Teaching in the "New Normal": Using an Evidence-Based Process to Determine Should It Stay or Should It Go (SISoSIG).

After pivoting to emergency remote instruction due to the COVID-19 pandemic, medical educators have added new techniques to their toolbox. As we welcome a "new normal," we may be able to teach even more effectively than we did before by adapting some of these techniques. This paper provides an evidence-based decision-making process for faculty to consider what should stay and what should go as they revise and enhance instruction from one semester to another. The SISoSIG process provides opportunities to reflect on lessons learned and discuss how to build on that learning to become even more effective practitioners.

Evidence-Based Guidelines for Recording Slide-Based Lectures.

Pre-recorded lectures can be an efficient way to convey instructional content to students in distributed environments, but videos that are not of high quality can potentially reduce student engagement. These guidelines are designed to help faculty and staff prepare and develop effective recorded lectures using presentation software such as PowerPoint and Google Slides. The guidelines are evidence-based and represent best practices for the use of media in education. Effective creation of pre-recorded lectures with presentation software is not an easy process, but the time and effort invested will generate a valuable resource.

It's a matter of trust: exploring the basis of program directors' decisions about whether to trust a resident to care for a loved one.

There has been increased attention to and emphasis on competency-based medical education and the transformation from highly supervised medical students towards independent, entrustable physicians. We explored how program directors (PDs) justify decisions about whether they would trust finishing Post Graduate Year 1 (PGY1) residents to care for the PD or a loved one. Using an end of year survey with validity evidence, we assessed PDs' responses (Yes, No, Not Sure) and written comments about this entrustment decision for USUHS medical students from graduating classes of 2013-2015 (PGY1). We performed a qualitative inductive content analysis to identify themes in how PDs justified their decisions as well as descriptive statistics and a contingency table analysis to examine associations between trust decisions and election to membership in Alpha Omega Alpha (AOA), or conversely, referral to the Student Promotions Committee (SPC) for remediation. Qualitative analyses revealed five themes related to this trust decision about medical residents: personal, interpersonal, knowledge, competence, and developmental. Neither AOA status, nor SPC referral status was significantly associated with the trust measure, overall, but positive trust decisions were significantly higher among those elected to AOA than in those who were not. Positive trust decisions were significantly associated with AOA status but negative trust decisions were not significantly associated with referral to the SPC. This study offers insights into what attributes may underpin trust decisions by PDs. Our findings suggest that PDs' frequent use of personal and interpersonal characteristics to justify trust decisions contrasts with the use of clinical and knowledge based assessments during undergraduate medical education (UME), and emphasize the importance of critical intrinsic abilities.

Can blended classroom and distributed learning approaches be used to teach medical students how to initiate behavior change counseling during a clinical clerkship?

Medical school curricula often provide insufficient time and instruction for health behavior change counseling. We examined the feasibility of blending classroom and distributed learning experiences to teach medical students how to initiate health behavior change counseling and analyzed the impact of this approach on their attitudes, knowledge, and skills. Usage patterns and pre- to post-class attitude and knowledge changes were assessed with self-report questions among 153 third year family medicine clerkship students. Most students viewed at least 90% of the online written content and took an average of 41 min (SD = 24 min 35 s) to view all of the content. Students' confidence in their ability to help patients change unhealthy behaviors significantly improved (p < .01). The blended learning curriculum facilitated learning of behavior change skills, encouraged interaction with course materials, and improved medical students' self confidence for using health behavior change skills.

Mild traumatic brain injury: a survey of perceived knowledge and learning preferences of military and civilian nurses.

Early case recognition and intervention by nurses for patients with mild traumatic brain injury (mTBI) can significantly improve outcomes for civilian and military patients. The "Concussion/mTBI Learning Needs Assessment for Registered Nurses Survey" was developed to evaluate bedside nurses' knowledge related to the assessment and care of patients with mTBI as well as their preferences for learning in order to develop a targeted curriculum. An anonymous, self-administered, Web-based survey was available from February to August 2009. A series of invitational e-mails were sent to nurses at a convenience sample of civilian, federal, and military institutions. A total of 1,224 nurses meeting the inclusion criteria of being bedside care providers and nonadvanced practice responded and were included in the analysis (civilian, n = 731; military, n = 494). Most respondents (91.3%) considered knowledge of mTBI to be important or very important to their practice, and 44.5% saw mTBI patients at least monthly. Despite this perception of importance and exposure to the patients, nurses' self-reported knowledge levels were very low. Overall, 39.8% expressed a high knowledge level (score of 4 [a lot] or 5 [expert] on a 1-5 scale) of the causes of mTBI. Fewer than 25% expressed high knowledge level in the skills needed for the identification and assessment of mTBI patients, and less than 15% had high knowledge in the treatment and prognosis of these patients. The nurses' preferred learning method was shadowing another provider (37%), but the most often used method was Internet searches (80.3%). There was minimal difference between military and civilian nurses. Although nurses recognize the importance of familiarity with mTBI for their practice and most clearly self-identify knowledge deficits in all aspects of care of the mTBI patients, a broad but succinct curriculum for the nonadvanced practice bedside nurse could provide a cost-effective, quickly accessible way to provide the needed education.