To Grade or Not to Grade (the Quiz): The Impact of Two Formative Assessment Grading Approaches on Summative Assessment Outcomes in an Integrated Pre-clinical Curriculum.

Introduction: Formative assessments have overall been shown to improve summative evaluations in medical education. However, it remains unclear if utilizing them for course credit in an integrated curriculum over multiple subspecialties is beneficial for student acquisition of knowledge. We set out to determine if grading formative quizzes had an effect on student acquisition of knowledge via summative assessments. Materials and Methods: In 2020, quizzes remained mandatory, but were not graded for course credit. We collected and compared formative (quiz) and summative (unit exam) score data from student cohorts when quizzes were graded versus not graded. Medical college admission test (MCAT) score, gender, and underrepresented in medicine (URM) status data were utilized to determine if they had effects on outcomes. We used a predefined region of indifference (± 5%) and second-generation p-values to determine if there were meaningful differences in average summative exam scores. Results: Despite a drop in quiz scores after removing course credit, differences in average summative exam scores fully resided within the region of indifference for three of five course blocks, indicating no meaningful differences in summative exam scores existed for those blocks. In other blocks, the difference was not fully nested within the region of indifference; however, all data overlapped with this region, implying exam score differences were inconclusive for these blocks. Conclusions: Our study demonstrates that there is either no meaningful effect on summative assessments or no conclusive detrimental effects when mandatory quizzes are not graded for course credit.

A New Normal: Assessment Outcomes and Recommendations for Virtual Versus In-Person Curricula in Post-COVID-19 Times.

Introduction: COVID-19 response efforts that began in March 2020 prompted an urgent need to transition medical education from an in-person to a virtual format. Our aim is to provide evaluation of a virtual platform for a fully integrated curriculum to provide future guidance in teaching methods. Materials and Methods: We used summative assessments and course evaluations from pre- and post-transition from in-person to virtual delivery of educational content to measure the impacts of this transition on student performance and perceptions. Additionally, we surveyed students about their in-person versus online educational preferences. Results: There were no statistically significant differences in student knowledge acquisition as assessed by weighted averages of summative assessments when comparing an in-person to a virtual educational platform. While the transition to virtual learning was initially well-received by students, our studied cohorts gave lower scores for the overall learning experience after prolonged virtual learning (p < 0.001). Students had a strong preference that anatomy and other group sessions should be delivered in-person. There was no strong preference whether other learning modalities should be given in-person or virtually. Conclusions: Although student knowledge acquisition remained stable on a virtual platform, the student learning experience varied. We recommend that when returning to a new normal after COVID-19 restrictions are lifted, sessions that require 3-dimensional or group learning should remain in-person, while other educational activities may be offered on a virtual platform and that, whenever virtual learning is employed, attention be paid to ensuring ongoing social and academic engagement between learners and faculty.

Can telephone counseling post-treatment improve psychosocial outcomes among early stage breast cancer survivors?

OBJECTIVE: To determine whether a telephone counseling program can improve psychosocial outcomes among breast cancer patients post-treatment. METHODS: A randomized trial was conducted involving 21 hospitals and medical centers, with assessments (self-administered questionnaires) at baseline, 12 and 18 months post-enrollment. Eligibility criteria included early stage diagnosis, enrollment during last treatment visit, and the ability to receive the intervention in English. Endpoints included distress (Impact of Event Scale), depression (Center for Epidemiologic Studies Depression Scale), and two study-specific measures: sexual dysfunction and personal growth. The control group (n=152) received a resource directory for breast cancer; the intervention group (n=152) also received a one-year, 16 session telephone counseling program augmented with additional print materials. RESULTS: Significant intervention effects were found for sexual dysfunction at 12 (p=0.03) and 18 months (p=0.04) and personal growth (12 months: p=0.005; 18 months: p=0.03). No differences by group were found in mean scores for distress and depression, with both groups showing significant improvement at 12 and 18 months (all p values for within-group change from baseline were

Telephone counseling in psychosocial oncology: a report from the Cancer Information and Counseling Line.

Providing psychosocial counseling services to cancer patients and their significant others by telephone is emerging as an alternative to traditional (in-person) counseling programs in psychooncology. In this paper, data are reported describing the clients of such a program that has been in continuous operation since 1981: the Cancer Information and Counseling Line (CICL) of the AMC Cancer Research Center. An examination of call record forms completed between 1 June 1998 and 30 May 1999 (N = 1627) revealed that the vast majority of callers were female (77%), non-Hispanic White (77%), with at least some college education (62%). Only 27% were cancer patients/survivors, compared to 43% who were spouses, other relatives and friends of cancer patients/survivors, and 16% who were symptomatic callers. Breast cancer was by far the most frequently mentioned cancer site (30%). Although initial topics of inquiry were dominated by requests for medical information (77%), with only a small percentage of callers initially requesting psychosocial support and counseling (12%), by the time, the call was completed, 67% had received some form of psychosocial support and/or counseling. Recommendations for future research are discussed within the context of this review.

Bridging the transition from cancer patient to survivor: pilot study results of the Cancer Survivor Telephone Education and Personal Support (C-STEPS) program.

OBJECTIVE: To develop a feasibility study of a theory-driven telephone counseling program to enhance psychosocial and physical well-being for cancer survivors after treatment. METHODS: Participants (n=66) were recruited from two Colorado hospitals with self-administered questionnaires at baseline and two weeks post-intervention. The one group, intervention only design included up to six thematic telephone counseling sessions over three months. Topics included nutrition, physical activity, stress management, and medical follow-up. Primary outcomes were cancer-specific distress, self-reported fruit and vegetable consumption and physical activity. RESULTS: Of 66 subjects, 46 completed at least one counseling module and the follow-up assessment (70% retention rate). Mean satisfaction was 9 out of 10, and all participants would recommend C-STEPS to other survivors. Cancer-specific distress (Impact of Event Scale - Intrusion subscale) decreased for entire study population (p<0.001) and stress management session participants (p<0.001). Fruit and vegetable consumption increased for nutrition and exercise session participants (p=0.02) and the entire sample (p=NS). Physical activity increased in the entire group (p=0.006) and for nutrition and exercise session participants (p=0.01). CONCLUSION AND PRACTICE IMPLICATIONS: C-STEPS is a feasible telephone counseling program that transcends geographic barriers, demonstrating the potential to decrease distress and promote coping and healthy lifestyles among cancer survivors.

Randomized controlled trial of a psychosocial telephone counseling intervention in BRCA1 and BRCA2 mutation carriers.

BACKGROUND: Responses following BRCA1/2 genetic testing are relevant for the comprehension of risk status and may play a role in risk management decision making. The objective of this study was to evaluate a psychosocial telephone counseling (PTC) intervention delivered to BRCA1/2 mutation carriers following standard genetic counseling (SGC). We examined the effect of the intervention on distress and the concerns related to genetic testing. METHODS: This prospective randomized clinical trial included 90 BRCA1/2 mutation carriers. We measured anxiety, depression, and genetic testing distress outcomes at intervention baseline and 6 and 12 months following disclosure. We evaluated the effects of SGC versus SGC plus PTC on psychological outcomes using intention-to-treat analyses through generalized estimating equations. RESULTS: At 6 months, PTC reduced depressive symptoms (Z = -2.25, P = 0.02) and genetic testing distress (Z = 2.18, P = 0.02) compared with SGC. Furthermore, women in the intervention condition reported less clinically significant anxiety at 6 months (chi(2)(1) = 4.11, P = 0.04) than women who received SGC. We found no differences in outcomes between the intervention groups at the 12-month follow-up. CONCLUSIONS: As an adjunct to SGC, PTC delivered following disclosure of positive BRCA1/2 test results seems to offer modest short-term benefits for distress and anxiety. These results build upon a growing literature of psychosocial interventions for BRCA1/2 carriers and, given the potential impact of affect on risk management decision making, suggest that some carriers may derive benefits from adjuncts to traditional genetic counseling.