Summary

Medical students in the required Family Medicine Clerkship will receive hands on telemedicine training. My hypothesis is that while students may be comfortable with technology, they may underestimate communication challenges in telemedicine. I am also interested in understanding their general attitudes about the quality of care in a virtual visit in comparison to an in-person visit, and how they may approach nuances in determining which visits are appropriate for virtual heath.  

Summary

The objective of this project is to develop interdisciplinary simulation cases as a novel teaching methodology for psychiatry residents learning to manage behavioral agitation. The study will determine the extent by which this simulation training to manage acute agitation improves resident physician objective competence and subjective confidence in the management of acute agitation, anxiety while on-call, and perceived interdisciplinary communication.

Summary

The ability to connect with patients in an empathetic and humanistic way is the foundation of patient centered care. In order to create a culture where compassion, respect, and empathy are at the core of health care, the work begins with the training of empathic and humanistic medical students. The HumMed project aims to identify key attributes of this connection using novel data including voice, body motion and posture utilizing clinical encounters between medical students and standardized patients. Current methods of assessing empathy in medical students offer only qualitative assessments by standardized patients, prone to subjectivity and not reflective of empathy in actual practice. The goal of HumMed is to make possible qualitative and quantitative feedback to help faculty to better assess, give feedback to, and remediate medical students as they strive to learn these skills. Our project aligns with Stanford’s vision of personalized, precision medicine by focusing on personalizing and creating precision in teaching and feedback for our medical students and physicians in training. Ultimately, we hope to be able to use this approach to identify ideal candidates for admission to the medical school as well as help in faculty development and assessment of clinicians and educators throughout Stanford. 

Summary

In this project, we will incorporate a hands-on diversity and inclusion project into GENE208, a spring quarter, 3-unit graduate course that is taken by Stanford undergraduates, graduate students, professional students and post-doctoral fellows. The course will be given for the third time in Spring 2018 and is co-taught by Profs. Falkow, Bhatt, KC Huang, and Sonnenburg. In this project, students will leverage stool samples collected under an IRB-approved protocol by the Bhatt lab in collaboration with colleagues at the University of Witwatersrand (Johannesburg, South Africa) and the INDEPTH consortium. 

Summary

This is a medical education project that aims to develop a clinical training curriculum and evaluation program focused on the provision of linguistically appropriate health services by medical students and clinical trainees. The goal of this project is to develop a curriculum that can be incorporated into clerkship, residency, or fellowship training that will improve the care delivered by medical students and trainees in clinical encounters involving patients or families with Limited English Proficiency (LEP).

Summary

Narrative Medicine is the concept that close reading of literature and creative writing is essential to training physicians to be attuned to their patient's story.  Most current literature focuses on such curriculums impact on patients, which is important and positive.  I plan to study the impact of a pilot Narrative Medicine curriculum on medical student's well-being.  This is distinct from existing studies by evaluating a unique outcome and important for advocating for its formal placement in medical student education.  In this way, this project has the potential to significantly impact medical student curriculum at Stanford and beyond.  

Summary

This grant outlines a proposal for the creation of a comprehensive, case-based video cirriculum on diagnostic clinical reasoning for Stanford medical students. This cirriculum consists of multimedia video instruction on the core concepts of diagnostic clinical reasoning, accompanying facilitator guide for small group discussion, and a series of case scenarios to be used for evaluation. It is our hope that by delivering this content in an organized and deliberate fashion, we will provide a solid foundation upon which this important skill can be refined and mastered during future years of training.

Summary

CBT for psychosis has been shown to be an effective treatment for people with a psychotic disorder in reducing distress associated with positive symptoms and improving functioning. More recently CBT-informed interventions have been developed for front line providers in community or long-term psychiatric facilities but, to date, this has not been applied within an acute inpatient setting. The Stanford Hospital Inpatient Psychiatry Unit commissioned a CBT-informed training for a multi-disciplinary cohort of unit staff in early 2016. Analysis of pilot data suggested that participants gained knowledge and confidence in the use of the skills taught. Further training sessions with additional staff were conducted in 2017. There is a need for filmed clinical role plays to demonstrate the skills in action and the development of a training manual to ensure sustainability of this training initiative. In addition, it is necessary to develop a fidelity tool to measure skill acquisition and ensure that participants can demonstrate accurate use of the skills acquired. Development, and evaluation of these products, would allow for further dissemination of this intervention within the inpatient unit, and further afield, and would place Stanford Hospital at the forefront of teaching and education in this cutting-edge innovative training endeavor. 

Summary

Paloma Marin-Nevarez, Jecca, Steinberg, and Dr. James Lau will design, implement and assess the impact of a new seminar for medical students. The proposed seminar, SURG 234: Service through Surgery, Surgeons with an Impact, will take place weekly during Winter Quarter 2018 at Stanford School of Medicine. The purpose of the seminar is to expose medical students to passionate, model surgeons who manage to combine diverse surgical specialties with work addressing health inequities in underserved populations. The surgeon-leaders will give talks on their work to improve equity in surgery and advance healthcare for underrepresented groups (i.e. women, African Americans, Latinos, Asian Americans, LGBTQ individuals, immigrants and low-income families). The research team will measure the impact of the seminar on medical students' perspectives and career trajectories through quantitative and qualitative data collection and analysis. Any impact of this seminar course as revealed by a mixed methods program evaluation will be presented to the Department of Surgery either through a Grand Rounds Presentation or in the next annual Surgery Education Retreat.

Summary

We face a shortage of neurologists to treat an increasing number of neurologic patients.  Nonprocedural specialties, like neurology, experience difficulties attracting US medical students [Freeman] and they perceive neurology as the most difficult specialty [Zinchuk]. It’s estimated that the supply of neurologists will fall 20% below demand by 2020 [Bradley].   The most powerful tool used to diagnose and manage patients with neurologic complaints is neuroanatomical localization after performing a history and physical exam.  This is the foundation for Clinical Neurology and can help avoid misdiagnoses and unnecessary tests [Roberts; Gurbani; Mondelli].  Use of acting learning methods has been recommended in the literature as a key strategy to overcoming “neurophobia”[Alimoglu; Lim].  Our primary aim is to demystify neurology through tying clinical teaching solidly and repeatedly into neuroanatomical localization with a localization tool and through active, learner-centered, localization laboratory sessions.   In addition to increasing comfort and facility with neurology in all learners, we also specifically aim to attract more learners into the field of neurosciences through highlighting the variety of attractive career paths.  To this end, the second arm of our project consists of formulation of interactive sessions with both multidisciplinary teams of providers and the patients for whom they care.

Summary

I plan to create a medical student delivery room curriculum using short, online modules (2-5 minutes in length each) based on established neonatal resuscitation program (NRP) guidelines. Each video will be paired with an immediate assessment tool. The modules will include a variety of topics and situations, all directed at fulfilling the specific learning objective of having medical students and interns acquire confidence, familiarity, and an increased knowledge base regarding basic delivery room resuscitation. Using these online modules, I hope to enhance student skills and confidence in the delivery room. Outcomes measured include confidence regarding these skills, as well as objective scores from online quizzes in both control and intervention groups. Learners access these modules at their convenience, and review and practice challenging cases to cement concepts. My goal is for these modules to become widely available beyond the audience of Stanford medical students and interns. 

Summary

Dermatology is a highly visual field of medicine. Given that the organ of interest is readily accessible to both the human eye and image capturing modalities, dermatologists rely on the morphology and distribution of disease processes to complement information gathered from history and diagnostic tests. Much like the way machines learn via processing large datasets, trainees in dermatology benefit from repeated exposure to a wide variety of disease presentations during patient encounters and independent study via textbooks, image atlases or other archived resources. The goal of this project is to digitize, archive, and classify an irreplaceable collection of ~5,000 24 x 36 mm Kodachrome slides containing clinical images curated over a 40+ year career in dermatology practice recently donated to the Stanford Dermatology Residency Program. In its current form, this collection of slides is a treasured but impractical and constrained teaching resource. Through professional digitization, archival, and classification, however, we can convert the collection into an invaluable teaching and study tool that will be available at no cost to current and future dermatology trainees both at Stanford and in the broader community.

Summary

There has long been a gap between student desire for early, authentic interactions with patients, and formal opportunities for them do so. This gap is bridged in an innovative course for first year MD and PA students. Real patients are placed front and center in the exploration of the patient’s perspective and challenges of managing optimal health in a complex health care system. This collaboration between the Stanford Healthcare Innovations and Experiential Learning Directive, the Stanford Healthcare Patient and Family Partner Program, and the Office of Medical Student Wellness, brings together enthusiastic students and an engaged community of patient and family advocates interested in medical education and in helping to develop patient-centered perspective and interpersonal skills in future physicians. In addition to a monthly workshop, students are matched with a patient/family partner for the duration of the course, and meet on a monthly basis at the medical center or other location that relates to learning about the patient’s journey, and explore together the impact of the monthly topic at the individual level.

Summary

Antenatal hydronephrosis is found in up to 2% of all prenatal obstetrical ultrasounds. However, the terminology used to describe hydronephrosis of the fetus and the child is not standardized, and at Stanford, three different grading systems are most commonly used by obstetrics, pediatric urology, and pediatric radiology. This leads to ambiguity in transfer of information not only between these three specialties, but in communication with pediatrics and nephrology. The UTD (upper tract dilatation) grading system was developed by a multidisciplinary committee in 2014 and can be used in both the prenatal and postnatal periods. However, it is significantly more detailed than previous grading systems, which may make implementation through informal training more difficult. This project sets up a framework for education about and implementation of the UTD grading system between obstetrics, pediatric urology and pediatric radiology through the use of small group training sessions and a computer-enhanced visual learning module.