Department of Family Medicine Works

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    Raising the Bar: Evolution of a Statewide Interprofessional Education Program Following a 5-Year Outcomes Evaluation
    (JCIPE, 2022) Daulton, Brittany J.; Weber, Zachary A.; Newton, April D.; Romito, Laura; Manz Friesth, Barbara; Family Medicine, School of Medicine
    Indiana University is a complex campus system across the state of Indiana. IU-Bloomington hosts the main campus with nearly 50,000 students, while Indiana University-Purdue University Indianapolis (IUPUI) has approximately 30,000. Additionally, there are seven regional medical school campuses located throughout the state in Gary, Evansville, Fort Wayne, Muncie, South Bend, Terre Haute, and West Lafayette.
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    Becoming an Agile Change Conductor
    (Frontiers, 2022) Mehta, Jade; Aalsma, Matthew C.; O'Brien, Andrew; Boyer, Tanna J.; Ahmed, Rami A.; Summanwar, Diana; Boustani, Malaz; Family Medicine, School of Medicine
    Background: It takes decades and millions of dollars for a new scientific discovery to become part of clinical practice. In 2015, the Center for Health Innovation & Implementation Science (CHIIS) launched a Professional Certificate Program in Innovation and Implementation Sciences aimed at transforming healthcare professionals into Agile Change Conductors capable of designing, implementing, and diffusing evidence-based healthcare solutions. Method: In 2022, the authors surveyed alumni from the 2016–2021 cohorts of the Certificate Program as part of an educational quality improvement inquiry and to evaluate the effectiveness of the program. Results: Of the 60 alumni contacted, 52 completed the survey (87% response rate) with 60% of graduates being female while 30% were an under-represented minority. On a scale from 1 to 5, the graduates agreed that the certificate benefited their careers (4.308 with a standard deviation (SD) of 0.612); expanded their professional network (4.615, SD of 0.530); and had a large impact on the effectiveness of their leadership (4.288, SD of 0.667), their change management (4.365, SD of 0.742), and their communication (4.392, SD of 0.666). Graduates claimed to use Agile Processes (Innovation, Implementation, or Diffusion), storytelling, and nudging weekly. On a scale from 0 to 10 where 10 indicates reaching a mastery, the average score for different Agile competencies ranged from 5.37 (SD of 2.80) for drafting business proposals to 7.77 (SD of 1.96) for self-awareness. For the 2020 and 2021 cohorts with existing pre and post training competency data, 22 of the 26 competencies saw a statistically significant increase. Conclusion: The Graduate Certificate has been able to create a network of Agile Change Conductors competent to design, implement, and diffuse evidence-based care within the healthcare delivery system. Further improvements in building dissemination mastery and program expansion initiatives are advised.
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    An Online Resident-as-Teacher Curriculum Improves First-Year Residents’ Self-Confidence Teaching in the Clinical Learning Environment
    (Springer, 2023-07-05) Kochhar, Komal; Cico, Stephen J; Whitaker, Nash P; Pettit, Katie E; Brokaw, James J; Nabhan, Zeina M
    We implemented an online Resident-as-Teacher curriculum for all incoming residents (PGY1s) to provide them with a basic foundation for effective teaching in the clinical learning environment. The curriculum consisted of 5 asynchronous modules delivered via the web from 2017-2021. Prior to starting the course, the PGY1s completed a self-assessment of their teaching ability (pre-test) and then again 7-8 months after completing the course (post-test). Analysis of the paired data from 421 PGY1s showed a statistically significant improvement in the self-ratings of their teaching from pre-test to post-test (p < 0.001). Our findings suggest that an online Resident-as-Teacher curriculum can produce lasting benefits in new residents’ self-confidence as educators.
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    Pilot Study Evaluating a Post Hospital Follow-Up Curriculum for Internal Medicine Interns
    (2023-04-19) Frontera, Eric D; Ho, Monling; Kochhar, Komal
    Objective or purpose of innovation Successful hospital follow-up visits can prevent medication errors and mitigate readmissions. Medical education curricula typically focus on how transitions of care are forwarded to providers within an inpatient setting, or from inpatient to outpatient; however, there is little formal training among Internal Medicine (IM) residents in performing ambulatory hospital follow-up visits. Innovation Design A novel curriculum was created whereby IM interns (PGY1) attended a one hour-long interactive lecture that was offered virtually and in-person. The interns observed patient scenarios that highlighted hospital follow-up tasks, which were then used to create a checklist for the learner to apply to their clinic patients. Evaluation Plan: methods and measures Before and after attending the interactive lecture, the interns were asked to complete a pre-test (n=14) and post-test (n=12) regarding their knowledge and attitudes about hospital follow-up visits. PGY2&3 IM residents (n=26) were also asked to complete the pre-test, but were not asked to attend the interactive lecture. This was done to establish a baseline of clinical competence that might be expected in more experienced residents. Outcomes Chi-square analysis revealed no significant differences between the pre-test and post-test results of the PGY1 interns. In comparison to the more senior residents (PGY2&3), the interns remained significantly less likely (p< 0.05) to be confident in their ability to conduct hospital follow-up visits; to identify ways that hospital follow-up visits can help them understand inpatient care and management strategies; to consider social determinants of health as barriers and as possible triggers for readmission; and to be confident identifying next steps in patient care management following hospital discharge. Innovation’s strengths and limitations Our biggest limitation was the small sample size which may have obscured any impact of the intervention. There are ongoing efforts to replicate this intervention with larger sample size.
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    Implementation of an Annual Education Day to Foster Medical Education Scholarship in a Regional Campus System
    (2023-04-19) Kochhar, Komal; Soleimani, Leila A; Byrne, Bobbi J; Stefanidis, Dimitrios; Pettit, Katie E; Zakeri, Bita H; Denny, Kim; Brokaw, James J; Wallach, Paul M
    Purpose/Background The Indiana University School of Medicine (IUSM) employs a large geographically distributed system of medical education comprised of 8 regional medical campuses statewide and the main medical campus in Indianapolis. An inherent challenge of operating such a large multi-campus educational system is being able to provide professional development opportunities for all our medical educators across the state. Design/Methods To address the professional development challenge in a large multi-campus system, our steering committee planned an inaugural “Education Day” in 2020, which attracted proposals of educational innovations and scholarship from across the statewide system. After a peer-review process, the accepted proposals were scheduled for oral and poster presentations, workshops and small groups sessions, and themed sessions. A keynote address was given by a nationally recognized medical educator. The day ended with an awards ceremony for “best” faculty, staff, and student presentations. The Education Days were held in-person on the Indianapolis campus in 2020 and 2022; and it was held virtually in 2021. Outcomes/Results Across the 3 Education Days:  ~250 registrants participated each year  ~130 proposals were received each year; in 2022, we included an additional 40 proposals from medical students statewide regarding their Scholarly Concentration projects1  80% of the post-event respondents rated Education Day as excellent/very good  87% strongly agreed/agreed (SA/A) they were better able to collaborate with other IUSM medical educators  79% SA/A they were better able to identify best practices in medical education  72% SA/A they were better able to publish educational outcomes data To facilitate statewide dissemination, the presentations were archived in the University’s ScholarWorks Digital Repository.2 Strengths/Limitations IUSM’s Annual Education Day has established itself as a successful venue to share educational best practices and to forge new collaborations. Feasibility/Transferability Although the time and resources required for a successful Education Day are substantial, this event can be replicated elsewhere.
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    Implementation of a Foundational Online Resident-as-Teacher Program for All First-Year Residents
    (2023-04-20) Kochhar, Komal; Dilly, Christen K; Cico, Stephen J; Whitaker, Nash P; Pettit, Katie E; Brokaw, James J; Nabhan, Zeina M
    Purpose/Background Residents are expected to teach medical students, and yet few enter post-graduate training programs prepared to do so. Each year at the Indiana University School of Medicine, 400 first-year residents (PGY1s) from multiple specialties begin their post-graduate training. Our goal was to implement a school-wide Resident-as-Teacher (RasT) curriculum for all incoming PGY1s to provide them with the requisite pedagogical skills and self-confidence to teach effectively.1 Design/Methods We required that our curriculum be delivered asynchronously and on-demand to avoid having to schedule numerous in-person training activities across multiple teaching hospitals. We used the A3 problem-solving process2 to create a series of online training modules delivered via Canvas from 2017 to 2021. These modules focused on our institutional and clerkship learning objectives and incorporated videos of best practices for teaching in the clinical environment. Prior to the start of the course, the PGY1s completed a self-assessment of their teaching ability (pre-test) and again 7-8 months after completing the course (post-test). Outcomes/Results Of the 1,091 residents who completed the pre-test, 421 also completed the post-test (38.6%). Analysis was limited to 421 respondents who completed both the pre-test and post-test (paired data). According to the McNemar-Bowker Test, there was a statistically significant improvement in the teaching self-ratings from pre-test to post-test, e.g., 31% self-rated above average/excellent versus 53% self-rated above average/excellent (p < 0.0001). Moreover, the PGY1s self-reported significant improvements in 3 teaching skills: Teaching Strategies, Individualized Teaching, and Providing Feedback (p < 0.01). Strengths/Limitations Our findings suggest that an online RasT curriculum can produce lasting benefits in PGY1’s self-confidence as teachers (Kirkpatrick levels 1 and 2a) but is limited by the inability to assess higher-order benefits like behavioral change (Kirkpatrick levels 2b, 3, 4).3 This online approach to RasT training is feasible to administer, fulfils LCME requirements, and can easily be replicated.
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    Using the AHEC Scholars Program to Enhance Health Professions Learners’ Self-Efficacy for Practice Transformation
    (Wolters Kluwer, 2022-01) Taylor, Jennifer; Goletz, Sarah; Bruno, Danielle; Family Medicine, School of Medicine
    The Indiana Area Health Education Centers Scholars program is a 2-year leadership program designed to supplement health professions students' academic training and enhance practice readiness around 6 core topic areas including practice transformation. The study was a retrospective cohort study assessing learners' reported level of self-efficacy on a set of 6 competencies around practice transformation and quality improvement. A total of 68 students graduating in the first cohort responded to the competency questions. Area Health Education Center Scholars reported a significant increase in self-efficacy on the competencies Identify issues emerging in health care delivery such as accountable care organizations, medical homes, and health insurance exchanges; understand how to practice effectively within the organization and culture of the interprofessional team, practice setting, and local health care system, and use an electronic health record to retrieve relevant information and to document care. This study found that learners reported a significant increase in self-efficacy related to implementing practiced transformation.
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    Program Brochure - 4th Annual IUSM Education Day
    (IUSM, 2023-04-28) Kochhar, Komal
    An inherent challenge of operating a large multi-campus educational system is being able to provide professional development opportunities for all our medical educators across the state. To address this need, we implemented an annual “Education Day” at Indiana University School of Medicine to promote educational scholarship across our nine-campus system. Held each spring, Education Day showcased the educational scholarship of our faculty, staff, and learners, and provided a forum to share best educational practices and forge new collaborations in educational research.
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    Program Brochure - 3rd Annual IUSM Education Day
    (IUSM, 2022-04-28) Kochhar, Komal
    An inherent challenge of operating a large multi-campus educational system is being able to provide professional development opportunities for all our medical educators across the state. To address this need, we implemented an annual “Education Day” at Indiana University School of Medicine to promote educational scholarship across our nine-campus system. Held each spring, Education Day showcased the educational scholarship of our faculty, staff, and learners, and provided a forum to share best educational practices and forge new collaborations in educational research.
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    Program Brochure - 1st Annual IUSM Education Day
    (IUSM, 2020-03-06) Kochhar, Komal
    An inherent challenge of operating a large multi-campus educational system is being able to provide professional development opportunities for all our medical educators across the state. To address this need, we implemented an annual “Education Day” at Indiana University School of Medicine to promote educational scholarship across our nine-campus system. Held each spring, Education Day showcased the educational scholarship of our faculty, staff, and learners, and provided a forum to share best educational practices and forge new collaborations in educational research.