Abstract: Over the past decade much attention has been directed towards futuristic training models. It is felt by many that virtual (VR) and augmented (AR) reality training modules can be tailored to medical training. Virtual and augmented reality training can be utilized to teach important critical thinking as well as procedural proficiency. VR/AR may also be used to ensure longitudinal goals are maintained as training curriculums are altered. As educators and researchers see the value of VR/AR training, the question remains, do the participants find value in VR/AR training? In this study, we looked at the learner perspective of 23 paramedic students who recently completed a National Registry Paramedic-approved curriculum. Overall, 87% of paramedic students felt the VR/AR experience provided was beneficial to their training. Given the high rate of value applied to this training by the students, we feel additional studies and VR/AR training should be tailored to paramedic education during initial and proficiency training events.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: The advancement of three-dimensional visualization technology provides exciting new opportunities in medical education, including new methods for teaching complex anatomical relationships and promising tools for the training of postgraduate physicians. Information on how faculty use three-dimensional visualization technology for anatomy education is essential for informed discussions surrounding their effectiveness as a teaching tool and use in the medical curriculum, yet the current literature lacks necessary contextual details on how faculty integrate these technologies into actual medical curricula. Methods: Fifteen medical educators from North American medical schools and teaching hospitals completed semi-structured interviews and discussed how they use three-dimensional visualization technology for teaching in preclinical courses, clinical clerkships, and postgraduate programs. Transcripts were analyzed using the constant comparative method and resulting themes were used to inform the creation of a questionnaire. Results: The resulting themes of analysis were organized according to a curricular framework that describes how faculty use these technologies as an instructional resource and how this use is related to the purposes, content, sequence, instructional processes and evaluation of medical curricula. The results demonstrate how three-dimensional visualization technology is being is implemented in a variety of ways in the curriculum and revealed numerous similarities of use across the levels of medical education. Analyses revealed minimal use of three-dimensional visualization technology for assessment and indicated faculty face significant challenges in designing such assessment. Conclusions: Results suggest continuing assessment of the effectiveness of these technologies as a teaching tool needs to encompass broader aspects of use, such as those described in this study. Additionally, results showing similarities of use across levels suggest that educators and administrators should consider how threedimensional visualization technology can be thoughtfully integrated to address the changing needs of learners as they progress through medical education. Findings also suggest that administrators who want to support the integration of three-dimensional visualization technology into the curriculum need to provide adequate support and training to help faculty overcome time limitations and difficulties designing assessment methods.

The lack of diversity in medicine is a long-standing issue for US medical schools who have yet to make serious progress. Students who identify as Black, Hispanic, Native American, and Pacific Islander are considered Underrepresented in Medicine (URM) are those historically obstructed from entering medical school. There remain high costs to apply, enter, and stay in medical school. Additionally, the faculty who teach these students are more likely to be white and URM faculty are more likely to leave due to racism, discrimination, and the “minority tax” they experience too often. The effects of racism and discrimination combined with the lack of support negatively affect both URM students' and faculties’ mental health, which makes staying in medicine even more challenging. Many solutions have been proposed. Specifically, Pathways programs allow medical students to become involved and work hand-in-hand with their local colleges and medical schools by becoming mentors, establishing safe spaces, and disseminating advice and free resources. Although the evidence is anecdotal, Pathways programs show promise in creating solutions for URM students, this is exemplified by student testimonials. If medical institutions continue to fail to address the lack of diversity, their students can step up and create Pathways programs to fill the gaps they cannot seem to find. / Urban Bioethics

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The COVID-19 pandemic uncovered instructional changes within higher education. Accommodations for continued instruction included a transition to remote learning. However, little research exists regarding the experiences of medical residents during this transition in their education while combating the COVID-19 pandemic. This qualitative study, phenomenological in nature, aimed to explore the lived experiences of internal medicine medical residents at one medical college in Central Florida regarding the transition from face-to-face instruction to remote learning due to the COVID-19 pandemic. Eleven participating medical residents underwent semi-structured interviews via Zoom. Garrison's Community of Inquiry conceptual model and Hall and Hord's Concerns-Based Adoption Model theoretical framework were used. The researcher utilized Colaizzi's phenomenological analysis method to analyze the interview transcripts and Saldaña's coding method to code the data. Dedoose software was used in the analysis process. Participants were found to have shared and non-shared experiences and encountered both benefits and challenges from remote learning. Shared experiences included travel difficulties due to border closures and family challenges. Benefits included the presence of national guest speakers in lectures, attending lectures from the convenience and comfort of home, and the addition of interactive learning methods such as Kahoot and Jeopardy. Challenges experienced during the transition included curricular disorganization, distractions such as watching movies, a lack of interest in attending lectures, and a lack of interaction, with colleagues and by the instructor. Further research recommendations are discussed regarding emergency preparedness in higher education and graduate medical education, in addition to instructor perspectives.

Assessing Virtual Versus In-Person Experiential Learning in Medical Student Pediatric Clerkship Training Andrew Berry, Andrew Wigger, Karilynn Craig, Dr. Brock Blankenship, Dr. Jennifer Gibson, Center for Experiential Learning, Quillen College of Medicine, East Tennessee State University, Johnson City, TN. Simulation and experiential training have been incorporated into medical school training for decades. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience. As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, our research team was interested in understanding students’ perceptions of virtual and in-person experiential learning activities. The primary goal of this study is to compare medical students’ perceptions of the quality and value of in-person versus virtual experiential learning during their pediatric clerkship. Secondary measures of this study examine the differences regarding the retention of case information presented, the clinical relevance of the pediatric cases discussed, and the likelihood that students will attend similar future sessions. Our team hypothesized that students would perceive in-person sessions as more valuable and meaningful to their medical education. One academic year of medical students who participated in two experiential learning encounters during their pediatric clerkship was assessed. Each encounter involved a series of approximately ten patient cases over two hours; one encounter was done in person, and the other was done virtually. Each case was then discussed using a Socratic format; faculty would ask questions and engage students individually, assessing their decision-making capability (including differential diagnosis, treatment plans, and dispositions). Data was collected by a survey administered after both encounters, each with the same questions. Students generally felt the virtual format for this type of training was as well received as the in-person format (56% vs. 52.2% for excellent value ratings, respectively). Similarly, 43.5% of students reported that the in-person cases greatly improved their retention, while 40% said the virtual cases improved their retention of educational material to the same degree. The in-person experiences were reported as being extremely clinically relevant by 56.5% of students, while the virtual cases were perceived as extremely relevant by 48% of respondents. Lastly, survey data showed that 47.8% of respondents said they would very likely attend similar future in-person sessions (compared to 44% for similar virtual events). Our team feels that the results of this study demonstrate that utilizing a Socratic Model of teaching in experiential learning has excellent value, and high-quality training can be accomplished virtually, even during times of potential virtual fatigue. These findings are important as our results show that experiential learning can be adapted, yet still beneficial, when in-person activities cannot take place, such as what we encountered during the COVID-19 pandemic.

Medical simulations provide hands-on training at various levels of medical expertise. Yet these simulators fail to accurately mimic the look, feel and behavior of human tissue. Applying measured mechanical properties from human cadaver tissues promises to improve the fidelity of simulated tissue behaviors when subjected to medical procedures. Samples of human parietal pleura were tested under uniaxial tension to failure and measured characteristics were replicated in synthetic pleura. Context specific parameters were then collected and compared between human pleura and the new synthetics. These comparisons tested the hypothesis; H1 Gaps exist between synthetic and human pleura performance, H2: Human tissue fracture mechanics define desired performance of synthetic tissues, H3: Synthetic and human tissues with similar stress/strain parameters will behave similarly when blunt punctured. The results promote the future development of high fidelity tissue simulants for medical training. The studied tissue is parietal pleura which contributes the critical haptic "pop" indicating access to the proper anatomic space during the tube thoracostomy procedure. Once accessed through blunt puncture, tube is then inserted to drain air and fluid from around the lungs. Stress/strain based hyper-elastic and fracture properties calibrated from fresh human cadaver pleura were used to define performance requirements. Synthetic pleura were then prototyped and their mechanical properties were characterized. Commercial pleura simulants were puncture tested and compared to compliant custom and off-the-shelf formulations. A non-compliant but commonly used pleura substitute was also tested. Blunt puncture force and displacement were compared for each of the materials to test the stated hypotheses.

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The dissertation explores relationships between social mobility and tribal identification, based on observations made among a sample of medical trainees at the University of Ibadan (formerly, the University College, Ibadan) in Western Nigeria. The thirteen-month study was carried out during 1962-63. Data were collected on 270 Southern Nigerians entering medical training in the years 1952-1960. Material was taken from university records, personal observations, unstructured interviews, and formal interviews with a sub-sample of 103 trainees drawn from among graduates or potential graduates in the years 1960-1965. Social background characteristics were compared with performance in training. Based on the ability to sit for and to pass all parts of the standard Second M. B. and Final M.B.-B.S. examinations and to graduate in the minimum five-year training period, representatives of large triues (Ibos, Yorubas) had a significantly higher pass rate than representatives of small tribes (Binis, Ijaws, Efiks, Ibibios, and several smaller groups). Corrections for caliber and location of secondary schools attended showed no variations in this pattern. Nor was it possible to account for these differential performances in terms of examination procedures, faculty bias, degree of exposure of various groups historically to foreign impact, or feelings of social isolation during training. [TRUNCATED] / 2031-01-01

In regions of the world that experience a deficit of surgical care, educational initiatives can foster the development of a skilled surgical workforce. Implicit in training these health workers is the mandate to retain them in the country in order build capacity. Eyal’s framework presents ways in which locally relevant training can improve retention and outlines the ethical and pragmatic concerns of such initiatives. In 2006, Guyana established it’s first surgical training program, an example of locally relevant training. The University of Guyana Diploma of Surgery (UGDS) program was selected for this case study research. Consistent data collection, supported by a systemic procedure to analyze that data, is paramount to increase the effectiveness of the UGDS program. The purposes of this dissertation research were two-fold. Firstly, it sought to understand how the UGDS program influences retention and the ways in which the UGDS members contribute to capacity building and the program’s sustainability. Secondly, this program evaluation provides a useful context to inform Eyal’s framework. 8 graduates, 2 trainees, 4 faculty members and 2 persons identified as policy makers were interviewed. Interviews were conducted face to face, and then transcribed. Surveys were administered to graduates and trainees and reflective reports and presentations were coded and analyzed. Overall, the data mapped fairly well onto Eyal’s framework. The results of the study suggest that the benefits and concerns Eyal outlines would be better represented along a continuum rather than being classified as either advantageous or disadvantageous with respect to retention. While Eyal’s claims generalize across settings, he should acknowledge this limitation and consider the important role that context plays. Overall, the results suggest that the UGDS program has positively influenced retention and capacity building. Key recommendations were made to the UGDS program that aim to improve retention and capacity building. As regions continue to face challenges associated with providing adequate surgical care, fostering retention and capacity building is recommended so that a sustainable surgical workforce can meet surgical needs. / Thesis / Candidate in Philosophy

In light of Accessibility for Ontarians with Disabilities Act, 2005, medical schools witnessed increased number of students with disabilities matriculating in their program. However, the administrators face challenges because ensuring accessibility in dynamic clinical settings may not always be feasible or ideal while considering the resource implication and patient safety. There is little consensus and established guidance on how to provide responsible accommodations for otherwise-qualified medical students with disabilities. To understand the development of resilience in medical students with disabilities as they confront potential institutional barriers and social or self-imposed stigma, we asked: how do medical students with disabilities identify and communicate their learning needs to negotiate necessary accommodations with the Student Accessibility Services and/or the MD program? The Constructivist Grounded Theory approach by Charmaz (2006) served as the methodological guide. In-depth individual interviews were conducted capturing the students’ perspective on accommodations arranged by the program, inclusion challenges in medical education and their recommendations on how to enhance program accessibility. Three major themes emerged: 1) creating a dialogue to devise learner-centered accommodation strategies, 2) recognizing available extrinsic and intrinsic resources, and 3) optimizing available extrinsic and intrinsic resources. Self-reflection was the key underlying ingredient driving students’ resilience development in partnership with inclusive learning environment and supportive faculty. Student diversity present in the medical schools merits further research. Diminishing stigma towards health professionals with disabilities is imperative. Endorsement of cross-departmental and institutional collaboration that enables dissemination of cost-effective and comprehensive accommodation strategies is recommended. / Thesis / Master of Science (MSc)