Volume 10

Abstract

Objective: Our objective is to measure the rate of depression among licensed Utah Foster Parents.

Background and Rationale: The mental health of foster parents is a critical factor in providing adequate care for foster children. However, there is a lack of data regarding the mental health of foster parents, particularly in relation to depression. This study aims to quantify the rate of depression among foster parents in Utah and compare it to the rate of depression in the general adult population. In addition, this study also examines the potential correlation between depression rates and factors such as regionality, age, and length of time fostering children.

Design and Methods: A total of 155 foster parents in Utah participated in the study by completing the Patient Health Questionnaire-9 (PHQ-9) survey through the Utah Foster Care Bridge App.

Results: The results indicated that 54% of foster parents had a PHQ-9 score of 5 or higher, indicating at least minimal depression, compared to a rate of 23% in the general adult population. However, there was no significant correlation between depression rates and years of fostering or the number of children currently being fostered.

Conclusion: The results of this study highlight the need for increased support and resources for foster parents, particularly in addressing their mental health needs.

References

1. Mancinelli E, Dell’Arciprete G, Salcuni S. A Systematic Review on Foster Parents’ Psychological Adjustment and Parenting Style-An Evaluation of Foster Parents and Foster Children Variables. Int J Environ Res Public Health. 2021;18(20):10916. Published 2021 Oct 17. doi:10.3390/ijerph182010916.
2. Yang, Longfei, et al. “The Effects of Psychological Stress on Depression.” Current Neuropharmacology, vol. 13, no. 4, 2015, pp. 494–504., https://doi.org/10.2174/1570159×1304150831150507.
3. Mazure, Carolyn M. “Life Stressors as Risk Factors in Depression.” Clinical Psychology: Science and Practice, vol. 5, no. 3, 1998, pp. 291–313., https://doi.org/10.1111/j.1468-2850.1998.tb00151.
4. Statewide Facts: Children in Foster Care. https://utahfostercare.org/wp-content/uploads/2013/04/ufc-factsheet-general.pdf.
5. “Brief Mental Health and Foster Care.” National Conference of State Legislatures.

Abstract

Objective: To develop an effective faculty peer feedback program.

Background: Traditionally, teaching evaluation relies heavily on learner feedback, yet often produces biased results, reactive curricular decision-making, and is often unaligned with retention-promotion-tenure criteria. Some institutions have developed more holistic teaching evaluation processes to help faculty develop and thrive. Ideally, faculty should be partners in designing evaluation processes.

Design: A By-Faculty-For-Faculty framework was used to design a peer faculty feedback (PFF) program. 26 Spencer Fox Eccles SOM educators participated in 4 focus groups using standardized questions adapted from the literature. Focus group transcripts were analyzed by applying the Faculty Development Conceptual Framework to codes.

Results: Focus group findings suggest a PFF program should: 1) be rooted in growth mindset and relationships, 2) focus on formative feedback, 3) start with expectations for each role, 4) consider faculty preferences, 5) provide guidance for promotion, and 6) include feedback training.

Conclusion: Co-production models inherently promote stakeholder buy-in but are less frequently used in faculty-focused efforts. Soliciting early faculty input can promote statisfaction and sustainability. Our focus group findings became guiding principles in next steps to develop a PFF program. Challenges include varied educator needs/roles, resources, and stagnation in promotion metrics regarding teaching.

References

1. Ginsburg, Shiphra MD, MEd, PhD1; Stroud, Lynfa MD, MEd
2. Necessary but Insufficient and Possibly Counterproductive: The Complex Problem of Teaching Evaluations. Academic Medicine 98(3):p 300-303, March 2023. | DOI: 10.1097/ACM.0000000000005006 https://teval.net/ 
3. Englander R, Holmboe E, Batalden P, Caron RM, Durham CF, Foster T, Ogrinc G, Ercan-Fang N, Batalden M. Coproducing Health Professions Education: A Prerequisite to Coproducing Health Care Services? Acad Med. 2020 Jul;95(7):1006-1013. DOI: 10.1097/ACM.0000000000003137. PMID: 31876565.
4. Esterhazy R, de Lange T, Bastiansen S, Wittek AL. (2021). Moving beyond peer review of teaching: A conceptual framework for collegial faculty development. Review of Educational Research, 91(2), 237-271.

Abstract

Objective: The presentation aims to demonstrate the utilization of an innovative trial design, incorporating a smaller trial within a larger trial to assess the effects of supplemental, reinforced, risk-based training.

Background: Historically there is a lack of research on clinical trial operations. Our approach is rooted in addressing this gap, by exploring the impact of supplemental, reinforced risk-based trainings on clinical site preparedness within the context of a large-scale PRECISE trial.

Methods: We leveraged the existing infrastructure of the large-scale multi-center PRECISE trial and implemented a trial within the trial design, randomly assigning 12 sites to receive supplemental Training and the remaining 12 to follow standard training protocols. The REDCap survey served as the platform for Training implementation.

Results: Findings showed a trend in immediate increases in approach rates following training (p-value 0.074) but it did not reach statistical significance compared to their counterparts.

Conclusion: The insights gained from this trial underscore the need in studying the clinical trial operations themselves. To strengthen the credibility the innovative trial-within-a-trial model, it is recommended to replicate similar trials within larger RCTs over 12-month period. The positive findings encourage further exploration and validation of the risk-based training approach as a valuable tool for optimizing site performance.

References

1. Bechtel, J., et al., Improving the quality conduct and efficiency of clinical trials with training: Recommendations for preparedness and qualification of investigators and delegates. Contemp Clin Trials, 2020. 89: p. 105918.
2. Arango, J., et al., Good Clinical Practice Training: Identifying Key Elements and Strategies for Increasing Training Efficiency. Ther Innov Regul Sci, 2016. 50(4): p. 480-486.

Abstract

Objective: Evaluate 21 current dermatological health mobile device applications.

Background: Education plays a vital role in patients’ health care, especially those in rural areas. Smartphone apps provide accessible education to patients, allowing patients to track their condition over time. Mobile health apps can be a resource for managing and tracking dermatological health, as well as reducing education and location barriers for patients.

Methods: Twenty-one apps were chosen for our analysis. Apps were divided into categories related to dermatological health; including patient education, skin-care regimens, and tracking chronic condition progression. Apps were assessed by cost, languages offered, educational content, diagnostic/special features, country based in, country offered in, advertisements, and incentives.

Results: Sixty-five percent of the apps are only available in English, 18% offer 2-3 languages, and 17% offer 4+ languages, although the apps are available in multiple countries. 66.66% of the apps offer an educational component, and 40% of the educational apps are free. Many had additional or add-on purchases.

Conclusion: Utilizing mobile applications is a promising and innovative avenue for patient education. However, there is a wide discrepancy in the number of languages offered and cost, placing an emphasis on creating apps available in multiple languages and at a low price.

References

1. Bhattad PB, Pacifico L. Empowering Patients: Promoting Patient Education and Health Literacy. Cureus. 2022 Jul 27;14(7):e27336. doi: 10.7759/cureus.27336. PMID: 36043002; PMCID: PMC9411825.
2. Prabhu AV, Gupta R, Kim C, Kashkoush A, Hansberry DR, Agarwal N, Koch E. Patient Education Materials in Dermatology: Addressing the Health Literacy Needs of Patients. JAMA Dermatol. 2016 Aug 1;152(8):946-7. doi: 10.1001/jamadermatol.2016.1135. PMID: 27191054.
3. Ji-Xu A, Artounian K, Altman EM. Dermatology education resources on sun safety and skin cancer targeted at Spanish-speaking patients: a systematic review. Arch Dermatol Res. 2023 Jul;315(5):1083-1088. doi: 10.1007/s00403-022-02465-6. Epub 2022 Nov 30. PMID: 36449072.

Abstract

Objective: To foster professional identity formation within medical education using habit formation techniques.

Background and Rationale: As outlined in Linsenmeyers’s¹ work, incorporating self reflection increases professional identity formation. By combining these self-reflection strategies with the habit formation techniques discussed by Shnayder-Adams² we can develop a multitude of professional identity formation habits.

Design and Methods: In March 2024, all year one students will complete two survey questions: What top 1-3 habits would be helpful to promote in year one for your academic success?, What top 1-3 habits would be helpful to promote in year for your Professional Identity Formation? Responses will be thematically coded in time for the Core Educator Retreat. Survey findings will be combined with evidence from the literature to design a habit formation session in SCoPE.

Results: Pending.

Conclusions and/or Lessons Learned: While this project is still in a preliminary stage, we are hopeful the application of well studied behavioral economics concepts will foster medical education innovations both academically, and within professional identity formation.

References

1. Linsenmeyer, M., Long, G. Goal-Oriented and Habit-Oriented Reflective Models to Support Professional Identity Formation and Metacognitive Thinking. Med.Sci.Educ. 33, 569–575 (2023). https://doi.org/10.1007/s40670-023-01752-9.
2. Shnayder-Adams, M.M., Sekhar, A. Micro-habits for life-long learning. Abdom Radiol 46, 5509–5512 (2021). https://doi.org/10.1007/s00261-021-03185-7.

Abstract

Objective: To design an experiential learning session on decision-making bias, fallacies, and heuristics.

Background: Reducing decision-making bias improves patient care.^1,2 Teaching decision-making bias, fallacies, and heuristics early in medical education is the first step to reducing mental pitfalls in the healthcare system. There are short-term learning benefits to a cognitive bias session³, but the long-term impact is unknown. Kolb’s experiential learning model suggests long-term learning can be enhanced by having students apply content in a hands-on activity.⁴

Design: We designed a decision-making session with one day of didactics and one day of guided backcountry skiing (application/experiential learning). Students were prompted to pause and reflect on backcountry skiing decision-making pitfalls and discuss parallels to clinical learning.

Outcomes: Twenty-six students participated in the didactic day, and eight participated in the experiential learning day. Survey responses suggested an appreciation of the application to medicine, the importance of decision-making to patient care, and potential for the format to be applied to other settings.

Conclusions: Due to limitations of timing, funding, and the high knowledge and gear threshold, participation was severely limited. We will include a more inclusive experiential learning activity for all medical students when we scale up the session in SCoPE this August.

References

1. Stone, J., & Moskowitz, G. B. (2011). Non-conscious bias in medical decision making: what can be done to reduce it?. Medical education, 45(8), 768–776. https://doi.org/10.1111/j.1365-2923.2011.04026. 
2. Woolf, K., & Dacre, J. (2011). Reducing bias in decision making improves care and influences medical student education. Medical education, 45(8), 762–764. https://doi.org/10.1111/j.1365-2923.2011.04038. 
3. Hershberger, P. J., Markert, R. J., Part, H. M., Cohen, S. M., & Finger, W. W. (1996). Understanding and addressing cognitive bias in medical education. Advances in health sciences education : theory and practice, 1(3), 221–226. https://doi.org/10.1007/BF00162919. 
4. Kolb. (2014). Experiential Learning: Experience as the Source of Learning and Development (2nd edition).

Abstract

Authors: Adriene Pavek¹, Stormy Foster-Palmer¹, Annabelle Huntsman¹, Nathan Shen², Bryan E. Hull, MEd³, Shreya Sreekantaswamy, MD⁴, Julia Curtis, MD⁴

Affiliations:
¹ University of Utah School of Medicine, Salt Lake City, Utah
² University of Michigan School of Medicine, Mount Pleasant, Michigan
³ Spencer S. Eccles Health Sciences Library, Salt Lake City, Utah
⁴Department of Dermatology, University of Utah Health, Salt Lake City, Utah

Objective: Summarize the development of UtahDERM, an open-access and searchable database of a vast repository of clinical images.

Background and/or problem addressed: Dermatological diagnoses are challenging for clinicians. To address this educational gap, the University of Utah Department of Dermatology and Spencer S. Eccles Health Sciences Library digitized photographs of pediatric and adult dermatologic cases donated by Dr. Leonard Swinyer.

Design: Approximately 15,000 slides (400 DPI/slide) were digitized using CyberViewX5-MS for placement online in an image viewer. Dermatologists applied clinical characteristics (location, distribution, configuration, color, primary lesion, secondary change, and Fitzpatrick 1-VI) using Google Forms. The Editor-in-Chief reviews assigned standardized diagnoses in accordance with Bolognia textbook for accuracy.

Website usage data was collected via Google Analytics.

Results: UtahDERM’s Image Viewer is currently in an alpha release stage: Current functions include browsing by diagnosis, filtering by characteristics, and searching by textbook chapters.

The website received 13,000 views with 6,800 new users from primarily U.S (5,400), Canada (308), and UK (254) from 2022-2023.

Conclusions: UtahDERM is a promising advancement in dermatological education, but faces challenges in data collection, slide categorization, and reviewer recruitment. Ongoing refinement is necessary to provide a framework for future open-source large-scale image repositories.

References

1. Bolognia J. Schaffer J. V. & Cerroni L. (2018). Dermatology (Fourth). Elsevier.
2. University of Utah. (2023). UtahDERM Clinical Slides Viewer. UtahDERM. https://utahderm.med.utah.edu/image-viewer/