Summary:
Teaching LGBTQ+ Health (https://mededucation.stanford.edu/courses/teaching-lgbtq-health/) is a free, online, interactive, faculty development and CME course designed by members of our investigator team. It teaches health professionals the fundamentals of LGBTQ+ Health, as well as methods for teaching that content to their trainees. The course launched in 2021 on the Stanford MedEducation platform and has been well trafficked and positively reviewed. It was recently added to the Coursera platform and continues to have a steady increase in new registrations and course completions.

Our aim for this project is to update the Teaching LGBTQ+ Health course to include information and data about the care of transgender patients. Specifically, this would include an animated video about transgender health and two interactive case-based modules using a choose-your-own-adventure pedagogy to guide learners through the process of making medical decisions for gender-affirming care. This new content will fill an important training gap for most providers. Those who complete the course will be better prepared to provide equitable care for transgender patients and to teach others to do the same.

Summary:
Residents in neurology at Stanford have perennially stated their preference for learning via case-based learning (CBL) over lectures, in line with extensive research suggesting the superiority of CBL for resident education. However, neurology residents have received lectures instead because developing exercises for CBL is challenging, time-intensive, and requires niche expertise in the mechanics of CBL. To eliminate this rate-limiting step, we propose using ChatGPT to convert clinical cases (which are abundant) into case-based learning activities within minutes. This proposal supports a study wherein faculty and students complete surveys to assess their preference for CBL activities generated by different inputs (“prompts”) into the ChatGPT chat interface, a form of prompt engineering that is required to use ChatGPT optimally. Surveys will further assess the perceived accuracy of these activities, and respondents’ interest in doing the activity for education. The funds support survey incentives, access to the powerful ChatGPT tool, and fees for conferences and publication to disseminate and educate others on this novel approach to creating CBL activities.

Summary:
More than 70% of pediatric admissions are cared for in community hospitals across the country. Practice of pediatric community hospitalist medicine requires both distinctly different clinical and non-clinical skillsets compared to our tertiary center colleagues. Clinicians operate with less resources than an academic center, and often within an adult hospital paradigm. AGME-approved PHM Fellowship emphasizes clinical excellence, quality improvement and research. However, despite development of AGME core competencies and curricular frameworks for hospital medicine fellowships, recent informal needs assessments have uncovered that training in non-clinical skillsets essential for success as community hospitalists (e.g. hospital administration, billing, multi-disciplinary team leadership) have been lacking. To date, no formal curriculum exists to teach these types of non-clinical skills to fellows in PHM. Our study aims to perform a qualitative national needs assessment with previously graduated PHM fellows to assess and define the knowledge gap. Using this study data, we will design a novel, online non-clinical skills modular curriculum, with the aim to teach both PHM fellows and residents interested in PHM these crucial business, leadership, and systems skills needed to be leaders in pediatric community hospital programs.

Summary:
Improving surgical education in Obstetrics & Gynecology (Ob/Gyn) expands access and quality of care to women across all communities. Women’s health research remains underfunded and Ob/Gyn resident trainees must excel in increasingly complex minimally invasive surgeries to treat these women. High-fidelity training models improve resident’s motor and communication skills in risk-free surgical settings which translates to real-world cases. The primary goal of this project is to improve laparoscopic surgical performance and operator-perceived confidence in Ob/Gyn resident trainees using a cost-effective, high-fidelity porcine simulation training model. Aim 1 evaluates the effectiveness of high-fidelity simulation on laparoscopic skills improvement in fourth-year Ob/Gyn residents using the Global Operative Assessment of Laparoscopic Skills criterion. Aim 2 assesses the impact of high-fidelity simulation experience on perceived surgical confidence. As a secondary goal, Aim 3 expands high-fidelity simulation training to departmental Fellows performing advanced laparoscopy. For all learners we aim to 1) provide advanced surgical practice in a low-risk surgical learning environment and 2) evaluate the perceived effectiveness of high-fidelity simulation experience to improve real-world case confidence. This project will establish a high-fidelity laparoscopic teaching simulation that is currently unavailable within the Ob/Gyn department at Stanford University Hospital.

Summary:
Pediatric respiratory distress is the top cause of pediatric emergency department visits in the U.S. and globally. The problem is that many providers are not proficient in identifying children in respiratory distress. No scalable and sustainable online curricula exist that use real cases for teaching providers how to identify pediatric respiratory distress. Using Kern’s six steps, we developed a novel instructional video curriculum about identifying pediatric respiratory distress. This project will validate a tool to assess the knowledge, self-efficacy, and attitudes about the novel curriculum. We will collaborate with psychometrics and biostatistics experts and trainees to build validity evidence among nursing students, nurses, residents, and physicians via a multi-center study. We will use Artino’s seven-step process for creating a high-quality scale. After watching the instructional videos, providers should be better equipped to identify pediatric respiratory distress and teach parents to recognize it too. This proposal addresses the priorities of collaboration, diversity and inclusion, and impact and sustainability using rigorous approaches to scholarship and innovation.

Summary:
The goal of this project is to integrate and validate principles of deliberate practice and “Mastery” learning into Radiology image interpretation. We will utilize and advance a teaching file software platform we developed called STELLA (STanford Electronic Learning Library & Applications) which is a flexible tool for creating searchable metadata and displaying radiological images from Stanford’s Picture Archive and Communication System (PACS). Specifically, our team will build into STELLA a rigorous framework to help learners develop mastery of core image interpretation tasks critical to patient care and safety. This project addresses a significant weakness in Radiology education, which traditionally relies on a variable apprenticeship model where “competence” is highly subjective and may only reflect completion of a rotation. The current project will help to advance radiology education through creation of Mastery modules within the Stella Teaching Application, which allows for customized learning sets and individualized trainee viewing and scoring that can be quantified and utilized for concrete, specific feedback.

Summary:
Nearly every practicing anesthesiologist experiences at least one serious perioperative adverse event or patient death over the course of their career. The literature suggests that formal and informal peer support from a colleague is one of the most desired resources after an adverse event, yet when surveyed, most respondents felt that they did not have the skills or adequate knowledge to serve as an informal peer supporter. The typical anesthesiology residency curriculum does not currently include the development of skills to help with coping or supporting colleagues after an adverse event. To address this gap, we propose the introduction of a longitudinal curriculum which will include both a theoretical and practical framework for residents to be able to support themselves and their colleagues. This curriculum builds on a successful pilot workshop from Spring 2023 and will be comprised of a comprehensive toolkit including resident lectures on peer support and managing after adverse events, supplemental videos, and practice scenarios. There will be an additional component which will be a qualitative and quantitative evaluation of the developed curriculum. The lecture series will be targeted towards residents in anesthesiology but can be adapted broadly to other specialties within and outside of Stanford.

Summary:
Despite increasing awareness that implicit bias and structural racism affect clinical decisions and contributes to health disparities, many educators feel ill-equipped to teach this topic with learners. Current faculty development in anti-racism training comprises “one and done” workshops where a large amount of knowledge and concepts are taught without repeated exposure.

Our team created and published a framework and case-based curriculum on teaching racial justice in clinical decision making, the 5-Minute Moment for Racial Justice (5MMRJ). A Teaching & Mentorship Academy Innovation Grant supported the creation of an animated video library of this curriculum that is now available through Stanford CME.

We are seeking a Research Education Grant to study the impact of repeated, longitudinal exposure to the 5MMRJ framework and curriculum on educator’s teaching attitudes and practices towards anti-racism. Using mixed methods study design (surveys and focus groups), we will evaluate the implementation in adult and pediatric hospital medicine across three health care systems: Stanford Health Care, Lucile Packard Children’s Hospital, and Palo Alto VA. All sites have received approval from division leadership for the curriculum to be presented monthly at a division meeting.

Summary:
This project aims to enhance and evaluate an artificial intelligence (AI)-enabled dashboard called "PhacoTrainer" which provides automated surgical feedback to improve surgical training for cataract surgery. The project has already developed a version 1 preliminary dashboard that provides feedback on the time spent on each step, special techniques used, and complications encountered in cataract surgery. Building on this, the project aims to enhance the dashboard with our recently developed deep learning models for detecting surgical instruments and anatomical landmarks. The resulting version 2 dashboard will allow users to explore individual video timelines and visualize instrument tracking, and examine instrument total path length, area covered, and maximum velocity. For evaluation, we will analyze the correlation between our AI surgical performance metrics and surgical learning in Stanford ophthalmology residents, hypothesizing that metrics will improve as case count increases. Ultimately, the project aims to create an educational tool that can be widely used by ophthalmic surgical trainees to improve surgical performance, with the long-term goal of becoming a standard platform for enhancing surgical training.

Summary:
Our grant proposal aims to address the lack of equitable racial, ethnic, and socioeconomic representation in medicine by developing, implementing, and evaluating a technical skills experiential learning workshop across Bay Area community colleges. We will assess its impact on students' health career self-efficacy and qualitatively investigate attitudes and barriers faced in pursuing healthcare careers. Guided by the social cognitive theory of education, the workshop seeks to boost students' confidence in their ability to pursue careers in medicine by teaching them hands-on clinical skills. Collaborative efforts with expert faculty mentors and community college partners will ensure a theoretically grounded and evidence-based approach. The ultimate goal is to serve as a blueprint for fostering diversity and inclusivity in healthcare professions by leveraging the wealth of diversity that community colleges offer, thus creating more equitable opportunities for advancement in health careers.