bluuebunny/crossref_metadata_2025_split huggingface dataset:
1112. #EducationInTheTimeofCOVID: Using Twitter to Disseminate Evidence-Based Medicine during a Pandemic
Authors: Coleman Caroline G , Daugherty Timothy T , Chung Yooree G , Xiao Angel X , Sherman Amy C , Axell-House Dierdre B , Weatherhead Jill E , Woc-Colburn Laila , Chida Natasha , Chida Natasha , Jennifer Spicer O 
Published: January 2021

Abstract

Background
The medical community has used Twitter as a learning tool during the COVID-19 pandemic to digest the high volume of rapidly evolving literature. However, Twitter contains educational content of varying quality and accuracy. To address this issue, we created and disseminated visual abstracts of COVID-19 literature on Twitter to educate health professionals.

Methods
Fellows and faculty members from multiple institutions collaborated with Emory University medical students to create visual abstracts of published COVID-19 literature (Figure 1). ID fellows and faculty identified and summarized 10-15 high-impact COVID-19 articles each week. Medical students created visual abstracts for each article, which fellows or faculty reviewed for accuracy. We disseminated them on Twitter (@JenniferSpicer4, 4,373 followers) and our website (Figure 2). We measured engagement with tweets using Twitter Analytics.
Figure 1: COVID-19 Visual Abstract Example

Figure 2: Website hosting COVID-19 weekly literature summaries and visual abstracts (https://med.emory.edu/departments/medicine/divisions/infectious-diseases/covid19-roundup/)

Results
Since March 2020, we have created, reviewed, and disseminated 139 graphics with 116 student authors and 33 fellow/faculty reviewers across three academic institutions (Table 1). Topics included public health & prevention, virology & basic science, epidemiology, transmission & infection control, clinical syndrome, diagnostics, therapeutics, vaccinology, and ethics & policy. Tweets had a median of 9,300 impressions (interquartile range [IQR] 5,432-13,233) with 766 engagements (IQR 432-1,288) and an engagement rate of 8.6% (IQR 7.1%-10.0%) (Table 2). Each tweet had a median of 25 retweets (IQR 17-38) and 55 likes (IQR 34-81). A few tweets had significantly higher metrics; maximum values were 84,257 impressions, 9,758 engagements, 19.0% engagement rate, 239 retweets, and 381 likes. In addition to disseminating graphics on Twitter, we received requests to use them as teaching aids from multiple health professionals worldwide, and the visual abstracts have been translated into Spanish and disseminated on Twitter and Instagram via @MEdSinFrontera.
Table 1: Descriptive Statistics of COVID-19 Visual Series

Table 2: Twitter Metrics for COVID-19 Visual Series (as of 6/10/2020)

Conclusion
Engagement rates with our visual abstracts were high, demonstrating the power of Twitter. ID educators can use visual abstracts to summarize and disseminate accurate information to a large audience on social media, which is especially important in the setting of an emerging infection.

Disclosures
All Authors: No reported disclosures
1114. Identifying and Addressing Knowledge Gaps in Influenza Management with Targeted Continuing Medical Education
Authors: Robinson Katie , Frederick Jennifer , Lester Kevin , Esgro Robert A 
Published: January 2021

Abstract

Background
Influenza represents a year-round disease burden. Despite CDC recommendations, providers do not always effectively test for and treat influenza. To address identified knowledge gaps regarding the care of patients with or at-risk for influenza infection, a series of continuing education (CE) initiatives were implemented for distinct specialty audiences, and the impact of the education on provider knowledge was measured.

Methods
Between July 2018 and June 2020, Vindico Medical Education provided 35 CME programs (19 web, 14 live, and 2 print) targeted primarily to any of 4 specialty audiences – ID specialists, pulmonologists, emergency medicine providers, or primary care providers (PCPs). Baseline knowledge and educational impact were assessed via pre-and post-test, respectively, across 3 primary topics – testing, mechanisms of therapeutic agents, and treatment.

Results
As of June 1, 2020, 39,677 healthcare providers participated in the education and 19,209 had obtained CE credit. Baseline knowledge was lowest regarding testing (44%) and antiviral mechanisms (43%), particularly among all but the pulmonology specialists. Average post-test scores were highest among pulmonology (85%) and primary care (85%) providers. The average relative increase in knowledge across all topics and specialties was 69%. A total of 17,480 providers who see on average 8.5 patients per month presenting with flu-like symptoms committed to practice improvements, resulting in approximately 150,000 patients per month who are more likely to receive the latest evidence-based care. Moreover, three months following the education, 68% of providers reported implementing practice improvements, including applying the latest clinical guidelines and recommendations.

Conclusion
As data regarding new options for the treatment of influenza continues to emerge, CE education on these topics will be needed. This study highlights the efficacy of multimodal CE to address knowledge gaps among providers who see patients with or at-risk for influenza infection.

Disclosures
All Authors: No reported disclosures
1115. A Longitudinal Medical Education Program for Infectious Diseases Fellows
Authors: Steinbrink Julie M , Burns Charles , Seidelman Jessica L , Maziarz Eileen K , Maziarz Eileen K , Criscione-Schreiber Lisa , Alspaugh J Andrew 
Published: January 2021

Abstract

Background
Many Infectious Diseases (ID) fellows express interest in the education of future learners, yet there is little opportunity to develop these skills during training. We designed an immersive program to develop the teaching skills of ID fellows. We report our initial experiences and plans for future directions.

Methods
ID fellows were recruited to participate in the program after their first year. Enrollees had no changes to their clinical/research requirements. Faculty provided initial guidance on teaching techniques and instructed fellows on how to create a curriculum for medical student ID clinical rotations. This curriculum consisted of weekly teaching sessions led by the fellows and formatted to the fellows’ discretion. Teaching session goals were to provide education on high-yield topics at an appropriate level and in a separate environment from where student grading would be assigned. Fellows received faculty feedback on their teaching in real-time by direct observation and learner feedback by anonymous student survey. An annual survey also assessed the fellows’ experiences. Outcomes of interest included an evaluation of baseline teaching skills, experience designing a curriculum, and confidence teaching over time.

Results
Since its inception in 2017, 7 fellows have participated in the program. Teaching sessions consisted of various formats: lecture, roundtable discussion, case-based, and remote virtual conferences. Education sessions were well-received by students (Figure 1).
86% of enrollees reported only occasional lecturing experience prior to fellowship and requested additional training in design of an educational course (Table 1). After participation in the program, 57% rated their experience as better than expected and 100% agreed that fellow-led sessions should remain part of the rotation. After involvement, 57% reported strong interest in a career involving medical education.
Figure1

Table1

Conclusion
We developed a structured, longitudinal medical education program dedicated to improving fellows’ skills as academic teaching physicians. Thus far, it has been well received by ID fellows and students. The program is ongoing and continues to adapt to the fellows’ and learners’ needs as determined by routine quantitative and qualitative assessments.

Disclosures
All Authors: No reported disclosures
1116. AIMS-trained Residents Exhibit Specific Communication Skills in a Standardized Patient Model of Vaccine Hesitancy
Authors: Barton Shanna M , Calhoun Aaron W , Bohnert Carrie A , Multerer Sara , Statler Victoria A , Bryant Kristina A , Marshall Gary S 
Published: January 2021

Abstract

Background
Vaccine hesitancy (VH) is one of the top 10 threats to global public health. While VH is common among parents, there are no accepted best practices for counseling, and training in this area is not required in residency. Strategies are needed to help providers address VH in practice.

Methods
The AIMS (Announce, Inquire, Mirror, Secure) Method for Healthy Conversations is a structured communication strategy that attempts to build trust between provider and patient (or parent), inviting receptivity to healthcare recommendations. To assess whether relatively inexperienced providers exhibit AIMS behaviors after training, blinded pediatric residents were pseudo-randomized to receive either AIMS or control training. Subjects underwent pre- and post-training clinical encounters with blinded standardized patients (SPs) portraying vaccine-hesitant parents; encounters were video-recorded and assessed by 3 blinded raters using the Vaccine Hesitancy Communication Assessment (VHCA) tool, which was developed by an iterative process and validated in pilot testing. Subject confidence was assessed pre- and post-training.

Results
Overall VHCA intraclass correlation was 0.273 for pre and 0.681 for post encounters (2-way mixed averages); reliability varied with AIMS phases. Fifty-eight subjects completed the protocol, and VHCA ratings for 29 subjects were available for this analysis. AIMS behaviors were more commonly detected among AIMS-trained subjects than control (median change in score [scale 0–30]=4.5 versus 0 for control) (Figure 1). Confidence improved in both groups (Figure 2). SPs perceived no differences between groups, nor between pre and post within groups, in aspects of subject performance such as respect, empathy, and promotion of trust (P=0.936 [ANCOVA]; partial eta-squared 0.0).
Figure 1

Figure 2

Conclusion
Pediatric residents can be trained in AIMS behaviors, and an SP model of VH can be used to assess performance. AIMS training results in similar gains in self-confidence compared to control training. SP perceptions may be colored by their script, which in this case was to exhibit adamant vaccine refusal. Testing of AIMS training in longitudinal experimental scenarios and in real-world settings is warranted.

Disclosures
Kristina A. Bryant, MD, Pfizer (Research Grant or Support, Investigator on multi-center clinical trials) Gary S. Marshall, MD, GlaxoSmithKline (Consultant, Scientific Research Study Investigator)Merck (Consultant, Scientific Research Study Investigator)Pfizer (Consultant, Scientific Research Study Investigator)Sanofi Pasteur (Consultant, Grant/Research Support, Scientific Research Study Investigator, Honorarium for conference lecture)Seqirus (Consultant, Scientific Research Study Investigator)
1118. Development of a Curriculum for Internal Medicine Residents on Latent and Active Pulmonary TB: A Targeted Needs Assessment
Authors: Sherwood Kyla , Babik Jennifer M 
Published: January 2021

Abstract

Background
Internal medicine (IM) residents have previously been found to have significant knowledge and practice gaps in tuberculosis (TB) diagnosis, but it is unknown whether these gaps vary based on geography or TB incidence. San Francisco has the highest incidence of TB of any US city. UCSF IM residents encounter TB throughout their clinical training; however, the residency program does not have a dedicated TB curriculum. Following the Kern model of curriculum development, the aim of this project was to conduct a targeted needs assessment of UCSF IM residents regarding the need for and format of a TB curriculum.

Methods
An anonymous survey was sent to residents in February 2020 to assess their confidence in multiple domains in the diagnosis and management of latent and active pulmonary TB and gauge their preferences for the format and timing for delivery of a TB curriculum. All questions used a five-point Likert scale. Chi-squared test was used to compare confidence levels between interns and residents. The study received UCSF IRB approval.

Results
Seventy-five IM residents completed the survey (41% of residency; 32% interns and 68% residents). More than 50% of respondents reported that they were quite or extremely confident in only 1 of 14 domains assessed. Residents demonstrated significantly increased confidence compared to interns in only 4 of 14 domains. IM residents felt that a TB curriculum of a short video series, online videos interspersed with questions, or a house-staff handbook would be most useful, with more than 50% stating that these formats would be quite or extremely useful. While lectures and Powerpoint slides are common teaching methods, residents felt these formats were less useful. IM residents also felt they would be more likely to access a TB curriculum during ID elective or while caring for patients on wards and less likely on own time.

Conclusion
IM residents demonstrated lack of confidence in multiple domains in the diagnosis and management of latent and active pulmonary TB. Confidence did not markedly improve between interns and residents despite increased experience in a high TB incidence clinical setting, highlighting the need for a TB curriculum to address this gap. This curriculum should avoid lecture format and be integrated within relevant clinical time to maximize utility.

Disclosures
All Authors: No reported disclosures
1120. Impact of Training Residents to Improve HIV Screening in a Teaching Hospital in Mexico City
Authors: Guerrero-Torres Lorena , Núñez-Saavedra Isaac , Caro-Vega Yanink , Crabtree-Ramírez Brenda 
Published: January 2021

Abstract

Background
Among 230,000 people living with HIV in Mexico, 24% are unaware of their diagnosis, and half of newly diagnosed individuals are diagnosed with advanced disease. Early diagnosis is the goal to mitigate HIV epidemic. Missed opportunities may reflect a lack of clinicians’ consideration of HIV screening as part of routine medical care. We assessed whether an educational intervention on residents was effective to 1) improve the knowledge on HIV screening; 2) increase the rate of HIV tests requested in the hospitalization floor (HF) and the emergency department (ED); and 3) increase HIV diagnosis in HF and ED.

Methods
Internal Medicine and Surgery residents at a teaching hospital were invited to participate. The intervention occurred in August 2018 and consisted in 2 sessions on HIV screening with an expert. A questionnaire was applied before (BQ) and after (AQ) the intervention, which included HIV screening indications and clinical cases. The Institutional Review Board approved this study. Written informed consent was obtained from all participants. BQ and AQ scores were compared with a paired t-test. To evaluate the effect on HIV test rate in the HF and ED, an interrupted time series analysis was performed. Daily rates of tests were obtained from September 2016 to August 2019 and plotted along time. Restricted cubic splines (RCS) were used to model temporal trends. HIV diagnosis in HF and ED pre- and post-intervention were compared with a Fisher’s exact test. A p&lt; 0.05 was considered significant.

Results
Among 104 residents, 57 participated and completed both questionnaires. BQ score was 79/100 (SD±12) and AQ was 85/100 (SD±8), p&lt; .004. Time series of HIV testing had apparent temporal trends (Fig 1). HIV test rate in the HF increased (7.3 vs 11.1 per 100 episodes) and decreased in the ED (2.6 vs 2.3 per 100 episodes). HIV diagnosis increased in the HF, from 0/1079 (0%) pre-intervention to 5/894 (0.6%) post-intervention (p&lt; .018) (Table 1).
Fig 1. HIV test rates. Gray area represents post-intervention period.

Table 1. Description of episodes, HIV tests and rates pre- and post-intervention in the Emergency Department and Hospitalization Floor.

Conclusion
A feasible educational intervention improved residents’ knowledge on HIV screening, achieved maintenance of a constant rate of HIV testing in the HF and increased the number of HIV diagnosis in the HF. However, these results were not observed in the ED, where administrative barriers and work overload could hinder HIV screening.

Disclosures
All Authors: No reported disclosures
1121. Implementation and Evaluation of a Virtual Microbiology Laboratory for Pharmacy Students
Authors: Gruenberg Katherine , Trinh Trang D , Joyce Elizabeth , MacDougall Conan 
Published: January 2021

Abstract

Background
Health professions students learn microbiology concepts during in-person laboratories (labs). While highly rated by students, labs are extremely resource- and time-intensive. A virtual lab may minimize resource use while maintaining educational value. We report on the implementation and evaluation of a virtual lab designed to teach clinical microbiology to pharmacy students during an infectious diseases course.

Methods
We created a video in our clinical microbiology lab to depict the steps involved in processing and analyzing a patient sample. We also designed 2 web-based, interactive modules for students to practice lab techniques, such as virtually streaking an agar plate. Students viewed the video and completed the modules prior to attending a 2-hour in-person, case-based, small group discussion on higher-order clinical microbiology concepts. All students were invited to complete a post-session evaluation that assessed achievement of session objectives.

Results
Sixty-nine students (65%) completed the survey. Students highly rated the video, modules, and in-class cases (Table 1). Fewer students felt confident explaining the clinical microbiology process, compared to selecting antibiotics, interpreting cultures, explaining Gram stains, and interpreting an antibiogram (Table 2). Student comments highlighted the value of the video, modules, and instructor facilitation during the in-class session. Students also suggested improvements with the module user interface and reinforcement of certain topics (e.g. clinical breakpoints) during the in-class session.
Table 1: Student Ratings of the Quality of Instructional Materials

Table 2: Student Self-Reported Agreement with Achievement of Session Objectives

Conclusion
We demonstrated successful implementation a virtual microbiology lab within a pharmacy course. Overall student ratings of materials were favorable. We plan to refine and re-offer the virtual micro lab next year and measure its association with student performance. To facilitate the adaptation of this virtual lab by other schools, our teaching materials are available for use via https://vimeo.com/390087512 (video) and http://tiny.ucsf.edu/atlas (modules).

Disclosures
All Authors: No reported disclosures
1122. Improving Knowledge of Infectious Disease Fellows Regarding Infection Prevention & Antibiotic Stewardship Using a Multi-Faceted Approach
Authors: Mohajer Mayar Al , Pipkins Takei , Atmar Robert , Barradas Maria Rodriguez- , Young Edward , Giordano Thomas Giordano , Kulkarni Prathit , Serpa Jose 
Published: January 2021

Abstract

Background
Infection prevention and antibiotic stewardship are critical to the safe and effective delivery of patient care. The primary objective of this fellowship rotation is to train infectious diseases fellows to develop key competencies in the fields of infection prevention and antibiotic stewardship.

Methods
We implemented an infection prevention and antibiotic stewardship rotation for the first-year infectious disease fellows starting July 2017. This new one-month rotation included several lectures by infectious diseases physicians, infection preventionists and pharmacists. Fellows rounded with infection preventionists (isolation, device, environmental, and endoscopy rounds) and participated in infection control subcommittees (CLABSI, CAUTI, Clostridioides difficile colitis and surgical site infections). Fellows were required to present infection control data and develop a proposal for a quality improvement project using the Define, Measure, Analyze, Improve and Control (DMAIC) method. Knowledge was evaluated through a 25 item questionnaire administered before (pre) and after (post) rotation. Topics included definitions, surveillance, isolation, preventive methods, outbreak investigation, policies, antibiotic stewardship, healthcare economics, and leadership.

Results
Sixteen fellows have participated in the rotation (2017-2019); all completed the pre- and post- evaluations (same questionnaire). Fellows answered a mean of 11.1/25 questions correctly pre-course (SD 2.3). Scores improved significantly to a mean of 21.2/25 correct answers at the end of the course (SD 2.6, P&lt; 0.001). All fellows presented quality improvement proposals at the end of the rotation, with a mean score of 85.7% (SD 4.6). The fellows were highly satisfied with the course with mean evaluation score 6.2/7 (88.5%).

Conclusion
The one month duration infection control and antibiotic stewardship rotation that provides basic training in the field at the beginning of the fellowship led to significant improvement in the fellows’ knowledge, and was very well received. An additional track has been implemented during the second year to prepare interested fellows for careers in infection control and/or antibiotic stewardship.

Disclosures
All Authors: No reported disclosures
1123. Improving Quality Improvement: Increasing QI Competency in Internal Medicine Subspecialty Fellows
Authors: Subramanian Praveen , Kubat Ryan , Clough Lisa , Newman Jessica 
Published: January 2021

Abstract

Background
Medical errors contribute to 44,000 – 98,000 deaths annually, which can result in total national costs upwards of 17-29 billion dollars. The Institute of Medicine suggests the application of QI as on of its five core competencies for all health care providers. ACGME has recognized the importance of QI curriculum in the training of both residents and fellows. To date, most QI curriculums focus on participation rather than application proficiency. A review performed by ACGME found that participants appeared to have a limited understanding of QI even after partaking in QI curricula. An activity that emphasizes practical application and meets the time constraints of residents and fellows would prove more beneficial than standard approaches.

Methods
This study included 13 ID, Allergy and Immunology, and Endocrine fellows from the University of Kansas Medical Center. Utilizing a QIKAT-R assessment tool, fellows were given 3 cases for which they had to develop a QI project. The assessment was made based on the ability to make an aim, find a measurable outcome or process that could easily be tabulated, and propose a change that could be tested. Following this, a 1-hour power point presentation which included active learning prompts in developing a QI project was given to the fellows. At the conclusion of the presentation, 3 additional cases were given to the fellows. Their ability to develop a QI project was again evaluated using the QIKAT-R assessment tool. At the end of the session a 5-question satisfaction survey was completed. As a group mean, scores prior to the 1-hour presentation were compared to those afterwards. A paired, single-tail, t-test was utilized to obtain a p-value in order to determine significance of change.

Results
In total, there was a 42.2% (p=0.00001) increase in total QIKAT-R score after “QI Power Hour.” 92.3% of participants had a positive perception (Agree/Strongly Agree) of the 1-hour session.

Conclusion
The findings suggest that fellows are able to show a higher proficiency in QI understanding as well as development of future QI projects. Fellows satisfaction of “QI Power Hour” was overall favorable. This study shows that it is possible to easily integrate QI understanding for practical application into the time constraints of a fellowship or residency curriculum.

Disclosures
All Authors: No reported disclosures