Medical Education Research

Resilience Mediates the Effect of Rumination by Mitigating Student Psychopathologies

Emily Babcock¹, Changiz Mohiyeddini, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Medical students face a heavy workload, which causes detrimental mental health effects. Rumination, the repetitive negative focus on one’s own distress, is associated with multiple psychopathological disorders, including anxiety and depression. Stressful academic environments exacerbate ruminative tendencies, diminishing performance by consuming cognitive resources. This study investigated whether resilience buffers the impact of rumination and decreases psychopathological symptoms.

METHODS
Using a survey-based cross-sectional design, OUWB medical students provided data on rumination, depression/anxiety/stress, resilience, and exam scores. Utilizing normative standard deviations for a primary outcome measure encompassing depression/anxiety/stress, considering a significance level of 0.05, and using a desired power of 0.95, the necessary sample size ranged between N = 111 individuals (Cohen's d = 0.3) and N = 79 individuals (Cohen's d = 0.35). Correlation, mediation analyses, and ANCOVA were employed.

RESULTS
82 medical students were recruited (53 female, 28 male) with no significant age differences between genders. Rumination, anxiety, stress, and depression were negatively correlated, while well-being and resilience were positively correlated, to AFCP 1 practical exam scores. Females reported higher anxiety levels (M = 1.78, SD = 0.61) than males (M = 1.54, SD = 0.57) (t(79) = 1.73, p = 0.44). In addition, females reported higher stress levels (M = 2.22, SD = 0.0.69) than males (M = 1.96, SD = 0.46) (t(79) = 1.77, p = 0.40).

CONCLUSIONS
Rumination, a maladaptive coping strategy, is negatively associated with anatomy practical exam performance and is positively linked to symptoms of depression, anxiety, and stress. Resilience, an adaptive mechanism, buffers the impact of rumination. These findings suggest the need for emotion regulation training for medical students to enhance their resilience, well-being, and academic performance. Females demonstrated increased ruminative tendencies, with correspondingly higher levels of stress and anxiety than males; gender-specific workshops tailored to individualized stressors are warranted.

View Poster

Characteristics, Policies, and Practices of Clinical Ethics Fellowship Programs

Amanda Bachand, B.S.¹, Ellen Fox, M.D.², Jason Adam Wasserman Ph.D.³

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Fox Consulting
³Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
While clinical ethics fellowship programs (CEFPs) are now commonplace in U.S. hospitals, recent research has revealed significant problems including a shortage of personnel who are appropriately trained to perform ethics consultation, lack of access to high quality training for ethics consultants, and lack of funding for clinical ethics training. Our goal was to accurately describe the characteristics, policies, and practices of existing CEFPs in the U.S. and Canada as well as the opinions of CEFP directors regarding program standards, accreditation, and funding through a robust questionnaire. This project aimed specifically to develop a cognitive interviewing protocol in order to refine the questionnaire that would be used to measure core constructs of fellowship programs.

METHODS
Comprehensive literature review of cognitive interviewing techniques was performed to create a standardized interview script. The interview script consisted of relevant questions to interrogate questionnaire clarity and meaning consistency. Interviews were scheduled with individuals who had backgrounds similar to the expected study participants but were not expected to participate.

RESULTS
Nine cognitive interviews were conducted using the interview script. Qualitative data regarding question content, structure, and clarity was transcribed during each interview. Common themes were then compiled and reviewed for iterative refinement of the questionnaire. The final survey included 12 Likert-style questions (two of which contained eight subparts each) and five open-ended questions assessing opinions about accreditation and funding of CEFPs.

CONCLUSIONS
The cognitive interview process in this study allowed for researchers to identify and correct misconceptions found within initial versions of the questionnaire. By ensuring that each survey question fulfilled its intended purpose, the finalized questionnaire form was best able to capture the array of characteristics, policies, and practices of CEFPs across the U.S. and Canada.

View Poster

Preclinical Medical Students’ Sleep Quality During Hybrid and Remote Learning Periods

Darshana Blaise, B.S.¹, Kara Sawarynski, Ph.D.², Dwayne Baxa, B.S.², Garrett Perozich, B.S.¹

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Medical students sleep ~6.5 hours daily, similar to the general population, but they experience
more sleep disturbances and daytime dysfunction which negatively affects sleep quality.
This study assesses how different teaching modalities impact preclinical students’ sleep quality
using data from hybrid versus remote learning periods of the COVID-19 pandemic. Identifying
relationships between sleep quality and teaching modalities may support interventions in medical
education to improve sleep.

METHODS
Data of total and consecutive low sleep days (<6 hours of sleep in a day) was analyzed from 27
OUWB preclinical students wearing FitBit Charge 2-4 watches during remote and learning
periods in Fall 2020 and Fall 2021, respectively.
This retrospective study used data collected from a larger Project MedWell study which assessed
biometric data as markers of psychological health and wellbeing. This overarching study
collected data from 54 participants; however, study participants who didn’t wear their FitBits for
≥60% of the study were excluded from analysis. Ultimately, data from 27 participants was
analyzed with ANOVA.

RESULTS
There was no significant difference in total low sleep days between preclinical students amidst
hybrid and remote learning.
However, results showed that preclinical students undergoing hybrid learning experienced
significantly more low sleep days occurring 3 and ≥5 days consecutively (p-value <0.001).
Additionally, M2s had significantly more 1 low sleep days than M1s (p-value 0.042), while M1s
had significantly more low sleep days than M2s across 3 and ≥5 days consecutively (p-values
0.032 and 0.012, respectively).

CONCLUSIONS
This study shows significantly more 3 and ≥5 consecutive low sleep days for students
undergoing hybrid learning compared to remote learning. There are no significant differences
regarding total low sleep days across hybrid and remote learning periods. This study would
benefit from larger participant pools. Research could be furthered by analyzing more sleep
quality metrics and learning periods.

View Poster

A Call for Sexual Violence Education

Melanie Ermler, B.S.¹, Madison Saunders, B.S.¹, Changiz Mohiyeddini, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
- Sexual violence is a pressing public health issue in the U.S., causing various medical impacts on survivors.2

- While multiple agencies have set standard-of-care guidelines for treating these survivors, practice falls short.1,3-4

- Education is proving useful in enhancing medical students’ approach to caring for those affected by sexual violence.1,4

METHODS
- Design: cross-sectional, survey-based methodology

- Procedure: N = 72 OUWB students were recruited via Qualtrics.

- Analytical Approach: To test the hypothesis, correlation analysis, multiple regression analysis, and analysis of covariance (ANCOVA) were utilized. The Bonferroni correction was applied to control for the effects of multiple testing.

RESULTS
Our results demonstrated that prior education on sexual violence is negatively associated with rape myth acceptance, prior education on sexual violence is positively associated with comfort in caring for survivors, and rape myth acceptance is negatively associated with comfort in caring for survivors. 61.4% was the average score on the 20 questions based on knowledge of standard of care and knowledge of medical complications after sexual violence. 100% of students answered that they believe that medical school curriculum should include elements specifically dedicated to educating students about sexual violence and intimate partner violence.

CONCLUSIONS
Our research identified knowledge gaps, negative attitudes towards sexual violence survivors, and a confidence deficit in providing care for patients who have experienced sexual violence. As we believe a medical school’s role is to train medical students able to feel comfortable caring for any type of patient or patient population, this indicates a need for curriculum enhancements in the OUWB medical education. Moreover, there’s a student demand for learning about this issue. Therefore, we advocate for training medical students in screening, caring for, and treating sexual violence survivors.

View Poster

Implementation of Self-Directed Learning in a Preclinical Respiratory Medical Course

Kaycee Fillmore, B.S.¹, Dwayne Baxa, Ph.D.², Inaya Hajj-Hussein, Ph.D.², Kyeorda Kemp, Ph.D.², Tai Metzger, B.S.¹, Merzia Subhan, B.S.¹, Virginia Uhley, R.D. ², Ph.D., Claudio Cortes, D.V.M., Ph.D. ²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Self-directed learning (SDL) is imperative to incorporate in the medical curriculum to develop lifelong learning skills. The Liaison Committee on Medical Education (LCME) defines four specific components of SDL that must be incorporated into medical education. Here, we created an SDL activity and evaluated whether this format of SDL aligns with the SDL components defined by the LCME using students’ evaluations and reflections.

METHODS
Participants were first-year medical students enrolled in the preclinical Respiratory course during the 2021/2022 winter semesters (N= 245). Using thematic analysis, we analyzed students’ evaluations and SDL reflections to determine student satisfaction and whether SDL aligns with the SDL components defined by the LCME, respectively.

RESULTS
Our reconciled data shows mixed results from students when asked if SDL enhanced their learning. Using a 5-point Likert scale (1=strongly disagree and 5=strongly agree), students in the 2021/2022 classes (N=250) answered with a mean=3.2 (STD=1.35). In order of frequency, the percent contributions of mentioned themes from the thematic analysis of students’ evaluations (N=245) were appreciation (35.5%), knowledge (27.7%), awareness (15.6%), other (14.4%), environment (4.5%), and confidence (2.3%). Our results in thematic analysis identified several “other” themes, which is the intended topic of a future project that will employ grounded theory analysis to further characterize finding.

CONCLUSIONS
We developed an SDL activity that aligns with the components of SDL as defined by the LCME as well as multiple predefined categories described previously, supporting the notion that SDL is imperative for medical students to master and practice as future physicians. We also identified several “other” themes not previously described, which will be further characterized in future work to better understand students’ use of SDL in medical education.

View Poster

Examining Inclusive Language in Clinical Narratives in Medical Biochemistry Textbooks to Model Equitable Patient-Centered Care in Preclinical Undergraduate Medical Education

Sarah M. George, B.A.¹, Min Young Kim, B.S.¹, Dr. Akshata R. Naik, Ph.D.³, Dr. Brianne E. Lewis, Ph.D.³

¹_{Oakland University William Beaumont School of Medicine, Rochester, MI
²Oakland University William Beaumont School of Medicine, Rochester, MI
³Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI
⁴Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
When healthcare professionals use biased or stigmatizing language to describe people or conditions, it can impact the quality of care or erode the patient-physician relationship. It is not clear where healthcare professionals acquire biased and stigmatizing language in practice. This study focuses on examining language in educational materials used in training of medical students. Specifically, medical biochemistry textbooks were examined as they are often a first exposure to clinical narratives and communication standards. The aim of this project is to investigate whether medical biochemistry textbooks, widely recommended in preclinical UME, model inclusive language communication in clinical narratives.

METHODS
To determine if educational materials follow inclusive writing guidelines, we conducted a modified document analysis on a sample of medical biochemistry textbooks when clinical scenarios were described. Three independent researchers separately reviewed the textbooks, coded the language using NVivo, and generated themes.

RESULTS
Our results show that medical biochemistry textbooks contain language which is not in alignment with the best practices for inclusive language. Our analysis mapped codes to two primary themes of language misalignment. The first theme, "clinical language" (n = 92), included the following codes: difficult patient, general negative descriptive language, patient as failure, and questioning patient credibility. The second primary theme, "identity-first labeling" (n = 251), included 21 codes.

CONCLUSIONS
This study provides early evidence that the language used in medical biochemistry textbooks to describe people and conditions is not in alignment with inclusive language recommendations. This can reinforce the way future healthcare professionals speak to and about their patients.

View Poster

Gender and Racial Disparities in Pediatric Orthopaedic Surgery Fellows: A Decade-Long Analysis

Naomi Haque¹, Mazen Zamzam¹, Imran Bitar¹, Ehab Saleh²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Orthopedic Surgery, Corewell Health William Beaumont University Hospital, Royal Oak, MI}

Background:
The Association of American Medical Colleges (AAMC) has noted a significant rise in diversity among medical student applicants, with notable increases in the number of underrepresented students. However, this trend has not been mirrored in the field of orthopedic trauma surgery, where the demographics of fellowship programs have seen limited progress in diversity. This study aims to assess the gender, racial, and ethnic composition of incoming orthopedic trauma surgery fellows over the past decade, providing a comprehensive analysis of trends in diversity within this specialized field.

Methods:
Data from 2013 to 2023 were gathered from the Graduate Medical Education Consensus, published in the Journal of the American Medical Association. This dataset included self-reported race and gender information of orthopedic trauma surgery fellows. The study focused on analyzing the demographic trends over the decade, categorizing race into groups: White, Black, Asian, Native Hawaiian/Pacific Islander, American Indian/Alaskan Native, Multiracial, and other/unknown.

Results:
The analysis included a total of 180 orthopedic trauma surgery fellows. Of these, 82.2% were male, 17.2% were female, and 0.56% did not report their gender. Racial and ethnic composition revealed 69.4% White fellows, 8.3% Asian, 1.7% Hispanic, 2.2% Black, 0% American Indian/Alaskan Native, 0% Native Hawaiian/Pacific Islander, 1.1% Multiracial, 5% Other, and 12.2% Unknown. These findings indicate a significant gender imbalance and underrepresentation of minority groups in orthopedic trauma fellowships.

Conclusion:
The study reveals a persistent lack of diversity among orthopedic trauma surgery fellows, with substantial underrepresentation of women and minority groups. Despite incremental progress, the demographics of orthopedic trauma fellows do not align with the broader trends in medical student diversity. These findings underscore the need for targeted diversity initiatives, mentorship programs, and institutional support to foster a more inclusive and representative workforce in orthopedic trauma, ultimately improving patient care and innovation in the field.

View Poster

Enhancing Reproductive Anatomy Education: A Comprehensive Approach Integrating Near-Peer and Reciprocal Peer Tutoring

Hope Hefferan¹, Emelie-jo Scheffler¹, Erin Mueller¹, Varna Taranikanti, M.D./Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, Michigan
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan}

INTRODUCTION
Traditional medical education presents significant challenges, requiring extensive information retention and advanced learning skills. This study aims to improve student outcomes in reproductive anatomy through innovative approaches. Specifically, it addresses challenges in reproductive anatomy education by integrating near-peer tutoring (NPT) and reciprocal peer tutoring (RPT). NPT pairs a tutor who is at least one year ahead in training with a tutee, while RPT involves students within the same training year alternating as tutors and tutees. This study evaluates the impact of these tutoring methods on motivation, self-efficacy, and long-term retention of anatomical structures among M2 students.

METHODS
The research employed a two-session tutoring approach. In the first session, two M3 students tutored twelve self-selected M2 students. In the second session, the same twelve M2 students tutored their peers. Three weeks later, a survey was administered to assess the M2 tutors’ experiences. Quantitative data analysis, using descriptive statistics, evaluated the results.

RESULTS
Findings indicate that both NPT and RPT positively influenced motivation, self-efficacy, and long-term retention. Participants reported high engagement with clinical faculty and improved competence in clinical interactions. Notably, no statistically significant difference was observed between the effectiveness of NPT and RPT, suggesting both methods may be equally beneficial in medical education.

CONCLUSIONS
This study contributes to the evolving landscape of medical education by demonstrating the benefits of integrating NPT and RPT. While offering valuable insights, its limitations include a small sample size and single-site design. Future research with larger, multi-site studies could further validate these findings, expanding the applicability of peer tutoring in medical education.

View Poster

Etymological Dissection Approach to Learning Anatomical Terminology

David Howell, B.S.¹, Mallikarjuna Barremkala M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Medical students often struggle with anatomical terminology due to limited contact hours and exposure to Greek and Latin, leading to reliance on rote memorization. This approach hinders retention and comprehension, increasing the risk of medical errors. Etymology-based learning has been shown to enhance understanding and recall. This study evaluates the effectiveness of etymology modules as a supplemental learning tool and explores their potential integration into the medical school curriculum.

METHODS
First-year medical students from the Class of 2026 and 2027 (n = 126, 129) were provided with five optional, interactive Etymological Dissection Approach (EDA) modules, each with an embedded quiz aligned with the OUWB anatomy curriculum. Engagement was assessed based on completion rates and time spent on the modules. Survey responses provided feedback on module effectiveness and areas for improvement.

RESULTS
The total sample sizes for student engagement over the modules were n = 164 (2023–2024) and n = 71 (2024–2025). Median completion rates were 11.0% (Interquartile Range [IQR]: 3.0%–50.0%) and 15.0% (IQR: 4.0%–56.0%), with low median time spent per module (1.5 min, IQR: 0.17–6.64 min and 1.55 min, IQR: 0.19–7.07 min). Survey responses (n = 18) indicated that 82.3% of students reported improved comprehension, and 70.5% found the modules engaging, despite low participation. Notably, 72.2% of students had little to no prior exposure to Greek and Latin, which may have influenced engagement.

CONCLUSIONS
While EDA modules improved comprehension for engaged students, overall participation was low and highly variable. Many students did not progress beyond the first module, suggesting that EDA was viewed as supplementary rather than essential. Future efforts should focus on exploring curriculum integration and strategies to increase sustained engagement, such as expanding the modules to include embryology, pathology, and pre-course preparation.

View Poster

A Retrospective Pilot Study Assessing the Concordance between Referral Diagnoses, Referring physician Specialty, and EMG/NCV Results

Bodrul Islam, B.S.¹, Dr. Daniel Menkes, M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Corewell Health William Beaumont University Hospital, Royal Oak, MI}

INTRODUCTION
Electromyoneurography (EMG/NCV) objectively evaluates only large myelinated fibers. Nonetheless, EMG/NCV is often ordered for nonspecific symptoms such as pain. This study assessed the statistical association between a clinical diagnosis and EMG/NCV abnormalities. It also assessed the association between specialty and referring diagnosis.

METHODS
59 patient charts referred for EMG/NCV were retrospectively reviewed and characterized by an anatomical diagnosis or a symptomatic diagnosis. EMG/NCV results were then classified as confirmatory or non-confirmatory for anatomical diagnoses whereas symptom based diagnoses were assessed as having a normal or abnormal EMG/NCV. Referring providers were sub-grouped by specialty to determine diagnostic category, (anatomical or symptom-based), and its association with an EMG/NCV abnormality.

RESULTS
Patients with anatomical diagnoses were more likely to yield abnormal EMG results (p<0.01). Neuroscience specialists and orthopedic surgeons were also significantly more likely to submit anatomical diagnoses (p<0.01). However, no significant difference was found between provider specialty and the likelihood of an abnormal EMG/NCV.

CONCLUSIONS
Patients referred with an anatomical diagnosis were more likely to have an abnormal EMG/NCV. Orthopedic surgeons and neuroscience subspecialists were more likely to hypothesize an anatomic diagnosis but were not more likely to have an abnormal EMG/NCV. Symptom-based referrals rarely yielded abnormal EMG/NCV indicating its limited clinical utility in these patients.

View Poster

The Impact of Vaccine Recommendations from Physicians on the Pregnant Chaldean Community

Sylvia Kashat, B.S.¹, Nelia Afonso, M.D.^2,3

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI
³Corewell Health William Beaumont University Hospital, Royal Oak, MI}

INTRODUCTION
Vaccination skepticism and misinformation is at an all-time high. An important population to consider are pregnant women and their fetus. A subgroup that has been impacted by this is the Chaldean community. With a large part of the population being non-English speaking immigrants, the gap in patient-centered care is amplified. The objectives of this study are to determine the impact of education on vaccination during pregnancy to outcomes in vaccination rates.

METHODS
Participants were recruited through Facebook and completed an anonymous online survey. Pregnant Chaldean women between the ages of 19-40 years of age were included. The 32-item survey measured demographics, attitudes toward and importance, efficacy, and expected outcomes of vaccination as well as personal immunization status and intent to vaccinate their babies.

RESULTS
16 respondents (30.2%) do not plan on vaccinating their child after birth. For those planning to vaccinate, only 27 (50.9%) were willing to take physician recommendations on what vaccines to administer. When asked which vaccines the pregnant women received, the following was shown: 13 (24.5%) received the influenza vaccine, 21 (39.6%) received Tdap, and 18 (34%) received COVID-19 vaccination. When asked, only 26 (50%) of women felt as though they received enough information on vaccination during this pregnancy.

CONCLUSIONS
This is the first study to evaluate vaccination attitudes among pregnant Chaldean mothers. The results highlight the need for education on the importance of vaccination, for their own protection and the developing fetus. This information must be focused on when consulting Chaldean patients, as more education needs to be provided to foster a stronger physician-patient relationship that creates positive health outcomes to the mothers and their fetus.

View Poster

Impact of Team Based Learning on Student Response to Medical Uncertainty

Simon Keep, B.S.¹, Suzan ElSayed, Gustavo Patino, Pharm.D.³, Sarah Lerchenfeldt, Pharm.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI
³Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI}

INTRODUCTION
Healthcare providers frequently face situations involving making critical decisions despite the absence of well-defined answers. Although the importance of medical uncertainty is widely acknowledged, medical school students often lack formal training in managing such ambiguity. Team-Based Learning (TBL) clinical application exercises may offer a promising approach for teaching students how to recognize and respond to medical uncertainty. This study investigates whether TBL application exercises improve medical students’ ability to navigate uncertainty and develop effective strategies for managing challenging clinical decisions.

METHODS
Oakland University William Beaumont School of Medicine has used TBL as a core part of the pre-clerkship curriculum since its inception. A validated survey was distributed to all current medical students and alumni (all levels). The survey questions were designed to explore participants' perspectives on medical uncertainty and the effectiveness of TBL application exercises in helping students navigate uncertainty based on prior focus groups. Analyses utilized a combination of descriptive and inferential statistical methods to comprehensively evaluate responses and identify patterns across participant groups.

RESULTS
A total of 92 participants were included. All groups defined medical uncertainty similarly, but attendings were more likely than medical students to report a change in their understanding of medical uncertainty (p<0.0001). All participant groups reported that uncertainty was present at least sometimes in TBL application exercises. Most participants (45-70%) considered TBL clinical cases and complex exercises moderately to highly useful in developing an understanding of medical uncertainty. All the different characteristics of the application exercises were considered equally valuable for this purpose.

CONCLUSIONS
The findings highlight the utility of TBL in fostering understanding and engagement with medical uncertainty, particularly when exercises incorporate a certain level of complexity. Overall, TBL could be an effective approach for addressing medical uncertainty, with potential for further enhancement through explicit and structured discussions in educational exercises.

View Poster

Exploring Spirituality Rounds: A Reflective Inquiry Among Chaplains and Medical Students

Jessica Krone, B.S.¹, Kevin Hickey, M.S.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Medical schools aim to educate their students not only about clinical knowledge, but also about social factors that impact patient health. “Spirituality Rounds”, a half-day experience that third year medical students participate in during their Psychiatry clerkship, is a unique component of one medical school’s curriculum that gives medical students the opportunity to work alongside hospital chaplains and learn about the role of spiritual care in health care. The two main aims of this study are to explore the reflections and opinions of this experience from the perspective of (1) third-medical students and (2) hospital chaplains that lead Spirituality Rounds.

METHODS
An optional survey was sent out electronically to students who had completed the Spirituality Rounds experience, which asked open-ended questions about their experience. A 1-hour focus group was conducted with the four hospital chaplains who lead the experience.

RESULTS
From the student survey, three main themes were identified. Students thought that the experience (1) was useful for their future career by enabling them to feel more comfortable with conversations about religion and utilizing chaplains as a resource for patients, (2) taught them about the role of chaplains, and (3) allowed them to explore the connection between faith and medicine. From the chaplain focus group, main themes included that (1) students are engaged and eager to learn during the experience, (2) the experience is helpful in medical student education, and (3) evaluation of the experience, citing current strengths and minor changes to enhance the experience.

CONCLUSIONS
The Spirituality Rounds experience is a beneficial aspect of medical education, according to the opinions of medical students and chaplains. Further research is needed to further explore this notion, obtain objective data about the benefit of this experience, and evaluate the long-term impact the experience has on professional development.

View Poster

The Impact of Student-led Anatomy Mockticals on Performance and Learning in Medical School

Nikita Lee, B.S.¹, Jickssa Gemechu, Ph.D.², Stefanie Attardi, M.D.² Malli Barremkala, M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan}

INTRODUCTION
The concept of practice lab practical exams (PLPE) has long been known to improve the students' performance in health professions education. However, a novel approach to PLPE was introduced as mockticals (mock practicals). These mockticals differ from traditional PLPE as they are entirely student-led yet maintain the high-stress test-taking environment of a lab practical exam (LPE). This study aims to investigate the value of these mockticals on learning anatomy in medical school.

METHODS
A week before a midterm or final mocktical exam, each dissection group, consisting of 5-6 first year medical students (M1), contributes to the mocktical by tagging their donors for a total of 50 questions in the same format as a LPE. The M1s took four mockticals on iPads in the span of two anatomy courses. Each mocktical included three optional Likert scale questions that asked how prepared M1s felt for their upcoming lab exam. The iPad usage allowed for student responses and scores to be tracked and used for analysis.

RESULTS
Close to full attendance was observed from the M1 class (N=125) in each mocktical despite it being optional, thus showing the unique benefits of mockticals. A 2-sample t-test (N=90), showed that M1s who scored 70-89% on the mocktical exam had more preparedness than those who scores less than 70% (3-question Likert scale means scores of 6.8 vs 4.8; 7.3 vs 5.1 and 6.5 vs 5.0 respectively) which showed to be statistically significant (p-value <0.05).

CONCLUSIONS
The preliminary data analysis showed that increased perceived preparedness is positively correlated with higher mocktical scores. Further exploration is currently being conducted to examine correlations between the mocktical and practical exam scores. Additionally, this study will explore a more in-depth understanding of the value of mockticals with focus groups.

View Poster

Changes in Medical Students' Knowledge and Attitudes Toward Clinical Death After Teaching the Philosophy of Death

Nicholas Ludka, M.S.¹, Abram Brummett, Ph.D.², Jason Wasserman²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
The varied meanings of “death” within medicine are often a source of disagreement and frustration between physicians and surrogate decision-makers. We investigated whether teaching medical students about the irreducibly philosophical aspects of death would change their attitude towards surrogate decision-makers who assert non-standard views of death.

METHODS
This study centered on an 80-minute lecture covering philosophical debates surrounding medico-legal standards of death that was given to second-year medical students at Oakland University William Beaumont School of Medicine during neuroscience II. Participants completed a questionnaire containing Likert-scale and open-ended questions before and after the session. Knowledge about brain death was analyzed using McNemar tests, while attitude scores were compared with paired t-tests. Open-ended responses were narratively coded and categorized to identify emergent themes and used to elaborate quantitative findings.

RESULTS
Following the intervention, students expressed less frustration [χ ̅_(diff )= -0.64, 95% CI -0.15, -1.15], greater likelihood of accommodating ventilator removal [χ ̅_diff = 0.60, 95% CI 0.41, 0.85], and greater acceptance [χ ̅_diff = 0.63, 95% CI 0.28, 0.91] of surrogates who endorsed a whole-brain view of death. While students rated the high-brain view of death as more acceptable after watching the lecture [χ ̅_diff = 0.63, 95% CI 0.28, 0.91], they did not become more likely to remove the ventilator [χ ̅_diff = 0.19, 95% CI -0.30, 0.67]. Students were less likely to continue treatment for a brain-dead patient [χ ̅_diff = -0.61, 95% CI -0.91, -0.30] despite a lack of change in frustration [χ ̅_diff = -0.26, 95% CI 0.20, -0.70].

CONCLUSIONS
Second-year medical students lack understanding of the medico-legal standard of death. Increased awareness of the history, application, and philosophical debate over death aids in student reflection on their understanding and opinions of death. Our data supports educational interventions to prepare students for future interactions with diverse views on death.

View Poster

Assessing the Impact of Street Medicine Oakland on Medical Student Perceptions of Clinical Preparedness

Michael Marchiori, B.S.¹, Laura Ortiz, M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Corewell Health University Hospital Department of Emergency Medicine, Royal Oak, MI}

INTRODUCTION
Opportunities for in-field practice of clinical skills are typically sparse for medical students during their M1 and M2 didactic years. Medical students at Oakland University William Beaumont (OUWB) have the opportunity to volunteer with Street Medicine Oakland (SMO), an organization that provides medical care to patients experiencing homelessness at HOPE Shelter in Pontiac, MI. This volunteer opportunity provides students with exposure to medical care in a nontraditional setting as they practice clinical skills. This study aims to determine how SMO outreach impact student perceptions of clinical preparedness during their preclinical years.

METHODS
An online Qualtrics survey was distributed to SMO volunteers following HOPE Shelter outreach. The survey assessed student comfort levels in specific activities before and after participation in SMO outreach. Participants were asked to score their comfort levels on a Likert scale from 0-100, with 0 representing extremely uncomfortable and 100 representing extremely comfortable. Categories assessed included comfort taking a thorough HPI, completing a focused physical exam, formulating an assessment and plan, and presenting to a physician.

RESULTS
Surveys were distributed to 36 students after outreach with 11 volunteers responding (31% response rate). A paired t-test was utilized to analyze the mean change in comfort level across each domain assessed with a p value <0.05 used as the cutoff for statistical significance. Statistically significant increases in confidence were found in 11 of 14 categories.

CONCLUSIONS
These results support the hypothesis that volunteering with SMO improved student perceptions of their clinical preparedness. Providing medical students with opportunities to practice their clinical skills in a nontraditional medical setting leads to increased confidence in their bedside abilities.

View Poster

An Interactive Online Module to Improve Student’s Understanding of Female Pelvic Neurovasculature

Erin Mueller, B.S.¹, Renee Ringler, B.S.¹, Malli Barremkala, M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Human anatomy and cadaveric dissection remain an integral part of medical education. When combined with lectures, dissection guidance, and prosections, online learning tools have become the highest-ranked resource. As pelvic anatomy is challenging, creating new learning tools for pelvic anatomy and alternative dissection methods is a popular research topic. Progressive drawings of pelvic anatomy emphasizing a layered approach and tools depicting pelvic anatomy in hemisection improve understanding and performance.

METHODS
We created an interactive module with illustrations and donor images paired with a pelvic prosection to improve performance and confidence in pelvic anatomy. First-year medical students at OUWB were invited to participate. The module contains donor images, illustrations, and interactive tasks of pelvic neurovasculature in hemisection. This approach aimed to improve knowledge of pelvic anatomy and help bridge the gap between lecture material and donor structures. The unique display of donor images at various levels with illustrations allowed students to visualize the intricate anatomy of the pelvis. Integrating the module activities with a prosected donor aimed to help students develop a deeper understanding of the material and improve confidence.

RESULTS
Prior to utilizing the module, 77% of students rated their comfort with pelvic neurovasculature as uncomfortable or somewhat uncomfortable. Following module use, 100% of students reported that it effectively enhanced their comprehension of female pelvic anatomy and pathologies. Additionally, 92% of students strongly agreed that the module improved their ability to identify structures during practical exams. All students surveyed agreed that the module, when combined with pelvic prosection, enhanced their exam preparedness.

CONCLUSIONS
As the world expands its use of online resources, researchers must explore interactive online approaches to facilitate the development of online resources to improve anatomical understanding. This project shows the importance of connecting classroom learning to online resources to improve students' understanding of challenging anatomical concepts.

View Poster

Influence of Preclinical Curriculum on Medical Students’ Sleep Duration

Garrett Perozich, B.S.¹, Kara Sawarynski, Ph.D.², Dwayne Baxa, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Disturbances in an individual's sleep quantity and quality are known to alter their ability to encode, consolidate, and recall information. Students may attempt to maximize study time at the expense of their sleep, potentially harming the ability to maximize understanding of the material. This study aims to evaluate the relationship between the number of lecture hours (LH), number of mandatory lecture hours (MLH), and day of the week of assessments (DWA) on the weekly average sleep duration (WASD) of OUWB medical students to better understand the potential impact of these curricular components on sleep duration.

METHODS
FitBit fitness trackers were provided to 44 participating students in the OUWB classes of 2022 through 2025 to measure various biometric components, including nighttime sleep duration during the M1/M2 academic years. Average monthly sleep duration was calculated for students with FitBit sleep data for > 60% of nights over 4-week intervals, and statistical analysis was conducted to assess the association between LH, MLH, DWA, and changes in the WASD from each 4-week average.

RESULTS
In the M1 class of 2023, each additional LH was associated with a 28-second decrease in WASD (p=0.004), while in the M2 class of 2025, it was associated with a 70-second increase (p=0.045). Each hour increase in MLH was associated with an increase of 27 seconds in WASD for the M1 class of 2023 (p=0.045). There was no DWA that corresponded with a significant change in sleep duration across two or more classes.

CONCLUSIONS
This study found variable associations between LH, MLH, and WASD, suggesting that preclinical curricular demands may impact sleep duration inconsistently across the OUWB class years. Future research may benefit from increasing the number of participants and analyzing both additional curricular and non-curricular factors that may impact students’ sleep duration.

View Poster

Self-Reported Music Performance Anxiety and Interoceptive Accuracy in Collegiate-Aged Singers

Caroline Roberts, BMus¹, Drake Dantzler, DMA²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Oakland University School of Music, Theatre and Dance, Rochester, MI}

INTRODUCTION
Interoception is the representation of internal states within the human body, including processes by which one senses, interprets, integrates, and regulates internal signals. While anxiety has been associated with interoceptive accuracy (IA), research about performance anxiety in relation to IA has not been established. We predicted that singers who self-reported elevated performance anxiety would have better heartbeat perception compared to singers with low/average performance anxiety.

METHODS
In this cross-sectional study, participants (N = 36) from an undergraduate music background were recruited to complete a performance anxiety survey and cardiodynamic tests, consisting of heartbeat tracking for both 30 second and 1 minute intervals.

RESULTS
Contrary to our prediction, we found no significant relationship between overall performance anxiety and IA (p = 0.14 for 30 second interval, p = 0.83 for 1 minute interval). Participants with a resting heart rate of 80 beats per minute and higher had lower IA (p = 0.04), suggesting that differences in resting heart rate impact one’s ability to sense their heartbeat accurately. Participants who reported anxious apprehension interference during performances showed higher IA compared to other self-reported performance anxiety indicators (p = 0.035, r = -0.36). Three survey questions revealed significant differences relative to the groups of IA (high, average and low). These questions addressed dry mouth before a performance (p = 0.0073), parents’ encouragement to try new things (p = 0.034), and thoughts consistent with depression (p = 0.0424).

CONCLUSIONS
Our findings suggest that while interoception may influence emotional states, its direct relationship with performance anxiety may be more complex than previously hypothesized. The processes that lead to performance anxiety are multifactorial, and interoception does not necessarily contribute to them all, but it does have a relationship with some facets of performance anxiety.

View Poster

A Survey of Factors Affecting Students Ethical Attitude Toward Medical Disobedience

Quinn Simpson, B.S.¹, Jason Adam Wasserman, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
With increasing government involvement in medical practice, particularly after Roe v. Wade, physicians face ethical conflicts between patient care and legal restrictions. This study explores the influence of political ideology, religiosity, and participation in a Holocaust and Medicine program on ethical attitudes toward medical disobedience.

METHODS
Medical students at Oakland University William Beaumont School of Medicine were surveyed about political ideology, religiosity, and participation in a study trip to Auschwitz. Ethical attitude toward medical disobedience was assessed using hypothetical cases of physician disobedience. Multivariate regression was used to examine potential associations between religiosity, political ideology and study trip participation on attitude toward disobedience.

RESULTS
Responses from 44 students (21 males, 23 females) showed high internal reliability for religiosity (α = 0.873) and political ideology (α = 0.974), but low internal reliability for ethical disobedience (α = 0.126). Conservative political ideology was significantly negatively associated with ethical attitude toward disobedience on vignettes 1 (β=-.760; p<.001), 3 (β=-.435; p<.01), and 4 (β=-.690; p<.001), but significantly positively associated with ethical attitude toward disobedience on vignette 2 (β=.373; p<.05), while controlling for religiosity and study trip participation.

CONCLUSIONS
The vacillation of ethical attitude toward medical disobedience across case types illustrates that students do not have a principled view of disobedience. Rather, their ethical attitude toward disobedience appear highly situational and primarily influenced by political beliefs rather than consistent ethical principles. That is, students appear to support medical disobedience only when they agree substantively with the actor’s perceived ideology or motivations.

View Poster

Examining Medical Students’ Attitudes Towards Autism Spectrum Disorder

Chance Stevenson, B.S.¹, Changiz Mohiyeddini, Ph.D.², James Grogan Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Autism Spectrum Disorder (ASD) is a neurological and developmental disorder that affects how people interact, communicate, learn, and behave. With increasing prevalence, the need for medical care/knowledge for this population persists. There has been a variety of research demonstrating low general knowledge of ASD amongst medical students and dehumanizing attitudes towards individuals with ASD amongst non-autistic individuals. There is a lack of research regarding medical students’ attitudes on ASD, the impact of personality on attitudes towards ASD, and the attitudes towards the management of ASD. This study aims to identify student attitudes towards ASD, investigate the relationship between openness to experience from the Big Five Inventory (BFI), and improve medical student knowledge towards ASD and Applied Behavioral Analysis (ABA) Therapy.

METHODS
Consenting medical students at Oakland University were enrolled in a cross-sectional online Qualtrics survey. Survey components consisted of demographics, Marlowe-Crowne Social Desirability Short Form, Openness to experience (BFI), and survey components of attitudes towards ASD, knowledge towards ASD, and knowledge towards ABA therapy, measured via Likert Scale. The attitudes and knowledge components were completed in a pre-test and post-test format. Furthermore, an educational module regarding ASD and ABA therapy were included in between the pre-test and post-test to assess for improvements amongst participants. Data was analyzed via Microsoft Excel.

RESULTS
Assessing the impact of openness on attitudes towards ASD, scores were not statistically significant (p= 0.19), Pearson correlation coefficient (r) = -0.07. For the educational component, knowledge towards ASD was not improved in a statistically significant way (p=0.03), however 95% confidence intervals overlapped. ABA therapy knowledge improvement was statistically significant (p=0.0002).

CONCLUSIONS
Openness to experience was not related to attitudes towards ASD. The educational intervention did not demonstrate statistically significant improvements in knowledge towards ASD; however, it did demonstrate it for knowledge towards ABA therapy amongst participants.

View Poster