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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Assessment of Psychometric Properties of an Oral Health Care Measure of Cultural Competence Among Dental Students Using Rasch Partial Credit Model.

Reliability, validity, and feasibility of the only validated oral health care measure of cultural competence, the Knowledge, Efficacy, and Practices Instrument (KEPI), have been confirmed. However, the instrument's psychometric properties including item and person reliability, category response functioning, and scale targeting, as well as differential scale functioning for subgroups, have not yet been examined. The aim of this study was to test the psychometric properties of KEPI among dental students using Rasch Partial Credit Model to determine if this model provided broader valid information that cannot be demonstrated according to Classical Test Theory. A total 1,290 dental students in the first or final semester at four U.S. dental schools were invited to participate in the study in 2016. Of those, 1,231 individuals completed the survey, for a 95.4% response rate. The participants were 613 males and 618 females and 889 non-underrepresented minority (URM) and 342 URM students. The Rasch Partial Credit Model assessed the psychometric properties of KEPI's 20 items/three subscales. Differential scale functioning was found in the Culture-Centered Practice and Efficacy of Assessment subscales. Four items were endorsed differentially by gender; four items were endorsed differentially by URM/non-URM students. This study examined the psychometric properties of the KEPI using Rasch analysis to assess differential item functioning by dental student gender and race. The results provided valid evidence for the high internal reliability, measurement properties, and unidimensionality for the KEPI domains, ideal targeting, and well response category functioning, showing that the KEPI is a reliable instrument for measuring the subscales Knowledge of Diversity, Culture-Centered Practice skills, and Efficacy of Assessment for health care providers.

Ensuring Representativeness in Competencies for Research Coordinators.

Providing educational programs designed to promote clinical research coordinators' (CRCs') implementation of competency skills is essential to workforce development; however, little is known about how programs address CRCs' needs. The purpose of this study was to assess CRCs' experiences in a six-month course. Using focus group methods, six participants revealed how the training assisted them in daily work. The findings supported previous study results, and led to the identification of two competencies which are missing from the existing Joint Task Force for Clinical Trial Competency framework domains of "Communication and Teamwork" and "Leadership and Professionalism." The authors explain why these competencies are important for coordinators. The authors also discuss the instrumentality of qualitative research to ensure that competency domains reflect the needs of those for whom they are developed.

Dental Students' Readiness to Address Adolescent Risk Behaviors: A Pilot Study.

Adolescents' engagement in risk-taking behaviors is well documented. However, the role of the dental practitioner in helping teenage patients understand and avert those behaviors is relatively unknown. The aim of this pilot study was to assess dental students' familiarity with adolescent risk behaviors, comfort level in discussing adolescent risk behaviors with teenage patients, and ratings of the relevance of these topics in dental education. Of the 373 University of Florida dental students across all four years who were invited to participate in 2017, 151 (40.5%) completed the survey. Among these respondents, 66% were female, 53% were from an underrepresented minority (URM) group, 40% were above the age of 25, 53% were in their preclinical years of education, and 47% were in their clinical years. In the results, the males had higher levels of comfort discussing adolescent risk behavior topics than the females, and the non-URM students had higher levels of comfort than the URM students. The clinical students showed statistically significant higher levels of comfort and ratings of the relevance of adolescent risk behaviors than the preclinical students. This pilot study assessed these students' comfort in discussing adolescent risk behaviors with patients and their level of agreement about the relevance of those topics in dental education across groups (age, gender, minority status, and educational level). Future studies are needed to examine pre- and posttest changes following interventions aimed at enhancing students' knowledge and comfort in discussing adolescent risk behaviors.

Pharmacy resident teaching and learning curriculum program outcomes: Student performance and quality assessment.

INTRODUCTION: The purpose of this study was to assess: (1) student performance on topics taught by first and second year postgraduate pharmacy residents and (2) the quality of learning objectives and multiple choice questions prepared by pharmacy residents. METHODS: Using a retrospective cohort design, residents and students who taught or were enrolled, respectively, in the Medication Therapy Management course in years 2010 to 2012 were participants in this study. Student performance was assessed using scores earned on the individual readiness assurance tests (iRATs), team readiness assurance tests (tRATs), and course examinations. To assess the quality of the learning objectives and multiple choice questions written by pharmacy residents, criteria were established by the authors. Each learning objective and multiple choice question was then evaluated independently by two authors to determine if these criteria were met. RESULTS: Statistical differences were observed in student performance across all content areas among the three years for iRAT, tRAT, and course examination scores, with the exception of the heart failure course examination (p = 0.05; all other p-values < 0.05). A total of 20 (42%) learning objectives met all quality review criteria, while 73 (79%) of the multiple-choice questions met all quality review criteria. DISCUSSION AND CONCLUSIONS: Student performance varied significantly depending on the content, but the overall impact of resident instructors on student course performance was not educationally significant. Teaching and learning curriculum programs should focus on teaching residents to create quality learning objectives that help students focus on learning the most important course content.

Influence of Preparatory Workshops on Dental Students' Academic Performance and Stress on Their First Operative Dentistry Psychomotor Exam.

Predoctoral dental psychomotor examinations are known to generate high levels of stress among dental students, which may compromise their academic performance. At one U.S. dental school, all 93 first-year dental students were invited to attend a series of three workshop sessions prior to enrollment in their initial operative dentistry course. The workshops were developed to facilitate academic transition from the dental anatomy course to the operative dentistry course; provide early exposure to materials, instruments, and laboratory techniques; support the early development of psychomotor and self-assessment skills; and lessen students' stress and anxiety levels regarding psychomotor examinations. The aim of this study was to assess the impact of the workshops on the students' academic performance and self-reported stress and preparedness. All students who attended the workshop sessions and all who did not were asked to complete a pre-exam survey (immediately preceding the exam) and a post-exam survey (immediately after the exam) on the day of their first operative dentistry psychomotor exam. Of the 93 students, 21 attended one, 34 attended two, and 25 attended three workshop sessions, while 13 students did not attend any. Response rates for the pre- and post-exam surveys were 100% and 98.9%, respectively. Students who attended all three workshop sessions reported being significantly less stressed about taking the exam than the other groups. The mean exam grade of students who attended the workshop sessions was significantly higher than that of students who did not attend the sessions. These findings support the development and implementation of preparatory workshops to improve academic performance and decrease the stress levels of dental students prior to the first operative dentistry psychomotor exam.

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.

Advancing the Practice of CRCs: Why Professional Development Matters.

Clinical research coordinators (CRCs) assume critical responsibilities central to the success of the research team. The complexity of their role requires essential professional qualifications. One barrier to professionalization, however, has been the inconsistent, or absent, competency-based training. This study explored participants' perceptions of training experiences designed to prepare them for the national certification exam. Focus group methodology was used to document their experiences. The findings showed that sustainable mentoring relationships developed, participant confidence levels increased, and anxiety about performance capacity diminished. Cognitive reframing of the work environment and CRC roles was facilitated by training that fostered sharing and social reinforcement of professional and personal identities. Findings from this study suggest that access to meaningful training and quality instruction supports the professionalization of CRCs.

An Initial Validation Study of the Self-Rating Scale of Self-Directed Learning for Pharmacy Education.

Objective. The purpose of this study was to explore and validate the factor structure of the original SRSSDL scale with pharmacy students enrolled in a four-year Doctor of Pharmacy program at a southeastern university, and to assess the differences in the self-directed learning behaviors across different class years of students. Methods. Factor analysis was used to identify the factor structure of a self-rating scale of self-directed learning (SRSSDL) among pharmacy students (n=872) and to examine students' self-directed learning (SDL) behaviors by year in the pharmacy education curriculum. Results. Five factors - intrinsic motivation, awareness, collaboration, reflection and application - showed acceptable levels of reliability. P4 students scored significantly higher than P2 students on the total scale. P4 students scored significantly higher on awareness than P1 and P2 students, while P2 students had a significantly higher collaboration score compared to P1 students. Conclusion. The revised 55-item SRSSDL is a valid and homogenous scale of pharmacy students' self-directed learning within one pharmacy program. However, due to differences in factor structure compared to earlier studies, further research is needed before this survey tool can be broadly implemented in pharmacy education.