HPEC 2021 Saturday, February 13, 2021 - Professionalism and Resiliency During Challenging Times - Office of Medical Education
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HPEC 2021 Health Professions Education Conference 2021 Professionalism and Resiliency During Challenging Times Saturday, February 13, 2021 Sponsored by Office of Medical Education John A. Burns School of Medicine, University of Hawaiʻi
2 Welcome to the 2021 Health Professions Education Conference UH Mānoa John A. Burns School of Medicine UH Mānoa School of Nursing UH Mānoa Myron B. Thompson School of Social Work UH Mānoa Department of Kinesiology and Rehabilitation Science UH Mānoa Office of Public Health Studies UH Mānoa Dietetics Program UH Hilo Daniel K. Inouye College of Pharmacy Aloha! Welcome to our fifth Health Professions Education Conference. This conference focuses on faculty development and the sharing of educational scholarship, thus supporting improvements and enhancements to our educational methods and outcomes that allow us to teach and train high-quality health professionals, and to stimulate academic exchange between programs, departments, schools and institutions. Little did we know after last year’s HPEC 2020 in February, how much the world would change. It has certainly been a challenging time for all of us – faculty, students and trainees alike – and it has required amazing resiliency to adapt to this new and constantly evolving environment. I would like to thank the administration and faculty of all of our colleges, schools, departments and offices, for all their innovative efforts in modifying the curriculum while still providing a high standard of education quality to our health professions students and trainees. These times have also brought into focus, the importance of resiliency, mindset and wellbeing. For this reason, we are very pleased to welcome our plenary speaker, Julie G. Nyquist, Professor of Clinical Medical Education, Keck School of Medicine, University of Southern California. She will be discussing “21st Century Mindset and Wellbeing: Focus on Self Compassion”. A special thanks to our HPEC 2021 Conference Planning Committee, our HPEC 2021 Program Planning Committee, and to all the individuals who submitted proposals for sessions, oral abstracts and posters and who served as proposal reviewers. The theme of our conference is “Professionalism and Resiliency During Challenging Times”, and we have a wonderful assortment of peer-reviewed topics ranging from learning communities that promote connections, collaborations and compassion; interprofessional education addressing current and future needs; the use of telehealth in teaching trainees; developing and promoting resiliency, and much more! Thank you for joining us virtually at this conference, and participating in the collaborative spirit of teaching and learning from one another. Pūpūkāhi i holomua Unite to move forward; by working together, we make progress Sincerely, Sheri F.T. Fong, MD, PhD Noelani Ching Conference Chair Conference Coordinator
3 Acknowledgements We would like to sincerely thank and gratefully acknowledge the following individuals who have guided and helped us in the planning and implementation of this conference. Mahalo nui loa! HPEC 2021 Conference Planning Committee Dee-Ann Carpenter, Office of Medical Education Crystal Costa, Office of the DIO Kori-Jo Kochi, Office of Medical Education Jill Omori, Office of Medical Education Vanessa Wong, Office of Medical Education HPEC 2021 Program Planning Committee Hyeong Jun Ahn Department of Quantitative Health Sciences Kamal Masaki Department of Geriatric Medicine Kalani Brady Department of Native Hawaiian Health and Takashi Matsui Continuing Medical Education Department of Anatomy, Biochemistry and Physiology Lee Buenconsejo-Lum Barry Mizuo Associate Dean for Academic Affairs, Graduate Department of Pediatrics Medical Education and Department of Family Medicine and Community Health Holly Olson Graduate Medical Education and Department of Dee-Ann Carpenter Obstetrics, Gynecology and Women’s Health Department of Native Hawaiian Health and Office of Medical Education Susan Steinemann Graduate Medical Education and Department of Surgery Monica Esquivel Dietetics Program, Department of Human Nutrition, Lisa Taniguchi Food and Animal Sciences Department of Communication Sciences and Disorders Bret Freemyer Cedomir Todorovic Department of Kinesiology and Rehabilitation Department of Cell and Molecular Biology Science Sheri Tokumaru Sheri Gon College of Pharmacy Department of Medical Technology Lorrie Wong Robert Hong School of Nursing Department of Medicine Stacey Woodruff David Horio Department of Surgery Department of Pathology and Office of Medical Education Alan Katz Office of Public Health Studies Wendy Lum School of Social Work
4 Acknowledgements We would also like to acknowledge our wonderful volunteers. Thank you so very much for all your time and effort - you are amazing people! Nanea Cavaco Richard Kasuya Kelli Higa Eryn Nakashima Courtney Ip Amanda Sarabia A very special thank you to Yawen Hsiao, who designed the HPEC logo, website and title slide used at the start of the sessions and maintained the website. And lastly, we would like to thank ~ The Queen’s Health Systems for their generous support that has allowed for free registration for all students and trainees Diagnostic Laboratory Services, Inc. and Hawaii American Nurses Association for their sponsorship of our educational conference. Mahalo for your generosity!
5 Proposal Reviewers Hyeong Jun Ahn, Department of Quantitative Jannet Lee-Jayaram, Department of Pediatrics Health Sciences and SimTiki S. Kalani Brady, Department of Native Kyra Len, Department of Pediatrics and Office Hawaiian Health and Continuing Medical of Medical Education Education Wendy Lum, School of Social Work Lee Buenconsejo-Lum, Associate Dean for Kamal Masaki, Department of Geriatric Academic Affairs, Graduate Medical Medicine Education and Department of Family Medicine and Community Health Takashi Matsui, Department of Anatomy, Biochemistry and Physiology Dee-Ann Carpenter, Department of Native Hawaiian Health and Office of Medical Barry Mizuo, Department of Pediatrics Education Dan Murai, Office of Medical Education Jennifer DiRocco, Department of Pediatrics Stephanie Nishimura, Office of Medical Monica Esquivel, Dietetics Program, Education Department of Human Nutrition, Food and Holly Olson, Graduate Medical Education and Animal Sciences Department of Obstetrics, Gynecology, and Bret Freemyer, Department of Kinesiology and Women’s Health Rehabilitation Science Teresa Schiff, Department of Family Medicine Sheri Fong, Office of Medical Education and Community Health and Office of Medical Education Sheri Gon, Department of Medical Technology Chathura Siriwardhara, Department of Sara Haack, Department of Psychiatry Quantitative Health Sciences Jason Higa, Department of Anatomy, Susan Steinemann, Graduate Medical Education Biochemistry and Physiology and Office of and Department of Surgery Medical Education Lisa Taniguchi, Department of Communication Robert Hong, Department of Medicine Sciences and Disorders Travis Hong, Department of Pediatrics Cedomir Todorovic, Department of Cell and David Horio, Department of Pathology and Molecular Biology Office of Medical Education Sheri Tokumaru, College of Pharmacy Richard Kasuya, Office of Medical Education Joseph Turban, Office of Medical Education Riley Kitamura, Department of Surgery Christina Wai, Department of Surgery Alan Katz, Office of Public Health Studies Lorrie Wong, School of Nursing Kenton Kramer, Department of Tropical Vanessa Wong, Department of Native Hawaiian Medicine, Medical Microbiology and Health and Office of Medical Education Pharmacology, and Office of Medical Education Stacey Woodruff, Department of Surgery Damon Lee, Department of Family Medicine Paulette Yamada, Department of Kinesiology and Community Health and Office of Medical and Rehabilitation Science Education
6 Continuing Medical Education The goal of this faculty development conference is for participants to be better able to: • Describe, apply and utilize the knowledge, tools and skills associated with providing quality and innovative teaching, feedback and evaluation in health professions education. • Describe ways to demonstrate, teach and promote non-cognitive attributes such as resiliency, professional development, interdisciplinary teamwork, mindset and well-being, associated with providing comprehensive education. CME is available for the following sessions: • Plenary (1.5 hours) • Session I (1.25 hours) • Oral abstracts (0.25 hours each x 4) • Poster session (0.75 hour) • Session II (1.25 hours) • Session III (1.25 hours) We will be providing CME credit through the Hawai‘i Consortium for Continuing Medical Education (HCCME). HCCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The HCCME designates this live activity for up to 7.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. General Information Contact Information For questions related to the conference, please email us at: infohpecjoin-l@lists.hawaii.edu. Poster Session Poster presenters will be in their assigned breakout room for the poster session. Please see pages 10-12 for the zoom breakout room assignment.
7 Zoom Meeting Etiquette and Tips to Maximize Virtual Engagement 1. Please log in through the Zoom desktop client or mobile app (iOS/Android) to fully participate in breakout rooms, polls, emoji responses. We recommend upgrading to version 5.0 or higher. 2. Be familiar with mute/unmute features, so you can mute when not speaking and unmute should you be called on for participation. Audio/Visual settings are adjustable in the toolbar (far left side or in the participant box). 3. When speaking, please say your name and be sure to introduce yourself in groups or breakout sessions. 4. It is helpful for other participants if you update your screen name to spell out your FIRST and LAST NAMES. To rename yourself, hover over your name and click Rename to change your screen name displayed to other participants. 5. If you click on Reactions, you can “Raise Hand” if you have a question (and click again to lower hand), respond yes (green checkmark) or no (red x) to speaker questions (and click again to remove), use the clapping icon or thumbs up icon to show appreciation (these will disappear after a short while). 6. For Breakout Rooms (small group discussion), please pay attention to the screen for a Breakout Room Announcement. Remember, those using just a dial in option cannot see who is in the room - please introduce yourselves. And in small group discussions, we encourage you to turn on your video. It is more natural and much nicer to have a discussion with someone you can see. 7. Please feel free to use the Chat feature to type in any questions or comments. Someone will be monitoring the Chat feature throughout the meeting. 8. If there is polling during the session, please reply promptly.
8 HPEC Program Summary
9 Poster Session Summary Poster Session: 11:45 am – 1:15 pm Posters may be viewed at: https://scholarspace.manoa.hawaii.edu/handle/10125/72053 Presenters will be in assigned breakout rooms 12:15 pm – 1:15 pm
10 Poster/ Breakout TITLE and PRESENTER(S) PAGES Room # Professionalism at JABSOM: A Professionalism Philosophy to Live By 1 Presenters: Dee-Ann Carpenter, JABSOM Department of Native Hawaiian p. 41-42 Health and Office of Medical Education; on behalf of the 2020 Professionalism Task Force The Creation of a Wellness Panel for JABSOM’s Learning Communities Presenters: Kasey Tamamoto, MS2; Eryn Nakashima, MS2; Nikki Rousslang, 2 MS2; Clarke Morihara, MS2; Alyssa Peric, MS2; Sarah Murayama, MS2 p. 43-44 Faculty Sponsor: Kyra Len, Office of Medical Education and Department of Pediatrics Curriculum Development for JABSOM’s Learning Communities: Medical Ethics 3 Presenters: Kasey Tamamoto, MS2; Nikki Rousslang, MS2; Eryn Nakashima, p. 45-46 MS2; Clarke Morihara, MS2; Alyssa Peric, MS2; Sarah Murayama, MS2 Faculty Sponsor: Kyra Len, Office of Medical Education and Department of Pediatrics Medical Students for Mental Health: Curriculum Development for JABSOM’s Community Health Program 4 p. 47-48 Presenters: Kasey Tamamoto, MS2; Alyssa Peric, MS2 Faculty Sponsor: William Haning, Department of Psychiatry Medical Student Knowledge of Native Hawaiian Obstetrics 5 Presenter: Elisabeth Seamon, MS4 p. 49-50 Faculty Sponsor: Dee-Ann Carpenter, Department of Native Hawaiian Health and Office of Medical Education Addressing Microaggressions in Healthcare 6 Presenter: Patricia Burnell, Jayne Smitten, Michelle Higgins-Mahe, College p. 51-52 of Health and Society, Hawaiʻi Pacific University “Docs Talk Story”: A Novel Way of Using Podcasts to Provide Insight into Career Options for Medical Students 7 p. 53-54 Presenters: Rylie Wada, MS2; Enze Ma, MS2; Royce Kwon, MS2 Faculty Sponsor: Richard Kasuya, Office of Medical Education USMLE Step 2CK Timing and Effects on Performance 8 p. 55-56 Presenter: Kristen Teranishi, Office of Student Affairs Preparing for the Pediatric Clerkship: MSPREP (Medical Student 9 Preparatory Resource to Excel in Pediatrics) p. 57-58 Presenters: Courtney Taum and Lauren Ishida, Department of Pediatrics
11 Impact of Rater Training on Pediatric Simulation Assessment of Medical Students 10 p. 59-60 Presenters: Cory Sutton, MS2 and Chaz Kuniyoshi, MS2 Faculty Sponsors: Barry Mizuo and Travis Hong, Department of Pediatrics Effectiveness of Just-In-Time Training for Video Laryngoscopy in Emergency Pediatric Intubations 11 Presenters: Evan Lum, MS2; Kagen Aeby, MS3 p. 61-62 Faculty Sponsor: Jannet Lee-Jayaram, JABSOM SimTiki Simulation Center and Department of Pediatrics Medical Student Long-Term Skill Retention Following Cardiac Point-of- Care Ultrasound Training Based on the American Society of Echocardiography Curriculum Framework 12 p. 63-64 Presenters: Brandan Sakka, MS3 and Satoshi Jujo, JABSOM SimTiki Simulation Center Faculty Sponsor: Benjamin Berg, JABSOM SimTiki Simulation Center Ten Years Experiences of Evidence-Based Simulation from International 13 Journal Club p. 65-66 Presenters: Sanghoon Oh, JABSOM SimTiki Simulation Center Cross-Cultural Classroom: Assessing Student Opinion of Online Case- Based Learning Modules Utilizing MRI and XR Technology, in American and Turkish Medical Students 14 p. 67-68 Presenters: Nicole Nakamatsu, MS2 Faculty Sponsor: Scott Lozanoff, JABSOM Department of Anatomy, Biochemistry and Physiology Student-Created Video Supplements to the Cardiovascular Curriculum 15 Presenter: Gunnar Lee, MS3 p. 69 Faculty Sponsor: Richard Kasuya, Office of Medical Education Learning Immunology: Using Free Medical Education Video Platforms to Supplement Medical Student Understanding 16 p. 70-71 Presenters: Sarah Murayama, MS2; Alyssandra Baniqued, MS2 Faculty Sponsor: Damon Sakai, Office of Medical Education Qualitative Assessment of Anki as a Tool for Medical Education 17 Presenters: Elliott Koshi, MS2; Torbjoern Nielsen, MS2; Bradley Fujiuchi p. 72-73 MS2; Mattia Walter, MS2; Chaz Kuniyoshi, MS2 Faculty Sponsor: Damon Sakai, Office of Medical Education
12 Knowledge of Business Practices in Healthcare: The Overlooked Non-Technical Skill in General Surgery Residency Training 18 p. 74-75 Presenter: Matthew Camacho, MS2 Faculty Sponsor: Maria Chun, Department of Surgery Trends in Opthalmologists’ Recommendations to Patients for Prevention of Age-Related Macular Degeneration 19 p. 76-77 Presenter: Kevin Card, MS3 Faculty Sponsor: Malcolm Ing, Department of Surgery (Opthalmology) Student Pharmacists Develop and Implement a Virtual Diabetes/ Pre-Diabetes Education Program 20 Presenters: Brittany Luna and Kimo Okamoto, PharmD candidates p.78-79 Faculty Sponsor: Camlyn Masuda, UH Hilo Daniel K. Inouye College of Pharmacy The Effectiveness of a Virtual Interprofessional Teamwork Simulation Exercise for Nursing, Pharmacy, Social Work and Medical Students at 21 the University of Hawaiʻi p. 80-81 Presenter: Aida Wen, Department of Geriatric Medicine
13 Select Non-Profits Related to Our Sessions American Diabetes Association, Hawaiʻi Office: Hawaiians are increasingly feeling the effects of diabetes. Today, approximately 142,000 people in Hawaiʻi, or 12% of the population, have diabetes. The American Diabetes Association can provide resources for you and your family about all types of diabetes as well as information for caregivers and others affected indirectly by the disease. Mission: To educate our communities about how to Stop Diabetes and support those living with the disease. Hawaiʻi State Rural Health Association: The Hawai‘i State Rural Health Association (HSRHA) is dedicated to addressing rural health needs in Hawai‘i. It was incorporated in 1998 and is an active member of the National Rural Health Association (NRHA) and the NRHA State Association Council. Membership includes rural health practitioners, rural community residents and advocates, and members of local rural health associations statewide. HSRHA participates in national and local health initiatives, promotes health networks, provides grass-roots input into statewide health planning, and promotes development of new services for rural areas. Mission: To advocate for rural health issues and promote communication, education and research of issues related to rural health. Project ECHO: ECHO Hawai‘i is a replicating partner of Project ECHO® (Extension for Community Healthcare Outcomes) - a successful, innovative medical education and mentoring program that builds PCP skills and improves access to and capacity for specialty care. Project ECHO® originated at the University of New Mexico and is a movement to demonopolize knowledge and amplify the capacity to provide best practice care for underserved people all over the world. It uses existing technologies to nurture sustainable learning collaboratives, connecting an interdisciplinary team of experts with primary care providers in rural and underserved communities. Specialists help mentor participants in a “guided practice” model, with primary providers continuing their management and responsibility for patient care. Over time, clinicians develop comprehensive skills to treat specific, complex health conditions within their own practice. Mission: The goal of ECHO Hawai‘i is to be a resource that delivers high quality CME experiences that meet out user’s needs, builds capacity for improved patient care, and promotes best practices.
14 Plenary Speaker Julie Gayle Nyquist, Ph.D. Professor of Clinical Medical Education Keck School of Medicine University of Southern California Julie G. Nyquist, PhD is a Professor in the Department of Medical Education within the Keck School of Medicine (KSOM) of the University of Southern California. She directs the Master of Academic Medicine (MACM) program, chairs the department’s annual Innovations in Medical Education Conference (2014-present), and developed a flexible elective to help 4th year medical students transition to residency. Dr. Nyquist joined the faculty in 1981, served as program evaluator for the Medical Student curriculum (1981-2014) and co-chaired the school’s Competency-Based Education initiative (2010-2017). Within KSOM she has served on most of the curriculum committees and was a member of the central Education Committee for the school for 20 years (1993-2013). Within the MACM program she is on the teaching team for multiple courses focusing on the four key roles of faculty: teacher, leader, scholar and mentor. Dr. Nyquist has developed and led over 900 workshops and presentations to a variety of health care professions’ faculty members on topics related to leadership, teaching, evaluation, cultural competence, career development, and the 21st Century mindset. In conjunction with her USC position, she was also Director of Medical Education at a regional medical center in Bakersfield, California for 8 years (1993-2001). She has been the author or co-author on 14 federally-funded, education-related grants. Dr. Nyquist received her doctorate in Educational Psychology from Michigan State University in 1981.
15 Session and Oral Abstract Descriptions
16 Welcome and Opening 8:00 am – 8:15 am Zoom Room #1 S. Kalani Brady, MD – opening oli (chant) Associate Professor, Department of Native Hawaiian Health Sheri Fong, MD, PhD Conference Chair, Health Professions Education Conference Lee Buenconsejo-Lum, MD Associate Dean for Academic Affairs, John A. Burns School of Medicine Plenary 8:15 am – 9:45 am Zoom Room #1 21st Century Mindset and Wellbeing: Focus on Self-Compassion Julie G. Nyquist, PhD Professor of Clinical Medical Education, Keck School of Medicine, University of Southern California Learning Objectives: By the end of this session, participants will be able to: 1. Utilize your own Self-Compassion results to help you better support your own wellbeing 2. Assist learners to develop and use the skills related to self-compassion 3. Discuss Self-Compassion in the context of the entire set of 21st Century Mindset skills Brief Description of Session: Dr. Nyquist will energize the audience as she unwraps the concept of self-compassion as it relates to both faculty and learner well-being. Participants are encouraged to take the self-compassion scale provided via email to registrants prior to the conference so that they may fully benefit from the skill building discussions during this session. Target Audience: Students, staff, faculty and administrators of schools of health sciences
17 Session I: A: Oral Abstracts 10:00 am – 10:15 am Zoom Room #2 Racism in Medicine: The Effectiveness of a Student-Led Lecture to Improve Structural Understanding of Health Kalei R. J. Hosaka, MS41, Max Pono Castanera, MS41 and Damon Lee, MD2 1 John A. Burns School of Medicine; 2 Office of Medical Education and Department of Family Medicine and Community Health, JABSOM Introduction: There has been increasing awareness of the need to promote anti-racism education in institutions, including medicine, following the murder of George Floyd, Breonna Taylor, and Ahmaud Arbery in the Spring of 2020. Minority groups in the U.S. experience a disproportionate burden of poor health outcomes due to implicit and explicit racism that exist on individual, communal, and structural levels, both in the past and present. To improve knowledge of legacies of racism and disparities in medicine and increase the efficacy of future physicians to create positive change, we designed a one-hour lecture for medical students at the University of Hawaiʻi John A. Burns School of Medicine to address: (1) how overt racism has existed throughout the history of allopathic medicine; (2) the effects of structural racism on current health disparities; and (3) ways to improve health disparities through education, self-awareness, and constructive peer-to-peer dialogue. Objectives: Our primary aim was to determine whether our lecture was effective in enhancing understanding of racism in medicine, current healthcare disparities, and ways to create positive change. Our secondary aim was to identify whether this lecture would be received well by medical students. Methods: Our lecture focused on important historical and modern disparities, including specific examples from our Hawaiʻi and Pacific context. We also highlighted the ways in which poor health outcomes today are often related to implicit bias and social determinants of health. We created a 10-question self-report survey given before and after the lecture. We designed questions based off of the cultural competency framework in the AAMC's Core Competencies For Entering Medical Students. Statistical analysis was performed using Microsoft Excel and Stata IC 16. Results: Of the 78 students present, 70 completed pre-surveys and 50 completed post-surveys. 24% (n=17) of participants completed an undergraduate or graduate degree in a public health or social sciences (7% completed a minor or certificate). Participants had a strong self-reported understanding of the ways diversity and sociocultural factors affect their interactions with others. Results showed that participants demonstrated statistically significant improvement in recognizing and appropriately addressing bias in themselves and others (p=0.001). Moreover, participants demonstrated improved confidence in citing examples of racism in medicine, healthcare disparities, ways to improve health equity, and the ways that structural racism impacts health (all p
18 completed post-surveys, 96% strongly agreed1 that the presentation was effective (n=48), 94% strongly agreed that future classes of students would benefit from this lecture, and 82% (n=41) strongly agreed that they would benefit from more lectures that built upon the lecture’s content. Discussion: Results of our work show that our student-led lecture is an effective way to both improve understanding of racism in medicine and structural racism and discuss solutions for improving health equity in our community. Pre- and post-lecture surveys have a number of limitations, including generalizability and precision of results. Nevertheless, our work highlights the need to creatively design medical education initiatives to enhance understanding of systematic racism and its role in furthering health disparities for physicians in-training. Target audience: Medical students, residents, physicians, nurses, medical education faculty, health professionals 1 defined as >8 out of 10 (1=strongly disagree, 10=strongly agree) Key Phrases: Structural Racism Social Determinants of Health Medical Education
19 Session I: A: Oral Abstracts 10:00 am – 10:15 am Zoom Room #3 Increasing Diversity at JABSOM: How Important is the MCAT and GPA for Native Hawaiian Graduation Rates? Martina Kamaka, MD1 and Breanna Morrison, PhD2 1 Department of Native Hawaiian Health, JABSOM; 2 Department of Quantitative Health Sciences, JABSOM Introduction: Native Hawaiians suffer from some of the largest health disparities in the US. Although they make up 24% of the population of the State of Hawaiʻi, Native Hawaiian (NH) physicians make up less than 4% of the physician workfoce. Hawaiʻi data shows that Native Hawaiian physicians are more likely to practice in Hawaiʻi and other studies have shown that patients from marginalized poulations prefer physicians from their own background. Many schools around the country, including the John A. Burns School of Medicine (JABSOM), are looking at increasing the diversity of the physician workforce to help address health workforce needs as well as health disparities. For Native Hawaiians, a suspected barrier towards this goal was Native Hawaiian performance on national medical school admissions exams such as the MCAT (Medical College Admission Test) as compared to non Native Hawaiian (non NH) applicants. Objective: In this study, we wanted to see if NH medical school graduation was increasing over time. In addition, were NH MCAT and GPA scores (overall and science GPA) creating barriers to admission? First we looked at NH vs non NH graduation over a 23 year span from 1993-2015. Second, we wanted to see if there were differences between GPA scores and MCATs for NH vs non NH matriculants at JABSOM with available data from this same 23 year span. Finally, we wanted to evaluate whether admission MCAT or GPA scores correlated with successful graduation from JABSOM. Methods: We looked at NH vs non NH matriculation rates, MCAT, GPAs and graduation rates over a period of 23 years. Admission, matriculation and graduation data was collected from the Office of Student Affairs and the Department of Native Hawaiian Health at JABSOM. Data was deidentified. Differences between total GPA, science GPA, and MCAT scores for NH and non-NH, as well as graduates and non-graduates overall, were analyzed. Results: When looking at data aggregated over the years, although the number of NH matriculants has been stable, the class size has increased. The result is the NH matriculants as a percent of total class size has been decreasing over time. With respect to the total GPA, and to a similar but slightly less extent science GPA, both groups of matriculating students were fairly similar in those scores. However, there was a large difference in MCAT scores Key Phrases: MCAT and Medical School Success Native Hawaiian Medical School Graduation Rates MCAT and GPA as Medical School Admissions Criteria
20 with NH having lower scores. Total GPA, science GPA, and MCAT scores were not meaningfully different between those who successfully graduated and those who did not. Also, when looking at graduation rates tabulated by GPA and MCAT categories, graduation rates for all groups remained high (over 90% graduation for all sub-groups). Discussion: Graduation rates at JABSOM are universally high, so putting a lot of emphasis on MCAT scores in the admission proces, especially with lower performing groups such as Native Hawaiians, could be harming efforts to improve diversity at JABSOM. Utilizing GPA scores seems to have a less disparate impact and focusing more on GPA rather tha MCAT could help increase the diversity of our matriculants without compromising graduation rates. Target Audience: Medical school faculty, administrators, diversity related and admissions committee members and faculty and staff working in pipeline into healthcareer programs. Key Phrases: MCAT and Medical School Success Native Hawaiian Medical School Graduation Rates MCAT and GPA as Medical School Admissions Criteria
21 Session I: B: Workshops 10:15 am – 11:30 am Zoom Room #2 Learning While Live: Teaching Trainees During Telehealth Encounters Shandhini Raidoo, MD, MPH Assistant Professor, Department of Obstetrics, Gynecology and Women’s Health, JABSOM Paris Stowers, MD, MSCTR Assistant Clinical Professor, Department of Obstetrics, Gynecology and Women’s Health, JABSOM Kelsi Chan, MD Resident Physician, Department of Obstetrics, Gynecology and Women’s Health, JABSOM Patient care delivered via telehealth encounters has gradually become more common as a result of technological advancement, but the COVID-19 pandemic and the need to limit disease spread during in-person patient encounters has made the need for telehealth advancement and implementation more urgent. At the same time, many hospitals and clinics have restricted the numbers of trainees who can participate in patient care due to concerns about exposure and transmission of SARS-CoV-2 and the availability of personal protective equipment. Telehealth presents a unique opportunity to safely involve trainees in patient care and maintain their educational trajectory. Objectives: • Discuss involvement of trainees in telehealth care and optimization of educational opportunities • Provide guidance on maintaining patient comfort in a virtual setting and building rapport and empathy while engaging trainees in telehealth encounters • Recommend best practices for pre-encounter preparation and post-encounter debrief that includes structured feedback • Describe potential problems that may arise during telehealth encounters with trainees and provide strategies to address these Methods: This workshop will focus on strategies to successfully involve trainees in telehealth encounters, and will be divided into three parts. First, participants will engage in a short didactic and discussion session about telehealth in an academic learning environment and the opportunities to incorporate trainees such as students, residents, and fellows into telehealth encounters with patients. This will cover practical applications such as how to ensure patient privacy and security when the healthcare team may each be in different locations, how to introduce trainees and their roles in the patient encounter, professionalism tips for telehealth encounters with trainees, and how to navigate working with multiple different trainees during a patient encounter and meeting their educational needs. Participants will hear perspectives from healthcare providers who have experience working with trainees as well as from trainees who have participated in patient care via telehealth. Following the initial didactic and discussion, participants will be divided into small groups of up to four participants each to work through scenarios and role play of potential issues that may arise during the telehealth Key Phrases: Telehealth Medical Education Training
22 encounters with trainees. Scenarios will include navigating history-taking on sensitive health topics, redirecting trainees during complicated or erroneous counseling, the developing and using of visual aids in patient counseling, and strategies for identifying warning signs in patient responses that necessitate referral for emergent or in-person care. Each small group will be led by a facilitator and participants will rotate through all scenarios. For the final portion of this workshop, presenters will conduct a debriefing session, answering questions about implementation, management, and logistics of involving trainees in telehealth encounters. The presenters will provide participants with a detailed resource guide for conducting telehealth encounters with trainees. Intended Outcomes: By the end of this workshop participants should feel comfortable incorporating trainees of all levels into their telehealth practice while maintaining high standards of patient care and medical education. Participants will gain an in-depth understanding of the unique learning environment of telehealth and the opportunities that it presents for direct observation of patient interactions and counseling. Participants will gain skills in addressing potential issues that may arise in real-time while engaged in a patient encounter with trainees. At the conclusion of this workshop, providers will be comfortable with trainee involvement in their telehealth practice. Target Audience: This workshop is designed for healthcare providers who are currently providing telehealth or are considering incorporating telehealth into their practice who also work with trainees. Providers who currently work with trainees in a virtual setting are welcome to attend as this workshop will include strategies for optimizing the educational component of telehealth encounters when working with trainees. Providers who have not yet incorporated trainees into telehealth encounters are also encouraged to attend as this workshop will address strategies for trainee involvement. Key Phrases: Telehealth Medical Education Training
23 Session I: B: Workshops 10:15 am – 11:30 am Zoom Room #3 Resilience for Emerging Health Professionals – Strengthen Yourself to Strengthen Them Aukahi Austin Seabury, PhD Executive Director, Licensed Clinical Psychologist, I Ola Lahui, Inc. Francie Julien-Chinn, MSW, PhD Assistant Professor, Department of Social Work, UHM Myron B. Thompson School of Social Work Dee-Ann Carpenter, MD Assistant Professor, Department of Native Hawaiian Health and Office of Medical Education, JABSOM Marjorie Mau, MD, MS, MACP Professor and Myron “Pinky” Thompson Endowed Chair, Department of Native Hawaiian Health, JABSOM Camlyn Masuda, PharmD, CDCES, BCACP Assistant Specialist, Department of Pharmacy Practice, UHH Daniel K. Inouye College of Pharmacy Objectives: 1. Recognize the need for resilience training for Emerging Health Professionals (i.e. interdisciplinary health professional students) 2. List 5 methods to improve resilience in health care professionals 3. Identify resilient factors in yourself 4. Describe factors for a successful interdisciplinary team Introduction/Background: The Robert Wood Johnson Foundation (RWJF) is creating a “culture of health” through its numerous programs. The Clinical Scholars Resilience Hawaiʻi Team is part of the RWJF Clinical Scholars Program, bringing together clinicians from different disciplines to tackle a “wicked problem.” Our team chose to work with the homeless population to improve their resilience and diabetes/pre-diabetes (DM/preDM) self-management education by partnering with the H.O.M.E. (Homeless Outreach Medical Education) Project at JABSOM. The H.O.M.E. Project is a mobile outpatient clinic that provides ambulatory medical care to those who are homeless/houseless and in need of medical care. The H.O.M.E. Project is staffed by students of various disciplines and is supervised by volunteer faculty and community physicians. Our initial RWJF-funded project intended to provide DM/preDM self-management education to patients identified at the H.O.M.E. Project as well as our Emerging Health Professionals (EHP), the students in our disciplines (social work, psychology, medicine, and pharmacy) with special attention paid to increasing patient resilience and empowerment. Because of the unprecedented uncertainty caused by the COVID-19 pandemic, and the challenges it presented to the homeless patients, the H.O.M.E. Project, and the health care providers, especially the interdisciplinary health professional students, we quickly realized that our own health professional colleagues and students were in urgent need of developing interprofessional resilience and empowerment BEFORE they could perform their own professional duties. Thus, we "pivoted" our Hawai'i Resilience Team to develop and implement an on-line virtual teaching program to train health professional students and JABSOM faculty on developing resilience in their own lives and their daily work prior to teaching our students or patients Key Phrases: Resilience Interprofessional Training Emerging Health Professionals
24 on dealing with difficult times such as living in the midst of the COVID-19 pandemic in addition to our DM/pre- DM education modules. Thereafter, these EHP and faculty members would be better equipped to then train homeless individuals on DM/pre-DM who seek medical care at the H.O.M.E. Project. Methods: Our multi-disciplinary RWJF Clinical Scholars Team will outline our strategy and design for implementing resilience training in Emerging Health Professionals (EHP). Discussion will begin with our original project of resilience training in Hawai‘i’s homeless, which needed to be modified during this pandemic to address the need for resilience training in our EHP. Thereafter, an introduction to resilience training will be shared, to highlight some of the methods used in the training. Resilient factors will be explored by those who attend this workshop with practice and further discussion in small groups. Intended Outcomes: Reflect on your "passion" for being a healthcare professional during this pandemic to care for patients by (re) building your resilience using some of the strategies addressed in the workshop. Utilize strengths of inter- professional team presenting highlights of the resilience curriculum used with EHP this past year, to recognize your own resilience, thus becoming a better clinician educator. Target Audience: Faculty and students from across all healthcare disciplines Key Phrases: Resilience Interprofessional Training Emerging Health Professionals
25 Session I: C: Oral Abstracts 11:30 am – 11:45 am Zoom Room #2 Identifying and Filling the Need for a Social Justice Interdisciplinary Elective Rachel Gorenflo, MS21, Eden Ines, MS21 and Teresa Schiff, MD2, 1 John A. Burns School of Medicine; 2 Office of Medical Education and Department of Family Medicine and Community Health, JABSOM Context: Racially motivated homicides, fights over land and water rights, and the disproportionate way COVID-19 has affected marginalized communities, has awakened our nation to the prevalence of social inequality and sparked a revolution for social justice. To achieve health equity solutions, professionals across disciplines must collaborate. Current attempts at JABSOM and the University of Hawaiʻi (UH) to promote interdisciplinary education among Hawaiʻi’s future physicians, nurses, social workers, public health workers, and lawyers have been stunted due to conflicting schedules and geographic distance between campuses. Now, with the prevalence of online learning, students may find more opportunities for schedule overlap and geography will no longer be an issue. This course will be an important first step toward integrative and collaborative solutions to improve the health of our communities. Objectives: By the end of this course: 1. Students will feel more comfortable about working with students from other disciplines 2. Students will develop a toolbox regarding how to find resources and people to best help their patients and clients 3. Students will learn how to build respectful and reciprocal long-term relationships with community partners Our vision for this elective consists of two components: a seminar portion, which includes PBL discussions, and a longitudinal community partnership with the organizations mentioned above. Students will be placed in small interdisciplinary teams, in which they will read through a patient case involving medical, social, and legal issues. Students will then work together to devise a plan for how they would address each of the patient’s issues and present their conclusions to their group. They will then apply this knowledge at their community site, where interdisciplinary teams of students will intern together. Here, students will have the opportunity to collaborate on community-informed projects, which they will present to each other and the community organization at the end of the course. We will encourage students to also present at local conferences following their internships. Students will self-evaluate whether they met the course objectives by completing a survey at the start and end of the course. Students’ performance during their internships will also be evaluated by their respective community preceptors. Key Message & Conclusion: With this interdisciplinary elective, we hope to foster formative discussions surrounding social justice, deep community relationships, and lifelong interdisciplinary partnerships. While challenging to create an elective that Key Phrases: Interdisciplinary Social Justice Community Health
26 spans so many disciplines, the potential for better collaboration will have a significant impact on how patient care is implemented in all regards. By working with other disciplines, we can better apply an upstreamist approach to issues surrounding health, prevent chronic health problems more efficiently, and provide more holistic care of our patients. Social justice is an issue for all disciplines and by joining together, the effects of our solutions will be more profound and long-lasting. Target Audience: Students of JABSOM, Richardson School of Law, Myron B Thompson School of Social Work, UH Nursing Program, and UH Public Health Graduate Program Key Phrases: Interdisciplinary Social Justice Community Health
27 Session I: C: Oral Abstracts 11:30 am – 11:45 am Zoom Room #3 Approaches to Enhance Diversity in Health Profession Education Programs: A Case Study on Opportunities to Increase Native Hawaiian Student Success in Dietetics Monica K. Esquivel, PhD, RDN, CSSD1, Jessie Kai, MS1, M’Randa Sandlin, PhD2 and Marie Kainoa Fialkowski Revilla, PhD, MS, RDN, LD, IBC1 1 Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources; 2Sandlin Consulting Introduction: Registered Dietitian Nutritionists (RDNs) are food and nutrition experts. There are fewer than 1% NH or other Pacific Islander RDNs, while NHs experience a disproportionate burden of lifestyle related conditions. Increasing the number of NH RDNs is one tenet to improving diet-related health outcomes in the NH population. The national professional society for RDNs, is committed to creating a diverse and inclusive profession that closely resembles the communities that are served. However, little progress has been made in diversifying the profession. In 2002, 4% of all RDNs were African American compared to 2.6% in 2020. In the last three years, 9% of the University of Hawai‘i at Mānoa’s (UHM) Dietetics program students reported NH ancestry. Objective: The objective of this abstract is to share an approach informed by indigenous research method (IRM) strategies aimed at identifying pathways to improve NH dietetic student success. Methods: Select aspects of the IRM approach were identified for this process. This included 1) a research question that attempts to bring about positive change for an indigenous people informed by a topic of importance to an indigenous people; 2) research that was conducted by, in, with and for the benefit of indigenous communities; and 3) research that involved mixed methods (qualitative and quantitative). The research team included a NH graduate student, a NH dietetics faculty member, and a newly established NH Dietetics Advisory Council (NHDAC). The council informed aspects of study design, implementation, and analysis. The data analysis process continued to follow IRM, where findings were triangulated among researchers and NHDAC. Deviations to IRM were noted throughout the process and were reported. The mixed-methods approach included survey of all levels of NH dietetics students within the UH system and in-depth interviews were conducted with NH dietetic students, program alumni and supporting agencies. All interviews were conducted by the NH graduate student and scheduled to meet participant needs. Results: Our study was successful in completing this project, gathering input from the NHDAC, and institutionalizing the council to ensure sustainability. Lessons learned in implementing IRM were noted. Research that is 100% driven by the community was not achieved, where the NHDAC was established after the research award and protocols were drafted. Honorarium, or makana, for advisory council members was UH memorabilia, to operate within institutional purchasing restrictions, not necessarily representative of indigenous values. Key Phrases: Diversity Community Research Dietetics
28 Discussion: The framework employed by this study, particularly the inclusion of a NHDAC and threefold exploration of stakeholders, can inform strategies used by other health education training programs aiming to expand diversity. Implementing IRM within institutional practices and policies takes careful planning. Establishing councils prior to grant submission is recommended, however obtaining planning grant funds is needed to honor the value of council members’ time. Taking research activities, such as Advisory Council meetings and in-depth interviews off campus, supported indigenous community participation and relationship building. The implementation of IRM allowed us to attain our overarching study goal: To shed light on the disparities between supports for NH students and dietetic program accreditation standards. IRMs present an opportunity to develop strategies to increase diversity among health profession training programs. Target Audiences: Health profession training program educators, faculty, and directors Key Phrases: Diversity Community Research Dietetics
29 Session II: A: Oral Abstracts 1:30 pm – 1:45 pm Zoom Room #2 Pediatric ECHO Hawaiʻi: Development of an Innovative Learning Community to Share Expertise and Boost Capacity in a State with a Physician Shortage Maya Maxym, MD and Anna-Lena Lueker, MD Department of Pediatrics, John A. Burns School of Medicine Context: Hawaiʻi’s physician shortage, in particular on the neighbor islands, results in rural primary care providers bearing the burden of managing many patients who, elsewhere, might more easily be referred to a specialist. Pediatric ECHO Hawaiʻi (Extension for Community Healthcare Outcomes) has met this challenge by offering bimonthly tele-education sessions that provide clinicians with education on a wide variety of topics and enhance access to pediatric subspecialists. During our sessions, specialists present a high-yield topic in their field of expertise, after which participants are encouraged to ask questions and present a case to the group to discuss management options. CME and MOC Part 2 credits are also provided for free. Objectives: 1. Create a robust learning community with regular participation from many healthcare providers across various fields of practice 2. Improve pediatric care across the region, especially in the medical home 3. Decrease the need for referrals and simplify access to subspecialists if referrals are necessary 4. Decrease unnecessary hospitalizations and inter-island transfers Key Message: Over the first 18 months of Pediatric ECHO Hawaiʻi, our participants were invited to join sessions via Zoom, with our numbers growing from an average of 10 to an average of 27 participants during this time. Simultaneously, we increased our reach across the Pacific and observed growing diversity in our participants’ field of practice and practice setting. This created a unique learning environment and a community of peers and subspecialists with whom cases can be discussed both during and outside of scheduled ECHO sessions. Regular surveys of our participants revealed a reported increase from 25% to 100% in their confidence managing the conditions discussed, as well as increased confidence in reaching out to subspecialists when needed. Providers reported that ECHO sessions prevented delays associated with referral to subspecialists, as well as decreasing the need for patient referral, including air travel from neighbor islands, at least 4 to 7 times each for several individual providers. Conclusion: Pediatric ECHO Hawaiʻi has helped to create a dynamic learning community of healthcare professionals throughout the Hawaiian Islands and beyond. In addition to empowering providers to feel more confident in managing patients with complex medical conditions, participants have also reported increased confidence in reaching out to pediatric subspecialists to coordinate care. This has led to an increased ability to provide Key Phrases: Tele-education Learning Community Continuing Medical Education
30 specialized care in the medical home and decreased delays in care, as well as the need for referrals and transfer of care among facilities. Target Audience: Our target audience includes primary care physicians and allied health care providers in the community, especially those caring for complex patients in rural areas on the neighbor islands. Our presentation will also be informative for specialist physicians who have long waiting lists for referrals and might be interested in using the ECHO platform to expand capacity to care for certain patients in the primary care setting. Key Phrases: Tele-education Learning Community Continuing Medical Education
31 Session II: A: Oral Abstracts 1:30 pm – 1:45 pm Zoom Room #3 HIPE RCA2 Simulation: Introduction to Patient Safety Event Analysis and Investigation Holly L. Olson, MD, MACM, FACOG1, Lee E. Buenconsejo-Lum, MD, FAAFP1, Susan K. Steinemann, MD, FACS1, Melodee Deutsch, RN, MS, MPH, CPHQ2, Lorrie Wong, PhD, RN, CHSE-A2 1 Office of the Dean, John A. Burns School of Medicine; 2 School of Nursing and Dental Hygiene, University of Hawaiʻi at Mānoa Brief Description of the Curriculum: This is an interprofessional simulation to teach the concepts of Root Cause Analysis and Action Plan (RCA2) to advanced learners. We used the Zoom platform, Google Jamboard and Docs to increase learner engagement and created polls to assess learning throughout the didactic portion. Materials were provided in advance to maximize time available for learners to work through analysis of a case study, make a cause map and create an action plan. Need/Rationale: The ACGME Common Program requirements and Milestones state that “residents must participate as team members in real and/or simulated interprofessional clinical patient safety activities such as root cause analyses or other activities that include analysis as well as formulation and implementation of actions.” We previously had no specific formal curriculum to teach these concepts in an interprofessional manner. We determined that nursing students and pharmacy residents had similar requirements to participate in interprofessional learning during their training. The legal climate in Hawaiʻi precludes widespread trainee participation in root cause analyses. For this reason, the University of Hawaiʻi Interprofessional Education (HIPE) team created this curriculum to ensure that all graduating residents would have participated in at least one patient safety simulation event to include cause mapping. Methods: Partnership with the School of Nursing and the College of Pharmacy, members of the Office of the DIO and key hospital leaders met with nursing and simulation educators to develop the curriculum. Originally designed for in- person simulation over the course of four hours, we shortened the course to 2.5 hours when all instruction moved to distance learning. The planning group discussed goals and objectives, mapped out the agenda, created content and conducted rehearsals. The materials were sent to the learners in advance for pre-work. Each of three sessions included senior residents from the various GME programs, senior nursing students, and pharmacy residents. The facilitators provided brief didactics and the simulation consisted of a safety event that took place in a pathology lab. The Google Jamboard was then used to create a cause map by having the learners cite potential causes while a facilitator typed on the sticky notes. A second facilitator prompted the learners with a series of questions to reach the root causes. The Action Plan was created on a pre-templated Google doc and once complete, a debrief was conducted. The learners completed a survey at the end of the session and the facilitators conducted an after action review to create improvements with each class. After the first session, it was determined that we needed to assess learning during the class to ensure the concepts were clearly understood. Polls were conducted during the second and third sessions. Key Phrases: Interprofessional Education Root Cause Analysis Simulation
32 Results to Date: There was a total of 100 learners across the three disciplines. Quantitative results from the polls and surveys revealed very low knowledge scores in two specific areas after the first session. Based on the feedback from the first session, particular points of emphasis were made that resulted in improved scores in subsequent sessions. The survey data from all sessions indicated that the objectives were met based on scores from 4.03-4.47 on a scale of 1-5. The scores improved with each iteration of the event. The overall score increased from 3.83 to 4.46 from the first to third session. Qualitative comments demonstrated that learners acknowledged this curriculum increased their ability to “learn to appreciate everyone’s viewpoint” and “increased knowledge” in this competency. Several learners commented that they would feel confident conducting an RCA in their future practice. Based on the results, the curriculum met the need to conduct an interprofessional simulation of an RCA event. The sessions will be further modified based on learner feedback. The COVID-19 pandemic forced us to change quickly to an abbreviated, fully virtual session. Colleagues in the other health professions schools were not familiar with the different tools that could be deployed to increase participant engagement. Subsequently, more interprofessional simulations have been conducted virtually and designed for maximal interaction. This is now considered a best practice for virtual simulations. Key Phrases: Interprofessional Education Root Cause Analysis Simulation
33 Session II: B: Panels 1:45 pm – 3:00 pm Zoom Room #2 Connection + Collaboration + Compassion = Learning Communities Vanessa Wong, MD, MS Assistant Professor, Office of Medical Education and Department of Native Hawaiian Health, JABSOM Kyra Len, MD Assistant Professor, Office of Medical Education and Department of Pediatrics, JABSOM Jannet Lee-Jayaram, MD Assistant Professor, Department of Pediatrics and SimTiki Telehealth Research Institute, JABSOM Alyssa Peric, MS2 John A. Burns School of Medicine Chloe Asato, MS1 John A. Burns School of Medicine Nicholas Siu-Li, MS1 John A. Burns School of Medicine Objectives: 1. Describe JABSOM’s Learning Communities Program 2. Identify challenges to implementing a new program 3. Describe successes of the Learning Community Program Methods: The panel discussion will offer different perspectives on multiple aspects of JABSOM’s new Learning Communities Program. Learning communities are intentionally designed, longitudinal, small learning groups of faculty and students, and are meant to enhance the learning experience during medical school. The consistent, longitudinal relationships are at the foundation of the program and allow for meaningful exploration of important topics which can maximize learning and professional growth. Our goal is that through learning communities we will help our students become competent, compassionate physicians who are connected to their community. Panelists will begin with an overview of the concept of learning communities, and describe the ideation, development, and implementation of JABSOM’s Learning Communities Program. Curricular components demonstrating the integrated content, including professionalism, culture and community, ethics and clinical skills, will be highlighted. Additionally, the importance of collaborations with existing programs and courses will be stressed. Challenges, such as financing and launching a new program during the pandemic will be considered. Faculty mentors and student participants will share their respective experiences including challenges and successes of JABSOM’s Learning Community Program. Finally, participants will have an opportunity to engage in discussion with panelists and other participants about potential collaborations and input into the learning community curriculum. Key Phrases: Learning Communities Curricular Innovation Faculty and Student Development
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