bluuebunny/crossref_metadata_2025_split huggingface dataset:
749. Interactive Technologies for Preventing HIV in Title X Clinics in Metropolitan Atlanta
Authors: Aldredge Amalia , Er Deja , Anderson Katherine M , Campos Ilse , Joseph Veronica , Kottke Melissa , Williams Peyton , Sullivan Sara , Brooks Michael W , Sales Jessica , Sheth Anandi N 
Published: November 2023

Abstract

Background
HIV prevention in women is imperative to end the HIV epidemic in the US. However, pre-exposure prophylaxis (PrEP) uptake in this population has been low, and innovative and feasible approaches are needed. The Title X Family Planning Program provides federal funding for sexual health services and HIV prevention to low income or uninsured individuals. We sought to increase PrEP awareness and reduce barriers to providing PrEP for women in Atlanta. We designed, implemented, and evaluated educational tools (trainings, resources, and technical assistance) for staff at Title X clinics on topics relevant for PrEP care for cisgender women.
Figure 1.
Comparison of pre- and post-training 5-point Likert scale evaluations of ability to meet training objectives for the Overview of PrEP and PrEP for Clinicians Trainings. Two-sample Satterthwaite t-tests comparing pre- and post-training scores were significantly different by individual objective, for each training, and overall (all p&lt;0.001).

Methods
We offered a menu of nine 30-60 minute in-person or virtual trainings (Overview of PrEP, PrEP care for clinicians, PrEP insurance navigation, long-acting PrEP, alternative PrEP delivery models, reporting PrEP metrics, taking a sexual history, STI management, and substance use screening) to staff from 29 Atlanta Title X clinics. We also offered technical assistance with consultation on PrEP implementation planning or any training topic, and patient- and provider-facing resources about PrEP tailored for cisgender women. We used two-sample Satterthwaite t-tests to compare pre- and post- training self-reported ability to meet training objectives by 5-point Likert scale.

Results
In the first year, we provided 15 trainings covering 3 topics to 279 individuals in 20 clinics. We delivered 7 “Overview of PrEP” trainings; participants were medical assistants (31%), nurses (12%), advance practice providers (APPs, 6%), and other (37%). We delivered 7 “PrEP Care for Clinicians” trainings; participants were APPs (20%), physicians (17%), nurses (15%) and other (37%). Staff had significantly higher Likert scores (Figure 1) for ability to meet training objectives after trainings, both overall and by individual objective (all p &lt; 0.001).

Conclusion
We provided guideline-based PrEP trainings tailored for cisgender women to a staff with diverse clinic roles from a wide-reaching network of Atlanta Title X clinics. Ability to meet training objectives substantially increased post-training. Next steps include evaluating program impact on HIV testing, PrEP counseling, and PrEP prescription among cisgender women in Atlanta.

Disclosures
Melissa Kottke, MD, MPH, MBA, HRA Pharma: Advisor/Consultant|Organon: Grant/Research Support
752. Development of an Outpatient Infectious Disease Rotation for Internal Medicine Residents at a Rural Academic Medical Center
Authors: Bryan Nicole , Fisher Melanie A 
Published: November 2023

Abstract

Background
Infectious disease (ID) training is essential to the education of internal medicine residents and has traditionally occurred on inpatient rotations focused on hospitalized patients. However, these rotations offer limited experience with infectious diseases managed in the outpatient setting. Furthermore, inpatient rotations expose residents to only one aspect of the multifaceted contributions ID specialists provide. Given the nationwide decline in ID providers, demonstrating the diverse career paths that can stem from ID training is a potential opportunity to attract trainees to this field. Developing interest in ID amongst residents is even more crucial in rural areas where the infectious disease provider shortage is severe. Here, we describe an ambulatory ID rotation for internal medicine residents at a rural academic medical center. We provide a model for a structured rotation with diverse learning opportunities for medical residents, and show the rotation has been received positively by those residents who have completed it to date.

Methods
We established an outpatient ID rotation to offer as an elective for internal medicine residents. The rotation consisted of working one-on-one with ID faculty in a variety of settings in 2 or 4 week rotation blocks. A schedule was provided to each resident. Anonymous evaluations of the rotation were obtained upon completion of each block and aggregated.

Results
There were a total of 11 internal medicine residents who participated in the ambulatory ID rotation from 7/1/2020 until 1/3/2023. Residents participated in a variety of clinical experiences, conferences, and didactics as summarized in Table 1. Each day of the rotation was divided into morning and afternoon clinics with conferences and didactics scheduled first thing in the morning or at noon. A sample rotation schedule is provided in Figure 1. Resident evaluations of the rotation were positive overall as summarized in Table 2.Figure 1.Example medical resident rotation schedule for outpatient ID elective rotation

Conclusion
We present a model for an ambulatory outpatient ID rotation consisting of a wide variety of educational and clinical opportunities that also provides a more comprehensive overview of different career paths within the ID specialty. Residents who have completed the rotation today have evaluated it favorably.

Disclosures
All Authors: No reported disclosures
753. Impact of a "Real-Time" Case-Based Infectious Disease Elective on Student and Preceptor Perceptions of Confidence with Entrustable Professional Activities
Authors: Cady Beth , Bourland Kendra 
Published: November 2023

Abstract

Background
Pharmacy students often struggle transitioning from the didactic to experiential setting, primarily due to the lack of live clinical interaction. A didactic infectious diseases case-based elective was designed to implement this concept (using volunteer preceptors) to create rotation-ready students. The purpose of this project is to evaluate the impact of patient cases on students’ ability to engage in professional, interdisciplinary interactions and to subsequently determine if the students’ perceptions correlate with the evaluation of their performance from volunteer preceptors.

Methods
Third-year pharmacy students were enrolled in the elective and presented with two infectious disease cases throughout the course. Cases required students to interact with an infectious disease pharmacist/resident volunteer acting in the role of an attending physician or microbiology lab technician. Students contacted team members daily (mimicking "rounds") as part of an infectious disease consult service. Students completed each case “in real time” and were tasked with updating the attending physician with appropriate changes to the antibiotic regimen as more information (ie-labs) became available . Volunteer preceptors were surveyed on specific student entrustable professional activities. Students were also asked to self-assess their confidence in these areas. Results from students vs preceptors were then compared.

Results
Of 47 students surveyed (over 2 course iterations), 100% of the students felt confident in their ability to engage professionally with other members of the healthcare team, make evidence-based recommendations, and research complex drug information questions using primary literature at the end of the course. Of 41 preceptors surveyed, &gt; 85% of preceptors felt confident in the students’ abilities to interact professionally, utilize primary literature to make evidence-based recommendations, and answer complex drug information questions.

Conclusion
Student engagement in simulation activities requiring interactions with other healthcare members and research into primary literature leads to confidence in performing essential interprofessional and clinical skills. Preceptor assessment of these skills was in agreement with what students perceived.

Disclosures
All Authors: No reported disclosures
769. HIV Pre- and Post-Exposure Prophylaxis (PrEP/PEP) knowledge increases between Academic Curricula in Dominican Republic' Medical Students: A cross-sectional survey.
Authors: Tapia Leandro , Lora Hector J , Bisono Garcia Bismarck S , Nunez Marcos , Paulino-Ramírez Robert 
Published: November 2023

Abstract

Background
HIV knowledge and prevention strategies, like PrEP/PEP is a core element in current medical practice but represents a challenge for medical students’ curricula. In countries like Dominican Republic (DR), the stigma towards HIV infection restricts the delivery of HIV related information to the general population. Our study aims to understand the level of knowledge between different academical years pose regarding HIV/AIDS, PrEP and PEP and how their curricula content is covered across the years.

Methods
We survey medical students in the DR to measure knowledge on HIV, PrEP/PEP. Students who agreed to participate filled in a survey with 3 sections. Each section had 10 true or false questions. Responses were compared mean knowledge for each topic based on a score out of 10. We analyzed mean scores using ANOVA with Post Hoc analysis, assuming significance when p&lt; 0.05.

Results
A total of 503 participants participated in the survey. ANOVA results showed that there was a statistically significant difference in mean HIV knowledge (F (3, 499) = [25,58], p&lt; 0.001) and PEP knowledge (F (3, 499) = [13,77], p&lt; 0.001) between the academical years. Post-hoc analysis revealed that MS4 had a higher mean score for HIV knowledge (M= 9.3) than MS2 (8.7, p&lt; 0.01) and MS1 (m= 8.2, p&lt; 0.01). Similarly, MS3 had a higher mean HIV knowledge than MS2 (p&lt; 0.01) and MS1 (p&lt; 0.01). Likewise, MS2 had an increased mean HIV knowledge when compared to MS1 (p&lt; 0.01). When we compare mean PEP knowledge, we found that MS3 (m= 7.45) had increased knowledge than MS1 (6.4, p&lt; 0.01) and MS2 (m= 6.9, p&lt; 0.05). Similarly, we found that MS4 had increased mean PEP Knowledge (m= 7.5) when compared to MS1 and MS2 (p&lt; 0.001). When we studied mean PrEP knowledge, ANOVA analysis found no significant difference (F (3, 499) = [1,24], p= 0.29).

Conclusion
Our study suggests that the mean knowledge of HIV and PEP increases throughout the academic progression of medical school. Although there is no difference in PEP knowledge, this may suggest that medical schools are teaching PEP during MS3-MS4 cycle rather than the M1-M2 cycle. Also, the homogenous mean PrEP knowledge could suggest that the students are learning from non-academic sources. This emphasizes the curricular designers of medical schools to review the contents on prevention of communicable diseases.

Disclosures
All Authors: No reported disclosures
770. HIV Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) knowledge among Medical Students in the Dominican Republic: Are we missing the role of Future Healthcare Provider in PrEP and PEP roll out?
Authors: Lora Hector J , Bisono Garcia Bismarck S , Tapia Leandro , Paulino-Ramírez Robert 
Published: November 2023

Abstract

Background
HIV prevention continues to be a care gap in developing countries, like Dominican Republic. The lack of sufficient programs for prescription and information of general populations are barriers for better control of HIV infection in this country. The knowledge of HIV prevention strategies such as Pre-Exposure Prophylaxis (PrEP) or Post-Exposure Prophylaxis (PEP) among medical professionals and medical students is unknown. The goal of ending HIV Pandemic by 2030 is to rely on prevention strategies.
Our study aims to determine the level of knowledge of medical students in a pre-preclinical cycle and in a clinical cycle regarding HIV/AIDS, PrEP and PEP

Methods
We survey medical students in the Dominican Republic to measure knowledge on HIV, PrEP/PEP. We compared mean knowledge for each topic based on a score out of 10. We analyzed mean scores by using T-Tests and ANOVA with Post Hoc or Tukey Analysis, assuming significance when p&lt; 0.05.

Results
A total of 503 students participated in the survey. ANOVA results showed that there was a statistically significant difference in mean knowledge scores for HIV, PEP, and PrEP (F (2, 1506) = [196.6], p &lt; 0.001). Post hoc analysis revealed that medical students had a higher mean score for HIV knowledge (M= 8.9) than mean scores for PrEP (M= 7.6, p&lt; 0.01) and PEP (M= 7.1, p&lt; 0.01). Similarly, the difference in knowledge scores for PrEP was significantly higher than for PEP (p&lt; 0.01). We further divided participants into Preclinical Years and Clinical years and found that participants within the Clinical Years of Med School had a significantly increased mean PEP knowledge (m= 7.5) than Preclinical Years participants (m= 6.7) (t (460) = 5.8, p&lt; 0.001). Similar results were not appreciated with PrEP, where Clinical year participants had a non-significant increased mean knowledge (m=7.8) compared to their counterparts (m= 7.5) (t (486) = 1.4, p= 0.79).

Conclusion
Our findings might suggest that medical students acquire more knowledge about PEP as they progress into clinical training, but that PrEP knowledge may be emphasized equally in both pre-clinical and clinical training. Further studies should focus on identifying points for improvement and implementing strategies to tackle barriers. One of several limitations of this study is a response bias.

Disclosures
All Authors: No reported disclosures
771. The impact of infectious diseases research involvement on future infectious disease fellowship application
Authors: Marcus Joseph , Yun Heather , Barsoumian Alice E 
Published: November 2023

Abstract

Background
Infectious diseases physicians invest significant time mentoring medical students and internal medicine residents developing research projects as well as writing case reports. The impact of research or case reports on future application to infectious diseases fellowship is unknown.

Methods
All research projects and case reports published or presented at conferences from Brooke Army Medical Center between 2014-2022 with an infectious diseases senior author and a medical student or internal medicine resident first author were evaluated. The presentations and publications that resulted from each project as well as whether the trainee applied to infectious diseases were recorded.

Results
During the study period, 12 faculty mentored 51 trainees in 35 research projects and 26 case reports. Research and case reports were primarily performed by residents (88% and 96% respectively) (Table 1). Most trainees presented or published their research in multiple venues. Compared to case reports, research projects were more likely to be presented at national meetings (77% vs 31%, p=0.0003). Individuals who completed research projects had greater rates of infectious diseases fellowship application as compared to those who completed case reports (42% vs. 5%, p=0.006) (Table 2).
Summary of Research and Case Reports by Medical Students and Residents Mentored by Infectious Diseases Faculty at Brooke Army Medical Center, 2014-2022
Internal Medicine Resident and Medical Student Application to Infectious Diseases Fellowship Organized by Projects Mentored by an Infectious Diseases Faculty Member at Brooke Army Medical Center, 2014-2022

Conclusion
Internal medicine resident and medical student involvement in research mentored by an infectious disease physician was associated with a higher infectious diseases fellowship application rate as compared to those who were mentored for case reports. Despite the significant time required to mentor trainees, investment in trainee research should be considered as an important component to the infectious diseases recruiting effort.

Disclosures
All Authors: No reported disclosures
774. Trivia Game for Learning Zoonotic Diseases in Pre-clinical Medical Curriculum
Authors: Moreland Celeste L , Henry Catherine , Carey Adrienne 
Published: November 2023

Abstract

Background
Zoonotic diseases are high-yield material, frequently tested on USMLE Step 1. For learning infectious diseases, many medical students supplement or replace coursework with outside resources that are personalizable and utilize active learning1,2, but these resources can be prohibitively expensive, have questionable reliability, and align imperfectly with course content2. Spencer Fox Eccles SOM historically used a Team-Based Learning (TBL) format for teaching zoonotic diseases, but this content is primarily memorization-based, while TBL is well suited for conceptual material. To teach zoonotic diseases, we created a trivia game3 (“ZooTrivia”) to mimic the low-stakes, fast-paced, engagement of outside resources, while still capturing the cooperative learning environment of TBL.

Methods
We used the Kirkpatrick model for student reaction and learning to assess efficacy of ZooTrivia. The session was opt-in and students chose their own teams to answer trivia questions. All answers were provided at the end. We used attendance data and surveys to assess student enjoyment of and perceived learning from ZooTrivia.

Results
Twenty (20/125) students reported attending ZooTrivia. Three students, who do not usually attend class, chose to attend ZooTrivia, which suggests that trivia is an attractive format. 60% of attendees reported that they would like more games like this in their education. 30% responded that they would “maybe” want more games like this. For enjoyment, students on average reported preferring trivia over both TBL and outside resources (average 3.9 and 3.6, respectively on a scale of 1-5). However, for student learning, students on average reported TBL and outside resources as better learning formats (average 2.8 for both, on a scale of 1-5).

Conclusion
Trivia is an alternative to TBL-based learning of zoonotic disease that students report enjoying more but learning slightly less than TBL. Analysis of student learning was limited by incomparable attendance of ZooTrivia and TBL; ZooTrivia was an optional session, while TBL was required attendance. This comparison is a direction for future study.

Disclosures
All Authors: No reported disclosures
776. Clinical Practice Gap Analysis of Physicians’ Understanding of Cytomegalovirus
Authors: Larkin Amy , Nair Arun S , Misiuta Iwona 
Published: November 2023

Abstract

Background
Understanding clinical practice related to awareness and clinical understanding of cytomegalovirus (CMV) and can inform development of tools to improve physician practices and patient screening, diagnosis and management.

Methods
A survey instrument of 25 multiple choice, knowledge- and case-based questions allowed participants to assess their clinical knowledge with regard to CMV. These questions are designed to assess clinicians’ baseline knowledge, competence, and current practice. Immediate peer-response data solidify support for correct responses. The survey was available online to physicians without monetary compensation or charge. Respondent confidentiality was maintained and responses were de-identified and aggregated prior to analyses. Initial data collection occurred from July 27, 2022 to October 18, 2022.

Results
In total, 107 OB/GYNs and 77 pediatricians completed the full assessment within the data collection period. Physicians demonstrated gaps in the following areas:

Conclusion
This educational research on assessment of physicians’ clinical practices yielded important insights into clinical gaps related to CMV among OB/GYNs and pediatricians. While the gaps were similar in most areas, OB/GYNs showed larger gaps in identifying source of transmission, and management of possible congenital CMV compared with pediatricians, whereas pediatricians showed larger gaps in identifying seropositivity rates and diagnosing CMV.

Disclosures
All Authors: No reported disclosures
777. Cytomegalovirus: Curriculum-Based Online Education Improves Knowledge, Competence, and Confidence of Physicians
Authors: Nair Arun S , Larkin Amy , Misiuta Iwona 
Published: November 2023

Abstract

Background
This study assessed the impact of an online continuing medical education (CME) curriculum regarding CMV infection for obstetricians/gynecologists (OB/GYN) and pediatricians (Peds).

Methods
The educational intervention consisted of 4 online, CME-certified activities in multimedia formats published on a dedicated learning center on Medscape Education from March-July, 2022. Data were collected through January 2023. A repeated pairs pre-/post-assessment study design and a McNemar’s test (P &lt; .05 is considered significant) assessed educational effect. To assess changes in knowledge, competence, and confidence data were aggregated across activities and stratified by learning themes.

Results
The education reached over 65,979 clinician learners, including 20,349 physicians, 9,295 OB/GYN, and 4,407 Peds.
Overall, there were significant improvements in knowledge/competence among OB/GYN and Peds. Specific significant (P &lt; .001) pre-vs-post educational improvements across the curriculum include:
Remaining educational gaps (% incorrect answers):

Conclusion
The metrics and outcomes gathered in this assessment are a strong indicator that multimedia curriculum-based online activities on Medscape Education improve the knowledge, competence, and confidence of OB/GYN and Peds related to CMV care strategies. Despite the effectiveness of the education, persistent gaps remain that serve as future educational targets for continuing education.

Disclosures
All Authors: No reported disclosures