Summary

We aim to validate a global assessment tool for surgical skills in Endourology with the use of C-SATS, crowd-sourced online surgical evaluation technology. Beyond validation of the assessment tool we will be exploring a new method of capturing and archiving endoscopic skills that addresses control of the ureteroscope, treatment of stones, use of fluoroscopy and motor skills required to place wires and sheaths up to the kidney to enable treatment of kidney stones. While other types of surgery have well established global assessment tools that have been validated in a variety of settings, there is limited data on global assessment in Endourology. A validated assessment can be used for resident evaluation as well as for quality improvement throughout a surgeon’s career. We will capture not only video of endoscopy but the surgeons facility with wires, a back table and use of an assistant. This will be compiled into 10 minute clips for 25 surgeries ranging from novice to expert and will be validated by experts as well as surgery-naïve crowd sourced evaluators. 

Proposal Feedback

This is a well thought out study and appears to be a novel way of evaluation using crowdsourcing. It has a valid assessment tool and the product of 25 videos appear to be useful work products for the proposal. I also like the budget and the fact the author already has protected time for producing the intervention.

Summary

This application for a Teaching and Mentoring Innovation Grant seeks to fill an interdisciplinary gap in Fellowship training by developing and piloting an Interdisciplinary Curriculum designed to integrate systemic, structural, and strategic ways of working with families and introduce techniques to enhance clinical effectiveness from widely-used evidence-based models such as Parent Management Training (PMT) and Family-Focused Therapy (FFT).  Our aims are threefold:  to identify barriers to working effectively with complex families of youth receiving treatment; to develop and Interdisciplinary Curriculum based upon feedback from Focus Groups with Fellows, and to pilot this curriculum during a one-day Interdisciplinary Workshop for Fellows.  We anticipate publishing a brief report appropriate for a medical education journal (e.g., Academic Medicine) presenting qualitative and quantitative findings from Focus Groups and the Interdisciplinary Workshop as a formal way to educate Fellows across disciplines to effectively communicate and intervene with complicated families in service of the young patient. If successful, this interdisciplinary training model for Fellows could be expanded to other pediatric services. 

Proposal Feedback

Excellent proposal with emphasis on interdisciplinary training and focus on the competency of interpersonal and communication skills.Feasible and significant.

Summary

Residents in the Internal Medicine residency have expressed a lack of confidence in their ability to handle acute medical emergencies such as Code Blue and Rapid Response Team (RRT) activations in the hospital. This project seeks to use simulation to identify knowledge and behavioral deficiencies in their handling of such situations, and to evaluate the efficacy of simulation as a tool to address these deficiencies. A small group of residents will be brought to the simulation center every month and run through two scenarios that approximate RRT activations. Three months after the sessions, their retention of teaching from the simulation sessions will be measured and compared to their retention of teaching via online self-learning module. Furthermore, common errors and deficiencies in medical knowledge and crisis management behavior will be catalogued and used to guide future curriculum development.

Proposal Feedback

This project shows promise to improve residents' ability to direct care during acute medical emergencies, using simulations.  The PI might clarify whether it will be disseminated beyond Stanford so that it can be replicated elsewhere.

Summary

The increasing diversity of patient populations requires physicians to enhance their abilities to provide culturally competent care. The literature suggests that teaching medical students to provide culturally effective care will require innovative teaching to imbed knowledge into their practice behaviors. Critical to the effort to provide culturally competent care is allowing medical student to understand their own implicit (unconscious) bias as they interact with diverse patients. This proposal requests funding to support the development of a web-based module on implicit bias in clinical care for medical students, and to assess its usefulness in modifying the implicit biases of medical students in the care of diverse patient populations.  Our hypothesis is that implicit bias training for medical students will improve their care of diverse patient by decreasing their unconscious bias in patient interactions.  Drs. Mendoza, Osterberg, and Curtin will develop the module with the assistance of Cedar Interactive, the developer of a web-based implicit bias module for faculty in the SOM.  The module would be given to randomized E4C groups with assessment of implicit bias before and after this training.  Also, qualitative assessment of students’ abilities to care for diverse patient populations will be assessed. 

Proposal Feedback

Nice proposal that addresses an important question; we encourage the investigtors to consider how feasible the randomization will be since students can talk to each other and the IRB may not approve (because all students should be exposed to the same training); the pre-post evaluation might be adequate.

Summary

Virtual communication is becoming an integral part of health care delivery and will only continue to grow in importance (Appel et al, 2011, Linden et al 2010, Wenneberg et al, 2010, Wolever et al 2013). Virtual health coaching is especially useful in reaching populations that have a high need for, but low access to, regular health coaching (Albaina et al 2009, Hartung et al 2012). However, medical schools have not yet developed comprehensive and longitudinal training curricula to prepare graduates for this challenge. Given the potential for virtual health coaching to reach under-resourced populations and the current lack of training in the medical school curricula across the country, we propose to create such a training module for both pre-clerkship and clerkship students. We use a multi-disciplinary approach by collaborating with colleagues from Stanford School of Management to develop a novel curriculum teaching best practices in effective, personalized, and ethical virtual communication.  This project will empower students to gain concrete skills and expand their knowledge about modern health coaching, from the first years of medical training.

Proposal Feedback

This proposal is well written, benefiting from a solid organization, clear description of the status quo in the field and unmet needs, and defining clear objectives for the study. Envisioning a pilot phase of study to test the platform and troubleshoot possible pitfalls is a great approach proposed here. This proposal meets the majority of the criteria that were set for this funding: initiating collaboration between with experts within Stanford, increasing the chance of access to education for underrepresented minority groups, scientific rigor, and detailed and logical time plan for the study. I’d suggest further improvement of the evaluation plan, envisioning more tech-based evaluation approaches which would also enable to assess the experience od remotely-communicated patients. If relevant, you can elaborate which clinical model will be used or which communication framework will be used. There may be some potential connections with hospital projects on virtual medicine.

Summary

Low health literacy has been associated with poorer health outcomes, including increased utilization of emergency services and decreased asthma control.  Physicians admit to insufficient knowledge of health literacy and advanced communication techniques and they tend to overestimate their ability to communicate effectively with patients with low health literacy. Educating residents will better prepare the next generation of physicians to communicate effectively with a diverse patient population.   This project has the following specific aims: (1) To increase resident knowledge of health literacy and how low health literacy may affect health outcomes.  (2) To enable residents to communicate effectively with patients/caregivers of all health literacy levels and (3) To establish an effective and feasible method to teach residents fundamental tools of health literacy that can be disseminated to other programs and used in various scenarios of provider-patient communication.  The project will involve a randomized control trial testing the effectiveness of a health literacy based communication intervention curriculum.  Before and after the intervention, resident communication skills will be evaluated using the fundamental principles of health literate communication: limiting medical information, checking for understanding, using plain verbal and written language.  Each scenario will be videotaped and assessed using an evidence based assessment tool.   

Proposal Feedback

High significance within a field that needs growing attention and which is under studied. Good randomized design and evaluation measures. Evaluation of learners performance is also a strength.

Summary

We all have to be prepared to describe our work anywhere and to anyone. We are trained to use diagrams for props but these don’t work well outside of a formal lecture or poster setting; without these props we are left waving our hands in the air.  My goal is to equip students with a small object that they can use as a visual aid to focus listeners’ attention and help describe their work to both experts and novices.  I hand these objects to people and they can explore the data on their own during a discussion.  I find that it helps people understand what I’m describing; I see this as a subtle use of manipulatives that lets the diverse people I talk to understand my story better because I can engage them in different ways and not just focus on the verbal learner.  This helps switch a conversation from a simple didactic interaction to one where the listener is invited to actively explore my data, rather than passively absorb a description. These props help me teach inclusively by offering a variety of learning modes to my students.  My goal is to show Stanford students how to teach in this inclusive manner, and I will give a new mini-course in which I will teach students how to model their data or a representation of their work and then print this in a durable material. Grant funds will support my ability to rapidly produce the models designed by students. 

Proposal Feedback

This project is innovative, sustainable and something that really can improve teaching. Storytelling and the use of narratives is a great way to help people learn. Way back, this is how we as humans interacted and I find it helps me remember things.

Summary

This project proposes the development of a 3D-printed vascular access model (3DP-VAM) of normal femoral anatomy with a complementary vascular access simulation experience. The 3DP-VAM will be reusable and substantially less expensive to manufacture compared to currently available commercial models. The model will be developed using patient anatomy derived from computed tomography scans, allowing for complete customization to patient-specific anatomy. Trainees will complete vascular access training on a commercially available standard model or on the 3DP-VAM prior to starting the interventional radiology clinical rotation and will be assessed on their procedural competency per program policy; trainees completing a simulation experience will be compared to trainees without simulation experience. The knowledge gained from this initial normal model will be used to develop more complex future models of variant anatomy or pathology. This project will be performed in collaboration with members of the Department of Radiology, the 3D and Quantitative Imaging Laboratory, and the Center for Immersive and Simulation-based Learning; results will be shared with other disciplines in order to improve vascular access success for trainees. 

Proposal Feedback 

Goal is to generate 3D printed models for ultrasound guided vascular access.  This project is noteworthy in that this type of training can improve physician performance. The proposal would have been strengthened with clarification of how scalable this is, or how it will be disseminated beyond Stanford--will the 3D printer design files be made freely available? Would have been nice to have had more information on how many students can be taught with a single 3D printed model, and how long such a model might last. 

Summary

Dermoscopy, or the examination of the skin surface using magnification, facilitates the early diagnosis of potentially life-limiting skin cancers. Despite the benefits of incorporating dermoscopy into clinical practice, dermoscopic education in residency programs is lacking: only 52% of chief dermatology residents are satisfied with the dermoscopy training received during residency. Currently, dermoscopy training relies on the use of optical dermoscopy, which permits the examination of skin lesions by one viewer at a time. We propose to use videodermoscopy, which facilitates the simultaneous viewing of skin lesions by multiple viewers, as a novel tool to further dermoscopic education. To achieve this aim, videodermoscopy will be made available during Stanford Dermatology Grand Rounds meetings during the 2016-2017 academic year such that pertinent dermoscopic features can be highlighted and discussed among attending physicians, dermatology residents, and medical students. Grand Rounds attendees will be asked to complete a survey characterizing patterns of dermoscopy use and satisfaction with dermoscopy training prior to and following the addition of videodermoscopy to Grand Rounds programming. Moreover, the videodermatoscope will be used to create an annotated dermoscopic image repository for use by current and future dermatology residents, also to further the goal of improving dermoscopic education at Stanford.

Proposal Feedback

A very strong project that documents specific need and a specific goal with a good plan. I would love for the repository to be accompanied by short video’s going over the salient features for just-in-time learning. The possibilities of generalizability are wonderful. MedEDPORTAL for sure.  

Summary

Postdoctoral training is often viewed as a period of intense research training, during which scientists develop the independence required of academic faculty. Unfortunately, postdocs have few opportunities to develop the teaching skills that are also integral to faculty success. In this proposal, we seek to partially remedy this deficiency in postdoc training by designing and implementing a 6-session course in evidence-based educational practices for STEM postdocs. The adoption of evidence-based practices could improve retention rates for underrepresented groups in science when postdocs become course instructors. Moreover, the utilization of evidence-based mentorship practices among postdocs could improve research experiences for Stanford students.

Proposal Feedback

The value of providing STEM postdocs with teaching skills required of faculty, which they do NOT currently get, is high and the budget is modest. This is a strong proposal and worthwhile project.

Summary

Cognitive behavioral therapy for vaginismus (CBT-V) developed by Ter Kuile and colleagues is a highly efficacious, non-pharmacologic treatment for a common form of female sexual dysfunction. Despite its widespread use elsewhere, this treatment is not available to patients in the U.S., largely due to lack of U.S. based educational and training opportunities related to implementation of this treatment. We propose to address this training gap by creating and evaluating a CBT-V simulation protocol that can be implemented on standardized patients. As there are currently no trained clinicians in the U.S. who can implement (or supervise the implementation of this protocol) simulation based learning offers a novel, cost-effective means of safely pursuing a first stage of training. It is our long term goal to secure additional funding for this newly trained team to ultimately develop a Stanford based training on CBT-V for future generations of clinicians.

Proposal Feedback

Focuses on the development of a novel treatment for an under-studied disorder that affects only women. International collaboration and potential for impact beyond SU is great. Strong educational component, right kind of people coming in, evaluation plan looks solid. Can easily translate to future research. Scalable training, foundation for future improvements. Ultimately this is not a "teaching" proposal, but eventually if developed this could be implmented into MD curriculum and resident education. Stanford could become a learning center for this protocol. 

Summary

Mood and and anxiety disorders during pregnancy and postpartum are common, affecting an estimated 10-20% of women. Multiple national organizations and guidelines now recommend “universal screening” for depression, and there is increasing pressure for primary care physicians to begin treatment for perinatal psychiatric problems until psychiatry consults are available. However, currently there is no standardized national medical school curriculum on this topic, and this represents a major gap in medical school education, leaving future providers in women’s health without much needed knowledge about perinatal psychiatry. OBGYNs, pediatricians, and primary care physicians report that this lack of knowledge, and confidence, in treating psychiatric illness in pregnancy leads to decreased screening for postpartum depression, and delays in treatment. We propose to address this education gap through development of a concise curriculum designed for multiple disciplines that will teach a) differential diagnosis of high scores on the Edinburg Postnatal Depression Inventory (EPDS), the internationally recommended screening instrument b) risks and benefits of antidepressants  c) identification and management of psychiatric emergencies (patients who endorse self or infant harm on the EPDS). Through video teaching modules and accompanying in-class case based learning, we will teach a diverse group of residents important evaluation and treatment information.  

Proposal Feedback

Very important topic. Good measurement of retention of skills. Would be great to measure actual patient outcomes (chart review) if possible. Also, would recommend getting buy-in from appropriate residency program directors.