TTUHSC IME Abstracts | AAMC 2008
Abstracts from the 2008 AAMC Innovations in Medical Education (IME) Exhibit
San Antonio, November 2-3, 2008
Patti J. Patterson, Betsy Jones, Erin Braddock, Marie Hall Institute for Rural and
Community Health, Texas Tech University School of Medicine – Lubbock
Providing optimal health care for diverse populations involves understanding medical,
social, economic and political influences on health, and the ability to communicate
with people with different value systems, backgrounds and concepts of health and illness.
While many first year medical students have extensive experiences living and working
in other cultures, others do not. This project introduced students early in their
education to a disenfranchised population. Students interviewed poor, primarily homeless
persons in various community-based organizations. The goals were for students to better
understand the potential root causes and long-term personal and societal impact of
poverty and homelessness and to learn to more effectively communicate with persons
of varying economic, social, cultural and educational backgrounds. This presentation
outlines project goals, activities, teaching tools and evaluation results.
Corresponding Author: Patti J. Patterson, M.D. firstname.lastname@example.org
Andrew Dentino, Stephanie Leeper, Paul Casner, Lynn Bickley, Betsy Jones
University School of Medicine –Amarillo, El Paso, Lubbock
In July 2008, the Texas Tech University Health Sciences Center School of Medicine
implemented a required two-week geriatrics rotation for fourth-year medical students.
The result of many years of effort, as well as assistance from an Aging and Quality
of Life grant from the D.W. Reynolds Foundation, this curricular initiative is especially
noteworthy because it represents what may be one of the first efforts to adopt the
new AAMC Geriatrics Competencies as learning objectives and basis for measurable outcomes.
This Innovations in Medical Education poster will outline key features of the curriculum
as it is implemented on three geographically separate campuses of a single medical
school, all of which share rotation goals and objectives, but each of which takes
advantage of resources unique to its campus and community:
Lubbock: Students receive training in geriatric medicine in a variety of settings, including
assisted living facilities, long-term care facilities, home visits, hospice, and ambulatory
sites. Students also take part in TTUHSC’s innovative geriatrics podcasting project,
producing audio podcast episodes published to the Texas Tech MedCast Reynolds Geriatrics
Series and available for download from the iTunes Music Store. Each podcast is developed
for an audience of third-year medical students, based on a question from the USMLE
Step 2CK Sample Exam that uses a vignette of a patient aged 60 and older.
Amarillo: For an experience focusing on geriatrics, geriatric neuropsychiatry, and neurology,
students see patients in a skilled nursing facility, geriatric wellness clinic, nursing
home, and two senior assessment clinics. Students learn about the cultural aspects
of aging through experiences at the Family Medicine Senior Assessment Clinic. They
also participate in outreach activities such as the health fairs, where they have
provided information on depression in the elderly and dementia and provide screening
in these areas as well as blood sugars. Several groups of students lead community
service projects that involve interviewing family caregivers, reviewing the literature
on caregiver issues, and working with other seniors in the community.
El Paso: Students receive training in a wide range of sites and experiences, including outpatient
geriatric clinics, Hospice and Hospice home visits. They perform geriatric assessments
at a senior day care center and receive additional experiences at a rehabilitation
Corresponding Author: Betsy G. Jones, Ed.D. email@example.com
Betsy G. Jones, Lynn S. Bickley, Andrew Dentino, Fiona Prabhu, Charmaine Martin, Marichu
Balmes, Robert Neilson, Steve Urban, Dinorah Nutis Texas Tech University School of
Medicine –Amarillo, El Paso, Lubbock
Purpose of study: In its 2007 report, “Learn, Serve, Lead,” the AAMC recognized large-scale trends
that will affect academic medicine in the coming years, including “technology-enhanced
strategies” to help address “a rising burden of chronic disease and a mobile, diverse
population.” This project evaluates one such strategy—podcasts—to promote medical
student learning in geriatrics.
Methodology: During the fall of 2007, during their 8-week family medicine (FM; n=67) or internal
medicine (IM; n=50) clerkship, third-year medical students on TTUHSC’s three campuses
were assigned to listen to four podcasts, covering topics in geriatric functional
assessment, geriatric office visits, nutritional issues for the elderly, and preventive
screening for the elderly. These podcasts are part of a multi-episode geriatric series
of the Texas Tech MedCast. Afterward, students completed an evaluation instrument
including a 15-item content quiz.
Summary of Results: Using a 5-point Likert scale (5=strongly agree) to assess opinions about the podcasts,
students generally agreed that they understand the podcasts’ content and that they
had adequate opportunity to listen to the episodes. Students completing the FM clerkship
were more likely to agree that podcasts offer a valuable teaching tool than did students
completing the IM clerkship (means = 3.57 and 2.94 respectively; t (111) = 2.87, p
= .005). On the other hand, IM clerks had slightly higher scores on the cognitive
questions (90.85% vs. 90.5%, p<.86), reflecting IM’s use of those questions as part
of the clerkship exam.
Conclusions: Students generally appreciate the availability of podcasts, but their enthusiasm
for and use of this teaching tool varies according to their perceptions of the associated
incentives, such as extra exam points or other “high yield” rewards.
AAMC. Learn, Serve, Lead: The Mission, Vision and Strategic Priorities of the AAMC.
Corresponding Author: Betsy G. Jones, Ed.D. firstname.lastname@example.org
Suzanne Escudier, Department of Anesthesiology, Texas Tech University School of Medicine
Background: Medical students in anesthesiology clerkships learn by observing an anesthesiologist
or an anesthesiology resident. The students participate in theoretical discussion
during the administration of an anesthetic but usually do not participate in the formulation
of an anesthetic plan. Using a screen based simulator, the student can experience
the decision-making process first hand and, it is hypothesized, better understand
what is observed and what is discussed afterwards.
Hypothesis: Early simulation experience improves overall knowledge acquisition during
the clerkship and student satisfaction with the clerkship experience.
Study Design: Prospective, Randomized
Materials and Methods: Ten fourth year students who chose a four week anesthesiology clerkship performed
two anesthetics using a screen based simulator as part of their training. The students
were randomly divided into two groups. The first group completed one case simulation
during the first week of clerkship and the second case during the fourth week. The
second group completed both cases on the same day during the fourth week. First cases
and second cases were the same for both groups. The same anesthesiologist provided
all individual debriefing after each case. An assessment tool was used to evaluate
the students’ selections including appropriateness and safety of their anesthetic
After completing the second simulated case all students were surveyed as to
the quality of their clinical learning experience.
Results: (1) To determine if the simulation training at the start of the clerkship enhanced
performance as compared to simulation training only at the end of the clerkship, the
differences in the assessment scores of the first and second cases were compared between
the two groups.
(2) To determine if early exposure to simulation training affected
the students' assessment of their clinical learning experience, the student surveys
of the two groups were compared.
Conclusions: Work in progress for academic year 2008 – 2009.
Corresponding Author: Suzanne Escudier, M.D., email@example.com
Vaughan H. Lee, Anthony Allan Hewetson, and Branaslav Vidic: Department of Cell Biology
and Biochemistry, Texas Tech University School of Medicine – Lubbock
The objectives of these projects were to promote self-directed learning with 1) study
aids for cross-sectional and medical images and 2) peer teaching exercises during
laboratory dissection sessions. These projects were developed for first year medical
students in their first block which is Clinically Oriented Anatomy. Consistently labeled
cross-sectional and medical images were developed and distributed as hard-copy keys
and Web-based images for independent study. A peer teaching system called Students
Teaching Students (STS) was developed to help instruct dissection during Anatomy laboratory
sessions by utilizing a group of the students as teaching assistants. In our approach
to this method, the student teaching assistants (STAs) are provided with special pre-laboratory
instruction on the material for the upcoming dissection. It is then up to the STA
to prepare, guide and direct their small groups (4-5 students) during that laboratory
dissection. The STS system was expanded to its current form where approximately one
half of laboratory sessions were STS, while the others were classically presented.
Both of these projects help the students develop self-directed skills necessary to
become life-long learners, and begin to prepare them for the type of questioning they
will experience during clinical rotations. The effectiveness of these study aids has
been evaluated by measuring examination performance and by soliciting information
from the students for the last five years. There was no difference in academic success
associated with these new methods. Web-based materials were preferred for independent
study and hard-copy guides for small group learning in the gross laboratory. In conclusion,
these teaching methods have enhanced active self-directed and small group learning
experiences and reduced the need for passive, faculty-guided sessions. Supported by
TTUSOM Awards in Educational Innovation and Scholarship and the Dept. of Cell Biology
Vaughan H. Lee, Ph.D.
, TTUHSC/CBB Room 5B103
3601 4th Street
Lubbock, TX 79430,
Thomas F. McGovern, Terry McMahon, Kumud Joshi, and Jules Molina, Department of Psychiatry,
Texas Tech University School of Medicine – Lubbock
An enhanced focus on the place of spirituality/religiousness in our Psychiatry Residency
Program has been in place for the past three years. A grant from the Office of the
Dean, followed by a three year grant (now in its third year) from the George Washington
Institute for Spirituality and Health (GWish), John Templeton Foundation have facilitated
the development of an interactive, resident driven curriculum. This curriculum explores
the relevance of spirituality/religiousness in the personal and professional lives
of the residents as healers but, more importantly, in addressing the holistic care
The didactic component of the curriculum addresses, over a three year cycle, the following
topics: religiousness/spirituality in psychiatric practice, major religions in their
relationship with mental health, the assessment of spirituality and religiousness
in clinical work. These areas are covered in years One and Two. “Spirituality dinners”
on a monthly basis, introduce the residents, in the context of open animated table
talk, to the insights of major religions as presented by representatives of various
faith communities. The dinners have promoted dialogue, conversation and have enriched
a sense of community among the residents, who themselves represent the major religions
in the richness of many cultures. Other topics, addressed in the third and fourth
year, deal with the spiritual dimensions of suffering, grief, addiction, guilt and
forgiveness. The focus of these sessions is highly interactive and reflective, with
a distinct psychotherapeutic direction.
A Spirituality Awareness in Residents Psychiatric
Practice (SARPP) instrument is being used to measure change across several domains
including definitions, clinical competency, attitudes, and evaluations. Strongly endorsed
items indicate that residents, at the beginning of their training lack both comfort
and ability in dealing with spiritual issues. This improves over time. A Residents
Portfolio also evaluates resident response to the enhanced curriculum. This aspect
of the evaluative process is currently being examined. It remains to be seen how resident
awareness and competency in spiritual/religious matters translates into more holistic
patient care. Overall, the enhanced conversation of the past three years has been
challenging and rewarding and, above all, a community builder.
Corresponding Author: Thomas F. McGovern, Ed.D., Professor Thomas.McGovern@ttuhsc.edu
Ari Halldorsson, Department of Surgery, Texas Tech University School of Medicine –Lubbock
Introduction: Good communication and interpersonal skills are essential for any physician in clinical
Although the surgical profession has long accepted that surgeons need to
be “talkers” as well as “doers” teaching, evaluating and setting standards for these
skills are still being debated. These have traditionally been taught by role modeling
and global 360O evaluations used to assess the learner’s proficiency. The drawbacks
to using ward rounds and other clinical settings solely to teach and assess interpersonal
and communication skills include; lack of uniform experience, the subjectivity of
the teacher’s evaluation and lack of timely feedback.
Simulated patient program: Few years ago we began using simulated patients to evaluate interpersonal and communication
skills of surgery residents. The scenarios cover such topics as obtaining an informed
consent, interaction with religious and ethnic minorities, understanding and respecting
the patient’s autonomy and delivering bad news. Each resident is tested once per year.
Program evaluation: Before participating the residents almost uniformly felt that this would not be a
good method to assess their patient encounter skills. After taking the simulated encounters
they had a much more favorable opinion and thought that this was a useful educational
tool and a good proxy to clinical encounters. Most admitted that their own performance
needed more improvement than they expected. The Attendings commented on the importance
of observing the residents performance in a controlled environment. The importance
of being able to give and receive timely feedback was frequently mentioned as a major
positive to this method.
1. The simulated case needs to be concise and simple with clearly defined assignments
and detailed performance expectations.
2. Delineated attending evaluation form with a check list and evaluation of each component
of the assignment, not just over all performance.
3. Detailed and compartmentalized evaluation form for the standardized patient.
4. Immediate constructive feedback on each component of the scenario making sure
the resident understands deficiencies and accepts recommendations for improvement.
Conclusion: We have found that using simulated patient scenarios in a constructive, organized
manner was well accepted by the residents and Attendings and this method has become
a valuable tool in teaching and evaluating interpersonal and communication skills
in our program.
Corresponding Author: Ari Halldorsson, M.D.
Program Director General Surgery, Professor and Vice Chair,
Department of Surgery,
Texas Tech University Health Sciences Center,
3601 4th St.,
MS 8312, Suite 3A159
, Lubbock, Texas 79430-8312
, Phone: (806) 743-2460
, Fax: (806)
Marjorie Jenkins, Department of Internal Medicine - Texas Tech University School of
Medicine – Amarillo
In 2007 Texas Tech University Health Sciences Center (TTUHSC) established the Laura
W. Bush Institute for Women’s Health with the First Lady’s
permission. The Institute
is located across the TTUHSC campuses of Amarillo, El Paso, Lubbock and the Permian
Basin and in the future, Abilene and Dallas. Currently the impact area is 140,000
geographical miles The mission of the Laura W. Bush Institute for Women’s Health (LWBIWH)
is dedicated to the cultivation and advancement of multi-disciplinary science in women’s
health and to promote the well-being of women through research, education and community
The expansion of the LWBIWH brought together the strengths of TTUHSC’s Schools of
Medicine, Pharmacy, Nursing, Allied Health Sciences, F. Marie Hall Institute for Rural
and Community Health and the Garrison Institute on Aging.
The LWBIWH has an established Women’s Health Fellowship (WHF) program on the TTUHSC
Amarillo campus. In addition the TTUHSC El Paso Foster School of Medicine will launch
a WHF/MPH program in July 2009. These two training programs constitute 2 of 23 such
programs as listed in the annual Journal of Women’s Health Fellowship Directory.
The LWBIWH WHF training programs are multidisciplinary programs geared toward training
leaders in gender-specific medicine. Through involvement of Internal Medicine, Family
Medicine, and Obstetrics and Gynecology faculty our fellows are prepared to bridge
the gap between gynecology and primary care and take bench research to the bedside.
The LWBIWH will set the standard for multidisciplinary educational programs in gender-differences
and women’s health.
Corresponding Author and Creator of the LWBIWH Fellowship: Dr. Marjorie Jenkins
Contact Person: Marjorie Jenkins, LWBIWH, 1400 Wallace Blvd. Amarillo, Tx, 79106, 806.356.4617,