Money Matters: An Educational Intervention to Improve Financial Wellness and Literacy Among Medical Students

Objective or purpose of innovation: We created a curriculum for medical students that targets gaps in personal finance and assessed self-perception of financial wellness and literacy. Background and/or theoretical framework and importance to the field: Financial stressors associated with student loan debt and poor financial literacy leads to burnout among medical students and professionals. Providing earlier financial training may inform proactive planning and improve overall wellness. Design: First-year medical students participated in an education activity covering topics such as personal finance, budgeting, student loans, and loan repayment programs. Participants reviewed informational handouts and watched pre-recorded videos followed by a faculty-led debrief in small groups. A 12-question survey was delivered to participants after the activity to retrospectively evaluate self-perception of financial literacy before and after the curricular intervention (retrospective pre-post approach). Likert-scale items (1:4, strongly disagree: strongly agree) were used. Pre- and post-activity mean scores were compared using paired t-tests. Outcomes: Out of the 77 participants, 69 (90%) completed the survey. Overall, participants felt more confident in their personal financial knowledge (2.38 vs 3.06, p<.001), and 98% of participants agreed that this activity motivated them to learn more about financial literacy. For debt management, participants felt more confident in building a strategy to manage financial debt (2.77 vs 3.33, p<0.001), cultivated a better understanding of loan terms (2.49 vs 3.57, p<0.001), and became more aware of loan repayment options (2.43 vs 3.51, p<0.001). All participants agreed that this activity should be continued for future medical students (27% somewhat agree, 73% strongly agree). Innovation’s strengths and limitations: Financial literacy education is associated with improved understanding, confidence, and appreciation of personal finance among medical students and should be considered for inclusion in other medical education programs. Feasibility and generalizability: A short instructional video combined with group discussion can be an effective model for addressing this sometimes under-appreciated aspect of student wellness

The Effect of Senior Medical Student Tutors Compared to Faculty Tutors on Examination Scores of First- and Second-Year Medical Students in Two Problem-Based Learning Courses

At the University of Hawaii John A. Burns School of Medicine, senior medical student volunteers are used as tutors for some problem-based learning groups in both the first and second years. Previous studies on the advantages and disadvantages of student tutors compared to faculty tutors have been equivocal. This study expected to answer the following question: Are there differences in examination scores for learners in their first or second year tutored by fourth-year medical students compared to those tutored by faculty members on two different types of examinations? Students were assessed using more clinically relevant, modified essay question examinations and multiple-choice question examinations. Student grades for eight consecutive years were sorted for year and type of examination into those tutored by a faculty member and those tutored primarily by a senior medical student. The only difference favored faculty tutors on second-year examinations that contained more clinically relevant questions. This phenomenon may be explained by the clinical expertise of faculty tutors making a difference in the second year but not the first year

Introducing Anki, a Spaced-Repetition Program, as a Study Tool for First Year Medical Students

Description of Innovation Anki is a free flashcard program that can be downloaded from the internet onto electronic devices. Unlike other flashcard programs, it uses a learning technique called “spaced repetition” whereby Anki uses an algorithm to automatically test students with newer and more difficult flashcards more frequently than older and less difficult ones. To use Anki to study for exams, students may make their own flashcards in the form of “decks” (sets of flashcards divided by subject) and/or download “decks” from the internet made by peers from other medical schools. Evaluation of Innovation In the past several years, Anki gained popularity among medical students from both allopathic and osteopathic schools (Rana et al., 2020) after it was shown that students who used Anki performed better on the USMLE Step 1 than students who did not use Anki (Deng et al., 2016). Anki was introduced to JABSOM students when JABSOM’s ℅ 2023 made Anki decks which covered material on JABSOM’s MD2 (Cardiology and Pulmonology) unit. These decks were then shared with students from the ℅ 2024, the majority of whom reported success with using Anki to study for MD2 exams (Koshi et al., 2021). Context During the start of medical school, most first year students (MS1s) have difficulty identifying study habits that best suit their individual learning styles. This project introduced Anki to MS1s during JABSOM’s MD1 (Health and Illness) unit in hopes of easing the ℅ 2025’s transition to medical school and expanding upon the findings of Koshi et al., which were limited to JABSOM’s MD2 unit. The distributed Anki decks came with certain limitations. First, they only covered material related to MD1 PBL cases. Second, they were released one at a time after students finished their corresponding PBL cases so as to not interfere with the PBL process. Lastly, decks from PBL cases 5 and 7 were omitted to encourage students to practice making their own flashcards. This project also consisted of online workshops that taught students how to use Anki and “AnKing,” the most commonly used premade Anki deck for the USMLE Step 1 and 2. Students’ comfort with and utilization of Anki were monitored throughout the unit via weekly surveys. Objectives Made and shared Anki decks covering most MD1 PBL material with the ℅ 2025 to introduce and transition them to using Anki. Hosted workshops to teach the ℅ 2025 how to use efficiently Anki and AnKing as well as how to make their own flashcards and decks. Discussion The JABSOM ℅ 2025 (n=77) were emailed 9 Anki decks out of a total possible 11 PBL cases. An average of 66.14 students (85.9% of the class) used the PBL decks. At the beginning of this project, 30.8% of respondents felt somewhat or very comfortable with creating new Anki cards. At the conclusion of this project, this percentage increased to 65.7%. The final survey showed that all 67 respondents would recommend Anki as a study resource to future students. All but one respondent planned to continue using Anki as a study resource. Conclusion Most students gave positive feedback about the Anki decks, reporting they were helpful study tools. Furthermore, most students reported that this project eased their transition into medical school and would continue to use Anki to supplement their studying in future units. Target Audience The intended audience of this presentation includes health professionals, and medical school faculty, educators, and students. References 1. Deng F, Gluckstein JA, Larsen DP. Student-directed retrieval practice is a predictor of medical licensing examination performance [published correction appears in Perspect Med Educ. 2016 Nov 18;:]. Perspect Med Educ. 2015;4(6):308-313. doi:10.1007/s40037-015-0220-x 2. Koshi E, Nielsen T, Fujiuchi B, Walter M, Kuniyoshi C, Sakai D. Qualitative Assessment of Anki as a Tool for Medical Education. Health Professions Education Conference (HPEC). 2021. hdl.handle.net/10125/73407 3. Rana T, Laoteppitaks C, Zhang G, Troutman G, Chandra S. An Investigation of Anki Flashcards as a Study Tool Among First Year Medical Students Learning Anatomy. The FASEB journal. 2020;34(S1):1-1. doi:10.1096/fasebj.2020.34.s1.0973

Using dynamical mode decomposition to extract the limit cycle dynamics of modulated turbulence in a plasma simulation

The novel technique of dynamical mode decomposition (DMD) is applied to the outputs of a numerical simulation of Kelvin–Helmholtz turbulence in a cylindical plasma, so as to capture and quantify the time evolution of the dominant nonlinear structures. Empirically, these structures comprise rotationally symmetric deformations together with spiral patterns, and they are found to be identified as the main modes of the DMD. A new method to calculate the time evolution of DMD mode amplitudes is proposed, based on convolution-type correlation integrals, and then applied to the simulation outputs in a limit cycle regime. The resulting time traces capture the essential physics far better than Fourier techniques applied to the same data

First-Year Medical Student Feedback Regarding the Addition of Online Learning Modules to the Curriculum

Introduction: The first year of the medical student curriculum at the John A. Burns School of Medicine consists of four blocks. The first block–MD1: Health and Illness–is a 9-week introduction to Problem-Based Learning (PBL) and foundational sciences. In response to the COVID-19 pandemic, MD1 introduced online modules (pre-recorded lectures assigned outside of scheduled lecture times) for fall 2020. While student ratings of MD1 were mostly favorable, students expressed specific concerns regarding online modules in MD1 mid-course evaluations. Comments included, “we feel overwhelmed by the length and content in addition to the scheduled lectures we already have” and “we were not huge fans of the online modules”. Additionally, “Q&A and review sessions” corresponding with each online module were scheduled in the second half of MD1 to provide dedicated time for students to meet with instructors. The formats of these sessions were left to the discretion of the instructor, resulting in high variability. Students were surveyed to elaborate their thoughts towards online modules and review sessions. Although this project was done in the context of MD1 online modules, we hope to extend the recommendations to all lectures in the pre-clerkship units. Objectives: The purpose of this study was to identify strengths, areas of improvement, and suggestions regarding online modules assigned in MD1. Methods: A quality improvement online survey was administered in October 2020 to 77 students in the JABSOM Class of 2024. Quantitative and qualitative questions were newly developed based on feedback from the MD1 mid-course evaluations and addressed areas including preferred presentation style, lecture reviews, effective characteristics, and overall sentiment of the online modules. Patterns among the qualitative responses were identified by the authors to recognize student preferences. Results: The survey was completed by 63 (81.8%) students. Of note, 100% of enrolled students earned passing scores on MD1 end-course exams. Students rated their overall feelings about the online modules 5.9±1.5 out of 10. The majority (55.6%) of students preferred practice questions provided and discussed in pre-recorded lectures. Student comments suggested the most effective review session formats were based on instructors’ practice questions or overviews of key lecture slides. Respondents also reported the most effective lectures had exam-like practice questions with explanations and direct connections to MD1 PBL cases. Additionally, respondents recommended scheduling in specific time blocks to watch pre-recorded lectures during school day hours, to more closely mimic live, in-person lectures. Discussion: The prevalence of online learning in medical school curricula has increased, perhaps due to the COVID-19 pandemic. We surveyed the JABSOM Class of 2024 about their MD1 online learning experience and consolidated feedback to the following recommendations. (1) Regarding content, we recommend lecturers (a) relate the material to PBL cases and (b) discuss clinical examples. (2) Regarding practice questions, we recommend lecturers prepare and discuss practice questions during their lectures. (3) Regarding review sessions, we recommend lecturers prepare a summary of both (a) testable, key concepts and (b) additional practice questions. We propose these changes and practices can lead to improved learner satisfaction while maintaining the high standard of learner performance outcomes that faculty and students share. Target Audience: Students and educators, JABSOM Office of Medical Educatio

Library Resources Utilization: determining high yield resources for medical students

The University of Hawaii (UH) Health Sciences Library (HSL) provides a variety of resources critical for science and medical education at the UH, John A. Burns School of Medicine (JABSOM). These resources are accessible by all of the UH students and faculty, including affiliated sites. To provide tailored services for medical students, their educational needs must be identified. Currently, there is no standardized system that evaluates this. The usage data of HSL resources is collected through the number of log-in’s through the UH library system by all of UH Manoa users. As such, it does not distinguish between medical students and other UH users. We propose that resource utilization by medical students differs from those utilized by other UH users. The objectives of the survey were three-fold: 1) To identify utilization of HSL resources by medical students; 2) Compare the pattern of utilization of the HSL resources by medical students with UH Manoa users by comparing our survey results to 2021 HSL usage data; and 3) To identify utilization of resources not available through HSL system. An online survey was emailed to all current JABSOM medical students. The six item survey included two likert scale questions regarding utilization of library resources available and not available through the JABSOM library. Items were assigned a numerical value; Never =1, Rarely=2, Sometimes=3, Very Often=4, and Always=5 and an average value was calculated for each resource. The remaining four items were open-ended. Sixty-six total responses were obtained with 21% first years, 35% second years, 18% third years, and 26% fourth years. The most utilized HSL resources were Access Medicine, PubMed, Textbooks, and Clinical Keys. The least used library resources were Health and Psychology instruments, Natural Medicine database, JoVE, and Psych Articles. For both medical students and UH Manoa users, Access Medicine and Clinical Key were among the most used, whereas Health and Psych instruments, JoVE, and Natural Medicine database were among the least used. On the other hand, Cochrane was ranked higher and Psych Articles was ranked lower in overall relative usage among medical students compared to the relative ranking among UH Manoa users. The most utilized non-HSL resources among medical students were Boards and Beyond, Sketchy, Pathoma, and AMBOSS, respectively. In conclusion, our study assessed medical student resource utilization of library and non-library resources at the JABSOM library. The rank order of the utilized resources were similar between medical students and UH Manoa users, with some exceptions. The results identified the utility of non-HSL resources, suggesting they are key supplemental tools in medical education. Further studies should investigate why some resources are used more or less to guide efforts in improving availability of these services

Cosmology with a long range repulsive force

We consider a class of cosmological models in which the universe is filled with a (non-electric) charge density that repels itself by means of a force carried by a vector boson with a tiny mass. When the vector's mass depends upon other fields, the repulsive interaction gives rise to an electromagnetic barrier which prevents these fields from driving the mass to zero. This can modify the cosmology dramatically. We present a very simple realization of this idea in which the vector's mass arises from a scalar field. The electromagnetic barrier prevents this field from rolling down its potential and thereby leads to accelerated expansion.Comment: 15 pages, 8 figures, LaTeX (version accepted for publication in PRD). 3 new figures, extended discussion of observational consequence

Bonding, Moment Formation, and Magnetic Interactions in Ca14MnBi11 and Ba14MnBi11

The ``14-1-11'' phase compounds based on magnetic Mn ions and typified by Ca14MnBi11 and Ba14MnBi11 show unusual magnetic behavior, but the large number (104) of atoms in the primitive cell has precluded any previous full electronic structure study. Using an efficient, local orbital based method within the local spin density approximation to study the electronic structure, we find a gap between a bonding valence band complex and an antibonding conduction band continuum. The bonding bands lack one electron per formula unit of being filled, making them low carrier density p-type metals. The hole resides in the MnBi4 tetrahedral unit and partially compensates the high spin d^5 Mn moment, leaving a net spin near 4 \mu_B that is consistent with experiment. These manganites are composed of two disjoint but interpenetrating `jungle gym' networks of spin 4/2 MnBi4^{9-} units with ferromagnetic interactions within the same network, and weaker couplings between the networks whose sign and magnitude is sensitive to materials parameters. Ca14MnBi11 is calculated to be ferromagnetic as observed, while for Ba14MnBi11 (which is antiferromagnetic) the ferro- and antiferromagnetic states are calculated to be essentially degenerate. The band structure of the ferromagnetic states is very close to half metallic.Comment: 17 pages, containing 10 postscript figures and 5 tables. Two additional figures (Fig.8 and 11 of the paper) are provided in JPG format in separate files. Submitted to Phys. Rev. B on September 20th 200