Capstone Presentations
The Capstone Scholarship & Discovery Course (CSD) at UMass Chan Medical School is a mentored scholarly project for students to build on a personal passion related to medicine. CSD is a four year longitudinal curricular experience and students receive one month credit after successful presentation of the Capstone project during their fourth year. The Class of 2016 was the first class in the school’s history to complete long-term Capstone projects. See also these Capstone projects supported by the library: Streams of of Consciousness (journal) and Murmurs: Stories from Our Journey in Medicine (podcast).
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Recently Published
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Joining the Fight Against the Opioid Epidemic through the Head Start Program in Lowell, MAWhat is Head Start? Head Start, a federally funded program of the United States Department of Health and Human Services, promotes school readiness and family well-being in children from birth to age five who meet specific criteria. Lowell Head Start Partnership The Lowell Head Start program is engaged in efforts to combat the opioid epidemic after an incident involving an overdose by a parent in the center. To support the Lowell Head Start program, our team forged collaborations with facilities close to Head Start in Lowell by creating informational pamphlets that detail services offered to people with substance use disorders in Lowell. Opioid trends in Lowell Lowell is a very diverse city, with 40% of the population being non-white and 25% being foreign born. Lowell has a highest poverty rate at 19.1%, in the region, a low median household income at $49,164, and a high rate of unemployment according to the 2016 greater Lowell community health needs assessment (CHNA). Opioid overdose death rate in Lowell is 43 fatalities per 100,000 – a rate greater than double the average fatality rate in the state of Massachusetts. Quick overview of project To capitalize on the statewide and local efforts to bring opioid addition out in the open, the presenters created an informational pamphlet as a resource and educational tool for families that seek or are referred for services. Description of many relevant provisional services are expanded upon in the capstone project submission – including detox, hotline and support services, medication management, behavioral health, counseling and relapse tools training. Additionally, the presenters actively forged connections with local community organizations serving those struggling with opioid use disorder. Please see capstone document for additional information regarding specific resources. Conclusions With the significant rise in fatal overdoses in the city of Lowell, many departments and programs have been developed to combat the opioid epidemic. This project aims to provide vital information to the Head Start Program and the families they serve, and to provide established resources available in Lowell, such as medication disposals, Narcan and signs of overdose training, needle drop-off services, available hotlines, and city-wide programs, including Lowell Community Opioid Outreach Programs, MA Opioid Abuse and Prevention Collaborative of Greater Lowell, and Partnerships for Success Program.
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Health Education Fair at African Community Education, WorcesterHealth knowledge and health literacy are important social determinants of health, and can have a major impact on the health and well-being of an individual. Health education, through formal classroom instruction, peer education, or community health fairs, has been effective in increasing health knowledge and literacy. Worcester, MA is home to many refugees and immigrants from around the world, who represent a key population vulnerable to disparities in social determinants of health, especially health knowledge and literacy. This Capstone project created a Health Education Fair at African Community Education (ACE), an afterschool enrichment program in Worcester for refugee and immigrant students hailing from African countries. The Health Education Fair consisted of multiple stations: Hygiene, Mental Health, Nutrition, Sexual Health, and Substance Use/Peer Pressure. Curriculum and materials were created and University of Massachusetts Medical School (UMMS) student volunteers facilitated the stations. Evaluation of the curriculum was done using pre- and post- surveys administered to the ACE students on the day of the Health Education Fair. Survey data demonstrated that students who participated in the Health Education Fair had an average increase in knowledge, for all included stations, of 2 points on a 10-point scale. The Health Education Fair provided an important opportunity for UMMS students to collaborate with ACE and provide health education to this key population.
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Analyzing Wellness in UMMS StudentsBackground: Burnout in medical school students is an ongoing, growing issue that can be exacerbated in the clinical years, however, there have been challenges addressing individual student needs due to the variance of wellness practices and academic constraints. Objective: To provide longitudinal support to third year medical students (MS3s) at the University of Massachusetts Medical School while identifying sources of stress. Methods: Beginning in May 2020, MS3s were given four opportunities to participate in large group discussions with fourth year medical students (MS4s) to speak openly about current stressors and concerns. In concert, surveys were sent to MS3s to identify primary causes of stress and concern to guide discussions. Results: The August survey had a 97% response rate (165/170 responses) and the December survey had a 56% response rate (96/170 responses). Five main themes were identified as sources of stress: COVID-19, Step 1, No Voice/Feeling Unwanted, Lack of Communication, and Lack of Preparedness/Knowledge. A 6th non-stress related theme, Normalization, was noted in interactions among MS3s and facilitators. These themes continued to be prevalent in responses. In December, students ranked COVID-19 and clerkship grades highest and Step 1 being ranked lower. Conclusions: Check-ins throughout the year allowed MS3s to express their concerns, and have them validated by peers. Continuing supportive sessions and providing spaces for near-peer interactions can help decrease feelings of burnout and isolation among MS3s. Additionally providing medical students with opportunities to engage with self-identified interventions to support wellness while addressing systemic causes of burnout will be beneficial.
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Critical Reflection: Tracking professional identity formation in a medical student traineeWe sought to establish a framework to track professional identity formation (PIF) in one individual trainee through the use of reflective writing. Using the same six reflective prompts, one undergraduate medical trainee wrote six reflective essays each year of training which were subsequently analyzed by a faculty member and the author looking for specific themes. 22 of a possible 24 pieces were analyzed and the three major themes that emerged across four years were roots, emotions, and self-doubt. Overall, the themes highlighted the critical nature that an individual’s socio-cultural identity plays in medical professional identity formation. This work serves to emphasize that critical reflection is imperative for professional identity formation and argues that PIF is truly a dynamic interplay between a trainee’s personal identity and the medical community’s established dogma.
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Prehabilitation to Improve Positioning Reproducibility in Patients Undergoing Pelvic Radiation TherapyPrehabilitation to improve patient positioning: pelvic exercises assist in reducing sacral slope variability during radiation therapy Purpose/Objective(s): Reproducible patient positioning is essential for precision in radiation therapy (RT) delivery. However, a retrospective review of pre-treatment imaging demonstrated variability in daily patient set-up. We tested the hypothesis that a structured daily pre-treatment stretching regimen is both feasible and effective for minimizing variability in positioning, as measured by sacral slope angles (SSA). Materials/Methods: After obtaining IRB approval, we had 8 female patients undergoing pelvic radiotherapy perform a structured daily hip exercise regimen (extension and external rotation) immediately prior to both simulation and daily treatment, throughout the RT course. The control group of 20 patients (17 female and 3 male) had usual care. SSA measurements on daily pre-treatment imaging were compared to SSA measurements from the simulation CT for 5 weeks. The extent of SSA variability between two groups and over time was analyzed using a linear mixed model. The same two readers independently measured SSA of all subjects, comparing SSA on the day of simulation to SSA measured on each day of RT. Results: The average variation in SSA among the intervention subjects was 0.913° (±0.582°), with a range among subjects of 0.57°-1.3°. The average variation for the control subjects was 2.27° (±1.43°), with range among subjects of 1.22° - 5.09°. The difference between the two groups was statistically significant (p=0.002). There was a statistically significant SSA variation between groups at each week of treatment (Week (wk) 1: p = 0.007, wk 2: p = 0.008, wk 3: p = 0.01, wk 4: p = 0.005, wk 5: p = 0.008). There was no significant variation among the intervention subjects between week 1 and later weeks (wk 2: p = 0.88, wk 3: p = 0.74, wk 4: p = 0.97, wk 5: p = 0.40), whereas subjects in the control group demonstrated significant SSA variation between week 1 and the fourth week of therapy (wk 2: p = 0.87, wk 3: p = 0.92, wk 4: p = 0.02, wk 5: p = 0.22). There were no reported adverse effects of the stretching regimen. Conclusion: We demonstrated a significant decrease in the variability of SSA by implementing a simple pre-treatment stretching program, whereas control subjects exhibited an increasing variability of SSA over the course of treatment. We conclude that there is a potential benefit for prehabilitation during pelvic RT. A larger clinical trial is required to determine whether a pre-treatment stretching program would result in clinical benefit.
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WooFood CooksAs the obesity rates among children have increased examining the causes of this rise is imperative. One of the many reasons for the increase is the amount of meals eaten away from the home and even though young men of color may be less likely to be overweight or obese, chronic diseases associated with poor diets such as diabetes, hypertension, and hyperlipidemia still adversely affect them. Studies show that there is a connection between unhealthy eating and the development of the aforementioned chronic diseases. Therefore, the purpose of this Capstone Project, WooFood Cooks, is to bring high school-aged men of color into the kitchen, expose them to micronutrient rich foods, and teach them to cook healthy meals so that they can take these skills home to their families and employ these into adulthood. By having multiple opportunities to learn about, prepare, cook, and eat meals with fruits, vegetables, and lean meats, this program will hopefully have a long-term positive impact on the health of these young men. After the completion of the classes the young men enjoyed the time in the kitchen and learned new cooking skills that they could implement in their homes. However, this project demonstrated that there is more work to be done in the community with bringing families together into teaching kitchens to help them see a new way of cooking traditional meals. It will also impart the necessary knowledge to parents desiring to best serve the health outcomes and behaviors of their children.
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Medical Marijuana Education for Medical StudentsAs the nationwide discourse on medical marijuana evolves, with 28 out of 50 states approving its use, University of Massachusetts Medical School graduates will need to be prepared to discuss medical marijuana (MMJ) with their patients. There is currently no formal medical school education on MMJ. This project set out to understand the curriculum gap and provide a learning session to interested students. The presentation was created using research done by the author during the first three years of medical school, including visits to private MMJ clinics. Utilizing a pre/post-session online assessment of a group of twenty-six students, we found that student knowledge about Massachusetts’ MMJ law improved by 29%, following a ninety-minute session. In addition, self-assessed confidence in negotiating clinical scenarios involving marijuana improved by 34%. These improvements were statistically significant, with p-values of 0.0033 and 9.5x10-16 respectively. These findings support the formal addition of a sixty- to ninety-minute session focusing on MMJ to the UMMS curriculum.
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Thinking Like A Scientist ... And An Engineer: Training future leaders and innovators in health care systems and deliveryHealth care is increasingly becoming more complex with the advancement of accountable organizations, expansion of hospital systems, and major insurance and government reforms. As leaders of care teams, physicians are often expected to have a hybrid set of skills extending beyond clinical expertise. Examples of leadership knowledge and skill sets include organizational thinking, health quality improvement, health policy, financial literacy, health innovation, and many more. The number of MD/MBA programs has risen significantly since the 1990s and more recently, leadership pipelines for both medical residents and students have also emerged. These trends support a rising demand for well-rounded physician leaders. This project sets out to answer two questions: will a health care leadership program add value to undergraduate medical training for University of Massachusetts medical students? If so, what would such a leadership program look like? We used the Lean management framework and “A3” Plan Do Study Analyze cycle (PDSA) to identify the challenges and appropriateness of developing a leadership program, and then to highlight ideas for promoting leadership. Key components of the framework include a root cause analysis and development of counter measures. As a platform for analysis, we examined the experiences of the “Quality Improvement Health Care Elective,” a student led series of lectures on health care process, Lean management, and health care leadership. We tested our counter measures as well as other ideas in a student opinion survey that focused on level of interest in leadership, career aspirations, desired deliverables, and the option of a training certificate. An estimated 20% of the student population at UMass Medical School completed our survey (n=125). Our study discovered strong interest in the topic of leadership, with 20% of students stating they are very likely to take an elective on leadership, and 54% somewhat likely. Students were especially interested in career aspirations that included management and administration responsibilities, general career exploration, and opportunities for mentorship. These findings can be core features of developing a health care leadership option for medical students at UMass Medical School.
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Connecting with the Ghanaian Community through Church-Based Workshops: Healthy Ghanaian CookbookBased off our workshop series at Ghanaian churches in Worcester, MA, the Healthy Ghanaian Cookbook is a collection of recipes created by Peggy Akufo from the Apostolic Church at Bethsaida Christian Center. The recipes were altered to increase nutritional value. Calorie and nutrition breakdown for each recipe is included.
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Albanian Immigrants' Experience and Attitude toward Health Care in Albania versus the USAPurpose: To describe the experiences and attitudes of Albanian immigrants toward health care in Albania versus the United Stated (USA). Method: A cross-sectional descriptive survey using venue sampling was administered at the Albanian Festival in Worcester on June 5-7, 2015. The data was entered and analyzed using SPSS. Results: There were a total of 146 subjects eligible for analysis. Most subjects were female (52.7%) and the mean subject age was 41.6 with a range of 18-77 years old. Subjects moved to the USA at a mean age of 28.8 years with a range of 1-66 years old. Subjects have lived in the USA for a mean of 12.9 years, with a range of 3 months to 28 years. Categorical response items comparing health care in Albania versus the USA were statistically significant in favor of the USA health care system regarding comfort seeking care, care worth money, receiving preventative care, and having good communication with the doctor. Subgroup analysis of males vs. females showed a significant finding only on females receiving more preventative care. Continuous response items comparing health care in Albania versus the USA were statistically significant in favor of the USA health care system regarding the patient liking care received and trusting the doctors. Content analysis of the open-ended comments showed positive and negative perceptions of both health care systems. Conclusions: Our results show that Albanian Immigrants have an overwhelming positive experience and attitude toward the USA health care system in all categories including comfort seeking care, care being worth the money, having good communication with the doctor, trusting the doctors, receiving preventative care, and liking care received. These finding are important because they show that even though Albanian immigrants are exposed to under-funded and corrupt medical care in Albania, the majority does not allow this experience to influence the interaction with USA health care professionals. The findings from this study are applicable to the clinical setting in the USA and some recommendations can be made to USA health care providers about how to best approach Albanian immigrant patients.