The medical ethics curriculum is an important part of medical education as it helps foster students to become virtuous and compassionate caretakers. The format of the curriculum is intended to expose students to ethical and moral issues early in their careers and allow them to apply their knowledge in clinical situations. However, the implementation of the curriculum is incredibly varied and fraught with challenges. This thesis explores the challenges of the current format of the medical ethics curriculum and the repercussions that will extend throughout medical school and moving into residency and beyond. It will additionally delve into potential solutions that, if implemented conscientiously, can encourage more engaged and thoughtful discussions in the classroom and the clinical setting. It is the ultimate hope that such interventions will result in students’ increased moral development and shape these future physicians into better caretakers, colleagues, and leaders. / Urban Bioethics

Medical schools around the country are utilizing service-learning as a method of promoting cultural humility among future physicians and strengthening partnerships between academic institutions and their surrounding communities. Critical service-learning (CSL) is an approach which emphasizes the need to address the power dynamics inherent to service through guided critical self-reflection for student learners, and centers autonomy and self-determination for community stakeholders. STEM Stars is an afterschool STEM enrichment program at a community center in North Philadelphia which was piloted in the 2019-2020 academic year. It was created with a trauma-informed design to address the social and emotional needs of K-6 students at the community center and to introduce trauma-informed practices to staff at the center. STEM Stars also served as a more intensive CSL opportunity for medical student volunteers and a model for future service-learning programs at the medical school. This thesis is a gap analysis of STEM Stars: it will provide a background of the program, review the pilot year, assess its successes and shortcomings, and propose changes to be made in the coming years. / Urban Bioethics

ABSTRACT Despite changing demographics, policy, technology, and economics; medical education curriculum has changed very little from its inception over 100 years ago. The United States medical system has been under scrutiny for delivery of affordable, quality and accessible care for years. In order to address these challenges, we need to train physicians to consider these criteria when treating patients. A way to do this is through a curriculum that includes Health Systems Science (HSS). The challenge of HSS is that it adds additional topics and competencies to an already full medical education curriculum. In order to move forward in medical school, students are tested on their knowledge of basic science. Because HSS topics are not included in the required testing, students who have not been exposed to an HSS curriculum perceive HSS topics as less valuable than traditional medical school topics. This research sought to understand if students changed their perception of the value of HSS after exposure to an HSS curriculum. First-year medical students from a large, urban medical school were surveyed using a pre-test and post-test survey before and after exposure to an HSS curriculum. This study was conducted with two cohorts over two years to see if there was a change in student perceptions of HSS. An Institutional Cycle design was applied to compare the post-test from the students in cycle 1 to the pre-test of students in cycle 2. This approach was deployed for two reasons. The first because of restrictions placed on the data collection; the pre-test for each person could not be directly linked to the post-test. The second, because there was no way to create a control group. These cohorts could not be randomly assigned to another curriculum. Comparing the post-test of Cohort 1 to the pre-test of Cohort 2 allows for the analysis of change between the two cohorts. Student perceptions did not change significantly between the pre-test in cycle 2 and the post-test in cycle 1. More research is needed to provide guidance for the development of an HSS curriculum that aligns with traditional medical education components. / Educational Administration

When healthcare professionals perceive patients’ symptoms through media or media technologies, how do they respond to them? Many studies have explored the effects of the film, novels, music on empathy and recently a few studies started focusing on the virtual reality (VR) and augmented reality (AR) that visualize patients’ invisible symptoms and their effects on the empathy of medical students as future healthcare professionals; however, their psychological processes are not fully elaborated yet. This dissertation was designed to detail the psychological processes evoked by AR that visually mimics migraine symptoms and uses presence and narrative transportation to increase empathy. A mixed-method study was conducted to untangle the psychological processes of presence, narrative transportation, and empathy by exploring their existence, nature, strength, and meanings. Two treatment conditions were created: a head-mounted display (HMD) as a high immersive condition and a handheld display as a low immersive condition with a focus on media immersiveness as the degree to which AR submerges its users’ perceptual system. The study participants were a small (n=27), but motivated group of medical student learners. In the quantitative results, AR was not visually immersive enough to evoke presence as a perceptual illusion of non-mediation directly since there were systematic effects of media immersiveness of AR on presence, but there were no significant effects of media immersiveness on presence when controlling for medical students’ tendencies and abilities. It was assumed that presence occurred as a constructive perceptual process indirectly mediated through medical students’ tendencies and abilities. In a canonical correlation and stepwise regression, the maximal correlation among immediate sense of presence and narrative transportation and situational empathy revealed an optimal degree of perceptual involvement that leads to sympathy as a positive state of situational empathy. Another canonical correlation and stepwise regression among the traits of immersive tendency and physician empathy and situational empathy showed that there is also an optimal degree of medical students’ sensitivity trait that leads to sympathy as a relatively stable situational empathy. Since, as interview results showed, medical students’ motives were prosocial, it is possible to interpret distress or sadness as another type of situational empathy entailing caring about others. In the qualitative results, there were close relationships between media environment and presence. An immersive virtual environment (IVE) via AR, which affords users the perceptual or embodied feeling of physically being surrounded by its represented environment, was closely related to sensorimotor perceptual processing of presence. A continuous immersive mixed environment (IME) via AR, which affords users the imaginatively situated feeling by mixed reality, extended presence in the actual environment through the process of narrative transportation and affect. The contributions of the findings to the theory and research literature regarding presence are discussed along with recommendations regarding practical contributions to ongoing efforts to enhance healthcare professionals’ empathy and thereby effectiveness in treating patients with migraines and other conditions and illnesses. / Media & Communication

Disgust is a part of medical education. Whether in the anatomy lab, the operating room, or the hospital wards, medical school is often the first time that future doctors see human suffering manifested in bodies that elicit embarrassment, disgust and fear. Over the course of training, seeing such bodies goes from exceptional to commonplace as doctors learn to witness and empathize with suffering without becoming overwhelmed by it. In this thesis, I examine students’ first encounters with abject bodies in the anatomy lab, their later encounters with such bodies in their clinical years, and the educational programming shapes students’ gaze towards these bodies as they develop from laypeople into professionals. I argue that while medical humanities curricula implemented into gross anatomy help students manage challenging personal feelings elicited by the corpse, taboos and silences during the clinical years prevent students from thinking deeply about how patients experience having bodies that elicit disgust. The dearth of reflection on feelings of disgust during clinical training leaves doctors in training ill-equipped to promote and maintain patient dignity during medical care, particularly at the end of life. / Urban Bioethics

The purpose of this thesis is to examine the patriarchal undertones and overt sexism that informs and takes place within undergraduate medical education (medical school). Using a feminist analysis, I will expose some of the ways in which sexism occurs. This includes at the levels of who is given authority to teach medical students, the biomedical research we are using as our primary knowledge source, what material is chosen to be prioritized vs what is left out of the curriculum, how this material is taught and interpreted, and what the larger cultural and value system is that medical education is embedded in. I will demonstrate how the patriarchal values of masculinity, objectivity, heroism, competition, technicality/procedurality, objectivity, rationality, and so on pervade each of these levels, devalue femininity and non-biomedical sources of knowledge, exclude women, and cause harm to all trainees and future patients. / Urban Bioethics

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The overarching theme of this thesis is to discuss the research to date on intimate partner violence (IPV) in orthopaedic surgery and to begin to study selected issues that have been understudied in orthopaedic surgery and IPV. This thesis outlines the current state of knowledge in the field of IPV and orthopaedic surgery and provides some insight into three selected “emerging issues” in the field which warrant future research including: education of orthopaedic surgeons and residents to reduce barriers and improve perceptions; IPV perpetrators; and outcomes for victims of IPV. The findings demonstrate that a short course on IPV for orthopaedic trainees led to an improvement and retention of knowledge three months after the course. IPV education should be integrated into training programs for orthopaedic surgeons. Our systematic review on IPV perpetrator factors indicates that using alcohol or drugs, experiencing child abuse, witnessing interparental aggression, low socioeconomic status, and psychological conditions like depression and anxiety were commonly associated with IPV perpetration. Perpetrator treatment programs should take into consideration modifiable and preventable factors that are associated with IPV perpetration. This thesis proposes a pilot prospective cohort study as the first step toward determining how experiences of IPV affect orthopaedic outcomes such as injury-related complications. The proposed study will determine feasibility and assist in the development a larger-scale multinational prospective cohort study that will engage health care professionals from around the world to increase awareness of how IPV affects patients’ musculoskeletal outcomes. In the past decade, the field of orthopaedic surgery has become more aware of the issue of IPV, but there are many questions that remain. Future research into the above issues will be an excellent first step to fully understanding the issue of IPV in orthopaedic patients, and may lead to improved support of victims of IPV in the future. / Thesis / Master of Science (MSc)

No description available.

This is a systematic review of the research data between 1995 and June 2013 concerning faculty development in the use of high-fidelity patient simulation for health professionals and students with a search of the following databases: CINAHL, Nursing and Allied Health Collection: Comprehensive, OVID Medline, ScienceDirect, PubMed, Scopus, and ProQuest Dissertation/Theses Database. The primary search terms were high-fidelity patient simulation and faculty development. Reference lists from relevant articles were also reviewed. Twenty-five studies were included for this review. The majority of the studies were surveys with a few quasi-experimental designs. The themes were similar to those found in the non-research literature: strengths, incentives, barriers, use of faculty champions/simulation coordinator, and faculty development. The validity and reliability differed by study. There are numerous incentives and barriers to the use of high-fidelity patient simulation by faculty. Several examples of faculty development programs have been described in the literature but little evaluation has taken place beyond the end of the program. The goal of the use of high-fidelity patient simulation is to enhance the student’s knowledge, skills, and critical thinking in the care of patients. It is essential that the faculty are competent to provide instruction with high-fidelity patient simulation and therefore, the efficacy of these developmental programs need closer attention.