Addressing Racism in Medical Education: A Longitudinal Antiracism Discussion Curriculum for Medical Students.

Although recent efforts have been engaged to combat bias in medical education, minimal attention has been dedicated to developing antiracism curricula for medical students. We developed a year-long discussion curriculum for 175 first-year medical students centered around Ibram X. Kendi's How to be an Antiracist. The discussion curriculum consisted of six, 2 hour seminars. We evaluated students' perceptions regarding discussing and actively addressing racism. Students reported an improved ability and comfort to discuss and address racism within healthcare settings. These data suggest that antiracism discussion curricula may be effective for training medical students to address racism in their future careers.

The Physical Examination to Assess for Anemia and Hypovolemia.

Hypovolemia develops with the loss of extracellular fluid volume or blood. Rapidly identifying hypovolemia can be lifesaving. Indicators of hypovolemia on examination include supine or postural hypotension, increase in heart rate by 30 beats per minute or severe dizziness with standing, and a decrease in central venous pressure detected on visual inspection of the jugular venous pressure or ultrasound assessment of the inferior vena cava or internal jugular veins. Other findings with utility include a dry axilla and dry oral mucosa. With chronic anemia, hemodynamic changes detectable on examination may be minimal, as the body compensates by retaining extracellular volume.

The Current Status of Preclinical Endocrine Education in U.S. Medical Schools.

OBJECTIVE: To characterize the current landscape of preclinical medical endocrine education in U.S. allopathic medical schools. METHODS: U.S. endocrine curriculum directors were asked to voluntarily complete a 16-question email survey surveying the status of endocrine preclinical education at their medical school. RESULTS: Sixty-nine of 155 (45%) endocrine block director respondents completed the online survey between July 2021 and September 2021. A larger incoming class, a longer duration of the endocrine curriculum, and the offering of a separate endocrine curriculum (ie apart from the teaching of other organ systems) were each independently associated with an increased number of faculty teaching the course. Schools that used a gland-/organ-based curriculum only and those that used a combination of gland-/organ-based curriculum with topic-based curriculum differed significantly in their use of large lectures, small groups, and several curriculum components, including point of care glucose testing, continuous glucose monitoring, and insulin pumps. CONCLUSION: This survey study reports the current landscape of preclinical endocrine education in the United States and describes opportunities to improve interest in pursuing endocrinology as a career.

Driving Factors to Pursue Endocrinology Training Fellowship: Empirical Survey Data and Future Strategies.

OBJECTIVE: There is a current and anticipated labor shortage of endocrinologists in the United States. Over the past decade, the number of applications to endocrinology fellowship programs has plateaued despite increased available positions, and interest in endocrinology has declined relative to other internal medicine subspecialty fields. The examination of driving factors for pursuit of endocrinology as a subspecialty career is needed. METHODS: A 12-question online survey was developed to identify the primary reasons for current endocrinology fellows/trainees to pursue the field. This survey was sent to 152 U.S. endocrinology fellowship program directors for completion by their fellows between July and August 2021. RESULTS: A total of 176 of 629 fellows (28.0%) completed the survey. The majority (57.4%) had decided to pursue endocrinology as a career during residency, while 27.3% had decided during medical school. The endocrinology rotation during residency was ranked by 79 fellows (44.9%) as the most influential factor, followed by having positive experiences with a clinical mentor (27.3%). Endocrinology exposure during medical school was sparse, with only 2.8% noting the availability of an endocrinology student interest group, while 59.7% reported inadequate endocrinology exposure during their medical school curriculum. CONCLUSION: The majority of current endocrinology fellows/trainees report that exposure to the field during medical school was limited, and that their endocrinology elective and mentorship experiences during residency were the most influential factors for pursuing endocrinology as a subspecialty. Improved integration of endocrinology experiences between medical school and residency may enhance career interest in endocrinology.

The Efficiency of Online "Inked" Videos Versus Recorded PowerPoint Lectures on Teaching Pathophysiology to Medical Students in Pre-Clerkship Years: A Pilot Study.

BACKGROUND: As online learning develops an increasingly important role in medical education, new online teaching modalities are arising all the time. One such teaching modality that is gaining popularity among medical students is the "inked" video, a type of animated video that utilizes a virtual blackboard. Student reviews suggest that the dynamic style of the inked video allows it to teach more efficiently than traditional teaching modalities, but currently there is no quantitative evidence to support or guide the use of this teaching modality. HYPOTHESIS: When compared to the traditional recorded PowerPoint lecture, online inked videos teach the same pathophysiology concepts to pre-clerkship medical students in a shorter amount of time. METHOD: A randomized, crossover-design study was conducted with second-year medical students at the David Geffen School of Medicine at University of California, Los Angeles (n = 22). Students were randomized to 2 groups. Each group received 2 lessons on 2 different pathophysiology topics: one via a shorter inked video and the other via a longer recorded PowerPoint lecture. Two sets of dependent variables were used to test modality effects: immediate post-tests scores and delayed retention post-test scores. A perceptions survey was also administered to assess student preferences between the 2 teaching modalities. RESULTS: Students performed similarly on immediate and delayed post-tests for the shorter inked videos and the longer recorded PowerPoint lectures (P > .05). Students reported greater engagement (P < .05) and greater satisfaction with learning (P < .05) with the inked videos than the recorded PowerPoint lectures. CONCLUSIONS: This study, although limited by its small-scale and single-institution design, provides preliminary evidence that online inked videos may be a more efficient and non-inferior alternative to recorded PowerPoint lectures.

A Comparison of Simulation-Based Education and Problem-Based Learning in Pre-Clinical Medical Undergraduates.

This article was migrated. The article was marked as recommended. Introduction: Despite the increasing popularity of high-fidelity simulation (SIM), few studies compare the effectiveness of SIM with established small-group modalities such as problem-based learning (PBL) for factual learning among pre-clinical medical undergraduates. Methods: 162 second-year medical students were randomized to two groups. The first group encountered teaching points related to the management of hypertensive emergency during a traditional PBL session, while the second group covered the same teaching points through SIM. Both groups then completed a post-test. The students were subsequently crossed-over to the opposite modality and assessed on teaching points related to the management of chronic obstructive pulmonary disease exacerbations. Results: A total of 162 students participated in the study. For the hypertension case, the average proportion of correct questions for the SIM intervention was 83% compared to 70% for the PBL intervention (OR = 3.1, 95% CI [1.3, 7.2], p=0.009). For the COPD case, the average proportion of correct questions for the SIM intervention was 73% compared to 51% for the PBL intervention (OR = 2.6, 95% CI [1.8, 3.8], p < 0.001). Conclusion:Students scored significantly higher with SIM in both cases, indicating that SIM may be superior to PBL for factual learning among students with limited clinical exposure.

Comparing the effectiveness of a hybrid simulation/lecture session versus simulation alone in teaching crew resource management (CRM) skills: a randomised controlled trial.

Introduction: Various methods have been used to teach crew resource management (CRM) skills, including high-fidelity patient simulation. It is unclear whether a didactic lecture added on to a simulation-based curriculum can augment a learner's education. Methods: Using an already existing simulation-based curriculum for interdisciplinary teams composed of both residents and nurses, teams were randomised to an intervention or control arm. The intervention arm had a 10 min didactic lecture after the first of three simulation scenarios, while the control arm did all three simulation scenarios without any didactic component. The CRM skills of teams were then scored, and improvement was compared between the two arms using general estimating equations. Results: The differences in mean teamwork scores between the intervention and control arms in scenarios 2 and 3 were not statistically significant. Mean scores in the intervention arm were lower than in the control arm (-0.57, p=0.78 for scenario 2; -3.12, p=0.13 for scenario 3), and the increase in scores from scenario 2 to 3 was lower in the intervention arm than in the control arm (difference in differences: -2.55, p=0.73). Conclusions: Adding a didactic lecture to a simulation-based curriculum geared at teaching CRM skills to interdisciplinary teams did not lead to significantly improved teamwork.

A randomized controlled trial of high-fidelity simulation versus lecture-based education in preclinical medical students.

PURPOSE: The purpose of this study was to compare the efficacy of simulation versus lecture-based education among preclinical medical students. METHODS: Twenty medical students participated in this randomized, controlled crossover study. Students were randomized to four groups. Each group received two simulations and two lectures covering four different topics. Students were administered a pre-test, post-test and delayed post-test. The mean percentage of questions answered correctly on each test was calculated. The mean of each student's change in score across the three tests was used to compare simulation- versus lecture-based education. RESULTS: Students in both the simulation and lecture groups demonstrated improvement between the pre-test and post-test (p < 0.05). Students in the simulation group demonstrated improvement between the immediate post-test and delayed post-test (p < 0.05), while students in the lecture group did not demonstrate improvement (p > 0.05). When comparing interventions, the change in score between the pre-test and post-test was similar among both the groups (p > 0.05). The change in score between the post-test and delayed post-test was greater in the simulation group (p < 0.05). CONCLUSIONS: High-fidelity simulation may serve as a viable didactic platform for preclinical medical education. Our study demonstrated equivalent immediate knowledge gain and superior long-term knowledge retention in comparison to lectures.