Journal of Regional Medical Campuses

Implementation of an Annual “Education Day” to Foster Medical Education Scholarship in a Regional Campus System

Komal Kochhar — 2024-06-24

We implemented an annual “Education Day” at Indiana University School of Medicine to promote educational scholarship across our nine-campus system. Held each spring from 2020 to 2023, Education Day showcased the educational scholarship of our faculty, staff, and learners, and provided a forum to share best educational practices and forge new collaborations.

The Value of Gold and Silver Signals and their Correlation with Step Scores on OBGYN Interview Offers

Anthony Shanks — 2024-06-24

Competition for residency positions has led to application inflation. In the 2022-23 cycle, 16 residency specialties allowed applications to be submitted with a virtual “token” - signaling a preferred interest in a program. OBGYN was the only program using a two-tiered system that allowed applicants to assign signals using “gold” to indicate highest interest and “silver” indicating very high interest. We examined the impact of the tiered signals on interview offer trends of senior students pursuing OBGYN at a large allopathic medical school and if the interview rate was correlated with their USMLE step scores. A cross-sectional, anonymous survey included the number of interviews obtained from applications submitted using gold signals (3), silver signals (15), and no signal (no cap). Fifteen students identified as participating in the OBGYN match with 100% participation, ten of whom were from regional campuses (67%). The mean interview rate differed based on signaling, showing increased likelihood of interview offers based on signal type. Step 1 and step 2 quartile rank were not associated with signal interview rate. This study supports the use of tiered signals as a method for students to express an interest in specific programs and have it recognized by programs in extending interview offers. The authors have no conflicts of interest to disclose. This study was IRB exempt.

Emergency Department Provider Staffing among Critical Access Hospitals in Minnesota

Coleman Strosahl — 2024-06-24

Background: Access to healthcare remains a challenge in many rural regions. Rural critical access hospitals (CAHs) remain essential access points. Providing 24-hour access, CAH emergency departments (EDs) rely on medical staff who can treat a wide range of problems. Family physicians/general practitioners have traditionally staffed rural EDs. However, this staffing model may be changing. This study aims to characterize the current medical staffing profiles of Minnesota’s CAH EDs.

Methods: From January to February 2021, the executive leaders of all of Minnesota’s 77 CAHs were invited to complete a voluntary online survey about ED staffing patterns at their facility.

Results: 37/77 of MN’s CAHs responded to the survey (48% response rate). Just over half (51.4%) of the respondents reported ED physician staffing practices that included multiple physician specialties (family medicine, internal medicine, emergency medicine) while 32.4% reported staffing exclusively with family medicine physicians. A majority, 27/37 (73%), reported including non-physicians on their ED medical staff, especially at CAHs that were part of a larger healthcare system.

Discussion: CAHs often operate with limited workforce and resource options. This study demonstrates that MN’s CAHs exhibit a variety of ED staffing patterns with staffing decisions driven by multiple factors. Family medicine physicians contribute to CAH ED coverage. Future studies may expand our understanding of how ED staffing models impact community health, disease outcomes, and CAH financial viability.

Conclusion: ED staffing patterns across Minnesota’s CAHs vary significantly with variable use of physicians and non-physician providers. Family physicians remain an important specialty for CAH ED coverage

“Don’t I need research to get a residency?” Incorporating scholarly activity at a regional campus

Alexis Ruppel — 2024-06-24

The impact of Step 1 becoming pass-fail is yet to be known. Many believe the value and power of scholarly activity will increase across specialties, but opportunities for such activities differ across universities and even between campuses. At the Augusta University/University of Georgia Medical Partnership, a regional campus of the Medical College of Georgia, we hoped to better understand our students' current scholarly activity production and their reasoning behind pursuing these activities. Student surveys indicated that the three highest specialties of interest were primary care-based; students, on average, had one or two poster presentations and one or fewer manuscripts published in medical school thus far. The top reasons to pursue research were the transition of Step 1 to pass-fail, interest in a competitive specialty, and the encouragement of mentors. We hope by understanding our current medical students, we can further cater to their needs through the creation and implementation of new scholarly activity opportunity initiatives.

A longitudinal look at individual resident preferences to prevent burnout: Which matter the most?

William J. Crump — 2024-06-24

ABSTRACT

A longitudinal look at individual resident preferences to prevent burnout: Which matter the most?

Background and Objectives

Burnout among residents-in-training is being reported more frequently. Previous studies have shown that lower measures of emotional intelligence, mindfulness, emotional regulation, and gratitude earlier in residency were associated with higher burnout scores later. Many studies have reported interventions intended to lessen burnout but not chosen by the residents with variable results on subsequent burnout measures. This paper reports an individually paired longitudinal analysis of strategies ranked by the resident as important with a subsequent burnout measure.

Methods

From 2017 through 2021, 32 residents completed a survey ranking their preference of ten approaches to preventing burnout at the beginning of the academic year. Then they later completed a burnout survey at the end of each year.

Results

With a usable response rate of 94% and calculating Spearman’s Correlation, residents completing their first year of training after medical school (PG-1) who gave a higher rank to a workplace supporting their personal values (p=.016), self-care (p=.031), and administrative support (p=.046) showed less burnout at the end of the year. PG-3s (those completing their third year of training after medical school) who gave a higher rank to spending time with family and friends (p=.002) showed less burnout. For all three years, the most powerful correlation was with adopting a healthy philosophical outlook (p=.014, .008, <.001).

Conclusions

In this group of residents, the correlations of preferred strategies for lessening burnout differed by training level. Rather than faculty choosing an intervention, we propose these ten strategies as a potential menu, allowing the individual resident to focus on their preferences working with a mentor. Group discussion of methods used by individual residents to adopt a healthy philosophical outlook would also be helpful.

Exploring d/Deaf community perspectives regarding inclusive/accessible healthcare

Sylvia Blomstrand — 2024-06-24

Background: d/Deaf [1]patients face substantial barriers obtaining healthcare, including communication challenges, cultural differences, and unique psychosocial needs. Healthcare providers are generally undereducated on how to best care for this patient population. This project aims to identify healthcare disparities and areas for improvement in healthcare provider education from the d/Deaf-patient perspective.

Methods: A 40-question survey was distributed to d/Deaf groups across the United States. Nine focused interviews were conducted with d/Deaf patients.

Results: 62 d/Deaf individuals responded to the survey. Due to communication difficulties with healthcare providers, 33% did not access healthcare when needed, 52% had medical questions go unanswered, and nearly 40% did not understand their health. Focused interviews found that d/Deaf patients continue to face healthcare barriers due to communication difficulties, poor awareness of d/Deaf needs, and accessibility concerns. Survey and focused interview participants agreed improved healthcare provider education and awareness would improve their care.

Discussion: Data suggest that multifactorial healthcare disparities continue to affect the d/Deaf population and d/Deaf patients believe improved education of healthcare providers is paramount to improve healthcare. Specific curricular areas to improve upon include: communication, cultural/psychosocial issues, and improved awareness of the d/Deaf community.

Conclusions: The d/Deaf community faces substantial barriers to accessible healthcare that can be improved by improved healthcare provider curriculum and awareness.

Keywords: Deaf, healthcare disparities, curriculum, health literacy, physician training.

Mapping Student-Generated Learning Objectives Against USMLE Core Content

Lauren Mica Yoder — 2024-06-24

Purpose:

To compare the content covered by student-generated, case-based, learning objectives with United States Medical Licensing Exams (USMLE) core-content guidelines, both in terms of range of topics covered and time spent with different topics. Secondarily, to examine the impact of online learning during the COVID-19 pandemic on the content covered by student generated learning objectives (SGLOs).

Methods:

The data used in this study was drawn from university records of SGLOs over the course of five years, including approximately 1,600 individual SGLOs, organized by semester and year. SGLOs were coded to correspond to topics on the USMLE core content guidelines. Two lists of core content provided by the USMLE were used in this study. The first consisted of 18 broad topics and 222 nesting subtopics tested on STEP 1. The second consisted of 11 broad topics with a corresponding percent range of how many questions on STEP 1 address that topic.

Findings:

Percent Coverage: 50-60% of USMLE core content topics are covered within the first year. Multiple regression analysis showed this number remaining consistent between first year classes, between semesters, and during COVID.

Topic Weight: 7 out of 11 broad topics fell within the same ranges of the USMLE, with Social Sciences being the greatest outlier (significantly more coverage). 2 out of 11 topics were addressed less by SGLOs than by the USMLE.

Gaps: 53 individual USMLE core content sub-topics were not addressed by a UP first year class in any learning objective. Notable trends in the identified content gaps included topics relating to congenital disorders, embryonic development, male and female reproductive systems, endocrine disorders (other than thyroid disorders and diabetes), normal ageing and age-related changes, psychiatric disorders and behavioral health, and drug adverse effects.

Conclusions:

SGLOs covered consistent amounts of material from year to year, suggesting curricular stability over time. The same standard of SGLO creation was also maintained during online COVID 19 activities. The agreement in weighting of topics between our student-driven curriculum and the USMLE core content indicate that students prioritize topics effectively. Identified gaps in coverage represent areas for improvement. This study further supports successful collaborations between faculty and medical students in regards to curriculum development and execution.

Conflicts of Interest: None.

This study (Study ID: STUDY00015600) was deemed exempt by the Institutional Review Board (IRB) at the Penn State College of Medicine.

Ten tips to effectively engage community-based preceptors in distributed medical education settings

Aaron Johnston — 2024-06-24

The effective engagement of community-based preceptors in distributed medical education (DME) settings is an active challenge in medical education. DME is a model of medical education that involves training medical students in multiple, geographically dispersed locations. DME environments include regional medical campuses (RMCs) and rural areas. Preceptors at regional medical campuses (RMCs) and in rural settings have diverse needs that may differ substantially from faculty at central medical campuses. Well-intentioned engagement efforts that fail to understand the unique needs and motivations of community-based faculty can fall short. We present 10 tips for effective engagement of community-based DME faculty. These tips are rooted in the literature and can provide important context for productive faculty engagement in the DME setting.