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| Transformation in Medical Education: A New Frontier for Behavioral Systems Analysis |
| Wednesday, November 15, 2017 |
| 8:00 AM–9:50 AM |
| Studio F, Niveau 2 |
| Area: CSS/OBM |
| CE Instructor: Ramona Houmanfar, Ph.D. |
| Chair: Ramona Houmanfar (University of Nevada, Reno) |
| Discussant: Maria E. Malott (Association for Behavior Analysis International) |
| Abstract: Through recent empirical work in behavioral systems analysis, behavior analysis is increasingly placing itself in a position to theorize effectively and test empirically educated guesses about the functioning of leadership decision making in organizations. Change in complex organizations such as medical schools is a challenging and lengthy process. In their role as guides, leaders create new verbal relations between the current and future state of the organization, and between the future organization and its niche in the future environment. On the other hand, by recognizing individuals' implicit responding and values, leaders can design and implement effective organizational contingencies that promote wellness and effective team dynamics. This symposium will outline the collaborative efforts of the School of Medicine and Behavior Analysis Program at the University of Nevada, Reno. Presentations will highlight the creation, and adoption of behavior analytic assessments and interventions throughout an organization-wide curricular restructuring at the School of Medicine. |
| Instruction Level: Intermediate |
| Keyword(s): behavioral systems, burnout, interprofessional communication |
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| Integrating a Behavior Analytic Framework into a School of Medicine's Strategic Planning Process |
| (Applied Research) |
| MELISSA PATRICIA PIASECKI (UNR Med), Carolyn Brayko (University of Nevada, Reno) |
| Abstract: In 2012, the University of Nevada, Reno School of Medicine (UNR Med) adopted a behavioral analytics framework to guide a number of change processes including curricular restructuring. Over the following few years, this framework was also applied to faculty development and the creation of a new office for continuous institutional assessment. In the context of significant state wide changes in medical education, we extended our behavioral analytical framework for strategic planning. Over the course of one year we applied an iterative approach to institution-wide strategic planning that relied upon data-based decision making and continuous feedback loops. The process produced a systemic plan to guide us through our next phase of development. The newly articulated direction of UNR Med will be actualized through both strong leadership and by engaging the entire school of medicine community. Re-evaluating institutional goals and objectives will facilitate UNR Meds effective interaction with larger metacontingencies of healthcare and medical education in the state of Nevada. |
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| Burnout of Medical Students: An Epidemic on the Rise |
| (Applied Research) |
| Thomas L. Schwenk (University of Nevada, Reno School of Medicine), MELISSA PATRICIA PIASECKI (UNR Med) |
| Abstract: Despite having seemingly greater access to medical and mental health care, as well as medical and behavioral knowledge, medical students and residents suffer from a higher prevalence of depression than do age-matched controls, and physicians have a higher risk of suicide than the general population. The prevalence of depression in medical students and residents appears to have increased over the last 20 years. The prevalence of burnout, a different but related construct to depression, is roughly 50% in all recent studies of medical students and physicians. Depression, if undiagnosed and untreated, is associated with cognitive dysfunction, loss of empathy, professional dysfunction and low esteem, and suicide risk. Burnout is associated with exhaustion, depersonalization, low professional satisfaction and unethical professional behaviors.These data areof great concernto medical educators,and are considered one of the major challenges facing medical education today. This concern is leading to new approaches to assessment, building resilience, eliminating the stigma of seeking diagnosis and treatment, and reducing adverse educational environments, requiring new tools for enhancing self-awareness, providing measurable feedback on behavioral changes, and developing new approaches to teaching. |
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| A Behavioral Systems Approach Toward Assessing and Alleviating Burnout Among Medical Students |
| (Applied Research) |
| ALISON SZARKO (University of Nevada, Reno), Ramona Houmanfar (University of Nevada, Reno), Nicole Jacobs (University of Nevada, Reno School of Medicine), Gregory Scott Smith (Chrysalis, Inc.; University of Nevada, Reno School of Medicine), Carolyn Brayko (University of Nevada, Reno), Mary Froehlich (University of Nevada, Reno School of Medicine) |
| Abstract: The rising epidemic of burnout among medical students has led to an increased interest in medical schools seeking curricular elements that can increase student resilience. Although wellness programs have been developed nationwide to address the needs of student’s mental health, stigmatization of seeking help and students’ compact schedules have led to consistently low rates of students actively taking advantage of the services provided. By using a curriculum-based intervention, all medical students are taught skills to prevent burnout and depression when the inevitable stressors set in. Understanding the implications of behavioral assessment tools (i.e. the Implicit Relational Assessment Procedures; IRAP) and the effects of behavioral interventions, such as, Acceptance and Commitment Training (ACTraining), are necessary steps toward the active prevention and understanding of burnout in a medical school setting. This presentation will discuss the development of modules teaching six essential components of ACTraining as a potential means of decreasing the likelihood of medical student burnout. A variation of the IRAP has been developed to specifically meet the needs of a medical school population. The variation of the IRAP and measures taken from it to assess burnout will also be discussed and explained from a behavior analytic perspective as a means of assessing the effectiveness of an ACTraining approach. |
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| An Interprofessional Approach to the Training and Assessment of Interprofessional Communication With Medical and Nursing Students |
| (Applied Research) |
| AMBER MARIE MARACCINI (Renown Health), Ramona Houmanfar (University of Nevada, Reno), Anthony Slonim (Renown Health), Melissa Patricia Piasecki (UNR Med) |
| Abstract: Preventable adverse events have been identified as the nation's third leading cause of death in the United States. Faulty teamwork and communication amongst healthcare providers has been identified as the root cause of such adverse events. To enhance teamwork, communication, andas a resultpatient safety, the incorporation of interprofessional education (IPE) into healthcare training has been advised. Introduced in June 2011, the I-PASS handoff bundle curriculum is one evidence-based technology currently used in IPE settings. Interprofessional teams who have completed the I-PASS handoff curriculum demonstrate improved communication, coordination, and leadership skills within groups. One component that remains missing, however, is the psychological training of individual values and perspective-taking skills. Within behavior analysis, a methodology known as ACTraining exists to address these psychological deficits. Given this information, the current study implemented a comprehensive IPE programbased on the I-PASS curriculum, ACTraining literature, and descriptive analytic measurement methodsinto a medical and nursing school. Behavioral assessment procedures (e.g., simulated patient handoffs) and measures related to interprofessional communication were taken before, during, and after exposure to the curriculum intervention. |
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