Back to the Future: Maximizing Student Learning and Wellbeing in the Virtual Age.

The virtual age of learning is no longer a concern of the future. It is here. The Fall 2021 Webinar Audio Series (WAS) of the International Association of Medical Science Educators (IAMSE), titled "Back to the Future: Maximizing Student Learning and Wellbeing in the Virtual Age," was designed to help health science educators equip themselves with tools to teach the next generation of health care professionals successfully. From September 2, 2021 to September 30, 2021, the Fall 2021 Series was broadcast live to audiences at academic institutions worldwide in five weekly webinars. This five-part webinar series explored theories and best practices in delivering content over virtual and online media while simultaneously promoting a positive learning environment and enhanced student wellbeing.

USMLE Step-1 is Going to Pass/Fail, Now What Do We Do?

The Winter 2021 Webinar Audio Series (WAS) of the International Association of Medical Science Educators (IAMSE), titled, "USMLE Step-1 is Going to Pass/Fail, Now what do we do?" was broadcast live to audiences at academic institutions worldwide in five weekly webinars from January 7, 2021, to February 4, 2021. Recognized experts from various stakeholder groups discussed the impact of the decision to score the United States Medical Licensing Examination (USMLE) Step 1 exam Pass/Fail (P/F). The speakers identified challenges to their respective programs and explored creative ways to address potential consequences. Sessions included the perspectives of allopathic and osteopathic residency program directors, basic science faculty, undergraduate medical education curriculum designers, clinical educators, and programs for international medical students matriculating to the United States. On February 25, 2021, a bonus session provided cutting-edge updates from a co-chair of the Coalition for Physician Accountability Undergraduate Medical Education (UME) to Graduate Medical Education (GME) Review Committee (UGRC).

Building Health Systems Science Education from the Core Domain of Interprofessional Education at Virginia Tech Carilion School of Medicine.

The Virginia Tech Carilion School of Medicine (VTCSOM) is a 4-year allopathic medical school in Roanoke, VA. The curriculum is organized into four learning domains: basic science, clinical science, research, and interprofessionalism (IPE). A recent curriculum renewal effort allowed the school to embark upon a redesign of the IPE learning domain to incorporate new core content from health systems science (HSS). We describe how our unique approach to IPE is being preserved as we innovate to produce graduates who are future thought leaders and "systems citizens," prepared to deliver patient care with an expanded knowledge of the health systems in which they will eventually practice.

From traditional to patient-centered learning: curriculum change as an intervention for changing institutional culture and promoting professionalism in undergraduate medical education.

The authors reframe a curriculum change from a traditional lecture-based to an integrated patient-centered approach as an intervention for changing the culture and hidden curriculum of an institution in ways that promote professionalism. Within this context, the authors articulate some of the inherent process and relational factors brought about by these curricular changes that are essential elements of this intervention process. In 1998 the University of North Dakota School of Medicine and Health Sciences (UNDSMHS) introduced a new preclinical patient-centered learning (PCL) curriculum for first- and second-year medical students. Case-based, small-group learning forms the critical foundation of the PCL process, and an integrated basic and clinical science didactic component supports this process. At the student level, the case-based PCL process generates innovative opportunities for professionalism education from the explicitly articulated formal content that arises naturally from the cases, but more importantly from the implicit values inherent to the PCL small-group process itself--humanism, accountability, pursuit of excellence, and altruism. Further, the organizational changes necessary for the transformation to the PCL curriculum required process changes at student, faculty, and administrative levels that have resulted in a cultural shift toward relationship centeredness within the institution. The authors describe the evolution and structure of the PCL curriculum at UNDSMHS and how this curricular transformation has served as an intervention that promotes professionalism and institutional culture change through (1) processes at the student level that present new opportunities for professionalism education, and (2) processes at student, faculty, administrative, and institutional levels that have created an institutional culture that supports, models, and promotes relationship-centered professional values.

Significant glomerular basement membrane thickening in hyperglycemic and normoglycemic diabetic-prone BB Wistar rats.

The diabetic-prone BioBreeding Wistar rat (BB/DP) is an autoimmune model of insulin-dependent diabetes mellitus. Approximately 80-90% of the animals are hyperglycemic (BB/DP(h)) by 90-120 days of age while those that do not become diabetic in adolescence (BB/DP(n)) remain normoglycemic for life. Likewise, rats in the diabetes-resistant (BB/DR) strain are normoglycemic. Although renal morphological studies have been carried out in this model, ultrastructural observations of age- and diabetes-related extracellular matrix (ECM) changes, including glomerular basement membrane (GBM) morphometry, are not available. Moreover, possible renal changes in the relatively uncommon BB/DP(n) control animals have not been reported. The current electron microscopic study was carried out to investigate temporal changes in detergent-treated acellular ECM in BB/DP(h) rats at 2 weeks, 3 months, 6 months, and 1 year postonset of moderate hyperglycemia. Age-matched BB/DR and BB/DP(n) control animals were also examined. Our data demonstrate age- and diabetes-related alterations in mesangial matrix distributions and GBM widths and show for the first time significant increases in GBM thickening in both hyperglycemic (BB/DP(h)) and normoglycemic (BB/DP(n)) rats when compared to age-matched BB/DR controls. Surprisingly, the rate of increase is greatest in BB/DP(n) animals. Although the pathogenesis of diabetic basement membrane disease is not completely understood, GBM thickening is widely regarded as a morphological consequence of hyperglycemia. However, data in the current investigation show that ECM alterations, including significantly increased GBM thickness, may occur in genetically diabetic animals in the absence of hyperglycemia.

Measuring inter-rater reliability of the sequenced performance inventory and reflective assessment of learning (SPIRAL).

PURPOSE: To measure the inter-rater reliability of the Sequenced Performance Inventory and Reflective Assessment of Learning (SPIRAL), a twenty-three item scoring rubric designed to assess first and second-year students' competencies such as "acquisition of knowledge," "peer teaching and communication skills," and "professional behavior" in a problem-based learning (PBL) curriculum at the University of North Dakota School of Medicine and Health Sciences. METHOD: In 2001, the authors constructed a 69-item multiple-choice questionnaire consisting of descriptions of "prototypical" (representing real students) PBL student performances. For each of the 23 SPIRAL items, the authors chose competency descriptions of an "emerging," a "developing," and an "advanced" student (69 prototypical students). These descriptions were obtained from narrative comments by PBL facilitators of real students in their classes in 2000-2001. Seventeen experienced facilitators (PBL tutors) were subsequently asked to rank the 69 prototypical students based on SPIRAL anchor points in the three competency levels. Kendall's coefficient of concordance was used to test inter-rater reliability. Modes were also determined to illustrate the extent to which the ratings of the 17 facilitators aligned with the ratings anticipated by the authors. RESULTS: Overall, inter-rater scoring for all items combined was considered to be reliable (Kendall's coefficient of concordance W =.75). Inter-rater scoring was also determined for each of the 23 SPIRAL items, with Ws ranging from.97 to.53. Facilitators rated students according to 55 of the 69 SPIRAL descriptors as the researchers anticipated. CONCLUSIONS: The scoring rubric is reliable. Further criterion-related validation study is warranted.