2017 GRIPE Meeting – Orlando

“Teaching Pathology in the 21st Century”

2017 Poster Abstracts

Session
Thursday, January 26, 2017

Teaching Pathology at UCF
Mänette Monroe, MD, MEd, FCAP

Plenary Session
Thursday, January 26, 2017

Novel Teaching Methods in Medical Education
Cynthia Perry, PhD

Provide new materials in areas of Pathology, Cell Biology, Molecular Biology and Biochemistry in the Scientific Principles of Medicine curriculum. This will focus on developing learning materials, assessment materials, labs and have key points in curriculum development for first and second year medical students within an integrated, clinical presentation based medical curricula.

Learning Objectives:

  1. Be able to discuss the current approaches in undergraduate medical education pathology curricula and recognize the challenges in delivery and student achievement.
  2. Identify innovative approaches to pathology UME at the Paul L Foster SOM and how they have been successfully implemented in a clinical presentation-based curriculum.
Concurrent Workshops
Thursday, January 26, 2017

Pathology in Integrated Curricula II – Strategies for Success and Survival (Presentation not available)
Sebastian Alston, MD and James Lyons, MD

During the 2016 GRIPE meeting in San Diego, a pre-conference workshop on pathology in integrated curricula was conducted. In medical schools throughout the country, discipline-based courses are being quickly replaced by integrated approaches. This trend has definitely included pathology. Although there are benefits associated with this trend and great opportunities for pathology education, there are also significant concerns. Such concerns include the identity of pathology, the amount of curricular time, and the availability of resources. This year’s workshop will again feature discussions of these aspects based on the experiences of participants and on available literature and other resources. Additional strategies and emphases will be incorporated into the workshop. Potential individual and collective strategies that can maximize the curricular rewards and minimize the concerns/risks will be recognized and developed during the workshop. Efforts will be made to contact attendees prior to the conference to encourage preparation for sharing approaches and experiences.

Innovating Solutions for Pathology Education in an Integrated Curriculum (Presentation not available)
Joanna Chan, MD

The movement of undergraduate medical education towards horizontal and vertical integration creates unique challenges in both teaching pathology and exposing medical students to pathology as a medical specialty. Many of these changes are being made to conform to ‘competency based’ education standards, including core competencies and entrustable professional activities (EPAs). Historically, medical schools followed the 2+2 format of two years of pre-clinical education followed by two years of clinical practice, with a defined pathology course taught by pathology faculty in the pre-clinical years. This format gave pathologists a chance to curate the student curriculum as well as expose students to pathology as a career. However, when the fundamentals of medicine such as pathology, anatomy, physiology and pharmacology are taught in a compartmentalized fashion, lack of clear topic connections obscure the clinical relevance of individual topics to future clinical practice and deficient communication between course directors can result in both redundancies and deficiencies in course content. Horizontal integration provides clinical context for medical students as well as clarifies teaching responsibilities for subject matter. Vertical integration often follows a three-phase competency based curriculum, Phase 1 being pre-clinical training, focusing on the science in medicine, Phase 2 being general clinical training, and Phase 3 being advanced clinical training and professional development. Both horizontal and vertical curricula typically result in decreased didactic time between medical students and pathology educators, leading to a decreased time teaching of pathology, as well as decreased visibility of pathologists. This not only lessens quality of medical education, but also affects the pipeline of new pathology trainees. With these challenges in mind, pathology educators and pathologists need to find new ways to teach pathology in undergraduate medical education while increasing the visibility of pathology as a medical specialty.

In this workshop, we discuss the goals of pathology educators in undergraduate medical education and alternative methods of achieving those goals. These goals can include identifying the essentials of pathology necessary to becoming competent and effective physicians, as well as educating medical students on the practice of pathology.

Pathology Essentials for the Non-pathologist: Basic Pathology Principles for Clinical Clerkships
Elizabeth Frauenhoffer, MD, Francesca Ruggiero, MD, and Nicole Williams, MD

The goals of this workshop are to design a course highlighting the basic pathology principles that should be taught to all medical students entering their clinical clerkships. The session will focus primarily on anatomic pathology. The second goal is to identify challenges to implementation of pathology coursework during the clinical clerkships. Lastly, best practices regarding the integration of pathology in the clinical curriculum will be discussed.

GRIPE Photo Review (Presentation not available)
Amy Lin, MD

GRIPE Question Bank Review (Presentation not available)
Geoffrey Talmon, MD

Attendees will:

  1. Identify key components of a well-written multiple choice question.
  2. Recognize and correct problems with sample questions.
Plenary Session
Friday, January 27, 2017

The Role of Medical School Curricula in Advancing the Importance of Laboratory Medicine in Practice
Michael Laposata, MD, PhD

There is a limited amount of teaching medical students receive on the everyday practice of appropriate laboratory test selection and correct laboratory test result interpretation. We need one successful interactive week long teaching program in laboratory medicine for a large class that equips students with the ability to select the correct test for clinical situations they are very likely to encounter; and the need to defer on test selection to experts when there is uncertainty about the need or clinical significance of a particular test(s). There is value of one successful teaching program in laboratory medicine for a large class which includes 1) test ordering for commonly encountered clinical scenarios using an audience response system; 2) analysis of the clinical significance of blood test results from students in the class who volunteer to have their blood drawn for the anonymous review; 3) informative tours led by laboratory directors of the main sections of the clinical laboratory; 4) development of proficiency in the performance of point of care tests and their use in establishing a diagnosis;

Learning Objectives:

  1. Recognize the limited amount of teaching medical students receive on the everyday practice of appropriate laboratory test selection and correct laboratory test result interpretation.
  2. Develop an awareness of one successful interactive week long teaching program in laboratory medicine for a large class that equips students with the ability to select the correct test for clinical situations they are very likely to encounter; and the need to defer on test selection to experts when there is uncertainty about the need or clinical significance of a particular test(s).
  3. Recognize the value of one successful teaching program in laboratory medicine for a large class which includes:
    • test ordering for commonly encountered clinical scenarios using an audience response system;
    • analysis of the clinical significance of blood test results from students in the class who volunteer to have their blood drawn for the anonymous review;
    • informative tours led by laboratory directors of the main sections of the clinical laboratory;
    • development of proficiency in the performance of point of care tests and their use in establishing a diagnosis;
    • completion of an examination which focuses on cases with challenges for test selection and result interpretation.
Concurrent Workshops
Friday, January 27, 2017

Use of Online KuraCloud Study Technology for Improving Pathology Education
Dale Voorhees, MA

This workshop will be a hands-on demonstration and guided activity in the use of the commercially available software for the development and delivery of Pathology online case-studies. Participants will first experience a case study from the student’s perspective, then will create their own case study (following best practices) using the KuraCloud software. Computers as well as images, and case data will be provided for participants to develop a case, but participants are free to use their own computers and/or bring their own images and lab data for cases they would like to develop in the workshop. Participants need to only have basic computer skills to attend this workshop. Designing the cases is the hard part, not using the software!

Self-Directed Learning Using Individualized Assessment Feedback on Desire2Learn (D2L)
Earl Brown, MD

Self-assessment is an important part of self-directed learning, and question feedback is a crucial part of self-assessment. Question feedback, however, is more beneficial for self-directed learning if that feedback is specifically geared toward each student’s question responses.

Individualized question feedback and self-assessment quizzes can be implemented using an online learning management system, such as D2L. This workshop will discuss how to develop and deliver self-assessment quizzes on D2L and then post individualized feedback to students using the private discussion forums on D2L.

This question feedback enhances self-directed learning because it is focused on the particular questions that each individual student missed. The online quiz results are used by our department to identify medical students who are at risk for not passing the USMLE Step 1 exam, while the feedback information is also used for appropriate intervention and tutoring of these students.

Incorporation of Medical Director Activities into Pathology Residency Training Programs
Stacy Beal, MD and Jesse Kresak, MD

The conventional method of Clinical Pathology training involves rotations through separate laboratories such as hematology and microbiology. Residents historically spend much of their time on the bench with a medical technologist, focusing education on technical rather than clinical aspects of lab tests. Although the technical components of laboratory tests are extremely important to understand, we believe more emphasis should be placed on the duties performed by a medical director. Furthermore, many of the milestones set by the Accreditation Council for Graduate Medical Education (ACGME) involve director-level responsibilities, such as consultation with colleagues in other departments regarding test selection and results and participation in quality improvement projects, root cause analyses, and regulatory body inspections. Therefore, we created a new rotation in which the resident serves as a director for the microbiology, virology, hematology, chemistry, point-of-care, and electrophoresis labs under mentorship. While integration of the resident into Anatomic Pathology services is fairly straightforward, novel arrangements are needed to allow residents to actively contribute (as opposed to shadowing and self-directed book learning) in the Clinical Pathology areas. This workshop will feature various approaches to increase resident participation in activities often performed by Pathology faculty. Participants will be able to apply these ideas to their institutions if desired and will learn how to evaluate the impact of curriculum changes on achievement of ACGME milestones, resident, faculty, and laboratory staff satisfaction, and medical knowledge.

Engaging Our Learners Using Technology Tools
Rajasekaran Koteeswaran, MD

As educators, we face common challenges in teaching such as difficulty in providing personalized instruction, feedback and remediation to our learners. One the emerging technology tools to engage learners is Adaptive learning. This session provides definition of Adaptive learning and clarifies common misconceptions about the usage of this term. This session focuses on one of the adaptive learning platform (BEST NETWORK/SMARSPARROW) that targets higher education and its potential use in teaching a visual course like pathology.

BEST (Biomedical Education Skills and Training) Network is a not-for profit network of biomedical Schools developing and sharing next-generation courseware and technology. It was founded in 2014, as a joint venture of Australian Universities funded by an education grant from the Australian government. As of now, the BEST network has a bank of over 20,000 images with annotations and courseware shared by its members.

The workshop attendees will be able to access one of the deployed lessons from the platform, which will help in understanding the functionalities of the adaptive learning platform in construction of lessons, answering the quiz, providing feedback and remediation paths. At the end of the lesson, the data analytics will be shown. Further, the advantages and challenges of using this learning platform will be discussed.

BEST Network Case Study
BEST Network Brochure

Plenary Session
Friday, January 27, 2017

Do Medical School Curricula Approaches Affect Competence in Laboratory Medicine?
Kent Hecker, PhD

Teaching modalities should be identified that are more effective in attaining the goal of educating students to truly apply what they learn in the practical clinical setting and also in encouraging them to develop appropriate habits for lifelong learning. Methods for inclusion of laboratory medicine principles during all stages of the medical student curriculum during all 4 years are critical to reap the benefits of integrated curricula, as is instruction in the use of electronic resources. An in-depth knowledge of laboratory medicine principles is vital to all practicing physicians. Great variation exists in the ways that medical students learn the principles of laboratory medicine.

Learning Objectives:

  1. Define competency-based curricular structures.
  2. Describe strengths and challenges of building competency based curricula.
  3. Outline relationships between competency-based programs, assessment, and student learning.
Plenary Session
Saturday, January 28, 2017

Progress and Potential: Training in Genomic Pathology
Richard Haspel, MD, PhD

Training Residents in Genomics (TRIG) working group was formed to develop teaching aids and promote the importance of genomics education. From its inception, there was a uniquely collaborative approach within the group. Whereas many curricula are designed by single organizations in a single specialty, the TRIG working group includes experts in molecular pathology, educational design, medical genetics and genetic counseling. Future goals for the TRIG working group include developing and assessing online modules. This will translate the in-person workshop learning experience into a virtual environment. In addition, workshops and courses continue to be held.

Learning Objectives:

  1. Describe core components of an introductory genomics curriculum for clinical trainees.
  2. Describe the advantages of a team‐based learning/flipped classroom approach for today’s learner.
  3. Demonstrate methods for integrating performance-based genomics teaching objectives, such as use of online tools, into a team-based learning format.
Concurrent Workshops
Saturday, January 28, 2017

“Why Should I Teach Myself?” Helping Students Develop Self-Directed Learning Skills (Presentation not available)
Amy Lin, MD

Introduction & Rationale: It is important for physicians to stay up-to-date with rapidly expanding scientific knowledge to provide the best care for their patients. Therefore, the development of self-directed and lifelong learning skills in our medical students is essential. The recently revised, Liaison Committee on Medical Education (LCME) accreditation standards reflects this position. The current standard, element 6.3, shifts the focus from active learning and independent study to self-directed and lifelong learning. The purpose of this workshop is to help pathology educators develop educational experiences that facilitate medical students’ development of self-directed learning skills and comply with LCME element 6.3.

By the end of this workshop, participants will be able to:

  1. Distinguish between active, independent, and self-directed learning
  2. Explain the key components of LCME element 6.3 (Self-directed and lifelong learning)
  3. Develop educational experiences that incorporate self-directed learning and fulfill LCME element 6.3.

Activities & Schedules: Introduction of basic concepts, including active, independent, and self-directed learning, and LCME element 6.3 (15 min). Participants will be divided into teams and given a scenario where the team is asked to develop educational experiences that fulfill LCME element 6.3 (40 min). Each team will present their solution to the entire group, and presenter will facilitate a whole group discussion about the strategies (25 min). Presenter will summarize key take-home points and conclude the session (10 min). (Total 90 min)

Expected outcomes: Pathology educators will become familiar with the concepts of active, independent, and self-directed learning, and the components of LCME element 6.3. They will be able to create educational experiences that help students develop self-directed and lifelong learning skills, and fulfill LCME element 6.3.

Small Group Learning in Large Classroom Settings – An Innovative Teaching Strategy
Savita Arya, MD and Michael Yakubovskyy, MD, PhD

Purpose: Millennial learners place emphasis on self-directed learning with innovative technologies and small group learning is a unique teaching pedagogy that builds skills for team-based collaboration, communication as well as problem-solving. The purpose of this study was to implement an innovative teaching strategy with new technology as an innovative teaching format that promotes critical thinking, fosters interactive student learning and enhances student performance and satisfaction for students.

Methods: A small group learning activity in large classroom initiated by the department of Pathology was integrated into the Ross University’s School of Medicine students’ curriculum of the fourth and fifth semesters in March 2016 incorporating interdisciplinary clinical cases to facilitate critical thinking and explore the use of open-ended questions. Questions reinforced complex concepts that were already taught in the traditional didactic lectures and were identified by statistical analysis of student performance in internal summative examinations. Students were sent all the cases with questions prior to the sessions providing them opportunity to work through cases individually. During the session, students were divided into small groups (6-8 students/group) with one student assigned as team leader. After discussing each question with all the team members, the team leader responded to the poll via an audience response system (ARS), ‘Poll Everywhere’ with a mobile device or a laptop. One computer screen displayed the Power Point presentation of cases with the open-ended questions to all students while the other displayed student poll responses and was shown only to participating interdisciplinary faculty. Based on the narrative student responses, faculty monitored student comprehension during the session and provided immediate feedback regarding their thought processes. Towards the end of the session, students were instructed to provide comments evaluating the perception of their learning experiences.

Results: The new small group teaching activity within a large classroom received positive evaluations from students as well as showed a positive trending in student performance. Use of a new ARS and an opportunity to provide descriptive responses including a differential diagnosis of the discussed cases (instead of a single best answer) in the open-ended question format kept students engaged during the session.

How Pathology Forms the Backbone of an Integrated Medical Education
Paul Shanley, MD and Karen Kelly, MS

Teaching the Adult Learner Across Generational Landscape (Presentation not available)
Darshana Shah, PhD

Plenary Session
Saturday, January 28, 2017

Virtual Pathology and Screencasts in Enhancing Teaching of Pathology
Alberto Marchevsky, MD

Virtual microscopy has been adopted by many medical schools but often without addressing the need for students to understand how to integrate slide observations with other diagnostic information. Several applications of digital pathology are currently being embraced by pathologists. Whole slide imaging is commonly used for pathology education in medical school, pathology workshops, and slide conferences. Web-based system empowered learners to have greater control over their content and work together in collaborative groups. The virtual microscope system saved faculty time and enhanced student performance on an identical practical exam.

Learning Objectives:

  1. Discuss how pathology education has evolved over the past few decades.
  2. Discuss how new digital technologies for enhancing the exposure of pathology residents and fellows to challenging anatomic pathology cases and other materials that provide a learning opportunity that otherwise might not be available to them.

Click here to download the Program Book.