2013 Atlanta Conference Poster Award Abstracts

Research Category

First Place Award

Poster Title: The difference in the Achievement of clinical practice examination According to the type of medical schools

Authors: Hoon-Ki Park, MD, PhD1, Jwa-Seop Shin, MD, PhD2 and Young-Mee Lee, MD, PhD31Family Medicine and Medical Education, Hanyang University, College of Medicine, Seoul, Korea; 2Medical Education, Seoul National University, College of Medicine, Seoul, Korea and 3Medical Education, Korea University, College of Medicine, Seoul, Korea.

Introduction: There are two tracks of medical education system for the degree of medical doctor in Korea. A few of 41 medical schools run both a medical college as an undergraduate course and a medical school for graduate course at the same class. The admission policy and students’ age were different for two tracks in a school, but the educational contents were same each other. The first graduate year of the mixed course was expected to show any difference in the exit outcomes of students according to the course.

This study was conducted to investigate the difference of clinical practice examination (CPX) as an exit exam among senior students according to the type of medical education courses.

Project Description: We included 378 senior medical students from three different medical schools/medical colleges who completed the CPX as an exit exam before graduation under the same CPX consortium. Multiple linear regression analysis was used for comparing the effect of type of school on the CPX scores and each area scores.

Outcomes: Two hundreds and sixteen students (57.1%) were in the course of medical college, 62.4% were male. Scores of data gathering, information sharing, and overall scores were not statistically different by the type of courses. Scores of patient-physician interaction (PPI) among students of medical schools were higher than those of medical college students. (65.0±5.2 Vs 63.8±4.9, p=0.02) Female students were better compared with male students in terms of CPX total scores (b=2.48, p<0.01) and PPI scores (b=2.09, p<0.01). Both scores were decreased with age (for total scores, b=-0.23, p=0.04). After adjustment for age, sex, and university, CPX total scores and PPI scores were not different according to the type of schools.

Multiple linear regression of CPX total scores on sex, age, and type of schools

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Conclusions/Discussion: There is no difference in the exit CPX achievement when the same educational contents are run even though medical education systems are divided into two tracks.

Research Second Place Award

Poster Title: Interprofessional Communication: A Comparative Teaching Strategy For Pharmacy Students

Authors: Hollis D Day, MD. MS., Susan M Meyer, PHD, Helen K Burns, PHD and Valerie L Fulmer, BS. 1Office of Medical Education, University of Pittsburgh School of Medicine, Pittsburgh, PA; 2University of Pittsburgh School of Pharmacy, Pittsburgh, PA; 3Excela Health, Greensburg, PA and 4Office of Medical Education, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Introduction: Interprofessional communication is a critical element to patient care. This study compared two methods of teaching pharmacy students how to communicate with physicians in challenging scenarios: standardized colleagues (an adaptation of standardized patients) and video triggers/group discussions.

Project Description: Fifty-seven (57) students interacted with medical faculty as standardized colleagues portraying particular professional roles, attitudes, and communication styles. Pharmacy and medical faculty provided feedback on demonstrated behaviors impacting communication effectiveness. Forty-seven (47) students viewed videos demonstrating interprofessional interactions and participated in facilitated discussions of the demonstrated interprofessional communication skills. A

self-evaluation of comfort and confidence in communication skills adapted from a validated instrument1 was administered at baseline, three, and six months. Students completed an evaluation of the perceived helpfulness of the activity.

Data from students with scores on all three time points were used in the analysis (n=92) using paired samples t-tests. An independent samples t-test was performed to determine differences in mean scores for the activities.

Outcomes: Significant difference between baseline (X= 8.51) and three-months (X= 10.46) (t= 7.615, p<.001), and between baseline and six-months (X= 10.65) (t=8.958, p<.001)Independent samples t-test revealed a significant difference in helpfulness/confidence/comfort between the standardized colleagues and video methods (t=2.396, df=82.69, p=.019).

Conclusions/Discussion: Using standardized colleagues can enhance students’ abilities to communicate effectively in challenging situations.

Innovation Category

First Place Award

Poster Title: Using Standardized Patients to Prepare “Super Users” for an EMR Rollout
Authors:  Jeanette Wong, MPA, BSN and Celeste Villanueva, CRNA, MS.1Health Sciences Simulation Center, Samuel Merritt University, Oakland, CA and 2Health Sciences Simulation Center, Samuel Merritt University, Oakland, CA.

Introduction: The rollout of an electronic medical record system is a significant event in a healthcare system. A strategy for success is trained staff ready to assist during the rollout period. In addition, providers struggle with maintaining patient focused care while documenting in an EMR. The traditional EMR preparatory training includes a combination of in classroom and on-line training modules. We included the use of standardized patients to add realism to the training and the opportunity to experience the potential obstacles in providing patient focused care and to develop strategies.

Project Description: The Health Sciences Simulation Center (HSSC) at Samuel Merritt University (SMU), an affiliate of Sutter Health, was requested by Sutter Health East Bay to develop a simulation experience for the Super Users (healthcare providers who volunteered to go through extensive EMR training to assist their colleagues during implementation) to have a “hands-on” experience before the system goes “live.” The experience was designed to use standardized patients because of the realism the encounter will provide. The learner groups were interdisciplinary and included physicians, nurses, respiratory therapists, pharmacists and other allied health care professionals. The case was a patient with sepsis requiring admission orders, an initial nursing assessment, a respiratory treatment, and medication delivery. These interventions allowed for an interdisciplinary team to interact with the patient and chart in the EMR system. The encounter was videotaped and then debriefed with HSSC faculty, EMR expert trainers, and, of course, the standardized patient.

Outcomes: More than 90 healthcare professionals participated in the EMR standardized patient training. The feedback was overwhelmingly positive and learners understood the importance of patient-focused care and how difficult it can be when working with an EMR system. The feedback provided the Super Users with strategies on how to maintain patient-focused care while working with the EMR; they were encouraged to share the strategies with their colleagues during the implementation phase.

Conclusions/Discussion: The experience was a unique and effective method in preparing Super Users to be role models for colleagues on how to communicate and continue to provide patient-focused care while utilizing an EMR system.

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Second Place Award

Poster Title: Interprofessional Error Disclosure Simulation Benefits Both Students and Faculty
Authors: Dena K Higbee, MS1, Gretchen Gregory, RN, MSN2, Erica Ottis, PharmD3, Leslie Hall, MD4 and Carla A Dyer, MD41Shelden Simulation Center, University of Missouri School of Medicine, Columbia, MO; 2Sinclair School of Nursing, University of Missouri, Columbia, MO; 3School of Pharmacy, University of Missouri-Kansas City, Columbia, MO and 4Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO.

Introduction: Error disclosure is a challenging part of clinical practice. An interprofessional error disclosure program from a collaborating institution was adapted to incorporate standardized family members. The goal was to demonstrate its adoptability and effectiveness by evaluating improvements in self-reported student knowledge and comfort while promoting interprofessional collaboration. The exercise also provided faculty development.

Project Description: 183 health professional students (second year medical, seventh semester baccalaureate nursing, and third year pharmD) participated in a three-hour error disclosure course. Following a lecture on disclosure techniques, interprofessional faculty facilitated disclosure training for groups of 10 students. After group planning, teams of 3-4 students disclosed the error to a standardized family member, who reacted uniquely to each group. Advance standard patient training included practice with a range of emotional responses and active debriefing techniques. Peers, family member, and faculty provided feedback following each disclosure encounter; interactive discussion followed. Students completed 10 IRB approved questions, using a 5-point Likert scale (5=strongly agree), regarding knowledge, attitudes and comfort with disclosure pre/post encounter. Students and faculty completed qualitative and quantitative evaluations. Analysis of paired pre/post survey responses is underway.

Outcomes: Post survey completion rate was 96-100% among groups of students. Mean confidence of students in disclosing errors increased from 3.71 to 4.48 (pharmacy), 3.28 to 4.22 (medicine) and 3.57 to 4.21 (nursing) following the event. Mean responses of knowledge regarding error disclosure techniques increased after the event from 2.90 to 4.43 (pharmacy), 2.38 to 3.95 (medical) and 3.12 to 4.19 (nursing). 95-100% of students and 100% of faculty agreed or strongly agreed that having interprofessional learners made this a more valuable learning experience. The majority of faculty/staff facilitators stated they would apply something learned to their practices.

Conclusions/Discussion: After minor modifications, this disclosure exercise was adopted from one institution to another to include a new valuable role for standardized family members. Results demonstrate significant improvement in self-reported knowledge of disclosure and comfort with the skill by all professional groups. Students also reported improved understanding of interprofessional roles and teamwork. Added benefits included the faculty development that occurred as a result.

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