Volume 13

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Title: Suicidal Ideation in Complex Regional Pain Syndrome
Authors: Sarah Petelinsek, Jarom Morris, Vidya Gopinath, MD
Date: 1/27/2025
Abstract: A 52-year-old male with a past medical history of complex regional pain syndrome (CRPS) diagnosed in 2017 presented for Emergency Room (ER) follow-up and persistent passive suicidal ideation (SI). Comprehensive workup was performed, including evaluation by 18 different specialties, 20 different imaging studies, 19 different procedures, and 15 medication trials. However, the patient had a minimal response to most treatments. Despite this exhaustive diagnostic evaluation and diverse range of treatments, there was minimal management of his comorbid psychiatric conditions, and his PHQ was documented only 10 times. This eventually culminated in his emergency room visit. This case demonstrates the need to recognize the approximately 10-fold increased risk for suicidal ideation in patients with CRPS, the importance of frequent screening for suicidal ideation and depression in these patients, the necessity of tracking depression trends over time, and the critical role of multimodal management in CRPS, including the diagnosis and treatment of psychiatric comorbidities

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Title: Building Bridges: Community Building and Engagement: Coyote Gulch House Service Project Activity
Authors: Monica Fernandez; William Steiner, Emily Hill, Claire Stanley, David Kim, Alison Day, Rawad Farhat, Celina Diaz
Date: 1/27/2025
Abstract: The mission of the house structure is twofold: to foster a sense of community within the house structure and to engage meaningfully with the people and patients served in their assigned clinics. Engaging patients within the context of their lives enhances the effectiveness of healthcare delivery and improves health outcomes. At an individual level, this approach enables whole-person, patient-centered care, creating opportunities to comprehensively address patient needs. A review of the literature highlights the demand for a holistic, consistent, and coherent structure that aligns education and healthcare to better meet local needs through meaningful partnerships with communities. This community-building and engagement initiative leverages interprofessional collaboration among medical students, student affairs (SA), community health workers (CHWs), and South Main Clinic leadership. To address individual patient needs, representatives from the Coyote Gulch House and staff from SA collaborated with South Main Clinic CHWs to design a family information survey. This survey allowed patients to indicate one or more social needs they required assistance with, particularly leading up to the holiday season. In response to the needs identified through the survey, students created an Amazon registry to gather necessary resources, which was widely distributed to encourage community contributions. Additionally, to foster stronger connections between the community and medical students, a service project was organized featuring meaningful interactive activities, such as face painting and a photo booth, aimed at creating a welcoming and engaging environment for patients and their families. Patient feedback, including direct quotes, will be collected and analyzed following the event on December 17, 2024. These insights will be shared to evaluate the impact of the initiative and identify opportunities for improvement in future projects.

Copyright: Academy of Health Sciences Educators ©2025

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Title: Aligning Expectations Between Doctoring Curriculum and the Student-Led Clinics
Authors: Brooke Austin, Dallen Calder, Serin Springer
Date: 1/27/2025
Abstract: A core component of the new SFESOM curriculum is early clinical exposure. First-year medical students (MS1s) are required to participate in a weekly clinic shift at a student-led clinic (SLC). Regular clinical exposure is intended for students to apply the knowledge they learn within the Doctoring curriculum to real-world settings. Recent feedback has revealed two problems: clinic preceptors have varied expectations of MS1s, which appears to stem from a lack of preceptor knowledge about what MS1s are learning and when, and a disconnect between the Doctoring curriculum and SLC experiences, such that MS1s are not directly applying their knowledge as intended. To address these issues, two calendar- style guides were created, targeting preceptors and students. The preceptor guide lists concepts and skills MS1s have and have not learned for each week. The student guide includes weekly summaries and key areas for students to focus on while in clinic. Both guides include links and QR codes to Doctoring resources and are available in physical and virtual formats. Evaluation of this project’s efficacy is centered around questions included in the End of Phase 1 survey. The deliverables, the preceptor and student guides, have received positive responses from Doctoring faculty. Survey data from the class of 2027 confirmed the need for greater alignment between Doctoring and SLCs: 58% of students said preceptor expectations differed from Doctoring teachings 50% or more of the time, and 8% reported almost never using Doctoring materials. Preliminary data indicates that students recognize the overlap between Doctoring content and SLCs, but there is still room for improvement regarding the application of Doctoring content. It is hypothesized that quick access to Doctoring materials will mitigate lingering disconnects between the curriculum and SLCs. The guides will be continuously updated to ensure the availability of reliable resources. The survey will be repeated with the class of 2028 and compared with the current pre-guide data.

Copyright: Academy of Health Sciences Educators ©2025

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Title: Medical Student Diabetes Education
Authors: Tyler Drummond, Maggie Hale, Katherine Welch
Date: 1/27/2025
Abstract: The objective of this project is to create diabetes educational modules for incoming University of Utah medical students, enabling them to teach and deliver diabetes education to patients in student-led clinics. Traditionally, diabetes education has been provided through scheduled onsite classes. However, based on prior experience at the People’s Clinics, attendance at these classes is often poor, primarily due to time constraints. Patients typically prefer receiving all necessary information during their clinic visit. Unfortunately, this approach is inefficient for both the healthcare provider and the patient. In student-led clinics, patients spend extended time with medical students and providers. To address this issue, we propose training medical students to deliver diabetes education during the patient’s initial visit. This eliminates the need for a follow- up visit, accommodating patients’ time limitations while ensuring they receive comprehensive education in a more personalized and effective manner. The methods include reviewing existing educational resources, compiling content, and incorporating preceptor feedback through collaboration. The outcomes include the creation of online educational modules for incoming medical students, with the eventual goal of implementing these modules in all student-led clinics. Ongoing work will focus on creating comprehensive modules and compiling diabetes information into an easily digestible format.

Copyright: Academy of Health Sciences Educators ©2025

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Title: The Community Perspective of Community Health Workers’ Effectiveness in Public Health
Authors: Jazmine Abril, Sonia Sehgal, Karishma Shah
Date: 1/27/2025
Abstract: Community Health Workers (CHWs) play a critical role in improving public health, particularly in underserved communities, by bridging gaps in healthcare access and addressing social determinants of health. Despite their growing numbers and importance, challenges remain in defining and measuring their effectiveness due to the complexity of their roles and the lack of standardized evaluation metrics. This study aims to qualitatively explore roles, barriers to efficacy, and potential metrics of eight CHWs in Utah to better evaluate their impact. In-depth, semi-structured interviews were conducted with eight CHWs, developed in collaboration with a CHW to ensure relevance to their experiences. The interviews addressed CHWs’ responsibilities, barriers, goals, and potential evaluation methods. Transcripts were analyzed using inductive thematic analysis to identify recurring themes, focusing on capturing the diversity of CHWs’ experiences and perspectives. Thematic analysis revealed seven overall key themes: the importance of personal stories, the need for community expertise, CHW as a multifaceted position, social and professional networks supporting efficacy, insufficiency of current quantitative methods, CHWs connecting communities to resources, and supporting healthy lifestyles. Key themes for efficacy measurement included the number of resources connected to, improvements in quality of life, and the significance of community and CHW support systems. The findings of this study highlight the multifaceted roles and barriers faced by CHWs, providing valuable insights into their effectiveness. By integrating themes such as resource connections, quality-of-life improvements, and support networks into an evaluation tool, standardized metrics can be created to reflect the complexity of CHWs’ impact. These insights will guide the development of a robust evaluation framework to better assess and enhance the efficacy of CHWs in underserved communities.

Copyright: Academy of Health Sciences Educators ©2025

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Title: Using Epic Diagnosis Data to Create a Case Log Reference Repository
Authors: Julia Michels, Ashley Khouri MD; Boyd Richards, PhD
Date: 1/27/2025
Abstract: University of Utah medical students in their clinical years are required to keep a case log to track clinical experiences they see during their rotations. These case log requirements include “umbrella” diagnosis categories, patient populations, and care settings and are set by the SFESOM curriculum committee, as mandated by accreditation standards, to document the breadth of students’ patient care experiences during their medical school training. Students tend to find the case logging process arduous and frustrating. Many diagnoses don’t have a corresponding “umbrella” case to log under. In addition, there is no repository of past logged diagnoses to refer to while completing their personal case logs. The data is entered into Tools, and not easily accessed for analysis. Fortunately, most students rotate within Utah Health, which uses Epic for their EMR, and data can be extracted directly from the system. Given the challenge of case logging for students, we extracted data from Epic for LIC students in the class of 2025 to collate patient diagnoses they have seen. The data set was defined by identifying encounters with notes written by students (specific users were selected), and included the primary diagnosis and setting for each encounter. Once the data was extracted, we correlated each diagnosis to the best-fit case entry, with secondary and tertiary categories documented as well. For multiple modalities of searching, the ICD-10 code was added per diagnosis, and specialties/settings were included. All the data was entered into a spreadsheet that is easily searchable and can be filtered/sorted based on individual needs. The spreadsheet has multiple diagnoses for each case log category and includes almost 2,000 unique diagnoses for reference. The next steps for this project include disseminating the reference to students using the case log system, continuing to grow the database with more diagnoses, and eventually using data extraction methods from Epic to automate the case log process.

Copyright: Academy of Health Sciences Educators ©2025

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Title: Standards of Culpability in Criminal Law: A Comprehensive Analysis of the Mens Rea Approach and its Implications for Student-Led Clinics
Authors: Jacob Taylor, Alise Williams, Rachel Polcyn MD, Jake Arbon, MD
Date: 1/27/2025
Abstract: This paper provides a comprehensive analysis of mens rea—the mental state of an accused individual at the time of a crime— as a cornerstone concept in criminal law for determining culpability. By investigating its foundational role in legal processes, the paper explores the ethical, legal, and methodological challenges associated with evaluating mens rea. Drawing on empirical studies, historical contexts, and contemporary legal precedents, it critically assesses variations in the interpretation and application of mens rea, particularly in forensic psychiatric evaluations. These challenges are particularly relevant to student-led clinics, where emerging healthcare professionals often engage with underserved populations, including individuals with complex mental health and legal needs. The paper aims to trace the historical evolution of mens rea defenses, evaluate the efficacy of current assessment standards, and address emerging challenges such as advances in neuroscience and shifting societal perceptions of mental illness. Ethical concerns, including the potential for discriminatory practices and the tension between patient advocacy and public safety, are explored in depth. Through a systematic review of 22 studies, the paper examines diverse methodologies, populations, and findings, highlighting insights that are directly applicable to clinical training. By developing standardized approaches to mental health evaluations, student-led clinics can play a pivotal role in bridging gaps between clinical and legal systems. This includes offering frameworks that emphasize transparency, consistency, and fairness, fostering interprofessional collaboration between medicine, law, and psychiatry. The analysis reveals significant inconsistencies and biases in current practices, underscoring the need for standardized, evidence-based frameworks that medical trainees can incorporate into their practice to ensure equitable patient care and informed collaboration with legal systems. Ultimately, this paper advocates for the integration of forensic psychiatric principles into clinical education to better equip future healthcare professionals to navigate the intersections of medicine, law, and ethics. This approach ensures that clinics serve as incubators for justice-oriented practices while minimizing potential bias and error in mental health assessments.

Copyright: Academy of Health Sciences Educators ©2025

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Title: Situational Judgment Tests to Assess and Nurture Cultural Humility
Authors: Jenna M. Weber, Jennifer L. Murray MPH, Kristine Snyder MPH, Siale V. Teaupa MD, Nadia Schellenberg, Matthew S. Prewett PhD, Brian Good MD, Paloma Cariello MD, Boyd Richards PhD, Rawad Farhat MD
Date: 1/27/2025
Background: Medical schools seek to graduate students with essential non-cognitive competencies like cultural humility. However, methods to assess and foster such competencies remain inconsistent. Some schools use secondary essays in admissions to assess cultural humility, but once students are admitted, strategies for continued development and assessment of such competencies rarely exist. We hypothesize that Situational Judgment Tests (SJTs) offer a solution to this gap. Methods: SJTs are standardized exams that present a series of hypothetical scenarios that students may encounter in medical school. They require examinees to evaluate the effectiveness of various responses to each scenario. Recently, schools have begun to use SJTs in their selection processes, such as AAMC’s Professional Readiness Exam (PREview). At SFESOM, a collaborative team developed and piloted a set of cases with faculty, staff, and medical students. The SJT test was administered for the first time to first-year medical students in 2023. Subsequently, the cases were discussed with the students to facilitate reflection, and the response frequencies of each case were reviewed to determine the most appropriate approach. Results: Input from students after the review session suggests that they were able to integrate unfamiliar cultural concepts and apply them to patient scenarios. Conclusions: In addition to generating quantitative data for assessment purposes, SJTs and group-based review sessions can foster cultural humility in medical school students. The continued use of SJTs throughout medical education, beyond the admissions process, will enable students to develop the skills necessary to work effectively across diverse communities and cultures.

Copyright: Academy of Health Sciences Educators ©2025