Matching Items (10)
Description
Virtual Patient Simulations (VPS) are web-based exercises involving simulated patients in virtual environments. This study investigates the utility of VPS for increasing medical student clinical reasoning skills, collaboration, and engagement. Many studies indicate that VPS provide medical students with essential practice in clinical decision making before they encounter real life patients. The utility of a recursive, inductive VPS for increasing clinical decision-making skills, collaboration, or engagement is unknown. Following a design-based methodology, VPS were implemented in two phases with two different cohorts of first year medical students: spring and fall of 2013. Participants were 108 medical students and six of their clinical faculty tutors. Students collaborated in teams of three to complete a series of virtual patient cases, submitting a ballpark diagnosis at the conclusion of each session. Student participants subsequently completed an electronic, 28-item Exit Survey. Finally, students participated in a randomized controlled trial comparing traditional (tutor-led) and VPS case instruction methods. This sequence of activities rendered quantitative and qualitative data that were triangulated during data analysis to increase the validity of findings. After practicing through four VPS cases, student triad teams selected accurate ballpark diagnosis 92 percent of the time. Pre-post test results revealed that PPT was significantly more effective than VPS after 20 minutes of instruction. PPT instruction resulted in significantly higher learning gains, but both modalities supported significant learning gains in clinical reasoning. Students collaborated well and held rich clinical discussions; the central phenomenon that emerged was "synthesizing evidence inductively to make clinical decisions." Using an inductive process, student teams collaborated to analyze patient data, and in nearly all instances successfully solved the case, while remaining cognitively engaged. This is the first design-based study regarding virtual patient simulation, reporting iterative phases of implementation and design improvement, culminating in local theories (petite generalizations) about VPS design. A thick, rich description of environment, process, and findings may benefit other researchers and institutions in designing and implementing effective VPS.
ContributorsMcCoy, Lise (Author) / Wetzel, Keith (Thesis advisor) / Ewbank, Ann (Thesis advisor) / Simon, Harvey (Committee member) / Arizona State University (Publisher)
Created2014
Description
Medical students acquire and enhance their clinical skills using various available techniques and resources. As the health care profession has move towards team-based practice, students and trainees need to practice team-based procedures that involve timely management of clinical tasks and adequate communication with other members of the team. Such team-based procedures include surgical and clinical procedures, some of which are protocol-driven. Cost and time required for individual team-based training sessions, along with other factors, contribute to making the training complex and challenging. A great deal of research has been done on medically-focused collaborative virtual reality (VR)-based training for protocol-driven procedures as a cost-effective as well as time-efficient solution. Most VR-based simulators focus on training of individual personnel. The ones which focus on providing team training provide an interactive simulation for only a few scenarios in a collaborative virtual environment (CVE). These simulators are suited for didactic training for cognitive skills development. The training sessions in the simulators require the physical presence of mentors. The problem with this kind of system is that the mentor must be present at the training location (either physically or virtually) to evaluate the performance of the team (or an individual). Another issue is that there is no efficient methodology that exists to provide feedback to the trainees during the training session itself (formative feedback). Furthermore, they lack the ability to provide training in acquisition or improvement of psychomotor skills for the tasks that require force or touch feedback such as cardiopulmonary resuscitation (CPR). To find a potential solution to overcome some of these concerns, a novel training system was designed and developed that utilizes the integration of sensors into a CVE for time-critical medical procedures. The system allows the participants to simultaneously access the CVE and receive training from geographically diverse locations. The system is also able to provide real-time feedback and is also able to store important data during each training/testing session. Finally, this study also presents a generalizable collaborative team-training system that can be used across various team-based procedures in medical as well as non-medical domains.
ContributorsKhanal, Prabal (Author) / Greenes, Robert (Thesis advisor) / Patel, Vimla (Thesis advisor) / Smith, Marshall (Committee member) / Gupta, Ashish (Committee member) / Kaufman, David (Committee member) / Arizona State University (Publisher)
Created2014
Description
There is growing concern among physicians, scholars, medical educators, and most importantly among patients, that science and technology have begun to eclipse fundamental attributes, such as empathy in the doctor-patient relationship. As a result, “humanism” in medicine has been a widely debated topic—how to define it, how to promote it, whether it can be taught, and how to qualify (much less quantify) its value in the practice of medicine. Through this research project I sought to better understand the role of humanities coursework in American medical school curricula, and determine whether there was a relationship between the integration of humanities coursework and the maintenance or enhancement of empathy levels in medical students. I reviewed literature with three objectives. (1) To better understand the influential social and political factors of pervasive reforms in US medical school curricula at the beginning of the 20th century, which led to science exclusive pedagogy in physician training (2) To become familiar with the works of iconic personalities in the history of American medical school pedagogy, paying special attention to attitudes and claims describing the role of humanities coursework, and the concept of humanism in the practice of medicine. (3) To observe the discourse underway across a variety of disciplines with regard to the current role of humanities coursework in medical curricula. My research shows that empathy is an essential attribute in the healing relationship, which benefits patients, physicians and improves health outcomes. Despite the importance of empathy, current physician training is documented as eroding empathy levels in medical students. Though the definition of ‘humanities’ in the context of medical school curricula remains vague and even contradictory, support for integration of humanities coursework is growing as an effective intervention for maintaining or enhancing levels of empathy.
ContributorsCraer, Jennifer Ryan (Author) / Maienschein; Lynch, Jane; John (Thesis director) / Ellison, Karin (Committee member) / Robert, Jason (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-05
Description
There is growing concern among physicians, scholars, medical educators, and most importantly among patients, that science and technology have begun to eclipse fundamental attributes, such as empathy in the doctor-patient relationship. As a result, “humanism” in medicine has been a widely debated topic—how to define it, how to promote it, whether it can be taught, and how to qualify (much less quantify) its value in the practice of medicine. Through this research project I sought to better understand the role of humanities coursework in American medical school curricula, and determine whether there was a relationship between the integration of humanities coursework and the maintenance or enhancement of empathy levels in medical students. I reviewed literature with three objectives. (1) To better understand the influential social and political factors of pervasive reforms in US medical school curricula at the beginning of the 20th century, which led to science exclusive pedagogy in physician training (2) To become familiar with the works of iconic personalities in the history of American medical school pedagogy, paying special attention to attitudes and claims describing the role of humanities coursework, and the concept of humanism in the practice of medicine. (3) To observe the discourse underway across a variety of disciplines with regard to the current role of humanities coursework in medical curricula. My research shows that empathy is an essential attribute in the healing relationship, which benefits patients, physicians and improves health outcomes. Despite the importance of empathy, current physician training is documented as eroding empathy levels in medical students. Though the definition of ‘humanities’ in the context of medical school curricula remains vague and even contradictory, support for integration of humanities coursework is growing as an effective intervention for maintaining or enhancing levels of empathy.
ContributorsCraer, Jennifer Ryan (Author) / Maienschein; Lynch, Jane; John (Thesis director) / Ellison, Karin (Committee member) / Robert, Jason (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-05
Description
This study investigates the success of a method used to encourage active engagement strategies among community and research faculty in a College of Medicine, and examines the effects of these strategies on medical student engagement and exam scores. Ten faculty used suggestions from the Active Engagement Strategies Website (AESW), which explained four strategies that could easily be incorporated into medical education lectures; pause procedure, audience response system, think-pair-share, and muddiest point. Findings from observations conducted during sessions where an active engagement strategy was implemented and when strategies were not implemented, faculty and student surveys, and exam question analysis indicate faculty members found active engagement strategies easy to incorporate, student engagement and exam score means increased when an active engagement strategy was implemented, and students reported perceptions of attaining a higher level of learning, especially when the pause procedure was implemented. Discussion and implications address low cost and easy ways to provide faculty development in medical education that potentially improves the quality of instruction and enhances student outcomes.
ContributorsYanez, Lisa C (Author) / Puckett, Kathleen (Thesis advisor) / Crawford, Steven R (Committee member) / Standley, Paul R (Committee member) / Arizona State University (Publisher)
Created2017
Description
Mentions of diversity have become an essential part of every university and medical school’s mission statement. Yet, with such an emphasis on diversity, there is an evident absence of<br/>cultural competence education in the curricula of medical education. There is no clear answer of<br/>what is expected of physicians and no direct transitions for the different stages of medical<br/>training when it comes to cultural competence education. This is a vital issue, as there is a close<br/>relationship between the quality of patient care, patient adherence, and medical providers’ levels<br/>of cultural competence. This research analyzes the extent that cultural competence is taught at<br/>various points of the medical education cycle through a data analysis of an IRB approved<br/>questionnaire given to students within the medical education cycle and their value versus<br/>exposure of cultural competence.
ContributorsIbrahim, Aseel (Author) / Laubichler, Manfred (Thesis director) / Vélez-Ibañez, Carlos (Committee member) / School of International Letters and Cultures (Contributor) / School of Transborder Studies (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
The majority of trust research has focused on the benefits trust can have for individual actors, institutions, and organizations. This “optimistic bias” is particularly evident in work focused on institutional trust, where concepts such as procedural justice, shared values, and moral responsibility have gained prominence. But trust in institutions may not be exclusively good. We reveal implications for the “dark side” of institutional trust by reviewing relevant theories and empirical research that can contribute to a more holistic understanding. We frame our discussion by suggesting there may be a “Goldilocks principle” of institutional trust, where trust that is too low (typically the focus) or too high (not usually considered by trust researchers) may be problematic. The chapter focuses on the issue of too-high trust and processes through which such too-high trust might emerge. Specifically, excessive trust might result from external, internal, and intersecting external-internal processes. External processes refer to the actions institutions take that affect public trust, while internal processes refer to intrapersonal factors affecting a trustor’s level of trust. We describe how the beneficial psychological and behavioral outcomes of trust can be mitigated or circumvented through these processes and highlight the implications of a “darkest” side of trust when they intersect. We draw upon research on organizations and legal, governmental, and political systems to demonstrate the dark side of trust in different contexts. The conclusion outlines directions for future research and encourages researchers to consider the ethical nuances of studying how to increase institutional trust.
ContributorsNeal, Tess M.S. (Author) / Shockley, Ellie (Author) / Schilke, Oliver (Author)
Created2016
Description
Healthy lifestyle behaviors including quality nutrition have been shown to successfully prevent chronic disease or minimize symptoms. However, many physicians lack the knowledge and skills to provide adequate nutrition counseling and education for their patients. A major component of this problem is that medical schools are not required to teach nutrition education. The purpose of this feasibility study was to compare the changes in the perceived importance of nutrition in the medical field in medical students before and after participating in a week-long interactive nutrition course in order to determine if a week-long course can positively influence students’ perceptions of nutrition. Ultimately by changing these perceptions, medical students may be able to better help patients prevent chronic disease. The participants were first year medical students at the Mayo Clinic School of Medicine (Scottsdale, AZ) who chose to participate in this medical school “Selective”. The study included a five-day curriculum of case-studies, lectures from specialized health professionals, and a cooking class led by a chef who trained in France. An anonymous pre- and post-study questionnaire with five-point Likert scale questions was used to measure changes in attitudes. The data suggest that students’ perceptions regarding the importance and relevance of nutrition in the medical shifted slightly more positive after attending this Selective, although these shifts in attitude were not statistically significant. Limitations of this study include a small sample size and selection bias, which may have decreased the potential of having significant results. Both of these factors also make the results of this study less generalizable to all medical students. This study supports the need for a larger experimental study of a similar design to verify that an interactive, evidence-based nutrition class and culinary experience increases medical students’ positive perceptions of nutrition in the medical field.
ContributorsBaum, Makenna (Author) / Johnston, Carol (Thesis advisor) / Levinson, Simin (Committee member) / Sears, Dorothy (Committee member) / Arizona State University (Publisher)
Created2020
Description
Marijuana legalization will likely result in increased marijuana consumption with uncertain social and health impacts. This thesis looks to share user perspectives on marijuana, specifically addressing how users represent marijuana risks, benefits, and uncertain or unknown dangers. Data were collected from an online social-media forum that initiated the discussion by prompting readers to reflect on marijuana risks in a context of growing accolades concerning its benefits. Grounded theory and thematic analysis were both utilized to identify consistent themes or patterns across user comments. It was found that users identified both benefits and risks of marijuana, while some users had disputes about certain known risks (such as impaired driving) or uncertain or unknown dangers (such as reduced dream activity). Despite disagreements about the degree of risk associated with a particular activity (such as driving and dreaming), this thesis found risks and benefits were discussed in relatively narrow ways that suggest more education is needed around the full spectrum of the effects of various strains, including benefits, risks, and uncertainties.
ContributorsVannoy, Joshua (Author) / Nadesan, Majia H (Thesis advisor) / Walker, Michael (Committee member) / Ramsey, Ramsey E (Committee member) / Arizona State University (Publisher)
Created2019
Description
Empathy is a critical component of high-quality healthcare. When present in the clinical encounter, empathy is important to physicians (empathy is correlated with reductions in physician anxiety and burnout) and to patients (empathy is correlated with better medical decision making, enhanced trust, and improved treatment adherence). Unfortunately, there is an empathy gap in healthcare–physicians often miss opportunities to demonstrate empathy to their patients. This leaves patients feeling unheard, less likely to bring up details important to their care, and less likely to follow treatment guidelines from physicians, thus disrupting the physician-patient relationship. Luckily, communicating with empathy is a skill that can be taught and learned. With the right tools, learners can strengthen their empathic muscle and become better prepared for responding in difficult situations. The present thesis aims to validate a new tool for teaching empathy to medical trainees. This tool, an empathic communication guide, is drawn from social work as well as medical expertise. It is catered specifically to how medical trainees are accustomed to learning and provides the actual words to say in order to respond with empathy in difficult situations. A group of 8 palliative care fellows at MD Anderson Cancer Center in Houston, Texas received a copy of this guide and participated in an accompanying communication workshop. To gauge empathic responding ability, fellows completed pre- and post- surveys and patient simulations. These data were analyzed using a combination of novel and established methods for quantifying empathic behaviors. Fellows’ empathic communication skill significantly improved after exposure to the guide opening avenues for future study and application.
ContributorsMeyer, Laura Grace (Author) / Shafer, Michael S (Thesis advisor) / Epner, Daniel E (Committee member) / Beyers, Michelle (Committee member) / Arizona State University (Publisher)
Created2020