Building an Infectious Disease Diversity, Equity, and Antiracism (ID2EA) Curriculum: A Single Center's Experience and Reflections.

In response to longstanding healthcare inequities unmasked by the Coronavirus Disease 2019 pandemic, the infectious diseases (ID) section at the Yale School of Medicine designed and implemented a pilot curriculum integrating Infectious Disease Diversity, Equity, and Antiracism (ID2EA) into ID educational training and measured program outcomes. We herein describe a mixed-methods assessment of section members on whether the ID2EA curriculum affected their beliefs and behaviors regarding racism and healthcare inequities. Participants rated the curriculum as useful (92% averaging across sessions) and effective in achieving stated learning objectives (89% averaging across sessions), including fostering understanding of how inequities and racism are linked to health disparities and identifying strategies to effectively deal with racism and inequities. Despite limitations in response rates and assessment of longer-term behavioral change, this work demonstrates that training in diversity, equity, and antiracism can be successfully integrated into ID physicians' educational activities and affect physicians' perspectives on these topics.

Implementation of simulation-based health systems science modules for resident physicians.

BACKGROUND: Health system science (HSS) encompasses both core and cross-cutting domains that emphasize the complex interplay of care delivery, finances, teamwork, and clinical practice that impact care quality and safety in health care. Although HSS skills are required during residency training for physicians, current HSS didactics have less emphasis on hands-on practice and experiential learning. Medical simulation can allow for experiential participation and reflection in a controlled environment. Our goal was to develop and pilot three simulation scenarios as part of an educational module for resident physicians that incorporated core and cross-cutting HSS domains.  METHODS: Each scenario included a brief didactic, an interactive simulation in small-group breakout rooms, and a structured debriefing. The case scenario topics consisted of educational leadership, quality and safety, and implementation science. Learners from four residency programs (psychiatry, emergency medicine, orthopedics, ophthalmology) participated January - March 2021. RESULTS: A total of 95 resident physicians received our curricular module, and nearly all (95%) participants who completed a post-session survey reported perceived learning gains. Emotional reactions to the session were positive especially regarding the interactive role-play format. Recommendations for improvement included participation from non-physician professions and tailoring of scenarios for specific disciplines/role. Knowledge transfer included use of multiple stakeholder perspectives and effective negotiation by considering power/social structures. CONCLUSIONS: The simulation-based scenarios can be feasibly applied for learner groups across different residency training programs. Simulations were conducted in a virtual learning environment, but future work can include in-person and actor-based simulations to further enhance emotional reactions and the reality of the case scenarios.

Teaching well-being at scale: An intervention study.

Courses that teach evidence-based interventions to enhance well-being are a public health tool that could be used to improve mental health in the population. We compared the well-being of six cohorts of adult students before and after they completed one of two massive open online courses: The Science of Well-Being (N = 581; 441; 1,228) and a control course, Introduction to Psychology (N = 677; 480; 1,480). Baseline well-being levels were equivalent across all six samples. Students in both courses increased in their well-being from baseline to follow-up in all three samples (p < .001); however, at follow-up, students in The Science of Well-Being course had higher subjective well-being than the control course (sample 1: r = .18, d = .37, p < .001; sample 2: r = .21, d = .43, p < .001; sample 3: r = .19, d = .38, p < .001). Overall, across three samples, we found that students who completed either of these online psychology courses increased in their well-being--but that students in The Science of Well-Being course showed greater improvement. These findings suggest that large free online courses that teach evidence-based approaches to well-being could positively impact mental health at large scales.

Benefits of a College STEM Faculty Development Initiative: Instructors Report Increased and Sustained Implementation of Research-Based Instructional Strategies.

The Summer Institutes on Scientific Teaching (SI) is a faculty development workshop in which science, technology, engineering, and mathematics (STEM) instructors, particularly from biology, are trained in the Scientific Teaching (ST) pedagogy. While participants have generally reported positive experiences, we aimed to assess how the SI affected participants' teaching practices. Building on a previously developed taxonomy of ST practices, we surveyed SI participants from the 2004-2014 SI classes regarding specific ST practices. Participants' self-reported use and implementation of ST practices increased immediately after SI attendance as well as over a longer time frame, suggesting that implementation persisted and even increased with time. However, instructors reported implementation gains for some practices more than others. The practices with the highest gains were engaging students in their own learning, using learning goals in course design, employing formative assessment, developing overarching course learning goals, representing science as a process, and facilitating group discussion activities. We propose that the ST practices showing the greatest gains may serve as beneficial focal points for professional development programs, while practices with smaller gains may require modified dissemination approaches or support structures.

Supports: A Key Factor in Faculty Implementation of Evidence-Based Teaching.

Evidence-based teaching (EBT), such as active learning and formative assessment, benefits student learning but is not present in many college science classrooms. The choices faculty make about how to teach their science courses are influenced by their personal beliefs and motivations, as well as their departmental structures and institutional cultures. With data from 584 science, technology, engineering, and mathematics (STEM) faculty trained in EBT, we compare which of the following factors most relate to faculty's use of EBT: 1) faculty's personal motivations (e.g., teaching value, confidence, beliefs about intelligence); and 2) their experiences with their institutional teaching environments (e.g., departmental support, student enthusiasm). Faculty's perceived supports in their teaching environments (e.g., having supportive colleagues, being able to access curricular resources) were by far most predictive of their use of EBT. Faculty's personal motivations had little to no relationship when supports were included in these models. The effects were robust, even when controlling for faculty gender, minority status, and teaching experience. Much of the literature has focused on perceived barriers to EBT implementation (e.g., lack of time, constrained teaching space). The current data indicate that a focus on building supports for faculty may have the greatest impact on increasing the presence of EBT in college STEM courses.

Perceived supports and evidence-based teaching in college STEM.

BACKGROUND: Evidence-based teaching, such as active learning, is associated with increases in student learning and engagement. Although many faculty are beginning to adopt innovative practices, traditional lecture-based teaching tends to dominate college science education. What are the factors associated with faculty's decision to incorporate evidence-based teaching? While there are known barriers that limit adoption of evidence-based practices in science classrooms (e.g., lack of time, student resistance), the present work reveals that instructors' perceptions of supports (e.g., access to teaching resources, encouragement from colleagues) shows a stronger relationship to instructors' use of evidence-based teaching. RESULTS: These results come from a uniquely large dataset of college science faculty and instructors from across the USA (n = 584), who received training in evidence-based teaching. Multiple linear regression analyses of the relationship among perceived supports, barriers, and reported implementation of evidence-based practices showed that instructors report greater implementation when they perceive more social, personal, and resource supports even when barriers are also indicated as present. CONCLUSION: Faculty's perceived supports, not perceived barriers, are most strongly related to their reported implementation of evidence-based teaching. These findings suggest relevant stakeholders devote increased attention identifying and building the factors that promote evidence-based teaching in addition to reducing what inhibits it.

Trust, Growth Mindset, and Student Commitment to Active Learning in a College Science Course.

There is growing consensus regarding the effectiveness of active-learning pedagogies in college science courses. Less is known about ways that student-level factors contribute to positive outcomes in these contexts. The present study examines students' (N = 245) trust in the instructor-defined as perceptions of their instructor's understanding, acceptance, and care-and students' attitudes toward learning within an anatomy and physiology course featuring active learning. Analyses indicate that student trust of instructor and students' views of their own intelligence are both associated with student commitment to, and engagement in, active learning. Student-reported trust of the instructor corresponded to final grade, while students' views of their own intelligence did not. In an active-learning context in which students are more fully engaged in the learning process, student trust of the instructor was an important contributor to desired student outcomes.