A 10-Step Process to Align Problem-Based Learning With Accreditation Expectations for Self-Directed and Lifelong Learning.

OBJECTIVE: Self-directed and lifelong learning (SDLL) skills are essential skillsets in both undergraduate and graduate medical education (UME and GME). Hence, medical schools' accreditation bodies emphasize the requirements to acquire these skills in their accreditation standards. For example, in the United States, the Liaison Committee on Medical Education (LCME) clearly defines the components of the SDLL process in Element 6.3 of Accreditation Standard Six. Among the active learning pedagogies, problem-based learning (PBL) provides ample learning opportunities where SDLL skills are effectively applied. The aim of this article is to streamline the process of developing, delivering, and evaluating PBL sessions in line with the SDLL accreditation requirements through a 10-step design and implementation process. METHODS: Our 10-step process, detailed in the article, starts with developing learning objectives that inform the content of the PBL case and the required embedded learning triggers. The process carefully addresses the components of the SDLL process and other aspects of the accreditation needs within the framework of PBL. The approach to implementation, feedback, assessment, and evaluation is explicitly described to meet the regulatory expectations. DISCUSSION: In addition to the essential role in UME and GME, SDLL skills are vital requisites for continuing medical education of all physicians. Instilling this skillset early in medical students helps to cultivate their ability to apply these skills in their future professional roles. Using accreditation standards as a foundation for creating learning experiences, for example, PBL, requires careful content development and sequencing. Such a process needs explicit standardized steps that should not only be feasible, but also transferable for usage by different medical schools. CONCLUSION: Our streamlined 10-step process of designing and delivering an SDLL-oriented PBL experience can easily be adopted by other medical schools to address the SDLL skills acquisition as well as meeting the accreditation requirements.

Inclusive LGBTQIA+ healthcare: An interprofessional case-based experience for cultural competency awareness.

Introduction: Lesbian, Gay, Bi-sexual, Transgender, Questioning, Intersex, and Asexual (LGBTQIA+) patients report experiences of discrimination within healthcare settings due to a lack of provider knowledge and biases of healthcare workers. There is an identified need among all health professions to provide more culturally competent healthcare for this community. Early interventions during healthcare profession training programs may be effective to address this need. The overall goal of this study was to assess the educational impact of an active learning session that was specifically designed to enhance LGBTQIA+ cultural competency awareness using an interprofessional setting. Methods: This 2-year study involved students from 16 healthcare professional programs joining virtually to form interprofessional teams. A small group case-based learning approach was used and included pre/post-activity surveys to measure the change in student attitude and confidence, as well as the change in perception of the importance of the activity. Results: Results indicate an increase in perception of importance (p < 0.005) and in overall level of confidence (p < 0.001) with respect to LGBTQIA+ issues post-session. Key themes established through the session represent an overall recognition of the importance of interprofessional education and awareness of LGBTQIA+ healthcare needs. Discussion: The results demonstrate the effectiveness of a case-based approach for enhancing cultural competency awareness across different healthcare professions programs. This session also provided an interprofessional learning environment to allow multiple healthcare professions program students to interact and share perspectives. The positive impact of this intervention in a highly collaborative virtual learning environment also highlights that this immersive active learning approach that can be adopted across different programs and institutions.

Attitudes and Knowledge of Medical Students Towards Healthcare for Lesbian, Gay, Bisexual, and Transgender Seniors: Impact of a Case-Based Discussion With Facilitators From the Community.

BACKGROUND:  Lesbian, gay, bisexual, and transgender (LGBT) seniors are generally a medically underserved population that faces unique healthcare challenges. When compared to younger patients, LGBT seniors are at a greater risk for social isolation and have higher rates of smoking, disability, physical and mental distress, and lack of access to healthcare services. They are often reluctant to discuss their sexual orientations and gender identities with healthcare providers due to fear of discrimination and receiving inferior care based on prior unsatisfactory experiences with untrained or insensitive healthcare providers. Furthermore, recent research has revealed that only about 50% of primary care providers indicated confidence in providing culturally competent LGBT healthcare, highlighting the need for more LGBT proficiency training in medical school curricula. OBJECTIVES: The aim of this study was to provide early intervention training to first-year medical students regarding best practices for equitable healthcare for LGBT seniors through integrative, small group, case-based discussions. The impact of this activity on the knowledge and attitudes of medical students regarding LGBT healthcare was also assessed. METHODS: First-year medical students participated in a two-hour small group, case-based discussion. Each group consisted of seven to eight students with one of seven facilitators who were invited members of the LGBT community. Students were provided with two clinical case scenarios related to treatment of LGBT senior patients. Students were given a pre/post-session knowledge and attitude survey to assess the impact of the session on their attitudes and understanding of the importance of providing equitable healthcare to LGBT patients. A rubric was also used by facilitators to evaluate level of student engagement and professionalism. RESULTS: A total of 51 first-year medical students attended the session and 38 (74.5%) completed the pre/post surveys. There was diverse representation in our student demographic with 5.2% of respondents identifying as LGBT. Survey results showed a significant increase in knowledge confidence and attitudes following the session. Students' attitudes regarding determinants of health status changed significantly for nine of the 13 (69%) survey items. In addition, their confidence in knowledge regarding healthcare barriers, health issues, and practices for LGBT culturally competent care significantly increased post-session. Data from our assessment rubrics also show that students were highly professional and engaged with the LGBT facilitators. CONCLUSION: Our study provides some evidence that case-based training of medical students regarding issues that affect health of LGBT seniors can improve attitudes and sensitize them to the unique needs of this population. Through this activity, the students indicated their desire to learn more about the topics covered and to receive further training in this field of study. While the study was somewhat limited by a small participant number, the significance of the data demonstrates the effectiveness of the approach involving members of the LGBT community as facilitators. Future work with these students as part of a longitudinal curriculum will include additional LGBT proficiency training to be offered in the subsequent blocks of instruction. Additionally, this intervention could potentially be adapted by other medical schools.

From Introduction to Integration: Providing Community-Engaged Structure for Interprofessional Education.

BACKGROUND: Training future healthcare profession students using interprofessional education (IPE) is critical to improve quality of health care and patient safety. OBJECTIVE: The objective of this study was to implement an IPE program and determine student satisfaction with each session, including a clinical case requiring teams with members from each profession addressing clinical scenarios. SUBJECTS: The subjects of this study were students from Athletic Training, Medicine, Nursing, Pharmacy, Physical Therapy, Physician Assistant, Social Work, and Speech-Language Pathology. METHODS: Evaluations, administered to all participating students, consisted of Likert-style responses, rating agreement with a series of questions, and space for descriptive comments. Score differences for each question were compared using independent group t-tests with a P-value of 0.05 to determine statistical significance. RESULTS: There were statistically higher satisfaction ratings for the problem-based learning case when compared to less interactive sessions (P < 0.0001). CONCLUSION: Students perceived benefits of the IPE program. Perceptions improved when various students had the opportunity to work together on clinically relevant problems.