The increasing rise of national public concerns for the opioid epidemic within the United States regarding substance abuse and addictions has led to the development of opioid response networks. This study aimed to examine barriers to access to Medication for Opioid Use Disorder (MOUD) for opioid addiction in West Virginia. It focused on the availability of clinics, weekly out-of-pocket cost for treatment, acceptance of Medicaid and earliest available appointment. The study analyzed data from 100 randomly selected MOUD clinics obtained from The Opiate Addiction & Treatment Resource (OATR) website through survey phone-calls. Results showed that only 23% of the clinics responded, 35% of the phone numbers provided were no longer in service and 42% went to voicemail. The average wait time for an initial appointment was within 1 week but could range up to months. The weekly cost of treatment varied greatly, with an average of $122 per week. However, 70% of the clinics reported accepting Medicaid. The study highlights barriers to access to care and lack of reliable information on MOUD clinics in West Virginia, making it difficult for patients to access much-needed treatment in a timely manner.

Dialing For MOUD: Barriers to Finding Help

Background
Imposter Phenomenon (IP) involves a pattern where individuals doubt their skills and worry they will be exposed as frauds. Students who experience IP tend to discount positive feedback and their accomplishments. Furthermore, IP predisposes to depression, anxiety, and suicidal ideation. Of concern, the estimated prevalence of IP in medical students ranges from 22.5%-46.6%. Despite this, there is scant empirical literature exploring IP in clinical medical students. The few studies that exist suggest that aspects of medical education may contribute to IP, but there is currently little longitudinal data exploring this. Therefore, the purpose of this study is to assess IP in third-year medical students prior to and after clerkships. 
Methods
A single class of medical students was surveyed immediately prior to (Time 1) and after clerkships (Time 2) using the Clance Imposter Phenomenon Scale. Data was analyzed using Wilcoxon signed-rank tests to determine significant differences in IP. After Time 2, students participated in semi-structured interviews to assess their personal experiences with IP. Interviews were conducted using a predesigned interview guide consisting of nine open ended questions. Thematic analysis was performed to determine protective and contributing factors to IP. 
Results
Of the 141 students, 18 students took both surveys and 10 participated in semi-structured interviews. There was no statistically significant difference in IP scores (p=0.970), with scores indicating “frequent imposter feelings”. Thematic analysis of student responses revealed protective factors such as increasing confidence, safe learning environments, and role model/peer interactions. Contributing factors included making comparisons to other students, perceived knowledge gaps, and evolving/new stressors. 
Conclusion
Medical students in our study reported frequent imposter feelings, with no significant difference in scores. These scores are comparable to other studies examining IP during clerkships. Students in our study suggested that while they built confidence in the clinical domain, other stressors elicited feelings of doubt and imposterism, such as upcoming board exams. Furthermore, comparisons to other students and perceived knowledge gaps can elicit these feelings. Despite this, students found that conversations with mentors and peers can build comradery and reduce feelings of IP. As other studies have noted, institutional culture is important. Students in our study suggested that preceptors who create a safe learning environment helped reduce IP feelings. Institutions may benefit from encouraging this type of dynamic, while also creating opportunities for students to build comradery during clerkships. 




A Mixed-Methods Longitudinal Assessment of Imposter Phenomenon in Third-Year Medical Students

Background 

Despite the prevalence of sexual health-related issues, only half of medical schools in the United States necessitate formal education in sexual medicine. The lack of standard guidelines leaves trainees unprepared to handle sexual health, undermining the quality of overall healthcare.1 This deficit disproportionately impacts women, gender minorities, and the LGBTQIA+ community. 

To address this, we developed a structured, week-long educational initiative, 'Sex Positivity Week' (SPW). This student-led program aimed to address these gaps in formal curriculum, focusing on sexual health of marginalized communities. 



Methods 

SPW is a week of student-run and professional-taught workshops and lectures on topics including birth control, gender and sexual diversity, sexually transmitted infections, sex work, mental health, and anatomy. 

One week before SPW 2022, preclinical students were invited to complete a voluntary, anonymous survey that utilized a 6-point Likert scale (strongly agree to strongly disagree) to assess self-reported comprehension of sexual health and positivity before and during medical school. After SPW 2022, students were sent the same survey with additional questions about SPW 2022’s impact. Data was analyzed with SPSS.   



Results 

In the first survey, 79% of students reported not having an LGBTQIA+ inclusive education prior to medical school, and 34.2% and 55.2% of students felt uninformed about women’s sexual health and non-heteronormative sex, respectively. 

Responses reflected perceived inadequacy of the required curriculum. 62% of students agreed the curriculum failed to make them feel knowledgeable about sexual health needs of LGBTQIA+ patients, and 78.2% and 65.6% of students disagreed that the curriculum educated them on non-heteronormative sex practices and female patient needs, respectively. 

Following SPW, 96% of students agreed they learned more about sexual health from SPW than from the required curriculum . 94% and 96% of students agreed SPW made them feel more knowledgeable about women’s health and LGBTQIA+ sexual health topics, respectively. Furthermore, 96% of students reported they felt more comfortable speaking about LGBTQIA+ sexual health topics, and 94% of students agreed they felt more comfortable discussing birth control options with patients. 



Conclusion 

Medical students report poor understanding of LGBTQIA+ and female sexual health before medical school. This poor understanding persists with current curriculum standards. Following SPW, students felt more knowledgeable about sexual health and more comfortable discussing it. This study identifies a gap in medical school education regarding sexual health of LGBTQIA+ and female populations, and an improved reported understanding of these topics following implementation of inclusive sexual health education delivered through SPW. 







References: 



Beebe S, Payne N, Posid T, et al. The Lack of Sexual Health Education in Medical Training Leaves Students and Residents Feeling Unprepared. J Sex Med. 2021;18(12):1998-2004. doi:10.1016/j.jsxm.2021.09.011

Improving Future Provider Understanding of LGBTQIA+ and Women’s Health Through a Novel Curriculum Enhancement Model for Sexual Health Education in Medical School

Background
Nearly 38.3 million people are food-insecure nationwide. Food insecurity has been associated with diabetes, hypertension, obesity, arthritis, asthma, and decreased mental health. Despite food insecurity, nearly 35% of all grown food goes unsold or unconsumed, equating to around 130 billion meals and up to $285 billion in annual losses. Redistribution programs can alleviate hunger and provide tax benefits to donors. This study sought to investigate the challenges and successes of Brown County, Wisconsin food sectors regarding food waste, redistribution, and salvaging. Educational resources were provided to interested donors.

Methods
Electronic surveys were distributed via email or social media to 479 potential donors, including K-12 schools, colleges, restaurants, and more. Data was collected and analyzed via Qualtrics.

Results
Results (n=31) showed that although most donors expressed food sustainability concerns, a large number have no or low familiarity with food redistribution and salvaging. Further, greater than 50% of donors do have reduction efforts in place; however, only 40% have efforts specific to redistribution. On average, 5.84% of inventory goes unused each month; prepared foods comprise 50.29% of disposed foods, followed by baked goods and fresh produce each at ~15%. Finally, only 23% and 35% of potential donors expressed knowledge of tax benefits and legal protections, respectively.

Conclusion
Although statistical significance was not attained, this study demonstrated great potential for donors to alter food practices, providing donations to those in need. Additionally, there are significant opportunities for education on redistribution logistics and benefits. Future directions include outreach to additional donors, dissemination of information on tax advantages and legal protections, and small-scale pilot studies.

Food Salvaging and Redistribution in Brown County, Wisconsin

Background: The long-term sequelae of undiagnosed and untreated obstructive sleep apnea (OSA) are well-established. Current research supports the existence of racial disparities in prevalence, risk factors, and treatment utilization in OSA. However, most studies focus on adult patients or sample from limited cohorts. The aim of this study is to investigate possible racial disparities in the diagnosis and treatment of OSA in patients aged 0-20 years.
Methods: The TriNetX national database was utilized to identify patients under the age of 22 who were diagnosed with OSA in this retrospective cohort study. The incidence of surgical treatment (tonsillectomy, adenoidectomy, or adenotonsillectomy) and Positive Airway Pressure (PAP) treatment, as well as polysomnography (PSG) rates were examined across multiple races with sub-analyses performed on demographics including age, ethnicity, sex, BMI class, and comorbidities.
Results: We identified 143,111 patients with a diagnosis of OSA using ICD-10 codes across 71 healthcare organizations. 96,181 patients were Caucasian, 41,463 were African American (AA), 4,002 were Asian, 1,127 were American Indians or Alaska Natives (AI/AN), and 338 were Pacific Islanders/Hawaiian Natives (PI/HN). Rates of surgical treatment differed by race (p<0.001), with AA (37.4%), Caucasian (39.5%), AI/AN (37.5%), and PI/HN (34.9%) compared to Asian patients (27.2%). AA (26.3%) and Caucasian (26.4%) children were more likely to obtain a PSG compared to AI/AN (23.8%), Asian (20.2%), and PI/HN (16.9%), p<0.001. In addition, more Caucasian patients (36%) received surgical treatment before 12 years of age compared to AA (34.1%), Asian (24.6%), AI/AN (32.7%), and PI/HN (31.4%) groups (p<0.001) despite AA patients receiving PSG in young children. The adjusted odds of CPAP use were 1.6 times greater for AI/AN vs. Caucasian (95%CI 1.06-2.4) and 1.2 times greater for AA vs. Caucasian (95%CI 1.1-1.3). Significant differences remained after controlling for demographics, BMI, and comorbidities.
Conclusion: There are differential rates of PSG and OSA treatment utilization when analyzed by race in this national sample of pediatric OSA patients. Given the importance of diagnosing and treating OSA early to prevent undesirable outcomes, more studies should be done to confirm these differences and investigate the factors contributing to them.

National Trends in Pediatric Obstructive Sleep Apnea Diagnosis & Treatment Utilization Among Various Racial Groups

**Scoring is only possible in the semifinals hall**

**Abstract:**



Attitudes toward Remote Medical Education at an Urban Allopathic Medical School During the COVID-19 Pandemic

COVID-19 Vaccine Uptake and Perceptions among Hispanics/Latinos: Disparities, Hesitancy, and Implications for Equitable Access

Background: Many post-graduate masters’ programs have been shown to benefit pre-medical students upon entering medical school, but there haven’t been any investigations into the improvement of medical knowledge with shorter, more concise programs tailored to the expectations and responsibilities of a medical student. A common trend in today’s medical school application process is first to obtain a master’s degree. Although this displays to medical programs the dedication, knowledge, and academic maturity of the applicant, these programs have narrow scopes of learning and have become a financial burden. The goal of the IMPRESS (Introduction to the Medical Profession: a Rotation to Empower Students) program was to expose pre-medical students to the academic and professional life of medical students, teaching both skills and knowledge to help increase their understanding of medicine. 

Methods: We collected data from 11 underrepresented undergraduate students from the inaugural class of the IMPRESS program. These students were exposed to a 4-week long course that involved clinical skills, research, and didactics. Prior to the start of the program, each student completed a pre-test, which assessed their level of clinical and medical knowledge. They were not given the answers and they didn’t have access to the questions after taking the pre-test. They subsequently completed the same test at the end of the program. 

Results: The median pre-test score was 54.5% (IQR 15.9%) and the median post-test score was 63.6% (IQR 6.8%), the p-value is calculated to be 0.01 using the Wilcoxon signed rank test. The median score increased by 9.1% following the four-week program.

Conclusion: Our findings show that exposing a student to a wide variety of medical school-based learning opportunities increases their medical knowledge in a short period of time. The benefit of the program is not limited to medical knowledge, but also exposes the students to clinical, practical, and research experience.


Impact on medical knowledge after an immersive pathway program for the underrepresented community

Background
Shortages in clinical skills faculty exist nationwide, affecting medical students' clinical skills education. Moreover, medical students have previously expressed that clinical supervisors may not fully understand their learning struggles due to the knowledge gap between them. Teaching assistants (TA) may help address both challenges. However, current literature on the efficacy of TAs in teaching clinical skills is mixed. Improving upon previous research, this study evaluates the viability of second-year medical students as clinical skills TAs by providing extensive, standardized retraining before near-to-peer instruction.
Methods
Six second-year medical students and six faculty taught physical examination techniques for the musculoskeletal system to 130 first-year medical students (M1). Prior to instruction, second-year TAs underwent retraining in physical examination techniques by a clinical expert, instructional videos, and standardized patients (SP). M1s were randomly assigned to be taught by either faculty or TAs each week. Each clinical skills session included the following: 1) pre-session study of physical exam instructional videos and protocol; 2) 20-minute large group demonstration conducted by a faculty expert with an SP; 3) one-hour deliberate practice on an SP with either a TA or faculty member (randomized 3-4 students per group); and 4) evaluations in randomized groups of 7-8 students co-led by a faculty member and TA. Faculty administered evaluations while TAs scored them based on predetermined criteria. Both faculty and TAs were blinded to whether M1s had been taught by faculty or TAs. Formative evaluations covered observation, palpation, and special tests, with a maximum score of 12 points and minimum score of 0. End-of-course OSCE scores were analyzed for differences among students receiving zero, one, two, three, or four TA-instructed sessions.
Results
No significant difference was found between evaluation scores of M1s taught by faculty and those taught by TAs across each week. During week one, faculty-taught M1s averaged a score of 10.38 while TA-taught M1s averaged 10.92 (p=0.064). In week two, both faculty-taught and TA-taught M1s scored 10.14 (p=0.99). In week three, faculty-taught and TA-taught M1s scored 11.06 and 10.56, respectively (p=0.13). In week four, faculty-taught M1s averaged 11.48 while TA-taught M1s averaged 11.37 (p=0.57). When stratified by number of TA-instructed sessions received, OSCE scores yielded no significant difference.
Conclusion
With proper training, near-to-peer TAs are competent clinical skills instructors. When access to trained faculty is limited, TAs may viably supplement faculty shortages without sacrificing quality of instruction.

Near-to-peer teaching assistants effectively supplement clinical skills instruction

Background
Research is recommended in medical training and residency, as per the Accreditation Council for Graduate Medical Education (ACGME). This not only encourages academic interests among residents but also helps them adopt evidence-based approaches while treating patients. Early research training has been linked to continued scholarly work and informed career choices. However, many medical students and residents focus more on non-hypothesis-driven research, likely due to inadequate technical support and low interest. We have developed an OpenAI GPT3-based web application called AutoAnalyze to address this issue. 
Methods
The program was created using Visual Studio Code, and the code was written with Python, along with Streamlit and a variety of visualization packages. For ad hoc visualization, additional programs are invoked de novo by user input. Application programming interfaces (APIs) for OpenAI ChatGPT3.5 were integrated for activation depending on specific user feature choices. Custom prompts and APIs enabled highly focused functionality, with coding details available on 
GitHub repository under the MIT licence: https://github.com/DrDavidL/auto_analyze.Streamlit.io hosts the application on a public site: https://data-auto-analysis.streamlit.app/.
Results
AutoAnalyze simplifies the technical aspects of hypothesis-driven research, making it easy to conduct research using pre-coded options or via natural language inputs. With AutoAnalyze, users can perform data exploration, missing data imputation, and data visualization. Additionally, it generates publication-worthy images like bar charts, pie charts, scatterplots, and principal component analysis with just a few clicks. AutoAnalyze also provides teaching pearls on visualization techniques and summarizes relevant statistics in table format. AutoAnalyze can perform machine learning analytic methods like logistic regression, decision trees, random 
forests, gradient boosting machines (GBMs), and support vector machines (SVM) to perform predictive analysis in an easy-to-comprehend user-friendly format. It does this without requiring the user to type in any code or understand a computer programming language. Furthermore, the chatbot teacher feature enables users to probe data or learn data science using regular English words and sentences.
Conclusion
Overall, AutoAnalyze represents an efficient solution to address the inadequate technical support for medical research challenges medical students and residents face. It has the potential to increase their research interest in academic medicine.


Increasing Interest in Medical Research and Academic Medicine With Auto Analyzer; an OpenAI GPT-3-Based Web Application

Background
Given increasing competition for residency positions and emphasis on USMLE performance in residency application evaluation, medical students must often prioritize studying for the USMLE over other responsibilities. There has been an explosion in the number and availability of USMLE test preparation resources over the past two decades as students use these resources for board exam preparation and as a supplement to their medical school curriculum. With increased pressure to excel in both school and board exams, these resources have become an increasingly valuable, yet expensive necessity for students. To date, comprehensive review of the number of students using third-party resources across multiple-institutions has not been performed. This systematic review aims to determine the commercial third-party resources used by medical students as supplements to the standard medical curriculum or as aids in USMLE board exam preparation.
Methods
A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy designed by a medical librarian was used to retrieve articles from Embase.com, Ovid-Medline All, Scopus, Web of Science, and ERIC (ProQuest). Inclusion criteria was original research articles centered in US medical schools that included information on student use of third-party commercial resources. The meta-analysis was performed for resources that had a minimum of three studies investigating student use of that resource. Effect size was computed for each study and a pooled effect summary with 95% confidence intervals was calculated to summarize across studies.
Results
A total of 1056 citations were screened with 19 full-text studies included in this review. Of these, 21% had a study population comprised of osteopathic medical students, 79% had a study population comprised of allopathic medical students, and 5% was comprised of both. 22 unique third-party resources were examined across all studies, with meta-analysis revealing the three most common commercial resources used by medical students to be First Aid, UWorld, and Pathoma with effect summaries of 78.22% (39.20%-117.23%), 75.96% (53.61%-98.31%), and 63.64% (36.86%-90.42%) respectively. 
Conclusion
In this systematic review and meta-analysis, we synthesized findings from 19 different studies investigating the use of 22 commercial third-party resources by medical students with the most popular being First Aid, UWorld, and Pathoma. In light of the widespread utilization of third-party resources, medical faculty should consider adapting their curriculum to better cater to the learning needs of students and establish systems that ensure equitable access to verified commercial resources.

Unlocking Medical Student Success: A Systematic Review and Meta-Analysis of Third-Party Resources Used as Supplements for Medical Education and USMLE Board Preparation 

Background:
Historical redlining, a discriminatory practice that denied mortgage loans to people of color based on perceived risk, has had lasting effects on communities. These redlined areas, marked as high-risk on maps, continue to face health disparities. This study investigates the relationship between redlining and all-cause mortality rates in Austin, Texas.


Underline digital video library

Dialing For MOUD: Barriers to Finding Help

A Mixed-Methods Longitudinal Assessment of Imposter Phenomenon in Third-Year Medical Students

Improving Future Provider Understanding of LGBTQIA+ and Women’s Health Through a Novel Curriculum Enhancement Model for Sexual Health Education in Medical School

Food Salvaging and Redistribution in Brown County, Wisconsin

National Trends in Pediatric Obstructive Sleep Apnea Diagnosis & Treatment Utilization Among Various Racial Groups

Attitudes toward Remote Medical Education at an Urban Allopathic Medical School During the COVID-19 Pandemic

COVID-19 Vaccine Uptake and Perceptions among Hispanics/Latinos: Disparities, Hesitancy, and Implications for Equitable Access

Impact on medical knowledge after an immersive pathway program for the underrepresented community

Near-to-peer teaching assistants effectively supplement clinical skills instruction

Increasing Interest in Medical Research and Academic Medicine With Auto Analyzer; an OpenAI GPT-3-Based Web Application

Unlocking Medical Student Success: A Systematic Review and Meta-Analysis of Third-Party Resources Used as Supplements for Medical Education and USMLE Board Preparation

90 Years Later: How Historical Redlining Predicts All-Cause Mortality in Austin, Texas

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