Kern Institute

A diverse physician workforce promotes health equity through better understanding of the beliefs, values, and customs that shape healthcare needs. Lack of understanding, underrepresentation, and exclusion of populations based on race, ethnicity, religion, sexual orientation, gender identity, disability, geographical location, and socioeconomic status, among other factors, leads to culturally ineffective healthcare and poor health outcomes. Our project will create an innovative longitudinal curriculum with the goal of advancing cultural humility in medical student and resident trainees. Our objectives are to highlight strengths, disparities, and unmet needs for medically underserved patients in Milwaukee ; identify potential trainee and institutional biases pertaining to these populations and how they challenge culturally sensitive healthcare ; develop skills to respond to such biases in ourselves and in the workplace ; and cultivate a partnership with a diverse group of medical students, particularly our URiM cohort, through mentorship and engagement in curricular development

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Implicit bias, the negative unconscious thoughts of a person based on different characteristics, is something everyone has. Implicit bias has been rooted in poor health outcomes, especially for those who are non-white and poor. Given today’s economic landscape, minority and lower SES populations are the majority of patients, so this is not something easily ignored. As future medical professionals this is something we need to address before treating patients, otherwise we will likely fall into the same traps implicit bias has already had on patient care. Utilizing best practices in implicit bias training program, our project is to create a pilot program for future medical students to have an opportunity to challenge their own bias and learn about countering it in a multi-session-based program.

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Performance during the clinical clerkship phase of medical school is an essential component analyzed in the residency application process. In addition, clerkship grades have been linked to student induction into the Alpha Omega Alpha Honor Medical Society which serves as an advantage when applying for a residency position within a competitive medical specialty. It has been shown that Under-Represented in Medicine (URiM) students consistently receive lower clerkship grades than their non-URiM counterparts. This disparity in grading could be attributed to a lack of mentorship and preparedness of URiM students entering their clinical rotations. Understanding one’s role during the transition from M2 to M3 year of medical school can be overwhelming, confusing and intimidating. Our project seeks to develop and implement a mentorship program designed to introduce URiM medical students to URiM physicians in various fields that can assist in the guidance of second year medical students that are preparing to transition from classroom to clerkship.

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While women make up 50% of the current U.S medical students, they are still highly underrepresented in healthcare leadership. Only 15% of the department chairs, 16% of medical school deans, and 18% of hospital CEOs are women. As a result, the workplace policies in healthcare are not reflective of the needs of all genders, and women in medicine face systemic barriers such as salary inequalities, maternal bias, and discrimination. By the time women have access to formal leadership training, many have already developed their professional identities and the hesitation towards executive roles has solidified. Our goal is to empower female medical students to build on their existing strengths and recognize that their unique qualities can be beneficial even if they do not reflect traditional leadership characteristics. While not everyone wants to take on an executive role, as medical professionals we all need the skills to negotiate, communicate, and advocate. Thus, we see leadership as ability to influence change.

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Unconscious bias can negatively affect the provider-patient relationship, resulting in mistrust and inaccurate clinical decisions. Research has shown unconscious bias adversely effects African Americans, women, the obese, and patients with chronic pain or fatigue. Unconscious bias training emphasizes that bias is the result of restrictive neurobiological mechanisms and, therefore, a natural occurrence. This emphasis shifts the training from a place of guilt and blame to one of personal responsibility. We plan to  implement a structured reflection checklist to guide teaching faculty in the review of clinical cases across the medical school curriculum. In addition to unconscious bias training, faculty will also receive training and support related to the creation and revision of curricular materials. 

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Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) members are three times more likely to contemplate suicide and almost five times more likely to have attempted suicide compared to their heterosexual peers. Furthermore, LGBTQ people of color, specifically within the Asian American community, have an even higher risk for mental health issues such as depression, anxiety, substance use as well as suicidal ideation. Although these disparities among the LGBTQ communities are well-documented, there continue to be gaps in the training of health care professionals to improve these disparities. While some medical schools dedicated approximately five hours on LGBTQ content, over a third reported zero hours during student’s clinical years, and approximately 7% reported zero hours during pre-clinical years. Our project will address these issues by developing educational sessions to provide future healthcare professionals with the tools and experiences to understand and communicate with Hmong LGBTQ patients. 

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Research shows that intergroup dialogues can offer students one of their first meaningful opportunities to explore “taboo topics” in a small diverse group setting. Such engagement across differences enables them to challenge misconceptions and stereotypes, develop increased personal and social awareness of social group membership, develop more complex ways of thinking, build skills for communication and working with disagreements, and identify ways of taking actions for social Justice. Dialogue can encourage greater awareness; connection and action through voicing and listening, reflection and inquiry; and a search for value in all participant perspectives and experiences. Our project will use Intergroup dialogue along with media outlets, such as podcasts or webinars, to bring students together from different backgrounds to explore topics related to gender, nationality, disability, race, sexual orientation, or socioeconomic status in more depth, while practicing and engaging in meaningful dialogue across differences. These sessions will be peer, faculty, and community facilitated.

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Healthcare disparities are recognized due to patient-, provider-, and institutional-level issues, causing compromised care among underserved groups. In large part, the lack of diversity among provider and biomedical researcher has been associated with misguided treatment. Leadership Education to Advance Diversity among Underrepresented Populations in Medicine (LEAD-UP) will prepare trainees historically underrepresented in medicine/biomedical research to advance as faculty-leaders in academic medicine. LEAD-UP will harness participant’s existing skill-sets with opportunities to learn alongside local and national leaders to promote diversity and inclusion efforts in patient care and research.

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Professionalism and character are important for a developing physician, and there is a need for defined curriculum to address things like professional identity formation, self-awareness, empathy decline during medical training, and low levels of wellness. Medical trainees need the ability to think about important events and derive meaning from them, considering those situations from multiple perspectives. They must process both their own experience and the experience of others, including patients or someone on their medical team. Additionally, they must be able to assess their own behavior and correct it if necessary, including setting and executing goals for improvement. Unfortunately, formal coursework focused on medical knowledge does little for development of professional identity, which is impacted more by hidden and informal curricula. The educational tools of reflection and self-assessment can help develop these skills. The goal of this project is to create a longitudinal reflective thread from M1 year to residency, focusing on professional identity formation and character. 

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According to the Centers for Disease Control and Prevention, three in five Americans have at least one non-communicable, chronic disease, like cardiovascular disease, cancer, or diabetes. A majority of Americans will also be diagnosed with mental illness during their lifetime. Lifestyle modifications, like exercising more and eating a healthier diet, are protective factors for many non-communicable diseases and mental illnesses. Yet, physicians do low levels of lifestyle counseling during clinic visits for reasons like limited time, lack of training, and skepticism that intervening will be effective, despite evidence that physician advice is one of the most effective catalysts for these lifestyle modifications. We plan to create a program that enables Under-Represented in Medicine (URiM) students to improve their health; become members of an affirming, local community of professionals; and develop skills to help future patients similarly improve their health.  

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Literature suggests that Under-Represented in Medicine (URiM) students need support and mentoring to excel. URiM students are less likely to seek support due to various factors such as embarrassment, fear of judgment, fear of discrimination, a sense that they should keep things inside, and lack of awareness. We propose a mentoring program aimed at providing information, guidance, mentoring and social support to URiM students, encouraging them to be successful in attaining their academic and personal goals. The program will include opportunities for learning, team-building, networking and guidance, including advice on how to write a personal statement, a CV, and a manuscript, as well as how to handle microaggressions and improve communication skills.

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According to the National Alliance on Mental Illness (NAMI), approximately 1 in 5 US adults experience mental illness each year, with suicide being the 2nd leading cause of death in people aged 10-34 years. Despite these alarming statistics, many healthcare professionals feel unprepared to assist individuals experiencing mental health crises. Mental Health First Aid USA (MHFA) is a 3-year certification program through the National Council for Behavioral Health. Originally designed for non-healthcare professionals, it teaches participants how to recognize, assess, and respond to mental health crises (e.g. suicidal ideations, panic attacks, acute psychosis, substance overdose/withdrawal). We propose the creation of an elective course in academic year 2020-21 that certifies students in MHFA, with a future aim toward interdisciplinary offerings that strengthens student wellness campus-wide.

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To ensure that our Under-Represented in Medicine (URiM) students are being evaluated fairly, we must critically examine how our learners are being assessed and mitigate implicit bias. Educational interventions, including training or tools, may help make the underlying bias explicit. Implicit bias, self-awareness, and commitment to lifelong learning is important for character development. We propose developing strategies and a potential intervention/tool to mitigate implicit bias in clerkship evaluations. Through the design thinking process, we hope to explore ways to educate and guide faculty to realize their biases and develop strategies, interventions, and tools to mitigate them. Our goal is to design an intervention and/or tool to pilot with faculty involved in departmental clinical clerkship evaluations and measure the impact. By confronting implicit bias, we hope to improve equity for our URiM students and promote character in medical education.

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Mentorship and scholarship are crucial for success in academic medicine. Mentors that share similar cultural backgrounds and academic interests are more likely to build meaningful, positive relationships with mentees. Serving as role models, mentors guide and shape the character, attitude, and values of their mentees. Studies have proven that underrepresented minority students (URMs) often have difficulty finding strong mentor support to aid in their professional development. Our transformational idea aims to combat this problem by creating a platform for URM students to get early and easy access to mentors that care about their academic success, share similar backgrounds, and will support and advocate for them through medical school and beyond. 

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By Pinky Jha, MD; Sanjay Bhandari, MD; Brian Hillgeman, MD; Patrick Foy, MD; Hari Paudel, MD; Mario Scarpinato; Kevin Schlidt

We propose developing a longitudinal curriculum to help M3 and M4 develop empathy skills during their M3 inpatient clerkship and M4 ambulatory medicine rotation, respectively. We will use multiple modalities of teaching including real time patient feedback, short app-based secure tweets, and group-based didactics, all aimed on addressing barriers. Students will be asked to tweet short narratives via a secure app to reflect upon their patient interactions, and we will survey students with regards to the efficacy of direct patient feedback, workshop and narrative tweets, and their overall perceptions of empathy.

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By Michael Nordness, Med Student; Nathan Fleming, MD, MPH; Audrey Burghardt, MSCP, CSW; PI: Theresa Maatman, MD, FACP; Joanne Bernstein, MD; Bob Waite

We propose the development of an app-based SDOH education tool that instructs learners on how to screen for and address health-related social needs to address this SDOH knowledge gap. Using the proposed app before seeing each patient, students would enter each patients zip code, which would generate a list of SDOH indicators for the patients community. Students would additionally be able to click on the individual SDOH indicators for a brief educational summary of each indicators influence on health outcomes. They would also have access to both SDOH-based interview questions and the contact information for 2-1-1, a nationwide non-profit that connects people with community resources, to help address each patients SDOH needs.

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By James McCarthy, MD; Kelsey Porada, MA

We propose developing a mobile app to assess the impact of mobile learning on students in the third year pediatric clerkship. For over a year we have been producing a podcast, titled Peds Soup, that focuses on evidence-based review of core topics in pediatrics. In this project, we plan to develop a mobile app as a supplement to the podcast. The app would include pre- and post-test questions for students to track their knowledge gain after listening to podcast episodes, links to relevant articles for further reading, and a progress report where learners can compare their scores against the overall average and identify their own strengths and weaknesses.

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By John Hayes, DO; Jessica Hayes, MS4; Shena Johnson, PsyD

We propose the creation of difficult conversations OSCEs to be used as a formative tool, facilitating debriefing that will coach students on handling these challenging scenarios. We will use simulated patient conversations, teaching students how to master these encounters before they must do it in real life. Students will leave these sessions better able to identify pitfalls in patient communication before they effect patient care.

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By Amy Prunuske, PhD; Jacob Prunuske, MD, MSPH; Carolyn Nash, MD; Eric Giordano, PhD; and Haley Pysick, Med Student

We propose the development of a tool to assess the competency of students with respect to community engagement. We will work with community partners to identify student-level competencies for effective community partnerships, with an emphasis on the character aspects of trust and teamwork, and nurturing caring relationships. Once those competencies are identified, we will refine with students, faculty, and community partners to optimize language, relevance, and consistency of conceptual understanding. We will then seek to develop an app that will allow real-time feedback from community members regarding student progression and attainment of competencies in community engagement.

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By John Astle, MD, PhD; Paul Guillod, MD (Massachusetts General Hospital); Alexandra Harrington, MD; Maria Hintzke, MD; Steven Kroft, MD; Vasiliki Levantaki, MD; and Molly Young

We propose developing an interactive informational resource that will help rotating pathology residents access hematopathology information in a way that follows the diagnostic thought process. This project aims to provide a proof of concept for a resource that will ultimately be useful for learning and reviewing nearly any area of diagnostic medicine. While initially useful primarily to physicians-in-training who are learning the diagnostic thought process, this resource has the potential to provide practical learning and review for even the most seasoned physicians, particularly by reminding them of rare diseases to consider, notifying them of novel laboratory tests that have become available, and aiding in interpretation of atypical findings.

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By Michael Nagy, PharmD; Kajua Lor, PharmD; Meaghan Hayes, MEd; Kenneth Lee, MD; Sean Blaeser, Pharm Student; Megan Grochowski, Pharm Student; Isabelle Sviatloslavsky, Pharm Student; Taylor Williams, Med Student

We propose to develop and implement an interprofessional elective course between the medical and pharmacy schools that trains and evaluates students on providing competent care for veteran and military members. The main focus is on the culture and communication surrounding this unique population.

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By Valerie Carlberg, MD; Stephen Humphrey, MD; Alexandria Bear, MD

We propose to develop a collaborative curriculum titled "The Art of Observation" between the Medical College of Wisconsin and the Milwaukee Art Museum to improve visual literacy, diagnostic accuracy, communication, self-reflection, tolerance for ambiguity, and build empathy. By sharing observations aloud, students will build confidence and communication skills, as well as improved observation skills leading to increased competence in diagnostic reasoning. Through listening and paraphrasing others observations, students will develop an appreciation for diverse perspectives and increased tolerance for situations without a clear answer.

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By Sonali Srivastava, Med Student; Srisha Kotlo, Med Student; Alonzo Walker, MD; Kurt Pfeifer, MD; PI: Malika Siker, MD

We propose to address the challenge many URM medical students face in finding mentors from diverse backgrounds and specialties to obtain invaluable career advice and encouragement as they begin to define their medical interests. This program will facilitate mentorship relationships between first/second year medical students and clinical faculty through regular, casual lunches over diverse cuisines. This program will pair mentors with students to provide career guidance, serve as role models, and help provide implicit knowledge of how to navigate the medical profession, as well as imparting emotional support and encouragement.

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By Courtney Barry, PsyD, MS; Rachel Piszczor, PsyD; Constance Gundacker, MD, MPH; Jonathan Perle, PhD, ABPP; Carly Wallace, MA; Jineane Shibuya; Mai'ana Feuerborn; Michelle Leininger

This project, which is a collaboration between the Medical College of Wisconsin and Midwestern University-Downers Grove, aims to improve trauma-informed care knowledge and skills. This unique partnership, between MD and DO programs, will foster interdisciplinary collaboration between physicians, psychologists, medical and psychology students. The training will address topics on ACEs and trauma, the physiologic response of trauma, the presentation of trauma in a medical patient, and finally, tools that providers can utilize during an encounter. The goal is to develop competent and caring future healthcare providers, who understand the impact of trauma on health outcomes.

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