They were then interviewed to better understand each participant’s experiences. Survey results were analyzed using multivariate regression analysis. Interview responses were codified and analyzed using frequency charts.
RESULTS
50 participants met inclusion criteria, and 5 went on to complete the interview. Intrinsic motivation correlated positively with PTG (r = .35, p = .017). Amotivation correlated negatively with PTG (r = -.36, p < .05) and positively with burnout (r = .71, p < .01). In the interview, 60% (n=5) of the participants cited “death or illness in family or self” as the most important factor in pursuing medicine. All 5 of the participants felt their event was “protective against burnout”.
CONCLUSIONS
There is a subset of medical students that utilize prior traumatic events as a motivating factor for becoming a physician. Students with this motivation could be better equipped to experience PTG and combat burnout. This suggests we should begin to reshape our view of trauma away from a solely destructive force to one through which motivation and protective factors can be derived.
Therapeutic efficacy of zinc in the treatment of COVID-19 patients: A systematic review
Olivia Schimmel, B.S.1, Varna Taranikanti, M.D./Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Novel therapeutic interventions are of utmost importance to alleviate the clinical symptoms caused by inflammation in COVID-19 patients. The beneficial role of zinc has been suggested due to its ability to mitigate the effects of the inflammatory cascade. Hence it has been hypothesized that patients with zinc deficiency may benefit symptomatically from treatment with zinc. The primary goal of this systematic review of randomized controlled trials conducted between February and March 2021 is to determine the efficacy of zinc as a treatment for COVID-19 infection.
METHODS
Using key search words, 178 articles were collected from databases including PubMed, Cochrane, and Embase. Inclusion criteria for screening included randomized controlled trials (RCTs) with COVID-positive patients treated with zinc. Exclusion criteria included articles that were not RCTs, animal studies, zinc used for prevention, and unrelated studies. After screening, pertinent data was collected from the remaining two articles and conclusions were drawn.
RESULTS
In the first RCT, it was shown that hospitalized COVID-19 patients who were treated with IV zinc were successfully treated for their zinc deficiency by day six of hospitalization. However, due to limitations in target enrollment, the primary outcome investigating the reduction in oxygenation in non-ventilated patients and improvement in PaO2/FiO2 in ventilated patients was not assessed. The second RCT revealed that there was no significant difference in the number of days required for patients to reach a 50% reduction in symptoms severity between patients treated with zinc gluconate and placebo.
CONCLUSIONS
The results do not support the hypothesis that zinc shortens the number of days between COVID-19 symptoms onset and 50% reduction in symptoms. Additionally, more research will be required to investigate whether or not intravenous zinc can effectively decrease the oxygenation and ventilation requirements in COVID-19 patients. This systematic review highlights the necessity of well-designed RCTs to increase the quality of evidence.
Pre-Medical Student Concerns Regarding Applying to Medical School During COVID-19 Pandemic
Rachel Connell, B.S.1, Jason Wasserman, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Over the last two years, the COVID-19 pandemic has altered the system processes of medical education. The primary goal of this study is to identify themes regarding the concerns of pre-medical students in the 2020-2021 application cycle through qualitative analysis of www.studentdoctor.net medical school admission forum posts in order to contribute to the limited literature available on this relatively novel topic.
METHODS
A sample of 8 medical schools, 4 public and 4 private, was randomly selected across four geographic regions. The primary data studied included posts from March-December 2020, with a matched comparison from March-December 2019 medical school admission threads. An inductive coding approach was utilized to conduct a thematic analysis to identify pre-medical student concerns during the 2020-2021 admission cycle.
RESULTS
6953 posts across 8 medical school admission forums in March-December 2019 and 2020 were analyzed. Four common themes regarding pre-medical student concerns were identified as most prevalent in the selected medical school admission forums: 1) Changes to application process secondary to the pandemic, 2) Curriculum changes, 3) Cost of attendance and availability of financial aid, and 4) Cost and coordination of application and interviews. A decrease in concerns regarding cost and coordination of interviews was noted from 2019 to 2020.
CONCLUSIONS
In contrast to initial expectations, concerns regarding a shift to virtual learning, social and professional dynamics, and long-term impact of the pandemic on medical education were largely absent from the studied forums. Student concerns about the effects of the pandemic were focused on delayed application submission and decision timelines. A reduction of concerns surrounding cost and coordination of interviews accompanied the transition to a virtual interview format. Identified student concerns could be used to better prepare medical school administrations to address student concerns when implementing curriculum changes or altering their admissions process in the future.
Virtual Reality as an Instrument of Improving Empathy and Spatial Presence
Sara Ama, B.S.1, Zexin Ma, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Communication, Journalism, and Public Relations, Oakland University, Rochester, Michigan
INTRODUCTION
Empathy is a core component of medical interviewing. Implementing virtual reality to promote empathy needs to be further explored. The primary goal of this study is to identify the effectiveness of virtual reality in comparison to non-virtual reality mediums in empathy and spatial presence scores. A secondary goal is to evaluate what role perspective has in moderating scores.
METHODS
The medical interaction is a clip between two physicians who are discussing the unsuccessful cancer treatment of a young boy to his parents. 59 participants were randomized into one of the following conditions: VR/patient’s perspective; PC/patient’s perspective; VR/physician’s perspective; PC/physician’s perspective. Following the condition, the participants took a post-test to assess compassionate empathy toward the patient and his parents and the spatial presence experience.
RESULTS
An ANOVA test was performed to compare the different conditions. There was a significant effect of the platform on the mean score of compassionate empathy toward the patient and his parents, with the virtual reality platform having a greater mean score, F (1, 59) = 4.94, p = .030. There was a significant effect of the platform on the mean score of spatial presence experience, with the virtual reality platform having a greater mean score, F (1, 59) = 5.164, p = .027. There was no significant effect of perspective on empathy or spatial presence scores. Additionally, there was no significant interaction between platform and perspective on the outcome variables.
CONCLUSIONS
These results are valuable because virtual reality is a potential strategy in promoting empathy in health care curricula that is more accessible for programs that are unable to fund standardized patients. It would be beneficial to complete this study with a larger sample size in order to determine significance in regards to the role of perspective taking.
Death Exposure Influence on Medical Students’ Attitudes Toward End-of-Life Care
Sara J. Barlow, B.S.1, Nelia Afonso, M.D.2, Jason Adam Wasserman, Ph.D., HEC-C2,3
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan
3Department of Pediatrics, Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Advance directives help guide individuals and their families in making end-of-life decisions that physicians must respect and carry out on behalf of patients to provide optimal care that aligns with their wishes. The facilitation of end-of-life care and the application of advance directives are impacted by physicians’ attitudes and knowledge regarding this topic. Current studies focus on the perspective that practicing physicians have toward advance directives. Our goal is to examine the end-of-life preferences of medical students at Oakland University William Beaumont (OUWB) School of Medicine before and after clinical exposure to better appreciate how and when opinions regarding end-of-life care develop during physician’s education.
METHODS
400 medical students from all four classes at OUWB School of Medicine received an anonymous survey about advance directives and end of life experiences and opinions with items adapted to utilize Likert responses. The 254 responses were then divided based on responses prior to descriptive statistical analysis using two-sample t-tests and Fisher’s Exact tests.
RESULTS
The pre-clinical (n=203) and clinical (n=51) cohorts had no statistically significant differences in response to advance directive inquiries, but showed an increase in end-of-life experiences in clinical years (44% to 76%, p= <0.001). Compared to the pre-clinical group, the clinical group showed a preference towards less aggressive terminal life management (3.161.43, p=0.073) with a p-value nearly indicating significance.
CONCLUSIONS
The results show an increase in end-of-life experience with clinical exposure that begins in the third year of medical school. Despite no statistically significant results indicating changes in responses to advance directives between pre-clinical and clinical groups, this pilot study shows the possibility of an association that could be further analyzed with a greater sample size in future research.
Mindfulness-Based Stress Reduction for Pre-Clinical Medical Students: Exploring Efficacy and Benefit
Scott Sabbagh, B.S.1, Alyssa Heintschel, B.S.1, Patrick Herndon, B.S.1, Michael Moussa, B.S.1, Ruth Lerman, M.D.1,2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan\
2Beaumont Center for Mindfulness, Beaumont Health System, Royal Oak, Michigan
INTRODUCTION
Studies suggest that healthcare-affiliated populations are at an increased risk of experiencing chronic stress and burnout. Mindfulness meditation has become an established method to address and alleviate their effects, though it has not been extensively studied in the medical student population. The primary goals of this study are to assess the feasibility and efficacy of an 8-week, 30 contact hour MBSR course for first and second year medical students, and to assess its impact on their reported levels of stress, burnout, fear of compassion, and mindfulness.
METHODS
23 first- and second-year medical students from OUWB volunteered to participate in an MBSR course at no cost to them. This is an 8-week interactive program that meets weekly for 2.5-3 hour sessions and a seven-hour silent retreat between sessions six and seven. Through methods including yoga, seated meditation, and the body-scan, MBSR teaches participants how to cultivate a mindful awareness of the events in their lives as well as their reactions to them. Verified survey methods were used to assess the impact of this course on students’ reported levels of stress, burnout, fear of compassion, and mindfulness. Follow-up surveys were administered at 4 and 12-month intervals from the last class.
RESULTS
The results of this study partially support our anticipated results regarding the impact of the MBSR course. 13 participants (56.5%) completed both pre- and post- survey scales and were included in this analysis. Overall, significant findings included a reduction in PSS scores as well as MBS Exhaustion and Cynicism subscales. Data regarding compassion and mindfulness trended in expected directions but failed to achieve significance.
CONCLUSIONS
Overall, an 8-week MBSR course provided a means for stress and burnout alleviation in pre-clinical medical students. Future studies exploring participation maximization with implementation strategies are warranted.
