Consensus Building to Inform Common Evaluation Metrics for the Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) Program.

Common measures facilitate the standardization of assessment practices. These types of measures are needed to develop instruments that can be used to assess the overall effectiveness of the U54 Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) funding mechanism. Developing common measures requires a multi-phase process. Stakeholders used the nominal group technique, a consensus development process, and the Grid-Enabled Measures (GEM) platform to identify evaluation constructs and measures of those constructs. Use of these instruments will ensure the implementation of standardized data elements, facilitate data integration, enhance the quality of evaluation reporting to the National Cancer Institute, foster comparative analyses across centers, and support the national assessment of the CPACHE program.

Training Community African American and Hispanic/Latino/a Advocates on Prostate Cancer (PCa): a Multicultural and Bicoastal Approach.

African American communities are disproportionately impacted by prostate cancer (PCa) compared to other racial/ethnic groups. Whereas the incidence of PCa in Hispanic/Latino men is lower than the incidence in non-Hispanic/Latino White men, Hispanic/Latino men are more likely to be diagnosed with PCa in late stages, and less likely to be knowledgeable about PCa, resulting in significant disparities. We developed, culturally adapted, translated, implemented, and evaluated a PCa Cancer Advocacy Training in African American and Hispanic/Latino/a communities. Culturally and language specific content for African American and Hispanic/Latino/a patients on PCa causes, risk factors, epidemiology, detection, diagnosis, and treatment were delivered through a workshop and simultaneously broadcasted in Spanish in Los Angeles County (n = 29) and in English in Tallahassee, FL (n = 9). Pre- and posttest surveys assessed impact. Pre vs post differences were statistically significant in knowledge (5.0 ± 1.6 vs 6.3 ± 1.1) and advocacy intentions (3.9 ± 0.9 vs 4.3 ± 0.8), on correctly identifying warning signs for PCa (50% vs 87%), intent to inform and educate about PCa within the next 3 months (69% vs 95%), to ensure that high-quality research is sensitive to the priorities of patients (63% vs 84%), to help increase patient recruitment, compliance, and retention for clinical trials within the next month (62% vs 84%), intent to engage in PCa patient education within the next 3 months (67% vs 92%), and in engaging in PCa community outreach within the next 3 months (67% vs 94%). There were no significant differences due to race/ethnicity. The Cancer Advocacy Training led to increased knowledge, awareness, and intention to engage in advocacy regarding PCa in the next 3 months. Results suggest that delivering culturally and language specific educational information increases engagement of Hispanic/Latino/a and African American patient/community advocates.

An Analysis of U54 Partnerships to Advance Cancer Health Equity (PACHE) Publications.

Using document review, we identified 963 publicly accessible NIH RePORT publications across the 16 funded U54 Partnerships to Advance Cancer Health Equity (PACHE) center programs. Using the 868 publications that met criteria, we determined the frequency of publications across the funded PACHE programs by longevity; reported the frequency of studies focused on cancer health disparities; determined the proportion of institutions serving underserved health disparity populations, underrepresented students (ISUPS), and co- and lead-authored works; and categorized the scope of studies by commonalities in their reported purposes. The study findings showed that (1) center longevity was not necessarily related to the number of publications; (2) less than 20% of studies focused on cancer health disparities (CHD); (3) ISUPU co-authors appeared in 72% of publications, while lead authors were 48%; (4) 6.07% publications focused on cancer diagnosis, screening, treatment, and risk factors; 57.5% studies were mechanistic; 21.53% focused on the impact of interventions on health promotion, prevention, and quality of life; 5.62% studies were related to educational outcomes; and 9.28% studies were classified as epidemiological/survey outcomes. One of the primary purposes of PACHE centers is CHD research. Thus, we advocate increasing the frequency of CHD-focused publications. We suggest increasing the number of ISUPU lead-authored papers. To align with the PACHE mission, we also recommend increasing the number of studies focused on cancer diagnosis, screening, treatment, and risk factors and the impact of interventions on health promotion, prevention, and quality of life. To demonstrate the effectiveness and impact of training, increasing the number of educational outcome studies is also proposed.

Improving Representation of Underrepresented Minority (URM) Students in Oncology Biomedical Research Workforce: Outcome Evaluation from the ReTOOL Program.

The Research Training Opportunities for Outstanding Leaders (ReTOOL) program was implemented in 2012 to increase the representation of racial and ethnic minorities in the biomedical workforce. Specifically, the ReTOOL program aims to foster the capacity for scientific research among underserved populations as well as address the cultural appropriateness of research projects. This paper describes the impact of the ReTOOL program in enhancing the research training of underrepresented minority (URM) students. Forty URM students who completed the ReTOOL program between 2012 and 2019 were invited to participate in the program evaluation. The response rate was 73% with 29 participants. Of the 29 participants, 26 trainees self-identified as Black or African-American. A structured survey developed for the program was employed for data collection, using a Likert Scale ranging from 1 to 5, with 5 being the best. The item ratings ranged from 4.45 to 4.80. Responses to open-ended questions show that ReTOOL has been instrumental in socializing and acculturating participants into the habits of scientific thinking. The combined use of quantitative and qualitative inquiry depicts that ReTOOL has been highly successful in fostering participant enrollment in advanced health-related or professional degree programs.

Comparison of Two Veterinary Emergency and Critical Care Clerkship Grading Protocols.

Universal guidelines for evaluating veterinary students' clinical clerkship performance are unavailable. At our institution, each service determines its own grading protocol. In this study, researchers compared clinician, staff, and student perceptions of a traditional and newly devised grading practice on the Emergency and Critical Care (ECC) clerkship. ECC clinicians and technicians were asked to assess the existing grading protocol for the clerkship. The system was then revised to better align with clerkship objectives. The revised protocol evaluated students on 12 items encompassing knowledge, clinical, and communication skills. Following the assignment of values for each category, letter grades were calculated automatically. Clinicians and staff were invited to rate the revised grading system. Throughout the study period, a corresponding survey was sent to students shortly after they had received their clerkship grades. Students' open-ended comments were analyzed qualitatively to identify common themes. Clinicians and technicians reported that the revised protocol was more inclusive and better able to provide fair and accurate assessments of students' performances. Students were generally satisfied with both grading protocols, however, in the open-ended comments students' frequently expressed desire for more directed and timely feedback on their performance. The results of this study indicate that the graders' believed that the revised evaluation protocol provides opportunities to provide fair and accurate assessments of student performance. Overall, students were satisfied with the new protocol and have a desire for tailored feedback provided in a timely fashion.

Addressing Oral Health Disparities Via Educational Foci on Cultural Competence.

An ever-present challenge for the oral health profession is to reduce the extent of oral disease among racial and ethnic minority populations. Adding to this complex dilemma is the linkage between oral health and systemic health. We describe enhanced cultural competency, in the context of individual cultural beliefs, values, language, practice, and health behaviors, among dental professionals, as one approach to meeting the dental care needs of the underserved. An overview and examples of teaching methods used by University of Florida dental educators to enhance student cultural competency is provided. Evidence-based evaluation results provide evidence of methodology efficacy. We conclude by describing actions that can be implemented by academic dental institutions to facilitate development of culturally competent practitioners.

Comparison of Two Clinical Teaching Models for Veterinary Emergency and Critical Care Instruction.

Standards to oversee the implementation and assessment of clinical teaching of emergency and critical care for veterinary students do not exist. The purpose of this study was to assess differences in the learning environment between two veterinary emergency and critical care clinical rotations (one required, one elective) with respect to caseload, technical/procedural opportunities, direct faculty contact time, client communication opportunities, and students' perception of practice readiness. The authors designed a 22-item survey to assess differences in the learning environment between the two rotations. It was sent electronically to 35 third- and fourth-year veterinary medicine students. Bivariate analysis, including the Wilcoxon signed-rank test and the t-test, were used to compare differences between pre-test and post-test scores among students. Twenty-six students' responses were included from the required rotation and nine from the elective rotation. Findings showed that students preferred the elective community emergency department setting to the required academic setting and that there were statistically significantly more positive experiences related to the variables of interest. Students saw significantly more cases at the community emergency department setting. Findings from this study offer guidance to assess students' emergency department rotations, suggest how teaching interactions can be modified for optimal learning experiences, and ensure that students receive maximal opportunities to treat patients that are representative of what they would encounter in practice.

Digital Denture Fabrication in Pre- and Postdoctoral Education: A Survey of U.S. Dental Schools.

PURPOSE: To survey chairs of prosthodontics or restorative departments and program directors of postdoctoral prosthodontic programs in the United States regarding digital denture fabrication. The key objectives of the survey were to identify the current trends in complete denture fabrication using CAD/CAM technology and to determine how and to what extent this technique is taught and used in U.S. pre- and postdoctoral prosthodontic programs. MATERIALS AND METHODS: An invitation to participate in an online survey was sent to 52 prosthodontics/restorative chairs of U.S. dental schools and to all of the 50 program directors of postdoctoral prosthodontics programs. A version of the survey with the same questions was sent to a national sample of prosthodontics/restorative chairs and program directors of postdoctoral prosthodontics. The 20-item survey took approximately 15 minutes to complete. Dependent samples paired t-test was run on items that were the same in both surveys. RESULTS: The response rate for the survey was 63% for department chairs and 44% for program directors. All respondents with the exception of one department chair were aware of CAD/CAM technology used for denture fabrication. More than half of the program directors (52.4%) compared to 12.1% of chairs have incorporated some aspects of CAD/CAM denture fabrication technology into their curriculum. When asked if the fabrication cost prevented introducing this technology in the predoctoral/postdoctoral curriculum, 52.4% of the department chairs affirmed this response compared to 12.1% of the program directors. There was a significant difference between groups when asked if they had incorporated the CAD/CAM denture fabrication technique into the postgraduate/predoctoral curriculum. Department chairs reported less usage of CAD/CAM technology. Only 12.1% of department chairs reported using some aspects of CAD/CAM technology in the predoctoral curriculum compared to 52.4% in the postdoctoral curriculum (F = 13.528, p ≤ 0.001). While this technology is used in four predoctoral clinics, none of the chairs reported including CAD/CAM denture fabrication in their preclinical complete denture courses. For the schools using the technology, 33.3% of postdoctoral and 30.3% of predoctoral programs use it to make a denture with a try-in step; however, 19% of the postdoctoral and 18.2% of predoctoral programs process the dentures without a try-in appointment. Slightly less than half (42.9%) of graduate programs are using the technology to make just the denture bases. Only a small proportion (10% or less) of the total number of dentures processed in post- and predoctoral programs are made using CAD/CAM technology. The proportion of postdoctoral programs that process cases using CAD/CAM technology was significantly higher than in predoctoral programs (F = 5.106, p ≤ 0.028). Many schools indicated that they are in a "trial phase" to evaluate the technique, especially at the predoctoral level. Also, 19% (n = 4) of postdoctoral and 15.2% (n = 5) of predoctoral respondents have created continuing education courses. Of postdoctoral programs, 38.1% (n = 8) plan to introduce this technology at some point in the near future (next 1 to 4 years); 27.3% of predoctoral programs plan to as well. CONCLUSIONS: All program directors and department chairs who participated in the survey are aware of this technology with the exception of one department chair. More than half of the program directors reported that they have incorporated this technology in their curricula compared to only 12% of department chairs. Currently, only 10% or less of complete denture cases are processed using the CAD/CAM technology, at either the post- or predoctoral levels. Both groups reported that the main use of this technology is for the fabrication of denture bases and for processing dentures including the try-in step. The majority of respondents in both groups indicated they plan to add digital denture fabrication into their curricula within the next 1 to 4 years.

A Mixed-Methods Analysis of Changing Student Confidence in an Online Shelter Medicine Course.

Maddie's Shelter Medicine Program at the University of Florida College of Veterinary Medicine offers comprehensive training in shelter medicine to veterinary students based on a set of core job skills identified by the Association of Shelter Veterinarians. In 2012, this program began teaching online distance education courses to students and practicing veterinarians worldwide who sought additional training in this newly recognized specialty area. Distance learning is a novel educational strategy in veterinary medicine; most instruction at veterinary medical schools is classroom based. No previous studies have shown whether online courses can prepare veterinarians to practice shelter medicine. In this study, we investigated how an online, graduate-level course titled "Shelter Animal Physical Health" changed student self-reported confidence. First, we compared pre-course confidence regarding eight specific shelter medical practice scenarios to post-course confidence through statistical analysis. Quantitative analysis showed a significant (p<.001) increase in self-reported confidence for all eight scenarios. Next, we used open coding to identify themes within reflection papers that students were asked to write during the course and used those findings to corroborate or refute the quantitative results. Qualitative analysis of students' reflection papers identified six themes: confidence, communication, population management, outbreak management, medical care, and application. The results of this study show that distance education can be an effective method of preparing veterinarians and veterinary students to practice shelter medicine.

Assessing the Effectiveness of a Cadaveric Teaching Model for Performing Arthrocentesis with Veterinary Students.

The purpose of this study was to determine if a recently developed cadaveric canine model was an effective tool for teaching arthrocentesis to fourth-year veterinary students. Arthrocentesis is an important diagnostic tool and technical skill that can be difficult to teach in the clinical setting. Eighteen fourth-year veterinary students participated in a within-subjects experiment that evaluated their ability to successfully perform arthrocentesis in the canine model and in an unmodified control cadaver. Students completed an online survey about the experience. Ability to perform the procedure was assessed by monitoring the number of attempts and redirects required to enter the joint and by recording any volume recovered from the arthrocentesis. In both phases of the study, the participants were able to aspirate a measurable volume of fluid from the joints of the model. Participants recorded an increase in confidence with arthrocentesis after using the model in the first phase of the study and unanimously supported inclusion of the exercise in future teaching situations.

Crown-root Fracture Restoration on a Patient with Autism Spectrum Disorder.

INTRODUCTION: Children with intellectual and physical disabilities including autism are susceptible to dental trauma as a sequela from falls due to poor muscular coordination. In addition, their altered muscle tonus often results in an open bite with labial flaring of the maxillary incisors and lip incompetence, predisposing these teeth to fractures. This case report describes an alternative approach of restoring a fractured maxillary permanent central incisor with a composite strip crown during surgical repositioning of the periodontium on an autistic patient. The prognosis of the incisor is guarded due to the probability of re-injury. However, the decision to maintain the tooth clinically was esthetically preferable in comparison to an extraction or decoronation.

An assessment of faculty and dental student decision-making in ethics.

This study reports and compares dental student and dental faculty scores to national norms for the Defining Issues Test 2, a measure of ethical decision-making competency. The findings showed that dental students and faculty tend to make decisions that promote self-interest, paralleling the ethical orientation of business professionals. Differences associated with gender, language, and norms from previous studies were observed. The findings underscore the importance of raising dental faculty and student awareness of their own ethical decision-making approaches. More importantly, the findings highlight the need to ensure that dental faculty have both the knowledge and skills to train dental students about the central role that ethical decision-making must play in patient care.

Assessing collaboration among team scientists within a triadic research center partnership.

Few studies have utilized qualitative methods to assess the perceived effectiveness of collaboration among research center interdisciplinary team scientists. Stages of team development served as the theoretical framework to characterize minority serving institution (MSI) and predominantly White institutions (PWI) participants' challenges and successes during a National Institutes of Health (NIH) sponsored cancer health disparities training and research program. We present the finding of an inductive analysis of four open-ended survey questions across two years. Fostering an awareness of the inherently taxing, yet centrality of group (team) development may advance an understanding of team dynamics and lead to increased team cohesion and productivity. In conclusion, we provide recommendations to assist multiple principal investigators who embark on team development.

Informatics Training for Pathology Practice and Research in the Digital Era.

Pathology informatics is a relatively new field with limited structured training programs for pathologists, especially for computer programming. Here, we describe our efforts to develop and implement a training program in the department of pathology at the University of Florida to meet these additional needs of current students as well as faculty and staff. Three one-credit courses were created using a flipped classroom design. Each course was assessed with a novel survey instrument, and the impact of the program was further measured 6 months after program completion with interviews of 6 participants and thematic analysis. Course objectives were met but with room for improvement. Major factors that had a positive impact included collaborative learning and real-world practice problems. Also, it improved communication with informatics colleagues as well as job task efficiency and effectiveness. Overall, the program raised awareness of informatics professional development and career path opportunities within pathology.

College Students with Inflammatory Bowel Disease: A Qualitative Study of Challenges Associated with College Transition and Self-Care.

Introduction: The social impact of inflammatory bowel disease (IBD) on student transition to college is significant, yet poorly understood. Methods: Two 90-min focus groups (FGs) were conducted with eight student-patients with IBD. Reflective journals were used to corroborate, elaborate, or challenge emergent FG findings. Results: Six themes emerged: (1) transitioning to college, (2) interacting with physicians, (3) affecting social life, (4) managing the disease by yourself and through support, (5) coping strategies, and (6) facing disease challenges. These themes remained relevant in the reflective writings. Analysis of serial journal entries showed that students' social life and engagement in coursework was affected 66% and 54% of the time, respectively. Conclusion: Our findings offer guidance for improving students' college success, quality of care, and enhancing physician-patient interactions. Students with IBD have a disability that may not be obvious or visible. They require specific support to help them transition and succeed in college.

Exploring Dental Student Performance in Moral Reasoning Using the Defining Issues Test 2.

The aim of this study was to assess the initial levels of moral reasoning among four cohorts of dental students in the first semester of their first year of study. All 332 students at one U.S. dental school were invited to take the Defining Issues Test 2 (DIT2) during the first semester of their first year while enrolled in a mandatory ethics course in 2015-18. Students' mean scores on the DIT2 subscales were compared to their gender, underrepresented minority (URM) status, citizenship, English as primary language, and single status. The four subscales were personal interests (PI), in which self-motivated interests are the main focus; maintaining norms (MN), which takes into consideration what is expected from society; post-conventional (PC), which upholds ethical principles that promote the good of society; and N2 index, which indicates one's ability to discriminate between lower stage and higher stage items. A total of 245 students participated (74% response rate). The results showed no differences between gender, URM status, citizenship, or English as primary language and any of the DIT2 subscales. Single participants scored significantly higher on the PC and N2 subscales and significantly lower on the MN subscale. There was a significant correlation between humanitarian liberalism (HL) and all four subscales. Religious (Christian) orthodoxy (RO) was significantly correlated with MN, PC, and N2. The DIT2 subscale scores were not impacted by various exploratory variables, with the exception of relationship status, which had significantly higher MN and N2 scores. Participants with higher scores on HL and RO had higher moral reasoning scores, and females had higher levels of moral reasoning than males on their PC and N2 scores. These findings have implications for implementing educational activities that may help develop students' moral reasoning abilities over the course of dental school.

Individual Perspectives of Majority/Minority Partnerships: Who Really Benefits and How?

This study ascertained historically Black colleges and universities (HBCU) academic leaders' perceptions of equity between HBCU and predominantly White institutions (PWI) health professions school partnerships related to resource capacity, sustainability and scholarship. A focus group was conducted with seven HBCU health professions schools. A survey was sent to their PWI (n=14) partners. Four themes including positive and negative experiences, challenges, and recommendations to continue relationships with the PWIs were identified. Dissemination of the survey to PWIs resulted in no responses. Benefits of the partnerships include increased HBCU publications and PWI efforts to embrace HBCU students. Inequities in the distribution of social resources and of social justice include the fickle nature of partnership, little interest among PWIs in promoting HBCU expansion and independence, a lack of transparency and clarity in communications, and PWI claims of ownership for ideas proposed by the HBCU. Dual institutional appointments were also identified as problematic.

Impact of Team Formation Method on Student Team Performance Across Multiple Courses Incorporating Team-based Learning.

Objective. To assess the impact of forming student learning teams based on problem solving styles on team performance and student perceptions of team quality. Methods. This was a prospective observational study involving students in the first year of a Doctor of Pharmacy degree program. Collaborative learning teams (balanced, implementer, optimizer, and random assignment) were created based on students' results on the Basadur Creative Problem Solving Profile Inventory. The teams remained in place across all courses for the first academic year, and those courses that incorporated team-based learning (TBL) were included in the study. Team performance was assessed by administering team readiness assurance tests. The quality of team interactions was assessed using the team satisfaction domain in the Comprehensive Assessment of Team Member Effectiveness (CATME) Smarter Teamwork system and the Team Performance Scale. Results. Each of the 237 first-year pharmacy students enrolled was assigned to one of 41 teams. All teams participated in the study. A significant difference in team performance was observed in the Principles of Patient Centered Care course but not in any of the other courses. No significant differences were found in quality of team interactions. Conclusion. Neither team performance, nor team satisfaction, nor quality of team interactions was impacted by the method of team formation that was used. Given the existing evidence and the results of this study, team formation process, regardless of method used, may have negligible influence on the performance of collaborative learning teams in courses taught using TBL.

Assessing Mentor Academy Program Effectiveness using Mixed Methods.

The purpose of our study was to assess how an academic health center (AHC) mentor academy program affected mentor competence and optimized mentor-mentee relationship. Mixed methods were used to assess the effectiveness of an AHC mentor program at a clinical translational science institute (CTSI). Twenty biomedical research faculty mentors took a validated survey and submitted reflective writings to discover if they corroborated or refuted statistically significant survey results. There was significant improvement in participants' confidence of mentor skills, integral mentoring quality and the extent to which they fulfill mentees' expectations. Males provided constructive feedback and helped mentees develop goal strategies more often compared to females. Reflective writings supported these findings yet refuted two survey findings. The use of a mixed methods approach offers novel insight into how mentoring programs benefit translational research mentoring capacity building and raises questions about the sole use of surveys as evidence of program effectiveness.

A Multi-Institutional Study of Dental Student Readiness to Address Adolescent Risk Behaviors.

The aim of this replication study was to determine if prior findings at one U.S. dental school about dental students' comfort discussing and perceptions of the relevance of 15 risk behaviors to adolescent patient oral health care would be observed at other institutions. All first- and fourth-year dental students (n=414) at three U.S. dental schools in fall 2017 were invited to participate, and 218 completed the survey (52.7% response rate). These students reported feeling comfortable to uncomfortable discussing risk behaviors with adolescent patients, yet perceived those risk behaviors as relevant to their oral health. There were significant differences in student comfort discussing risk behaviors with adolescents and their perceptions of relevance by gender, age, class status, and school location. Males were more comfortable than females discussing oral health risk behaviors. There were no significant differences by race/ethnicity. Fourth-year students had higher levels of comfort discussing risk behaviors than first-year students. Compared to students in the South and Midwest schools, students at the West school were more comfortable discussing selected topics and had higher perceptions of their relevance to adolescent oral health care. These results suggest there is room for improvement in this area of dental education. Dental schools should aim to strengthen students' knowledge of and comfort in discussing oral health risk behaviors with adolescent patients with the use of educational activities and clinical experiences.