Join Michael Wesch and Elisa (EJ) Sobo for an exciting conversation on how to leverage generative AI for better teaching and learning! Together, they delved into the challenges presented by large language models and generative AI technologies, offering not only concrete suggestions for classroom practice but also timely reflections on the purpose of higher education.

"In meeting this new technology with creativity and purpose, we can reorient education’s compass needle back toward process as opposed to product – toward thinking about as opposed to merely recounting what others have said" – and as we do, we can bolster efforts to increase equity in higher education too: "The adaptations we create, not ChatGPT, could be the real revolution" (Sobo, 2023, 1). By guiding students to apply generative AI in innovative classroom activities and projects, we can empower our students to use this technology as a practical tool for inquiry and discovery while also interrogating its potential sociocultural impacts *(Sobo, E. (2023). Could ChatGPT Prompt a New Golden Age in Higher Education? Teaching and Learning Anthropology, 6(1). http://dx.doi.org/10.5070/T36160114)*



The REAL AI revolution: the benefits of Chatbot Augmented Instruction

Scholars of intersectional identities face unique challenges in their departments including disproportionate workloads, excessive service assignments, and additional mentorship obligations. Patricia A. Matthew, an English department faculty member at Montclair State University, describes these extra commitments as “invisible labor” - because institutions do not value this labor with the currency they typically use to reward faculty work: reappointment, tenure, and promotion. This webinar session, hosted by SSRC PROGRESS, is structured around a participant-led discussion of two case studies, with two discussion facilitators to support a meaningful dialogue on issues of department climate and academic workload/career advancement. The ultimate goal of this session is to have an open discussion of both challenges and successes in employing DEI interventions in anthropology departments.

PROGRESS is an NSF ADVANCE adaptation grant program that addresses organizational policies and procedures related to advisory board formation, peer review, and fellowship/awards conferment to ensure that diversity, equity, and inclusion measures are meaningful and effective. Housed within the Social Science Research Council, PROGRESS partners with five disciplinary associations - the American Anthropological Association, the American Economic Association, the American Historical Association, the American Political Science Association, and the American Sociological Association.

Presenters

* Veronica Zepeda, Program Director, Sloan Scholars Mentoring Network - Social Science Research Council
* Fred Palm, VP of Administration and Operations, P.I. of PROGRESS - Social Science Research Council

Department Climate and Academic Workload in Anthropology Departments

Background

Numerous studies have explored COVID-19 in adults and pediatric patients with chronic illnesses, but limited research has focused on previously healthy children. This study reports results from a COVID-19 screening program implemented at two pediatric clinics in central California, focusing on the clinical presentation of COVID-19 in this population.

Methods

Patients seeking care at the clinics completed a screening questionnaire to identify symptoms consistent with COVID-19. Temperature and oxygen saturation were measured, and nasal swabs were collected for antigen testing. Chief complaints, final diagnoses, and test results were recorded. The severity of COVID-19 illness was categorized using the CDC's severity index.
1) Asymptomatic/ pre-symptomatic - patient reported no symptoms and vital signs were normal.
2) Mild disease - respiratory or GI symptoms were present with or without fever.
3) Moderate disease; evidence of lower respiratory tract involvement was present.
4) Severe disease; oxygen saturation was < 94%.
5) Critical disease; the patient was transferred to the ER for further treatment.

Results

Between 11/2020 and 12/2022, 11,649 COVID-19 antigen screening tests were performed. Patients ranged in age from 0.1 to 17.0 years (mean 8.7, SD 4.5). 47.7% of patients identified as female, 50.5% as male, and 1.8% as other. In total, 1,560 pts. (13.4%) tested positive. Among these, 665 (43%) were asymptomatic/pre-symptomatic, 560 (36%) had mild disease, 318 (20%) had moderate disease, and 17 (1%) had severe disease. No critical cases or transfers to the emergency room were reported. A higher body mass index (BMI) was associated with increased severity of illness. 4,446 patients reported no symptoms at the time of screening. Among these, 85% tested negative, and 15% tested positive. Demographics were similar between these 2 groups. 7,203 patients report symptoms consistent with COVID-19. Among these, 87.6% tested negative and were presumed to have an infection other than COVID-19, while 12.4% tested positive. Median severity of illness did not differ significantly between the 2 groups.

Conclusion

The screening program effectively detected pediatric COVID-19 cases, including asymptomatic patients. In healthy children, COVID-19 was mild, with severity similar to other viral infections. Higher BMI is linked to greater illness severity. These findings enhance understanding of acute COVID-19 in outpatient pediatric populations, emphasizing the need for proper screening to ensure safe delivery of care.

Clinical Manifestations of COVID-19 in Previously Healthy Pediatric Patients Presenting to a Primary Care Office.

Introduction: Thyroid cancer is the most common endocrine cancer reported world-wide, with an increasing incidence over the past decades. Although the effect of numerous variables on thyroid cancer has been studied, the role of socioeconomic status (SES) remains a topic of interest. SES encompasses a range of factors such as occupation, household income, education, and health insurance, which have been shown to influence health outcomes in different diseases. Understanding the correlation between SES and thyroid cancer diagnosis and prognosis is critical for determining potential disparities and developing targeted interventions to improve patient outcomes. We conducted a review to provide a comprehensive synthesis of the existing literature through which we aim to illuminate the relationship between socioeconomic status and key outcomes in thyroid cancer, including diagnostic delays, disease stage at diagnosis, and survival rates. By identifying the specific socioeconomic factors that influence thyroid cancer outcomes, we can target interventions and policies to improving access to timely diagnosis and enhancing patient outcomes in diverse socioeconomic populations.
Methods: A pubmed literature search with the following search strategy was conducted: ("effect"[All Fields] OR "effecting"[All Fields] OR "effective"[All Fields] OR "effectively"[All Fields] OR "effectiveness"[All Fields] OR "effectivenesses"[All Fields] OR "effectives"[All Fields] OR "effectivities"[All Fields] OR "effectivity"[All Fields] OR "effects"[All Fields]) AND ("socioeconomic factors"[MeSH Terms] OR ("socioeconomic"[All Fields] AND "factors"[All Fields]) OR "socioeconomic factors"[All Fields]) AND ("thyroid neoplasms"[MeSH Terms] OR ("thyroid"[All Fields] AND "neoplasms"[All Fields]) OR "thyroid neoplasms"[All Fields] OR ("thyroid"[All Fields] AND "cancer"[All Fields]) OR "thyroid cancer"[All Fields]) AND ("prognosis"[MeSH Terms] OR "prognosis"[All Fields] OR "prognoses"[All Fields]). 
Abstract review of the resulting 13 studies was performed, of which 7 studies were included in the final review per inclusion and exclusion criteria. A comparative analysis was performed considering the methods, results, and conclusions of the studies. 
Results: Socioeconomic status (SES) was examined in seven studies in relation to the outcomes of thyroid cancer. Among these studies, four specifically looked at income, one investigated insurance access, and two considered multiple SES factors. The findings consistently showed that individuals with lower SES had worse overall survival rates (based on four studies) and were more likely to be diagnosed at a later stage (based on two studies), suggesting possible delays in accessing healthcare. Additionally, one study indicated a lower incidence of papillary thyroid cancer among individuals with lower SES indicative of lower early screenings.
Conclusion: Based on findings from the included studies, lower socioeconomic status is associated with unfavorable outcomes in thyroid cancer with delayed diagnoses and poorer overall survival. 


The Effect of Socioeconomic Status on Diagnosis and Prognosis of Thyroid Cancers


This project aims to investigate vaccine hesitancy in relation to the COVID-19 pandemic and how social/structural barriers to vaccine access and lack of trustworthiness may impact equitable vaccination rates in African American individuals who reside in the Southeastern US. Current research shows that 46% of participants in a similar study expressed uncertain/low intent to receive the COVID-19 vaccine with factors such as distrust in the efficacy of vaccines influencing intentions most strongly. This project will analyze data from the Southern Community Cohort Study (SCCS), a prospective cohort of approximately 85,000 adults, to examine predisposing, enabling, and need factors from the Andersen Behavioral Model as predictors of vaccine uptake. The results of this study will be presented at scientific conferences, distributed to members of the community, and used to inform dissemination strategies.

Investigating How Social & Structural Barriers to Vaccine Access and Lack of Trustworthiness May Impact Vaccination Rates Among African Americans During the COVID-19 Pandemic

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

Background: Many medical schools have begun including health systems science (HSS) in their curricula to address emerging healthcare needs. With this principle in mind, a clinical reasoning exercise was developed by the Johns Hopkins neurology clerkship team in 2017. Students are given a standardized case of a patient presenting with falls and asked to develop an assessment & plan. During the COVID-19 pandemic, Johns Hopkins replaced tiered grading (honors/high pass/pass/fail) with pass/fail grading for core clerkships. This study seeks to determine if clerkship grading (tiered versus pass/fail) influences the quality of the differential diagnoses, localization of the disease process, clinical reasoning, and diagnostic/management options.

Methods: Data was extracted from the case reports submitted by students in the Neurology clerkship between 2017 and 2022. Report elements in tiered versus pass/fail curricula were compared using chi-squared tests.

Results: Of the 592 students, 306 (51.7%) were in the tiered curriculum, and 286 (48.3%) were in the pass/fail curriculum. With respect to differential diagnoses, students were more likely to include drug-induced parkinsonism (p<0.05) in the tiered system, and Lewy body dementia (p<0.05) in the pass/fail system. The inclusion of other diagnoses was not significantly different between the two systems. For localization, students were more likely to localize to the substantia nigra specifically (p<0.05) in the pass/fail compared to tiered system. Clinical reasoning elements like dysautonomia and timing (p<0.05) were cited more in the tiered system, while discussion of REM sleep behavior was not significantly different between the two systems. Students were more likely to order labs but less likely to order imaging (p<0.05) in the tiered versus pass/fail system. Lastly, for management, students were more likely to request outside consultations/referrals, initiate physical therapy, stop metoclopramide, and treat urinary symptoms and hypotension (p<0.05) in the tiered versus pass/fail system. Treatment with carbidopa-levodopa did not significantly differ between the two systems.

Conclusion: Although clerkship grading does not appear to influence differential formation or clinical reasoning strongly, it does influence diagnostic testing and management choices. Tiered grading correlates with aspects of HSS, including value-based care (deferring imaging, stopping metoclopramide) and interprofessional collaboration (consults, physical therapy).

Looking Backwards to Look Forward: An Analysis of Clinical Reasoning Reports in the Neurology Core Clerkship before and after the transition to Pass/Fail Grading

Background: Despite advances in mental healthcare in the U.S., only 46.2% of adults diagnosed with any mental illness and 64.5% of those with severe mental illness received mental health treatment in 2020. Primary care providers (PCPs) are at the front lines of identifying and treating mental health conditions and are essential in bridging the mental health treatment gap. The present study examines the relationship between having a PCP and perceived unmet mental health treatment need in adults living in New York City (NYC).  
Methods: This cross-sectional study uses data from the 2019 and 2020 NYC community health survey (CHS). The two years were compared to account for any effect of the COVID-19 pandemic on access to PCPs. Unadjusted odds ratios were used to identify predictors of having a PCP. A binary logistic regression model assessed the association between having a PCP and perceived unmet mental health treatment need, adjusting for sociodemographic and clinical covariates. Post-stratification survey weights were applied using SPSS complex samples.   
Results: In 2019 and 2020, 25.1% and 29.7% of those with non-specific psychological distress (NSPD), respectively, had perceived unmet mental health treatment need. Having no insurance (2019: OR 0.082, 95% CI 0.063, 0.105, p=0.000; 2020: OR 0.171, 95% CI 0.137, 0.214 p=0.000), having perceived unmet medical (2019: OR 0.471 95% CI 0.358, 0.620 p<0.001; 2020: OR 0.656, 95% CI 0.522, 0.825 p<0.001), and mental health treatment need (2019: OR 0.580 95% CI 0.376, 0.894 p=0.014; 2020: OR 0.613 95% CI 0.435, 0.865, p=0.005) were associated with reduced odds of having a PCP. Adults lacking a PCP had increased odds of perceived unmet mental health treatment need in unadjusted analysis, but after adjusting for confounders, this relationship no longer reached statistical significance. Having NSPD (2019: OR 8.632 95% CI 5.506, 13.532, p=0.000; 2020: OR 11.108, 95% CI 7.404, 16.664) and perceived unmet medical treatment need (2019: OR 5.332 95% CI 3.466, 8.203, p <0.001; 2020: OR 3.5857 95% CI 2.583, 5.758, p<0.001) was associated with increased odds of perceived unmet mental health treatment need.   
Conclusion: More than a quarter of NYC adults needing mental health treatment perceived unmet mental health treatment need. To improve access to quality healthcare both within and outside the primary care setting, there needs to be improved patient health literacy, enhanced healthcare professional training in cultural competence and mental health management, and regular mental health screenings and integration of behavioral health into primary care.

The effect of access to a primary care provider on perceived unmet mental health treatment need in NYC adults

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
Coronary artery disease (CAD) is the leading cause of death in the United States. In Hawaii, three of every ten deaths are due to CAD. Access to cardiac catheterization centers (CCC) is crucial for reducing morbidity and mortality, but most CCCs are concentrated in the capital, Honolulu. No prior studies have assessed the distribution of CCCs in relation to the demand and capacity for catheterization services in Hawaii using Geographic Information Systems (GIS). This study analyzed both current demand vs. capacity for CCCs, as well as projected optimal CCC locations based on time and distance considerations on the island of Oahu. 

Methods
GIS is a powerful tool with which location-allocation problems may be addressed. Data from the Hawaii Department of Health was implemented to estimate the number of patients in need of CCCs. Patients were then randomly distributed across residential areas in the location-allocation model. Using network analysis in GIS, residents’ travel time from their homes to the nearest CCCs was approximated. Travel time and demand vs. capacity maps were created to enable assessment of the accessibility of CCCs in each region and to highlight areas with unmet demand.

Results
Time-to-care analysis showed significant time burdens for patients in certain areas of Oahu. Under optimal traffic conditions, it took >60 minutes for patients in West Oahu and the North Shore, and >40 minutes for patients in Northeast Oahu to reach the nearest CCCs. Analysis of the demand vs. capacity of CCCs revealed the CCC in Central Oahu, which serves many of the patients with significant time burdens, exceeded its annual capacity by more than 985 patients. Meanwhile, all CCCs in South Oahu had significantly higher capacity than demand. To best decrease time burdens and mitigate capacity concerns for the greatest number of patients, an additional CCC should be established in West Oahu.

Conclusion
GIS analysis showed that the current CCCs on Oahu are not positioned to optimize patient outcomes. Patients in areas with significant time-to-CCC burdens likely face worse outcomes when they need emergent catheterization. This disparity could be remedied with the addition of CCCs closer to these regions, particularly in West Oahu. Looking forward, this model may be applied to other healthcare resources, such as emergency departments, to analyze current demand and geographical distributions and to influence future resource allocation. GIS has the power to improve healthcare efficiency, thus enhancing clinical outcomes.

GIS Analysis of Cardiac Catheterization Centers on the Island of Oahu


Purpose: The adoption of artificial intelligence (AI) in image generation raises concerns regarding potential bias, as these technologies may not be reflective of the underlying population in the images they generate. Our study investigates whether AI-generated images of medical students accurately represent the diversity of the current student population.

Methods: Using the DALL-E (Open AI) image generation algorithm, we created 300 images with the text prompt "medical student." These images were independently analyzed by two researchers for demographic indicators including sex, race/ethnicity, age group, setting, and attire. We summarized the results with descriptive statistics and subgroup analyses were performed to analyze differences in portrayals based on student sex and race/ethnicity. The demographic proportions in the virtual cohort of images was graphically compared with AAMC medical school enrollment data of actual medical students.

Results: Of the 300 generated images, 227 (76%) were females and 223 (74%) were White, indicating over-representation compared to actual medical school demographics. Images of Black and Latino/Hispanic students were more commonly depicted in scrubs compared to White students, who were often portrayed in white coats or collared shirts (p=0.002). No representation was found for Native American/Alaskan Native or Native Hawaiian/Pacific Islander students.

Conclusion: Our study reveals significant disparities in the representation of demographic groups in AI-generated images of medical students, indicating potential bias in these technologies. These biased portrayals could perpetuate existing stereotypes and hinder diversity efforts. Future research should aim to further identify and address these biases to promote more equitable applications of AI tools.

Portrayal of Medical Students in Artificial Intelligence Generated Images

Background: 
Following devastating hurricanes, such as Hurricane Ike and Hurricane Harvey, Galveston has struggled to replenish its previously existing affordable housing infrastructure due to socioeconomic and political forces. This has caused many to fall into homelessness or live in unstable housing situations. According to the 2022 Point in Time Count, there are 166 reported individuals experiencing homelessness in Galveston County. Street Medicine Galveston aims to meet unhoused individuals where they are in the community through Street Rounds, care for their physical and social needs, and bridge gaps in collaboration between Galveston organizations serving this population. 

Methods: 
We provide essential living necessities, seasonal supplies (winter gear, bug spray, sunscreen, etc.), wound care, and healthy meals from produce donated by community gardens and Galveston’s Own Farmers Market. Additionally, we have created a community network with several other community organizations that serve the unhoused community which allows us to refer individuals to the appropriate resources based on their unique needs.

Results: 
Through Street Rounds, we have learned that meeting unhoused individuals where they are within the community provides a unique solution to several barriers to care including lack of transportation and limited cellular/ internet access. Additionally, levels of education and awareness of available social resources vary widely within this population. By consolidating a community resource guide, our team bridges these gaps by providing recommendations for what community resources to visit based on their expressed needs. Lastly, within the past year, we have been able to serve 253 individuals thus far, 94 of which are recurrent clients and 174 who are new clients. This is a greater number of individuals than were reported within the Galveston County Point in Time Count. 

Conclusions: 
Through Street Rounds, we were able to collaborate and form trusting relationships with the unhoused community as well as several community partners. In the span of 10 months, we were able to serve a total of 253 people experiencing homelessness. With the help of donations, we were able to successfully provide winter gear for more than 50 people and assisted with referrals to other services in Galveston. In the future, we hope to continue exploring different avenues like collaborating with social services, and medical specialties like Psychiatry to provide further care.

Underline digital video library

The REAL AI revolution: the benefits of Chatbot Augmented Instruction

Department Climate and Academic Workload in Anthropology Departments

Clinical Manifestations of COVID-19 in Previously Healthy Pediatric Patients Presenting to a Primary Care Office.

The Effect of Socioeconomic Status on Diagnosis and Prognosis of Thyroid Cancers

Investigating How Social & Structural Barriers to Vaccine Access and Lack of Trustworthiness May Impact Vaccination Rates Among African Americans During the COVID-19 Pandemic

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

Looking Backwards to Look Forward: An Analysis of Clinical Reasoning Reports in the Neurology Core Clerkship before and after the transition to Pass/Fail Grading

The effect of access to a primary care provider on perceived unmet mental health treatment need in NYC adults

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

GIS Analysis of Cardiac Catheterization Centers on the Island of Oahu

Portrayal of Medical Students in Artificial Intelligence Generated Images

Street Medicine Galveston: How We Created a Community Resource Network

Stay up to date with the latest Underline news!

PRESENTATIONS

CONFERENCES

COMPANY

RESOURCES