• Building a Medical App: Approach, Infrastructure, and Challenges of Developing a Congenital Heart Defects App for Educational Purposes

      Stoker, Alexander; The University of Arizona College of Medicine - Phoenix; Richardson, Randy (The University of Arizona., 2016-03-25)
      Mobile software application (apps) have exploded in popularity since 2008, when Apple’s App Store opened and have become increasingly present in medical education and medical practice. As evidence of educators realizing the potential apps have for educating students, the University of Arizona has created a department called the Office of Instruction and Assessment (OIA), which has a programming team that is committed to assisting faculty in the design, development and implementation of apps for University of Arizona Students. Congenital heart defects are the most common type of birth defect in the United States, affecting nearly 1% of, or about 40,000, births per year. There are complex three‐dimensional relationships involved in many of the congenital heart defects that may be difficult for students to fully understand through the traditional method of reading and looking at two‐dimensional diagrams. The principle goal of this project was to participate in the design and development of an educational mobile app that allows the user to interactively rotate digital 3D models of hearts with congenital heart defects. Multiple approaches to developing an educational medical app were explored including utilizing basic app‐building programs that do not require computer coding or programming, paying a for‐profit company to develop an app, and collaborating with a larger educational institution that has the resources available for developing an app and has a potential use for the app. This thesis aims to describe the resources available to develop an educational app, the major factors that determine the best approach for app development and the challenges associated with each approach. Through the case example of developing “Heart Defects” with the Office of Instruction and Assessment at the University of Arizona and publishing the app on the Apple App Store it was determined that the major factors guiding the approach to app development are complexity of the app, computer programming experience of the individual planning to develop an app, and having access to a larger institution with the ability to develop apps and the institution having a perceived benefit from developing the app.
    • Effectiveness and Student Perception of Simulated Case Based Learning in a Pre Clinical Medical Education

      Weed, Michael; The University of Arizona College of Medicine - Phoenix; Savi, Christine (The University of Arizona., 2016-03-25)
      Over the past decade, patient simulation has become an important teaching tool in allopathic medical education. Initially, medical simulation was used exclusively in the clinical years of medical training, but implementation into pre‐clinical curriculum is becoming increasingly common. Because simulated teaching experiences are a relatively new practice in pre‐clinical medical education, little is known about their value in this setting. We hypothesize that high‐fidelity patient simulation is an effective method of teaching basic medical sciences during the pre‐clinical years and that it will be viewed favorably by students when compared to other established teaching modalities. The purpose of our study is to: (1) test for an effect of teaching method on test score performance by comparing the results of relevant test items given to two student groups: a simulation group and a traditional case‐based instruction group; (2) determine student perception of simulation as a learning method for basic medical sciences. Methods: A one tier, mixed methods design was used to sequence this study. Test item scores were obtained from the classes of 2015 and 2016 at the University of Arizona College of Medicine ‐ Phoenix and results were analyzed using descriptive statistics to compare means and item difficulty. A Fisher’s exact test was conducted to compare test item performance between students who did and did not use simulation in their case‐based instruction group. Presimulation and post‐simulation surveys were also administered and thematic extraction used to triangulate results to quantitative findings. Results: There was no significant difference between performance of the simulation (n=48) and non‐simulation (n=79) group on the three test items. Survey results from this particular study indicate that students do enjoy learning in the simulated case‐based environment and that they find it to be intellectually stimulating. They also believe simulation will be useful in their careers. They do not, however, believe that it is as effective at teaching basic medical sciences when compared to the traditional lecture hall setting. Students also find simulation learning to be more stressful than small group learning. Conclusion: Our findings suggest that students who learn material through simulated case instruction perform as well as their counterparts who learn the material in traditional small group non‐simulated settings. However, our survey data suggests that while student perception of simulation is positive overall, there are instances in which simulation is viewed less favorably than both small group and traditional lecture environments. When analyzed together, the test item performance and survey findings show that while simulation can be an effective teaching tool in pre‐clinical medical education, there was not a significant difference when compared to lecture hall and non‐ simulated small group learning settings.
    • “It’s About Heart”: A Qualitative Study of Rural Family Physician Training Needs.

      Varner, Samantha; The University of Arizona College of Medicine - Phoenix; Brown, Steven (The University of Arizona., 2016-04)
      Efforts to reduce a chronic physician shortage and meet the needs of rural communities face long standing challenges such as physician recruitment and retention. While these topics have been researched at length, issues surrounding the contribution of training specifically geared toward the needs of the Southwest’s rural communities are not well understood. The goal of this investigation is to discuss with rural family physicians the realities of rural practice and to determine what, if any, skills and competencies are specific to rural family practice and that, if addressed in training, would increase the number of students and residents pursuing rural family medicine and increase the number of physicians in rural areas. Methods: Physicians throughout rural areas in the Southwest meeting the role of thought leader were interviewed. Chain sampling was used to generate diversity of ideas. Interviews were conducted in person or by phone using a semi‐structured format and a topic guide. Participants were asked to discuss what skills they feel are important to a successful practice in a rural community, the degree to which the competencies were covered in their residency training, and how having or not having these skills might affect job satisfaction and retention. Interviews were recorded and transcribed. Transcripts were analyzed by a two person committee for repeating themes. Results: Seven major repeating themes were evident in the data. Of these residency training type, individual resilience, comfort with lack of resources, community were some of the most common and important to participants. Conclusion: This study has shown that the challenges to recruitment and retention of family physicians in rural areas are many and complex. These results combined with the extensive literature studying successful recruitment and retention programs demonstrates the enormous potential that exists in a multifactorial approach to rural recruitment and retention to meet the tremendous need for more family physicians in rural areas.