Background: National data demonstrates that on average, people are treated differently by doctors based on their gender. Unfortunately, this impacts the quality of care patients receive thereby altering health outcomes. This variation ranges from how seriously a patient’s pain is perceived to whether “unusual” signs of a myocardial infarction are noted. Even though the origin of this problem is often subconscious rather than malicious, it is our duty as future healthcare providers to ameliorate implicit gender biases in order to provide patient centered, equitable care. 

Methods: Two medical students under the guidance of two faculty members piloted a mandatory implicit gender bias curricular thread designed for preclinical years. The thread is composed of eight 15-minute sessions spanning the course of two years. The objective is to note if a sensitive topic such as implicit bias is better addressed in shorter, repetitive bursts by peers versus a hypothetical formal alternative led by faculty; and if a peer-led structure designed to remove power differentials and concerns over grades leads to more impactful education and growth. Session content ranges from real case studies within the medical school to bystander training aimed at preparing students to be allies during their clinical rotations. After each session, a survey is distributed to garner feedback and gauge the impact of the curriculum.

Results: Post-presentation survey data demonstrated that 86.1% of students (n=453) preferred to hear these presentations from peers alone, 1.8% preferred an option presented by both peers and faculty members, 6.8% had no preference, and 5.3% preferred an option taught by faculty members alone. Another survey question asked students to rank the statement “I gained something valuable from this presentation” on a scale of one to ten with one signifying “strongly disagree” and ten signifying “strongly agree.” For the first presentation, the average rank for the session was 6.9, the median was 7 and the mode was 10. For the second presentation, the average rank for the session was 8.4, the median was 9, and the mode was 10. 

Conclusion: Findings suggest that peer-to-peer teaching may be an effective model to ameliorate implicit bias in healthcare by leveraging the unique perspective that students develop throughout their pre-clinical and clinical experiences. This innovative approach can be further extended and tested throughout medical training for a wider reach.


Implicit Gender Bias: Development of a Peer-led Curriculum for Pre-clinical Years

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

**Abstract:**



OrthoReach: A Resident-Led Pilot to Develop an Orthopaedic Surgery Pipeline Program for Underrepresented Minorities in Chicago Increased Participant Interest in Orthopedics 


There are increasing calls for inclusion of education on medicine during the Holocaust in medical school curricula. Furthermore, curriculum outcomes of Holocaust in medicine have been understudied. This research describes the outcomes of a Holocaust and medicine educational program featuring a study trip to Poland, which focused on pervasive physician complicity during the Holocaust as well as exemplars of moral courage in health professionals who demonstrated various forms of resistance in the ghettos and concentration camps. The study trip included tours of key sites and museums as well as meeting with a Holocaust survivor, lectures from historians, reflective writing, and group discussions. In depth interviews and reflective writings were analyzed using techniques derived from grounded theory. Themes resulting from the analysis centered on greater understanding of the relationship of bioethics and the atrocities of the Holocaust, recognizing the need for moral courage and social awareness, deeper appreciation for the roles played by dehumanization and medical power during the Holocaust and their contemporary manifestations, and the power of presence and experiential learning for bioethics and humanism education and professional identity formation. These findings evidence the significant impact of the experience and validate the pedagogical strategies, suggesting broader adoption of pedagogies that include place-based and experiential learning coupled with critical reflection can amplify the impact of bioethics and humanism education as well as the process of professional identity formation of medical students.including development of moral courage and professional virtues that transcend the workplace which is of keen interest in medical education for ethical, humanistic patient care, research, and public policy.

Critical Reflection and Place Based Medical Education in Bioethics, Humanism, and Professional Identity Formation: The Impact of a Study Trip to Auschwitz

Background: The body and life individuals are born into comes with specific privileges. When

considering another’s plight, one must acknowledge one’s own inherent privileges and put them aside to gain a better understanding of the other person especially in the field of medicine. During the wake of the racially charged social unrest experienced in recent years, we sought to find a platform for openly discussing privilege with students, faculty and staff in our medical school. The goal of this work was and is to prepare healthcare providers to appreciate their privilege and better understand the diversity of lived experiences in society. When facilitators create a safe environment where participants with different lived experiences can ask questions of others, game-based simulations can drive sensitive social discussions and allow players to view how social injustices give some people privilege over others.


Methods: The Reality Check: The Game of Privilege board game was found to be a viable solution to this identified need. Play sessions were facilitated with faculty, staff and students in groups of 5-6 members (n=43). Special care was taken to create a safe space for mistakes such as an inappropriate use of a term. Each player was given a set of circumstances cards that included a particular socioeconomic status, sexual orientation, race and gender identity. Players assumed the role of these circumstances as they played. After each session, a facilitated focus group was used to debrief, and input was collected via an anonymous survey.


Results: Feedback and facilitator notes were reviewed for themes and ideas for refining future play sessions. General feedback from participants was positive with most openly agreeing the game should be played more often and incorporated into the formal curriculum. Topics discussed in the debriefing centered on the questions members of one group had about another but were uncomfortable asking in an open environment. Participants commented on the complexity of privilege and circumstance and how the game allowed them to explore the impact they can have on individuals and communities.
Follow-up survey response rate was 35%.



Conclusion: Privilege is a point of misunderstanding in general society with most not recognizing their own level and sources of it. Using a tabletop game such as described here, facilitators were able to create a safe setting for learners of all types to gain an appreciation for another’s lived experiences, so they felt free to ask questions and share ideas.



Use of a discussion provoking board game for revealing privilege

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: There is no standardized sexual assault (SA) or trauma-informed care (TIC) curriculum in medical education, resulting in little to no exposure to these topics for many medical students. The goal of this project is to evaluate medical student perceptions of TIC before and after a weeklong SA/TIC curriculum. We hypothesize that students will be more willing to use TIC strategies and think that it is more important after they have been introduced to instruction on the topic.
Methods: All second-year medical students at MCG participated in a weeklong SA/TIC curriculum in August 2021. Students were tasked with learning about TIC during the Case-Based Learning (CBL) sessions and a standardized patient encounter in Patient-Centered Learning (PCL). Students were given a voluntary survey on their perceptions regarding TIC before (pre-survey) and after (post-survey) this week as part of the curriculum. The survey was adapted from Cannon, et al. 2020 and used 5-point Likert scale (1 = strongly disagree, 5 = strongly agree) responses to 17 questions. Data were coded by the curriculum office and de-identified. After IRB approval, quantitative data were analyzed using descriptive statistics and paired t-tests.
Results: In total, 193 medical students participated in the SA/TIC curriculum. There were 101 pre-surveys and 99 post-week surveys completed for a response rate of 52.3% and 51.3% respectively. Results from the survey demonstrated significant gains in knowledge, skills, and attitudes and significant improvement towards trauma informed care overall on average (+0.360, p<0.001).
Conclusion: Our results demonstrate that having a TIC curriculum significantly improved medical students’ knowledge of and attitude towards providing trauma-informed care. This curriculum can be reproduced at other institutions to introduce future physicians across all specialties to principles of SA/TIC care to improve health outcomes.

Assessing Medical Students’ Perceptions of Trauma-Informed Care Beforeand After a Pilot Sexual Assault and Trauma-Informed Care Curriculum

Background: Trauma informed care (TIC) is an approach to clinical care centering how trauma affects patients, especially those in marginalized communities. TIC has been shown to improve psychobehavioral outcomes and increase trust between patients and clinicians. Despite the evidence for TIC’s role in patient-centered care, there is a gap in teaching TIC within medical education, particularly with an intersectional lens. To address this, we sought to develop, implement, and evaluate a TIC elective course. 

Methods: Through literature review and collaboration with faculty and community experts in TIC, we identified six intersectional topics for the 8-week course: sexual assault/trafficking, domestic violence, healthcare-induced trauma, state sanctioned violence, displacement trauma, and neighbourhood violence. Each class focused on one topic, with the first and last class consisting of an introduction to a trauma-informed care framework and medical student presentations, respectively. Teaching methodologies included traditional lecture, restorative discussion circles, and a case-based learning format incorporating dialogue with faculty/community TIC experts. 15 preclinical medical students participated. A nested mixed methods approach was used to evaluate the elective. Quantitative data included pre/post surveys with Likert-type questions on trauma-informed care knowledge and attitudes (Attitudes Related to Trauma-Informed Care, ARTIC). Qualitative data was collected through a focus group nested at the end of the course to explore students’ perspectives on the elective. 

Results: There was a significant increase of 29.0% in mean self-reported knowledge of TIC (p<0.001). There was a significant increase of 7.4% in ARTIC scores (p<0.05). Four themes emerged from focus group analysis: (1) need for consistent TIC teaching, practice, and assessment in primary medical education curricula, (2) importance of learning an intersectional TIC framework for understanding and responding to trauma, (3) appreciation for an interactive case-based discussion format and use of restorative circles, and (4) balance of teaching from academic medical faculty and community TIC experts. 

Conclusion: Evaluation of this skills-based, community-oriented TIC elective course showed improvement in medical students’ TIC knowledge and attitudes. Students shared positive feedback regarding the pedagogical approach utilized. They emphasized the need for this intersectional approach to TIC as a required part of medical education. The efficacy of TIC incorporation in medical education may be improved through use of more interactive teaching styles and an intersectional framework, with multiple opportunities to practice TIC skills. This may ensure that students can successfully utilize TIC in patient interactions now and in the future.

Transforming Medical Education: 
Intersectional Approaches to Trauma-Informed Care

Background
Trauma-informed care (TIC) is an approach that assumes every patient has probably experienced some traumatic event in their lifetime. Studies have shown that 63% - 89% of people living in the United States have experienced at least one traumatic event in their lifetime, which is evidence that supports the importance of this assumption. TIC is also an approach that recognizes common signs and symptoms of trauma that a patient may present with, such as dissociation, hypervigilance, or self-harm. Furthermore, TIC acknowledges that past traumas could still influence patients' current lives regarding their mental, physical, social, emotional, or spiritual well-being. For example, trauma can lead to the development of post-traumatic stress disorder (PTSD), which has been associated with an increased risk of chronic mental and physical health conditions such as substance use, depression and anxiety, diabetes, and cardiovascular disease. Trauma-informed care integrates these ideas and overall knowledge of trauma into practice and policy so that practitioners can proactively avoid retraumatizing patients while providing patients with the care they need.

Methods 
To promote the use of trauma-informed care by medical students at the University of Cincinnati College of Medicine (UCCOM), we decided to incorporate it into the preclinical curriculum. We revised the instructional packets used to teach physical exam skills to first-year medical students within the clinical skills course. These revisions included revised informational packets that included suggestions for how to drape patients during exams, how to approach sensitive topics or exam maneuvers, and other TIC practices. At the beginning of the academic year, first-year students were asked to respond to the statement “I feel confident in my ability to provide trauma-informed care.” Responses were based on a 5-point Likert scale from strongly agree (5) to strongly disagree (1). 

Results
After the introduction to TIC through the clinical skills course materials, the number of students who responded “agree” or “strongly agree” (likert rating of 4 or 5, respectively) increased from 20% to 76%. Additionally, the number of students who responded “disagree” or “strongly disagree” (likert rating of 2 or 1, respectively) decreased from 57.5% to 16%. The average rating increased from 2.45 to 3.76.

Conclusion
Students reported overall increased confidence in their abilities to provide trauma-informed care after exposure to TIC practices and suggestions during their preclinical courses. Based on these results, we intend to continue the integration of TIC into the preclinical curriculum for the upcoming academic year and hope to elicit more student feedback using existing evaluations collected by UCCOM for further improvement.

Incorporating Trauma-Informed Care into the Preclinical Curriculum

Background. Dialogue is recognized as a crucial medical competency that promotes adherence to medical regimens and health outcomes. Pain and substance use disorders (SUD) are frequently stigmatized, and its education in medical schools is currently fragmented across other courses. The LICENSE (Language, Impact, Communication, Engagement, Non-Stigmatizing, Effectiveness) curriculum is a longitudinal course, with the overall goal of teaching medical students how to better communicate with patients with SUDs. It describes the intersection of SUD with Social Determinants of Health (SDH) and treatment adherence, and how to conduct effective clinical interviews with this patient population.

Method. Students interact with this curriculum across the three phases of Stony Brook’s medical curriculum. At each phase, the Substance Abuse Attitude Survey (SAAS), a validated survey assessing attitudes about SUD, is administered. A 60-minute didactic session is then followed by case presentations and reflection questions. 

Results. Currently, this curriculum has been implemented across four years of medical students, with 290 participants for our data collection. Thus far, the qualitative data has shown an increase in awareness of SUD and of potential concerns of SUD. More, the SAAS values are trending toward less stigmatizing answers. For example, in phase 2, the statement “drug addiction is a treatable illness” is more strongly supported relative to phase 1. 

Future Directions. This study hopes to show that increased education on SUD and SDH helps to decrease stigma in these patient populations. We plan to continue this data collection and compare the SAAS data across all the phases of the curriculum to determine if attitudes change over time. We plan to also implement the Phase III portion of the curriculum starting with the graduating class of 2024. This portion will be developed and carried out in the spring of 2024.

Innovative Learning and Teaching About Substance Use/Opioid Use Disorders


The importance of understanding the healthcare needs of individuals with skin of color (SoC) in dermatology has gained increasing awareness. Though research suggests dermatologic literature is one of the key sources providers reference for patient care, the focus is primarily on lighter skin tones, which can be detrimental in providing care for patients with SoC. While there has been recent emphasis on incorporating SoC-focused lectures in residency training, we believe there remains a deficit of this knowledge due to the deficiency of instruction throughout medical school curricula. This study analyzes medical students’ comfort with diagnosing dermatologic conditions among different presentations based on their didactic training.
First and second-year Rocky Vista University medical students (n=22) attended an educational workshop where they were presented with seven dermatologic conditions and asked to diagnose each beginning with a SoC patient, followed by an identical condition in a Caucasian patient, and finally a medical vignette with common descriptors of the condition. Students completed an anonymous survey before and after the seminar to evaluate their comfort level change in identifying dermatologic lesions. Participants' self-reported their comfort in diagnosing these conditions on a scale of 1-10. The number of correct diagnoses was also analyzed.
Prior to the workshop, participants had a mean comfort level of 6.04 ± 1.84 for Caucasian presentations and 4.09 ± 1.54 for SoC presentations. After the seminar, the comfort level increased to 7.04 ± 1.79 for Caucasian presentations and 6.18 ± 2.01 for SoC presentations. Nineteen participants provided anonymous diagnoses for each condition in SoC, caucasian, and clinical vignette presentations. The average percentage of correct answers were 23.26% for SoC presentations, 34.58% for caucasian presentations, and 68.42% for clinical vignettes.
Based on our sample, medical students exhibited higher comfort levels in diagnosing dermatologic conditions in Caucasian skin tones compared to SoC presentations, and correct diagnoses also favored Caucasian presentations over SoC patients. However, following the seminar, the greatest increases in comfort level resulted in SoC presentations, indicating the effectiveness of this instruction in didactic training. Clinical vignettes received the highest correct diagnoses, highlighting the reliance on terminology rather than visual interpretation in early medical education. These findings emphasize the need for diversity of visual dermatological presentations in early medical education and the importance of shifting away from excessive reliance on "buzzwords" in clinical vignettes. By addressing curricular gaps in medical training, we hope to enhance the quality of care for patients with SoC.

How Comfortable are Medical Students with Interpreting Dermatologic Conditions During Didactic Training?

Trained medical interpreters are crucial to ensure that patients who speak English with limited proficiency (LEP) receive high-quality care
Current medical education lacks formal training that incorporates practice in simulated environments 
We sought to evaluate MS1 and MS2 ability to use interpreters and address knowledge gaps through near-peer training sessions

Analyzing Medical Students’ Preparation and Confidence with Interpreters

Background
Extensive research has been done on the necessity of DEI in the medical profession, particularly its benefits in increasing cultural awareness in physicians. However, there is very little in the literature about how medical students and new trainees’ view DEI events put on in medical schools, and the impact of these events in their personal journey towards becoming well-rounded physicians. This research study serves to examine the impact of DEI training in medical schools from the perspectives of medical students and first year residents. 

Methods
A cross sectional survey of medical students and first-year residents was conducted. A 17-question survey was constructed using a Likert-type Scale (Figure 1). The survey was disseminated via email, and on messaging platforms commonly such as discord and GroupMe. Survey results were stratified into three parts-exposure to DEI events and medical students and resident responses respectively. Statistical analyses were performed on these data sets via two sample t-tests and Pearson correlation coefficients. 

Results
Data analyses of student responses showed positive correlations between DEI events and improved cultural awareness and confidence in caring for diverse patient populations. On the other hand there was a negative correlation between DEI training and its usefulness in the post-graduate training setting. This seems to suggest that while medical students feel DEI events may be beneficial to their training, that impact is greatly diminished during residency training. 

Conclusion
The impact of DEI on medical student and resident training is a challenging parameter to quantify. However the efficacy of these events in medical training must be elicited to understand which events have more impact on the trainees, and which might better serve them as they provide optimal, culturally sensitive, patient-centered care. The goal is to provide medical trainees with the necessary DEI tools to care for a wide variety of patients, and to produce well-rounded physicians with whom patients can better relate.

Underline digital video library

Implicit Gender Bias: Development of a Peer-led Curriculum for Pre-clinical Years

OrthoReach: A Resident-Led Pilot to Develop an Orthopaedic Surgery Pipeline Program for Underrepresented Minorities in Chicago Increased Participant Interest in Orthopedics

Critical Reflection and Place Based Medical Education in Bioethics, Humanism, and Professional Identity Formation: The Impact of a Study Trip to Auschwitz

Use of a discussion provoking board game for revealing privilege

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

Assessing Medical Students’ Perceptions of Trauma-Informed Care Beforeand After a Pilot Sexual Assault and Trauma-Informed Care Curriculum

Transforming Medical Education: Intersectional Approaches to Trauma-Informed Care

Incorporating Trauma-Informed Care into the Preclinical Curriculum

Innovative Learning and Teaching About Substance Use/Opioid Use Disorders

How Comfortable are Medical Students with Interpreting Dermatologic Conditions During Didactic Training?

Analyzing Medical Students’ Preparation and Confidence with Interpreters

Medical Students and Residents’ Perspectives on the Impact of Diversity, Equity and Inclusion Events during Medical Training

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