Implementing Uniform Curriculum to Increase Efficiency and Access to Simulation

• Using Standardized Patients (SPs) is effective in improving communication skills. • Conducting SP training can be cost prohibitive in terms of time and labor. • Demands of current curriculum created a need for an innovative and more efficient approach to meet new CLER requirement.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2022/1039/thumbnail.jp

Improving Inclusive Communication: Pilot Results from a Simulation-Based Learning Opportunity to Practice Taking a Sexual Health History

Introduction: Sexual and gender minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients experience health care inequities. Simulation using standardized patients (SPs) is an effective tool for communication-based training. To promote equitable practice, we created an experiential learning opportunity for residents to practice inclusive communication and improve their comfort in caring for LGBTQ+ patients while maintaining the psychological safety of SPs. Methods: Our interdisciplinary team explored relevant simulation curricula, conducted a focus group with LGBTQ+ SPs, created a didactic presentation, and designed and implemented a simulated case. Family medicine residents participated in the training and completed pre- and post-training surveys rating their confidence in sexual health communication and working with sexual and gender minority patients. We compared Likert scale ratings in pre- and post-training surveys using a Wilcoxon signed-rank test. SPs completed post-simulation surveys rating their psychological safety. Results: Residents completed pre-training (n = 13) and post-training (n = 12) surveys. Confidence improved in every category, reaching significance for confidence in obtaining a sexual health history from LGBTQ+ patients. Four SPs completed post-simulation surveys. All SPs reported that the event had educational value and was a positive experience. Discussion: This innovative simulation training with an equity focus improved learner confidence and maintained the psychological safety of SPs. We speculate that curricular design elements of interdisciplinary collaboration and co-creation with SPs with lived experience may have contributed to the success. Conclusions: Through interdisciplinary collaboration and experiential learning, we created a valuable learning opportunity that allowed residents to improve their confidence in taking inclusive sexual health histories of LGBTQ+ patients

Simulation to Improve Health Equity- Pilot results from a Standardized Patient-based learning opportunity to practice taking an inclusive sexual health history

Improving Inclusive Communication Pilot results from a Simulation-based learning opportunity to practice taking a sexual health history.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2023/1019/thumbnail.jp

Optimizing Psychological Safety: Using a Focus Group to Acquire Perspectives from Standardized Patients Who Identify as LGBTQ+

Introduction: Gender and sexual minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients report poor health care experiences, partly because health care providers are not trained to meet their needs. Simulation can help learners practice competencies related to diversity, equity, and inclusion, but there are psychological safety considerations when recruiting standardized patients (SPs). Our objective was to incorporate the expertise of members of the LGBTQ+ community in our SP pool as we developed related curriculum. Methods: All SPs were invited to participate in a focus group if they identified as LGBTQ+ and wanted to contribute. Content experts developed a focus group guide and facilitated the meeting. Additional members of the research team took de-identified notes. After notes were reviewed for agreement, a thematic analysis was performed. An anonymous survey was sent to SP participants after the focus group meeting. Results: Six SPs verbally participated in a 90-minute focus group, and 4 completed an anonymous follow-up survey. SPs acknowledged psychological safety risks but universally supported the developing curriculum. Most were willing to assume personal risk for the greater good. They emphasized the importance of lived experience to authentic portrayal, but they were open to eventual broader casting with coaching and proposed SP peer support and learner preparation as possible protective measures. Discussion: SPs appreciated the recognition of content expertise and opportunity to influence curricular design. They shared concerns about LGBTQ+ SP self-portrayal in simulation and offered creative suggestions to promote psychological safety. Conclusion: SPs with lived experience can share nuanced feedback and be a resource to co-create curriculum related to diversity, equity, and inclusion

Code Blue! When a Simulation Isn’t a Simulation Anymore

Objectives: • To identify and remediate gaps responding to a medical emergency during a simulated event. • To provide a safe working environment for standardized patients and clinical staff.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2022/1038/thumbnail.jp

Optimizing psychological safety- perspectives of Standardized Patients who identify as LGBTQ+

Innovative collaboration with LGBTQ+ Standardized Patients yields remarkable impact in development of inclusive sexual health curriculahttps://knowledgeconnection.mainehealth.org/lambrew-retreat-2023/1021/thumbnail.jp

How to address health misinformation? Using focus groups to understand the experience and needs of Interprofessional undergraduate health professionals

The Problem of Health Misinformation Students from six different health professions share ideashttps://knowledgeconnection.mainehealth.org/lambrew-retreat-2023/1020/thumbnail.jp

High spatial overlap but diverging age-related trajectories of cortical magnetic resonance imaging markers aiming to represent intracortical myelin and microstructure

ABSTRACT: Statistical effects of cortical metrics derived from standard T1- and T2-weighted magnetic resonance imaging (MRI) images, such as gray–white matter contrast (GWC), boundary sharpness coefficient (BSC), T1-weighted/T2-weighted ratio (T1w/T2w), and cortical thickness (CT), are often interpreted as representing or being influenced by intracortical myelin content with little empirical evidence to justify these interpretations. We first examined spatial correspondence with more biologically specific microstructural measures, and second compared between-marker age-related trends with the underlying hypothesis that different measures primarily driven by similar changes in myelo- and microstructural underpinnings should be highly related. Cortical MRI markers were derived from MRI images of 127 healthy subjects, aged 18–81, using cortical surfaces that were generated with the CIVET 2.1.0 pipeline. Their gross spatial distributions were compared with gene expression-derived cell-type densities, histology-derived cytoarchitecture, and quantitative R1 maps acquired on a subset of participants. We then compared between-marker age-related trends in their shape, direction, and spatial distribution of the linear age effect. The gross anatomical distributions of cortical MRI markers were, in general, more related to myelin and glial cells than neuronal indicators. Comparing MRI markers, our results revealed generally high overlap in spatial distribution (i.e., group means), but mostly divergent age trajectories in the shape, direction, and spatial distribution of the linear age effect. We conclude that the microstructural properties at the source of spatial distributions of MRI cortical markers can be different from microstructural changes that affect these markers in aging

Equipping Health Professions Educators to Better Address Medical Misinformation

As part of a cooperative agreement with the US Centers for Disease Control and Prevention (Federal Award Identification Number [FAIN]: NU50CK000586), the Association of American Medical Colleges (AAMC) began a strategic initiative in 2022 both to increase confidence in COVID-19 vaccines and to address medical misinformation and mistrust through education in health professions contexts. Specifically, the AAMC solicited proposals for integrating competency-based, interprofessional strategies to mitigate health misinformation into new or existing curricula. Five Health Professions Education Curricular Innovations subgrantees received support from the AAMC in 2022 and reflected on the implementation of their ideas in a series of meetings over several months. Subgrantees included the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Florida International University Herbert Wertheim College of Medicine, the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, the Maine Medical Center/Tufts University School of Medicine, and the University of Chicago Pritzker School of Medicine. This paper comprises insights from each of the teams and overarching observations regarding the challenges and opportunities involved with leveraging health professions education to address medical misinformation and improve patient health

Novel genetic loci associated with hippocampal volume

The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of hippocampal structure here we perform a genome-wide association study (GWAS) of 33,536 individuals and discover six independent loci significantly associated with hippocampal volume, four of them novel. Of the novel loci, three lie within genes (ASTN2, DPP4 and MAST4) and one is found 200 kb upstream of SHH. A hippocampal subfield analysis shows that a locus within the MSRB3 gene shows evidence of a localized effect along the dentate gyrus, subiculum, CA1 and fissure. Further, we show that genetic variants associated with decreased hippocampal volume are also associated with increased risk for Alzheimer's disease (rg =-0.155). Our findings suggest novel biological pathways through which human genetic variation influences hippocampal volume and risk for neuropsychiatric illness