Medical Education Research
This section includes Class of 2024 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.
Assessing impact of image-based immunization education on pediatric vaccine uptake within families of low English literacy
Ahmed Ali, B.S.1, Mariam Bassalious, DNP, FNP-BC2, Sharfaa Chowdhury, DNP-FNP-BC2, Coral Hufnagel, DNP, FNP2, Salwa Bajjey, MPH2, Amaal Haimout, MPH2, Nelia Afonso, M.D,1,3, Raouf Seifeldin, M.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Wayne County Healthy Communities, Hamtramck, MI
3Department of Internal Medicine, Corewell Health East
INTRODUCTION
Vaccine hesitancy is commonly faced within the primary care setting. This is especially an issue for families of low literacy backgrounds as even appropriately translated vaccine education material is not optimal for their understanding. For such patients, numerous studies have shown the benefits of image-based health education. The primary goal of this study is to assess the impact of image-based immunization education on pediatric vaccine uptake within families of low literacy backgrounds.
METHODS
An educational tool pictographically conveying the science behind immunizations was developed and employed under the guidance of providers at Wayne County Healthy Communities (WCHC), a Federally Qualified Health Center located in Hamtramck, MI. Parents with low-literacy backgrounds of children requiring the Flu or Hep A immunization were recruited to meet with providers for health education counseling. Participants were randomly divided into control and treatment groups who received standard vaccination counseling and counseling utilizing the developed image-based immunization education, respectively. After the encounter, vaccination decisions were tracked and parents received a $10 Amazon gift card for their participation regardless of vaccination decision.
RESULTS
Twenty participants were recruited. In the control group, 62.5% (N = 5) of participants agreed to either the recommended Flu or Hep A vaccination after counseling vs. 75% (N = 9) in the experimental group. A Chi-Square Test of Independence, however, showed that this difference was statistically insignificant, X2 (1, N = 20) = 0.36, p = .55. Given our small sample size, a Fisher’s Exact Test was also used to analyze the results and also showed there was not a significant association between the counseling method and vaccination decision (p = 0.64).
CONCLUSIONS
Although there appears to be a positive association between image-based education and vaccination uptake, we failed to generate the statistical significance necessary to confidently support our hypothesis.
Examining the presentation and reliability of body image and self esteem in YouTube videos
Nell Brigoli, B.S.1, Dwayne Baxa, Ph.D.1
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
As the use of social media arises, studies have shown patients are turning more towards social media platforms for health advice, specifically for body image and its effects on self-esteem and confidence. There is evidence to suggest that there is a need for more patient-facing resources and PCP training on body image. This study aims to assess what YouTube videos on body image are popular to viewers and if these videos can be used as an educational tool for both physicians and patients.
METHODS
A systematic analysis of video elements and instructor characteristics was performed from a sample of videos selected from YouTube using search terms “body image” and “self-esteem”. Only videos between 1 -20 minutes in duration, in the English, and those where the presenter is talking about relevant topics (body image and self-esteem) were taken into consideration. Videos that were advertisements, meditation/affirmation based, or had no presenter were excluded.
RESULTS
102 videos were taken into consideration. The video combination that viewers most preferred was a video with animation and that information is presented by a mental health professional or celebrity (Pearson’s R .821, p < .001; Kendall’s tau .597, p = .003). There is a significant difference in viewership between the videos that focused on one’s appearance (M = 13869, SS = 700334289347) versus those that focused on other attributes, such as strength, feeling healthy, etc. (M = 264, SS = 5455344, t(101) = 1.167, p < .05).
CONCLUSIONS
The video combination that viewers most preferred were videos that contained animation and if the presenter of the information was a mental health professional or celebrity. There is a statistical significance when comparing viewership between videos that focused on appearance versus not. It is not advisable for physicians to rely on YouTube videos about body image as educational tools.
Effects of a Medical Education Initiative on Pediatric Muslim Fasting Practices in Michigan
Muhammad Haidous, B.S.1, Suzan ElSayed, Ph.D.2, Emman Dabaja, M.D.3
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, Rochester, MI
3Department of Perinatal Neonatal Medicine, Michigan Medicine CS Mott Children’s Hospital, Ann Arbor, MI.
INTRODUCTION
During the month of Ramadan, Muslims abstain from all water, food, and medications from dawn to dusk. Currently, the existing medical literature focuses on health outcomes among Muslim adults who fast.
METHODS
For 3 consecutive years, a 1-hour lecture was provided to residents, fellows, and attendings at 7 residency programs throughout the state of Michigan. A brief and anonymous post-lecture Qualtrics survey was administered.
RESULTS
Over 3 years, the study included 166 participants, mostly pediatric resident physicians. Results of the survey showed that the majority of participants were unable to correctly identify all restrictions a Muslim must undergo during the fast after the medical education intervention. However, most were able to identify the parameters that would exempt someone from fasting. Self-rated measures revealed that most participants felt more comfortable discussing the topic with their pediatric patients after receiving the intervention.
CONCLUSIONS
This educational initiative has yielded promising results, but more education is needed for physicians to better provide competent care for Muslim pediatric patients who choose to fast.
Heart Rate Metrics in Surgical Residents Performing an Educational Task Under Stress
Harkirat Jawanda, B.S.1, Kathryn K. Howard, M.D.2, Rose E. Callahan, M.S.2, Kathryn M. Ziegler, M.D.2, Victoria A. Roach, Ph.D.3
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Corewell Health, Royal Oak, Michigan
3University of Washington, Seattle, Washington
INTRODUCTION
One unique stressor experienced by surgical residents is observation by an attending surgeon during procedures, which has been shown to lead to an increase in stress related behaviors. The objective of this study was to examine the effect of an attending surgeon versus a neutral observer on learners’ heart rate metrics during the performance of two simulated surgical tasks.
METHODS
Sixteen General Surgery residents completed an institution-created resident stress survey and demographic survey, from which two attendings were identified and recruited to be the “stressful” attending surgeon observers. The participants were divided into two groups, with one group observed first by the attending, and the other observed first by a neutral observer. Each participant then crossed over and repeated the two tasks with the other observer. During task performance, the learners’ heart rate metrics were collected using a wireless heart rate monitor.
RESULTS
During the intracorporeal knot tying task, the participants had higher maximum heart rates (115.1 vs 108.3; p = 0.005) and average heart rates (95.8 vs 88.8; p = 0.038) while under attending observation compared to neutral observation. During the peg transfer task, the participants had higher minimum heart rates (78.0 vs 73.7; p = 0.036), maximum heart rates (109.7 vs 105.3; p = 0.049), and average heart rates (93.4 vs 88.8; p = 0.007) while under attending observation compared to neutral observation.
CONCLUSIONS
The results suggest that observation by an attending surgeon results in a greater stress response compared to a neutral, non-physician observer, indicated by an increase in heart rate. Future studies should aim to assess the impact of variant stress conditions on the acquisition of surgical skills, and how stress management techniques, such as performance psychology curricula, may ameliorate the effect of stress in the learner.
Critical Reflection and Place Based Medical Education in Bioethics, Humanism, and Professional Identity Formation: The Impact of a Study Trip to Auschwitz
Maxwell Li, B.S.1, Ramona Stamatin, B.S.1, Hedy S. Wald, Ph.D.2,3, Jason Adam Wasserman, Ph.D.1,4
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Warren Alpert Medical School of Brown University, Providence, RI
3Harvard Medical School Pediatrics Leadership Program, Cambridge, MA
4Corewell Health William Beaumont University Hospital, Royal Oak, MI
INTRODUCTION
There are increasing calls for inclusion of education on medicine during the Holocaust in medical school curricula. This project explored the outcomes of a Holocaust and medicine educational program featuring a study trip to Poland, which focused on pervasive physician complicity during the Holocaust as well as exemplars of moral courage in health professionals who demonstrated various forms of resistance in the ghettos and concentration camps.
METHODS
The study trip included tours of key sites and museums in Krakow, Oswiecim, and the Auschwitz-Birkenau concentration camps, as well as meeting with a Holocaust survivor, lectures from historians, reflective writing, and group discussions. In depth interviews and reflective writings were analyzed using techniques derived from grounded theory.
RESULTS
Themes resulting from the analysis centered on greater understanding of the relationship of bioethics and the atrocities of the Holocaust, recognizing the need for moral courage and social awareness, deeper appreciation for the roles played by dehumanization and medical power during the Holocaust and their contemporary manifestations, and the power of presence and experiential learning for bioethics and humanism education and professional identity formation.
CONCLUSIONS
These findings evidence the significant impact of the experience and validate the pedagogical strategies, suggesting broader adoption of pedagogies that include place-based and experiential learning coupled with critical reflection can amplify the impact of bioethics and humanism education as well as the process of professional identity formation of medical students.
Three Cohorts of Champions: Evaluation of the Diversity, Equity & Inclusion Champion Program
Amanda Mazzoli, B.A.1, Suzan Kamel-ElSayed, Ph.D.2, Tracey A.H. Taylor, 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 are few programs like the OUWB Diversity, Equity & Inclusion Council (DEIC) Champions program described in the literature. Many medical schools in Michigan offer extracurricular lecture series on DEI topics, but do not offer hands-on training programs. The DEIC Champions program at OUWB is a novel program. Evaluation of this program will allow thoughtful refinement of the program for future iterations. Additionally, publication of our findings may lead to implementation of similar programs at medical schools across the country.
METHODS
This research project was approved by the OU IRB. Champions were recruited and trained starting in the fall of 2020, 2021, and 2022. Before and after the program is implemented, participants completed a survey consisting of qualitative and quantitative questions. In addition, individual interviews with a representative sample of champions were performed. These interviews consist of 6 qualitative semi-structured questions. Data from the survey responses and the thematic analysis were analyzed with the help of an OUWB statistician.
RESULTS
There was a statistically significant increase in the degree to which Cohort 1 & 2 felt prepared to be a diversity champion at the end of the training compared to the beginning compared to Cohort 3 which did not show a statistically significant change.
After iterative analysis 6 main themes emerged: (1) Wanting to be more proactive about DEI work, (2) Learning from others experiences, (3) Too many repeated trainings without a clear curriculum, (4) Not comfortable in training future cohorts, (5) Many opportunities for real world application, (6) Larger involvement from students and administration is needed.
CONCLUSIONS
The results from this study revealed that the DEIC Champions program served as a tool for participants to be engaged with DEI. Their participation reflects a positive initial step in educating students, faculty, and staff on DEI.
The use of a short and user-friendly questionnaire as a screening tool to identify nutrition knowledge gaps in adolescent athletes.
Roben Ohev Shalom, B.S.1, Virginia Uhley, Ph.D.1, David Lick, M.D.1,2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Corewell Health
INTRODUCTION
Nutrition knowledge in adolescent athletes has direct effects of sports performance and general health but is rarely assessed formally by physicians. Reasons for this are multifactorial but the time needed to properly screen athletes may be a barrier. The goal of this research project is to create a short, user-friendly nutrition survey that can be used widely to assess nutrition knowledge in adolescent athletes at the time of their preparticipation examination. The first step is to create the survey and then use feedback from practicing physicians to improve the survey.
METHODS
The questionnaire was constructed using Qualtrics Survey Maker Tool. While all questions were unique, they were adapted from the longer Nutrition for Sport Knowledge Questionnaire. Images from free online stock photos were used to increase the visual interest for athletes completing the survey . The survey for athletes included 19 total questions: four demographic questions, three personal nutrition questions, and 12 nutrition knowledge questions. Eight additional questions were included for physician feedback on contents of the survey. The survey link was distributed by email to family medicine residents and attending physicians at Corewell Health.
RESULTS
The survey was sent to 40 family medicine residents and attending physicians. Twenty physicians (50%) opened the survey and five respondents (13%) fully completed the survey and provided feedback. Feedback suggestions clustered around insuring verbiage was at appropriate reading level for adolescents, avoiding the terms “healthy” and “unhealthy”, being more specific regarding portion sizes and suggestions for more impactful images. Overall most physicians felt that screening for nutrition knowledge was useful
CONCLUSIONS
Most physicians identified value in screening for nutrition knowledge among adolescent athletes. The feedback obtained will be used to revise and improve the survey for future use.
Appreciation for Interprofessional Collaboration and Communication Amongst Students at OUWB
Rajavi Patel, B.S.1, Kyeorda Kemp, Ph.D.1
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Teamwork is a vital attribute of being a healthcare professional. Literature shows medical students and clinicians have lower levels of appreciation for interprofessional collaboration and communication (ICC) compared to students and practitioners in health allied fields. Preliminary research from our research group indicates that medical students at Oakland University William Beaumont School of Medicine (OUWB) have higher appreciation for ICC compared to published reports. However, there was a concern that these samples were not representative of the OUWB population. The primary goal of this study is to determine if the medical curriculum at OUWB influences the level of appreciation for ICC amongst students.
METHODS
Appreciation for ICC was measured amongst first and second year OUWB medical students using the Jefferson Scale of Attitudes Towards Interprofessional Collaboration (JeffSATIC) Survey. Responses were collected during the 2021-2022 and 2022-2023 academic years. The survey was released twice in each year as a pre-test and post-test. Students created a unique identifier code and were encouraged to take the survey at the beginning and end of the school year to determine if there is a change in appreciation for ICC before and after being immersed in the curriculum. Analysis was conducted using paired t-tests.
RESULTS
Paired t-test analysis indicated a mean pre-test score of 94.6 (N=31) and mean post-test score of 92.0 (N=22), p=0.3775.
CONCLUSIONS
The results indicate there is no change in appreciation for ICC by being immersed in the curriculum at OUWB. This is in contrast to a study that showed appreciation for ICC decreased in medical students as they progressed in medical school. It is possible that the curriculum is protective. Future studies will have to explore this.
Assessment of Confidence in Nutrition Counseling Skills in Preclinical and Clinical Clerkships in Medical Education
Jonathan Raskin, B.A.1,2, Virginia Uhley, Ph.D.1,2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Family Medicine and Community Health at Beaumont, Rochester, MI
INTRODUCTION
National educational efforts have been made to increase the nutrition content in the medical school curriculum, including nutrition assessment skill training, with limited success in implementation.1 Many institutions have created initiatives to strengthen the nutrition training of their medical students, though, students are still rating their nutrition knowledge as substandard.1 The purpose of our study is to assess the nutritional knowledge of M3 students before and after their first clerkship, specifically evaluating their ability, attitude, confidence, and opportunity to proficiently apply nutrition counseling skills.
METHODS
Administration of a survey to all M3 medical students in the Class of 2023 and 2024 before and at the end of their first clinical clerkship rotation. The first survey was 22 questions and the second survey was 25 questions administered through an online Qualtrics platform.
RESULTS
The statistical analysis revealed that students reported a slightly increased confidence in their preclinical nutrition knowledge after partaking in their first clerkship rotation. However, students reported lower confidence in their counseling abilities in the fields of gastroenterology and hematology.
CONCLUSIONS
Our study demonstrated the limited amount of nutrition knowledge medical students have obtained in their preclinical and clinical years, with specific recommendations from students about barriers to education and opportunities that can enhance the educational initiative. Our outcome supports current research that identifies the lack of nutrition education in medical curricula resulting in students and physicians lacking confidence in their ability to implement nutrition counseling in clinical practice.2 We identified the lack of medical students’ perceived nutrition knowledge and application before and after their first clerkships, supporting the importance of greater integration of nutrition education into the medical school curriculum.
Patient Population Representation in Medical Education Textbooks: Gender Imbalance of Diagnostic Images
Yasin Sahin, B.S.1, Abdul-Majid Khan, M.D.1,2, Nicolas Baker, M.D.2, Joshua Daniel, M.D.2, Jacob Keeley, M.S.1
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Beaumont Health, Royal Oak, Michigan
INTRODUCTION
Gender inequality, a longstanding issue, has gained overdue attention, evident across income gaps, authority roles, stereotypes, and representation, even in esteemed institutions like medical schools. Society trusts medical students are given the knowledge to take care of all patients in the future. In 2019, the US Census Bureau reported a population of 49% male and 51% female. Therefore, gender should be equally represented and taught to medical students. However, gender representation in medical education may be skewed towards males, affecting training. The goal of this study is to determine the presence of gender bias in diagnostic images in medical education textbooks.
METHODS
The study utilized First Aid for USMLE Step 1 (2021) and Mettler’s Essentials of Radiology (2018), common medical school textbooks. Diagnostic images were categorized as male, female, or indeterminate based on gender-specific features like breast shadow, sex-specific anatomy, or explicit gender labels. Two observers assessed the images for agreement using a kappa coefficient, ensuring consistency. Only images with unanimous classification were used in the final percentage difference. The effective sample size was 1126.
RESULTS
Examining only the images that are labeled male or female, without indeterminates, illustrates the difference in representation. Overall, 61.34% of images were labeled male and females 38.66%. The kappa coefficient was 0.93 (0.89-0.98) with a standard error of 0.024, indicating a substantial level of agreement between the observers.
CONCLUSIONS
A 22.68% gap in gender representation within diagnostic images is concerning. Future research could explore additional textbooks and lectures, aiming to reduce indeterminate classifications. Current data was stratified by imaging modality and topic, which may show other areas of concern. Addressing such biases may require action from textbook publishers, medical schools, and the AAMC.
Efficacy of an Integrated Computer Assisted Learning (CAL) Module in Student Understanding of Cardiovascular Embryology
Nicolaas Schimmel, B.S.1, Forrest Bohler, B.S.1, Varna Taranikanti, M.D./Ph.D.1
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
INTRODUCTION
Studies have shown that embryology is one of the most difficult topics for students to master throughout medical school and that students are unhappy with current teaching methods, resulting in lack of confidence in understanding and negative perceptions of embryology. Computer Assisted Learning (CAL) modules incorporate animations, images, and interactive activities to deliver material in a way that fosters higher order thinking skills. Studies have suggested CAL modules as an effective tool in organ systems like endocrinology, so we set out to develop a cardiovascular embryology CAL module and evaluate its efficacy in improving student perceptions and understanding of material.
METHODS
An integrated CAL module was developed, addressing cardiovascular embryology and its relation to 5 congenital heart diseases. Our module utilized images, animations, interactive activities, and audio narration while incorporating various disciplines of medicine. 14 medical students completed a 22-question pre-test, the 1.5-hour module, a 22-question post-test, and an 11-question Likert scale perceptions survey (administered anonymously utilizing Qualtrics software).
RESULTS
Student perceptions were positive towards the CAL module. Most students responded positively regarding the utility for Step 1 preparation, increased confidence in cardiovascular embryology, generation of higher order thinking skills, and integration of ECGs and radiology. They also expressed interest in future CAL modules for other organ systems and a desire for more interaction using software such as H5P. Regarding efficacy of our CAL module in improving understanding of cardiovascular embryology, analysis of pre and post-test scores with an unpaired t-test showed statistically significant improvement (p=0.0001) with average scores of 9.64/22 and 18.43/22, respectively.
CONCLUSIONS
The results supported our hypothesis that an integrated CAL module would improve both student perceptions and student understanding of cardiovascular embryology, suggesting that CAL modules may be an effective and engaging tool for future utilization in other organ systems and with other traditionally difficult concepts.
Barriers to Mental Health Treatment Among Medical Students: Preclinical vs. Clinical Years
Urvashi Singh, B.S.1, Agnes Wrobel, M.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Corewell Health, Department of Psychiatry, Royal Oak, Michigan
INTRODUCTION
Medical students are at higher risk of experiencing mental health concerns than the general population but are reluctant to seek help. This study aims to investigate medical students' attitudes towards seeking mental health services, identify significant barriers that prevent them from seeking help, and compare differences in the types of obstacles that are more important to preclinical (years 1 and 2) vs. clinical (years 3 and 4) medical students.
METHODS
We conducted an anonymous online Qualtrics survey of M1-M4 students, gathering de-identified data. The survey included demographic questions, such as school year and gender, and questions about their willingness to seek help from a mental health professional if needed. Students were also presented with statements about potential barriers to seeking help and asked to rate their level of importance on a scale of 1 to 5 (1 = less important barrier, 5 = extremely important barrier).
RESULTS
106 students participated in the survey, with 62 M1 & M2 and 44 M3 & M4 students included in their respective preclinical and clinical groups. The study found that preclinical students were less likely to seek help than clinical students (43.6% vs. 75%, p<0.012). Preclinical students rated doubts about treatment effectiveness and stigma as significant barriers to seeking help, while clinical students rated these barriers lower (p<0.015 and p<0.042, respectively). Lack of time was the most significant barrier identified to seeking mental health services across all classes.
CONCLUSIONS
These results highlight the need to address doubts about treatment effectiveness and stigma as essential for promoting help-seeking among preclinical students. Additionally, offering flexible appointment options is crucial for encouraging timely treatment-seeking among all students.
Oakland University Needle Stick Rates and Barriers to Post-Stick Care
Collin Trainor1, Berkley Browne, Ph.D.2
1Oakland University William Beaumont School of Medicine, Rochester, Michigan
2Oakland University William Beaumont School of Medicine Department of Foundational Medical Studies, Rochester, Michigan
INTRODUCTION
Needle-stick events are adverse events that occur during healthcare encounters in which an individual is unintentionally stuck with a needle or other sharp object. Medical students may encounter unique barriers to post-stick care not experienced by other healthcare professionals. The purpose of this study was to assess the needle-stick rate of first through fourth-year medical students at Oakland University and to compare that rate to nationally reported averages. This study hypothesized that the needle-sticks at Oakland University will occur less frequently than nationally reported averages and that students will report experiencing or perceiving barriers to post-stick care.
METHODS
Study subjects completed a brief anonymous online survey assessing whether a needle stick has occurred during their medical education at OUWB, whether they obtained post-stick care, and about perceived barriers to post-stick care. At the end of the study, a link was provided to the current OUWB policies and procedures page regarding needle stick events.
RESULTS
36 survey responses were obtained in total (n=36). One student reported a dirty needle-stick, 30 reported no stick, and five chose not to respond. 31% do not agree knowing what to do after a stick, 7% do not agree they would report a stick, 28% fear being reprimanded for a stick, 41% stated if they were fearful it would impact whether they obtained care. 24% feared peer perception, and 20% stated peer perception would impact post-stick care. 41% thought learning could be affected, and 17% stated they would not obtain care to avoid learning interruption. 0% would opt out of a learning opportunity over fear of a needle-stick.
CONCLUSIONS
This study supports the hypothesis that needle-sticks occur less often at Oakland University William Beaumont (OUWB) School of Medicine (3%) than nationally reported averages (59%). This study also supports the hypothesis that students at OUWB experience barriers to post-stick care.
