Observed Structured Teaching Experiences (OSTEs) in a Students as Teachers Course.

Introduction: Teaching is an important competency in graduate medical education (GME). Many residency programs have implemented curricula to develop residents' teaching skills and observed structured teaching experiences (OSTEs) have been used to assess these skills. There is an increasing focus on building teaching skills earlier in the medical education continuum, however, there is limited literature on assessing medical students' teaching skills. The authors developed an OSTE for medical students enrolled in a students-as-teachers course to address this gap and provide formative feedback on teaching skills. Materials and Methods: OSTEs were conducted for fourth-year medical students (M4s) enrolled in a Students as Teachers Advanced Elective at a US medical school. An M4 observed a first-year medical student (M1) during a simulated encounter with a standardized patient. The M4 gave feedback and a chalk talk. A physician observer assessed the M4's teaching using the modified Stanford Faculty Development Program (SFDP) questionnaire. The M1s and M4s also completed the SFDP. The M4 completed pre- and post-OSTE self-efficacy surveys (score range 6-30) and a post-OSTE acceptability survey. Results: All (30/30) M4s completed the OSTE. The SFDP identified common teaching strengths and areas for growth. ANOVA tests demonstrated significant differences between the mean (SD) scores from physician assessors, M1s, and M4s [4.56 (0.63) vs. 4.87 (0.35) vs. 4.08 (0.74), p<0.001]. There was a statistically significant difference in mean (SD) self-efficacy scores pre- and post-OSTE [18.72 (3.39) vs. 23.83 (3.26), p<0.001]. All M4s (30/30) somewhat or strongly agreed with all three OSTE acceptability questions. Lessons Learned: The authors successfully conducted an OSTE in an M4 advanced elective. The OSTE was highly acceptable to participants, and M4s demonstrated improved teaching self-efficacy. Further research should explore the validity of the OSTE to measure medical students' teaching skills and the long-term impact of developing teaching skills in medical school. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01952-3.

Head Start's Role in Addressing Food and Nutrition Insecurity: Focus Group Findings.

OBJECTIVE: To elicit Head Start (HS) families' and employees' perspectives on family experiences with food and nutrition insecurity (FNI) and identify how HS addresses them. METHODS: Four moderated virtual focus groups with 27 HS employee and family participants occurred from August 2021 to January 2022. Qualitative analysis used an iterative inductive/deductive approach. RESULTS: Findings were summarized in a conceptual framework and suggested that HS's current 2-generational approach is useful for families when addressing multilevel factors affecting FNI. The role of the family advocate is essential. In addition to increasing access to nutritious foods, emphasis should also be placed on skills and education to decrease generational unhealthy behaviors. CONCLUSIONS AND IMPLICATIONS: Head Start intervenes in generational cycles of FNI by using the family advocate to add to skills building for 2-generational health. Other programs targeting underserved children can use a similar structure for the greatest impact on FNI.

Effect of a Virtual Home-Based Behavioral Intervention on Family Health and Resilience During the COVID-19 Pandemic: A Randomized Clinical Trial.

Importance: Virtual home-based interventions may bolster protective factors, such as family health and resilience, during stressors such as the COVID-19 pandemic; however, their effectiveness is unknown. Objective: To examine the effectiveness of a virtual health coaching intervention on family health and resilience during the pandemic. Design, Setting, and Participants: In this parallel-group, single-site randomized clinical trial, 123 parents and their 2- to 8-year-old children were enrolled at a pediatric clinic or community partner site in Tennessee from March 10 to August 11, 2021. Follow-up surveys were completed between June 29 and November 11, 2021. Interventions: All participants received 11 weekly cooking videos and associated home-delivered groceries. The intervention group also received 12 weekly, 30-minute virtual health coach sessions. Main Outcomes and Measures: The primary outcome was the validated 6-item (range, 6-30) Family Healthy Lifestyle Subscale (FHLS) scores. The secondary outcome was the validated 6-item (range, 0-6) Family Resilience and Connection Index (FRCI) scores. Outcomes were determined a priori and evaluated at baseline and 12-week follow-up. A priori independent t tests and multivariable tobit regression models assessed intervention effects, and post hoc, secondary interaction models assessed whether effects differed over baseline outcomes. Results: Among the 123 enrolled families, 110 (89%) were included in the primary analyses (parent mean [SD] age, 35.1 [8.2] years; 104 [95%] female; 55 [50%] non-Hispanic Black; child mean [SD] age, 5.2 [1.7] years; 62 [56%] male). Intervention-control group mean differences were nonsignificant for follow-up FHLS scores (0.7; 95% CI, -0.6 to 2.0; P = .17) and FRCI scores (0.1; 95% CI, -0.5 to 0.6; P = .74). Tobit regression model intervention effects were nonsignificant for FHLS scores (0.9; 95% CI, -0.3 to 2.2; P = .15) and FRCI scores (0.4; 95% CI, -0.2 to 1.1; P = .17). Post hoc, secondary models found no significant interaction for FHLS scores (1.3 increase per 5-point decrease; 95% CI, -0.2 to 2.7; P = .09), with significant intervention associations for baseline scores of 6 to 23. The interaction was significant for FRCI scores (0.4 increase per 1-point decrease; 95% CI, 0.01 to 0.8; P = .047), with significant intervention associations for baseline scores of 0 to 3. Conclusions and Relevance: In this randomized clinical trial of families with young children, weekly virtual health coaching did not detectably improve family health and resilience. Post hoc, secondary results provided preliminary evidence of potential effectiveness among families with low baseline scores. Trial Registration: ClinicalTrials.gov Identifier: NCT05328193.