Medical Education Research

An Empirical Study of Google Gemini’s Potential in Generating NBME-Style Pharmacology Questions: Challenges and Improvements

Wesam Almasri, B.A.¹, Marwa Saad, B.S.¹, Changiz Mohiyeddini, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Google Gemini is an Artificial Intelligence model created by Google to generate responses based on the user’s inputs. In our study, Google Gemini was asked to generate multiple choice questions on various pharmacological concepts which adhere to the NBME guidelines. 

METHODS
Prompt engineering was conducted to formulate a sufficient input to generate questions that were deemed sufficient according to NBME guidelines. The generated questions were then reviewed by pharmacology experts that have extensive experience writing NBME exam questions.

RESULTS
Google Gemini displays strong potential in generating NBME-standard questions that medical students can use for their medical education, but there are concerns regarding the accuracy of the AI’s medical knowledge. 

CONCLUSIONS
Google Gemini lacks the depth and complexity required for NBME-standard questions, which demand not only surface-level answers but also the application and integration of medical concepts in a clinical context. Google Gemini consistently provided “pseudo vignettes”, in which clinical vignettes were provided in the question stem but were not needed to pick the correct answer choice, consistently leading to generating questions that were only of basic recall. Additionally, it consistently provided cues in the question stem, giving the answers away. Despite medical inaccuracy, pseudo vignettes, and cues within the question stem, Google Gemini provided NBME questions that strongly adhered to the rest of the guidelines, displaying its potential to be a strong medical education resource after refinement.

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Narrative Medicine Impacts on Medical Students and Residents: Understanding Utility of the Workshop Space

Jade Ayers, M.S.¹, Jason Wasserman, Ph.D.², Andrea Eisenberg, M.D.³

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI 
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI
³Corewell Health William Beaumont University Hospital, Royal Oak, MI}

INTRODUCTION
Narrative medicine focuses on patient illness experiences and uses storytelling to communicate these experiences. This study seeks to evaluate narrative medicine workshops as a medical education tool where participants are asked to engage with poetry, art, or film and reflect on themes in relation to patients and oneself. This research project will compare the perspectives of medical students and resident physicians participating in narrative medicine workshops.

METHODS
Medical students participated in a class workshop series and residents participated in either a monthly didactic or certificate program workshop series. Participants completed pre- and post-workshop surveys consisting of 15 Likert-scale items gauging knowledge, skill, and application of narrative medicine principles. Surveys were matched and analyzed using t-tests. Qualitative data collected from interviews were transcribed and analyzed for narrative themes. 

RESULTS
There were 6 medical student and 9 resident participants. All participants were able to more accurately and robustly describe narrative medicine in their own words at the conclusion of the workshop series (mean change 0.80 ± 1.26, p=0.028) and all felt moved to a greater degree by the emotions of their patients (mean change -0.43 ± 0.65, p=0.028). In interviews, medical students expressed they felt more connected to classmates through vulnerability and residents discussed the utility of the workshop for clinical duties (writing reports). Medical students self-reported using writing more often to reflect on their experiences (mean 4.17 ± 0.41, p=0.0006) and residents felt better prepared to handle emotionally complex clinical situations (mean 4.11 ± 0.60, p=0.0125).

CONCLUSIONS
This study highlights the importance of using humanities driven medical education strategies to engage trainees to promote empathy and compassion. Specifically, narrative medicine workshops appear able to do this by offering a space for reflection and creativity and enhancing trainees’ engagement with humanistic elements of patient care. This ultimately has potential for strengthening the doctor-patient relationship. 

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Evaluating ChatGPT-4o’s Performance on a Radiology Training Exam: Implications for Diagnostic Artificial Intelligence

Imran Bitar, B.S.¹, Richard Olawoyin, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, Michigan
² Department of Industrial and Systems Engineering, Oakland University, Rochester, MI}

INTRODUCTION
Introduction: Artificial intelligence (AI) is increasingly influencing radiology, offering improvements in diagnostic accuracy, workflow efficiency, and clinical decision-making. Despite these advancements, AI models still face challenges in interpreting complex medical images. This study evaluates the performance of ChatGPT-4o on a standardized radiology training examination to assess its potential role as an educational and diagnostic support tool.

METHODS
Methods: A total of 106 multiple-choice questions from the 2022 ACR in-house training exam, spanning multiple radiology subspecialties, were administered to ChatGPT-4o. Questions were classified as either image-dependent or image-independent. The model’s answers were recorded, scored against the official answer key, and analyzed by question type and subspecialty using Fisher’s exact test for comparisons.

RESULTS
Results: ChatGPT-4o achieved an overall accuracy of 69.8% (74/106). Accuracy was significantly higher for image-independent questions (95.2%, 40/42) compared to image-dependent questions (53.1%, 34/64; p < 0.001). Subspecialty performance varied, with the highest accuracy in ultrasound (90.0%) and radiation physics (88.9%), and the lowest in musculoskeletal (50.0%) and pediatric radiology (55.6%). Notably, the model achieved 100% accuracy on image-independent questions in nine subspecialties.

CONCLUSIONS
Conclusion: ChatGPT-4o demonstrates strong performance on conceptual, text-based radiology questions but limited accuracy when visual image interpretation is required. These findings highlight the current strengths and limitations of large language models in radiology, supporting their role as educational adjuncts while emphasizing the need for further development to enhance image analysis capabilities.

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Medical Student Attitudes Toward Advanced Practice Provider Independence Legislation

Forrest Bohler, B.S.¹, Nikhil D. Aggarwal, B.S.¹, Christine A. Simon, B.S.¹, James R. Burmeister, B.S.¹, Varna Taranikanti, M.D. / Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
In response to the national primary care physician shortage, states are increasingly turning to legislation that expands the scope of practice for advanced practice providers (APPs), such as nurse practitioners (NPs) and physician assistants (PAs), to practice independently without physician oversight. While the effects of these laws will be multi-faceted, little is known regarding how these laws will affect states’ future abilities to attract and recruit physicians to practice within their state. This study explores medical students’ (MSs) attitudes toward APP independence legislation, focusing on their perceptions of equivalency of care, the potential impact of these laws on their future practice choices, and their views on professional collaboration.

METHODS
An anonymous survey was administered to MSs across all 4 years of schooling at a Midwestern medical school.

RESULTS
This survey had a 21% (109/518) response rate. 86% of MSs expressed disagreement that APP care is comparable to physician care. In addition, 59% of respondents reported they would be less likely to practice in states allowing APP independence, a figure rising to 71% among those interested in pursuing primary care.

CONCLUSIONS
The majority of MSs do not view APP-driven care as equivalent to care delivered by a physician. Further, states that enact APP independence laws may struggle to attract future physicians as the majority of MSs in this study consider the legislative landscape of the state they practice in. States considering APP independence laws should consider the results of these studies when attempting to address their physician shortage. 

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Enhancing an Asynchronous Medical School Physiology Lecture with Backward Design and H5P Technology

Brenda Bortis, B.S.¹, Akshata R. Naik, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
With an increasingly hybrid medical curriculum, medical educators must find strategies to move beyond passive prerecorded lectures. Backward design is an instructional model that begins with identifying key learning outcomes (LOs), then working backward to align instructional content and assessments. Inclusion of virtual teaching tools in asynchronous content may improve learner engagement and provide immediate feedback. This study aimed to determine whether redesigning an asynchronous first-year medical school lecture using backward design and H5P interactive activities improved student engagement and understanding.

METHODS
The lecture “Hormonal Control of Blood Glucose” was delivered asynchronously to 125 first-year medical students during Fall 2022 and 2023. The 2022 lecture consisted of three self-paced videos. In 2023, the lecture was redesigned using backward design principles, including revised LOs, and two embedded H5P activities: a drag-and-drop activity and a clinical case branching scenario. Student performance on four assessment questions was compared between years using Chi-square testing (p < 0.05). Student perceptions were assessed with an optional 5-point Likert scale questionnaire. 

RESULTS
Fifty students completed the assessment questions in 2022 and sixty in 2023. Following the redesign, mean assessment scores improved from 65% in 2022 to 70% in 2023 (NS). The most notable improvement in performance occurred for a topic reinforced by the H5P drag-and-drop activity. Specifically, performance on the glucose transporter (GLUT) question increased from 76% to 88.33% correct (p=0.088). Questionnaire response rates were low (2022: n=5; 2023: n=25), with no significant differences observed.

CONCLUSIONS
Redesigning asynchronous content using backward design and H5P activities led to a positive trend in student performance. These findings suggest that integrating virtual interactive tools into asynchronous modules can convert passive learning into structured, active learning experiences in medical school.  

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Caring for Caregivers: An Exploratory Study to Assess Institutional Support Provided by Medical Schools to Caregiving Students

Kaitlyn M. Butzin, B.A.¹, Jamie L. Vassel, Ed.D.², Brianne E. Lewis, Ph.D.³

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI 
²Student Affairs, Oakland University William Beaumont School of Medicine, Rochester, MI 
³Central Michigan College of Medicine, Mount Pleasant, MI}

INTRODUCTION
Caregiving is a role that may concomitantly occur for a student during the pursuit of a medical degree. The current scope of institutional support for medical students who are also caregivers has not been evaluated. Therefore, the purpose of this study is to evaluate and describe existing institutional support for student caregivers and identify gaps to guide administrators in developing supportive programs.

METHODS
In this exploratory study, the authors assessed institutional support by searching publicly available websites of 170 AAMC-accredited medical schools from January 2023 to April 2023 for caregiving support resources. Both the medical school and the associated university were searched to identify potential resources. Authors iteratively assigned a code to each identified resource. Two researchers screened available resources against the inclusion criteria, and if any discrepancies were encountered, a discussion was held with a third researcher to resolve the discrepancy. Data were generated by sorting codes into categories that described the target audience (parental support, non-parental support, and inclusive support).

RESULTS
Out of 170 medical schools that were evaluated, 87% (N=148/170) had at least one resource of any category, 87% (N=148/170) had at least one resource for parental caregivers, 6% (N=10/170) had at least one inclusive resource, and 2% (N=3/170) had at least one resource for non-parental caregivers.

CONCLUSIONS
While a majority of medical schools offer some level of support, there is a lack of support that is inclusive of types of caregiving roles. Supporting resources provided by medical schools were largely targeted towards parental caregivers. These data emphasize that medical schools should work towards normalizing the caregiving role within academic medicine through the development and evaluation of inclusive caregiving resources. 

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Eye Dissection Video Guide: An Innovative Approach to Anatomy Education of the Orbit, Eye, and Intraocular Lens

Jack Dryden, B.A.¹, Malli Barremkala, M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
² Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Cadaver dissection remains a cornerstone of preclinical medical education, yet students frequently enter the anatomy laboratory with limited familiarity with the regional structures they are about to dissect. The orbit, eye, and intraocular lens represent a particularly complex anatomical region that demands thorough preparation. To address this gap, a structured, step-by-step video guide of the eye dissection process was created and implemented for first-year medical students at Oakland University William Beaumont School of Medicine, with the goal of improving anatomical understanding and dissection confidence prior to scheduled laboratory sessions.

METHODS
A series of six narrated instructional videos, ranging from one to nine minutes in length, were developed to highlight distinct areas of orbital and ocular anatomy. Topics covered included the Left Orbit Anterior Approach, Eyelid and Lacrimal Apparatus, Contents of the Orbit, Orbit Osteology, Right Orbit Superior Approach, and Orbit Surface Anatomy. The videos were distributed to students via a Panopto link hosted on the course Moodle page. Following completion of the module, students self-reported their experience through a 14-question online post-module survey using a five-point scale assessing perceived usefulness and improvement in anatomical recall.

RESULTS
Post-module survey responses from 125 students demonstrated a significant improvement in self-reported anatomical preparedness and confidence prior to entering the anatomy lab. Engagement data confirmed strong student utilization of the video series across the study period, with notable spikes in views, downloads, and unique viewers in the days preceding scheduled dissection sessions.

CONCLUSIONS
The Eye Dissection Video Guide proved to be an effective supplementary resource for first-year medical students, supporting anatomical recall and pre-laboratory confidence. These findings support the broader value of concise, topic-focused video content as a scalable complement to traditional anatomy education, warranting development of similar modules for other complex anatomical regions.

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Use of Narrative Drawings to Improve the Understanding of Threshold Concepts in Cranial Nerve Anatomy 

Gallagher, Lindsay A., B.S.¹, Lee, Diana C., B.S.¹, Barremkala, Malli, M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Understanding anatomy is fundamental for disease comprehension and development of clinical competence in physicians. However, many medical students struggle with anatomy, particularly cranial nerve anatomy, due to its complexity, three-dimensional organization, and extensive detail. Research shows that visual demonstrations are effective in learning anatomy. This study aimed to determine whether presenting threshold concepts in cranial nerve anatomy through narrative drawing videos (NDVs) will improve students’ comprehension and overall learning experience.

METHODS
First-year medical students enrolled in Anatomical Foundations of Clinical Practice (AFCP2) at OUWB were invited to engage with NDVs. In each video, a narrator drew and explained complicated cranial nerve pathways and landmarks. Students were encouraged to simultaneously draw the structures on their own template. To assess short term retention, students were instructed to complete a pre- and post-module comprehension quiz. Students were provided with a survey of Likert scale questions to share their perceptions of the NDVs. 

RESULTS
During Fall 2023, a total of 127 students were provided access to seven cranial nerve NDV modules. These modules accumulated 472 views from 60 unique viewers. Significant improvements in post-module quiz scores were observed in five out of seven modules. Survey data demonstrated strong learner endorsement of the NDVs: 91.7% of students agreed or strongly agreed that the NDVs enhanced their understanding of anatomical concepts. Additionally, 41.7% of students strongly agreed that these modules are beneficial at the start of a block. 75% of students wished for NDVs covering additional anatomy concepts.

CONCLUSIONS
NDVs were associated with improved short-term knowledge acquisition and positive learner perceptions in cranial nerve anatomy. The observed improvements in post-module quiz performance, coupled with strong survey endorsement, support the effectiveness of integrating visual and interactive modalities into undergraduate medical anatomy education. These findings may inform future curricular design aimed at enhancing conceptual understanding and aligning instruction with learner needs.  

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Characterization of the Dunning-Kruger Effect in Thoracic Radiology

Matthew Granzotto, B.S.¹, Ali Beydoun, M.D.², Kiran Nandalur, M.D.³, Sayf Al-Katib, M.D.³

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²University of Michigan, Ann Arbor, MI
³Corewell Health William Beaumont University Hospital, Royal Oak, MI}

INTRODUCTION
The Dunning-Kruger effect states that individuals with lower competency
tend to overestimate their ability. This miscalibration can promulgate serious healthcare consequences, such as diagnostic errors and excess healthcare costs, that permeate beyond medical training into professional practice. This phenomenon has not been explicitly tested in radiology. The aim of this study was to characterize the
Dunning-Kruger effect in thoracic radiology and examine the trends in confidence and competence, among undergraduate medical trainees, radiology residents and attendings, with respect to training level and experience.

METHODS
59 participants completed a cross-sectional assessment testing the ability to interpret
chest CTs of various difficulty. Participants were asked to distinguish benign from malignant causes of chest CT abnormalities. Following completion, participants received a post assessment report with their score which also included the correct diagnoses. Participants reported their confidence before taking the test, after taking the test but
before receiving a score report, and after receiving a score report.

RESULTS
Low performers (≤2 correct) overestimated by 1.0 ± 1.7 cases, while high performers (≥4 correct) underestimated by -1.0 ± 2.7 (p=0.0015). Post-assessment feedback improved participants’ estimations of their relative competency, improving low performer’s initial average overestimation (25.8% ± 30.2% to 12.1% ± 22.3%) and high performer’s underestimation (-33.4% ± 28.3% to -16.2% ± 11.0%), although these findings did not achieve statistical significance (p=0.154 and 0.175, respectively).

CONCLUSIONS
These findings suggest the existence of the Dunning-Kruger effect in thoracic radiology and that post-assessment feedback may be a valuable tool in improving calibration of trainees. This study models a framework for investigating the Dunning-Kruger effect in other diagnostic specialties and these results contribute to increasing diagnostic training efficiency, reducing diagnostic errors and mitigating excess healthcare costs. 

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The Effect of Robot Mediated Instruction on Children with Autism Spectrum Disorder

Nathan Huang, B.S.¹, Pourya Shahverdi, M.S.², Wing-Yue Geoffrey Louie, Ph.D. ²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
² Department of Electrical and Computer Engineering, Oakland University, Rochester, MI}

INTRODUCTION
Children with Autism Spectrum Disorder (ASD) often experience challenges with social communication, peer interaction, and sustained attention in group learning environments. Although previous research has demonstrated positive outcomes in one on one robot mediated interventions, limited evidence exists regarding the effectiveness of robot led instruction in realistic group classroom settings. Because most educational and therapeutic services occur in group contexts, it is important to determine whether robotic instruction can generalize beyond individualized sessions. The purpose of this study was to directly compare robot led and human led group instruction (“Circle Time”) to evaluate their relative effectiveness in promoting engagement, communication, affect, and task performance among children with ASD.

METHODS
This was a within subject comparative study conducted over six months in structured group instructional sessions. Six children diagnosed with ASD participated in both robot led and human led Circle Time sessions, attending 10 sessions in each condition. Behavioral outcomes, including engagement, communication, affect, and task performance, were coded from Session 1 and Session 10 for each instructional condition. Inter observer agreement was established using Cohen’s kappa with a minimum threshold of 80 percent before independent coding. Due to the small sample size and non normal data distribution, the Wilcoxon Signed Rank Test was used for statistical analysis. A Bonferroni correction was applied to adjust for multiple comparisons.

RESULTS
All six participants completed the study and were included in the final analysis. Thirteen behavioral metrics were examined. After Bonferroni correction (adjusted significance threshold 0.00192), no statistically significant differences were found between robot led and human led sessions across measured outcomes. No adverse outcomes were observed.

CONCLUSIONS
Robot led group instruction performed comparably to human led sessions across behavioral domains. These findings suggest social robots may serve as a complementary tool in group based ASD interventions, providing structured instructional support while preserving meaningful human interaction. 

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The Effect of Empathy, Attitudes Toward Suicide, and Peer Influence on Medical Students’ Perception of Suicide Risk

Maya Jaradi, B.S.¹, Jamal Madison, B.S.¹, Kanako Taku, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Psychology, Oakland University, Rochester, MI}

INTRODUCTION
Suicide is a leading cause of death among adolescents and young adults in the United States. Despite growing awareness, many medical students feel unprepared to assess and manage suicide risk effectively. This study examines how empathy, attitudes toward suicide prevention, and peer influence affect medical students' clinical assessments of suicide risk, recovery potential, and discharge decisions.

METHODS
65 medical students from a Midwestern U.S. medical school completed a vignette-based survey. Participants were randomized to either a peer influence group, in which a peer explicitly endorsed patient discharge, or a control group without peer input. They assessed suicide risk, recovery likelihood, and discharge decisions for a hypothetical patient across five time points. Students completed validated measures of empathy and attitudes toward suicide prevention. Analyses included a series of independent-sample t-tests. Significance was set at p < 0.05.

RESULTS
Peer influence did not significantly affect discharge timing (t63 = -1.17; p = 0.245). Participants who chose not to discharge the patient at all time points, no matter what the patient insisted in the vignettes, had significantly less negative attitudes toward suicide prevention (mean = 2.01, SD = 0.29; n = 33) than those who discharged (mean = 2.29, SD = 0.50; n = 32) (t63 = 2.833; p = 0.06). Empathy did not differ significantly by discharge decision (t63 = -0.38; p = 0.71). There were also significant differences in risk assessment but not recovery potential between participants who did not discharge and who did. 

CONCLUSIONS
More negative attitudes toward suicide prevention and perception of lower risk were associated with a greater likelihood of discharge, whereas perception of recovery potential, empathy, or peer influence were not. These results emphasize the need for stigma-reduction training in medical education and greater awareness of how attitudes and context influence clinical decision-making in at-risk patients.

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Survey of Medical Student Attitudes Regarding Uterine Transplant for Cisgender and Transgender Women  

Brandon Kim, B.A.¹, Deidre Hurse, Ph.D.², Abram Brummett, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Uterine transplant (UTx) has become an emerging treatment method for cisgender women with absolute uterine factor infertility (AUFI). Current research shows limited discussion of the clinical feasibility and ethics of expanding UTx eligibility to transgender women. Our objectives for this study were to survey medical students’ attitudes regarding legality, funding, and conscientious objection of UTx in cisgender and transgender women.

METHODS
All currently active medical students at a single-campus medical school were invited to complete an online anonymous survey. Baseline demographics and medical specialty interest were collected, and four-point Likert scales were used on four pairs of questions to evaluate attitudes regarding UTx for cisgender and transgender women. Responses were collected and subjected to analysis. 

RESULTS
A total of 96 responses were collected, and responses were included if they answered at least one of questions 5 to 8, resulting in a final response count of 66. 19 (29%) self-identified as male and 43 (65%) self-identified as female. A majority of respondents (72%) believed that a clinician should be able to object conscientiously to UTx regardless of gender identity, but only 14% would personally object to any UTx. A minority of respondents (10%) would object only to UTx for transgender women. Overall, female respondents (Correlation Coefficient average = .939) were more likely to select the same answer to paired questions regardless of gender identity compared to their male counterparts (Correlation Coefficient avg = .558). 

CONCLUSIONS
This study shows some division among medical students regarding their attitudes toward the legality, funding, and conscientious objection to UTx for cisgender and transgender women. For medical students willing to participate in UTx for cisgender but not transgender patients, additional ethical analysis is needed to determine whether these attitudes constitute invidious discrimination.  

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Pilot Comparison of Wellness-Related Beliefs in Two Medical Student Cohorts

Nora Laban, B.S.¹, Dwayne Baxa, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Medical students develop beliefs about mental and physical health during training that influence how they conceptualize coping, recovery from exhaustion, burnout, and the role of psychological factors in patient care. Educational environments may shape how wellness is discussed and understood. Oakland University William Beaumont School of Medicine (OUWB) incorporates structured wellness programming through its PRISM curriculum. A comparable cohort of Chinese medical students participated in a structured wellness-focused course modeled in part after PRISM. This provided an opportunity to explore how students in two educational contexts conceptualize well-being in medicine.

METHODS
This exploratory cross-sectional study used a custom-designed multiple-choice survey administered to OUWB medical students (n = 26). The comparison cohort consisted of de-identified survey data (n = 26) collected in 2023 from Chinese medical students of similar training level enrolled in 5- or 8-year programs. Survey items assessed coping during training, recovery from mental versus physical exhaustion, perceived psychological influence on patient recovery, recognition of burnout, constructive responses to professional distress, and definitions of a healthy life. Analysis was descriptive given the pilot design and small sample size.

RESULTS
Students in both cohorts reported generally being able to cope with medical training (China 65.2%; U.S. 53.8%). Most perceived physical exhaustion as easier to recover from than mental exhaustion (China 69.6%; U.S. 61.5%). U.S. students more frequently endorsed psychological factors as critically important in physical recovery (69.2% vs. 39.1%) and were more likely to characterize burnout as epidemic (80.8% vs. 56.5%). Views on constructive responses and definitions of a healthy life were broadly similar.

CONCLUSIONS
Substantial overlap exists in wellness beliefs across cohorts, with notable differences in psychological emphasis and burnout framing. Findings are descriptive and hypothesis-generating, supporting further investigation into how cultural and curricular contexts shape professional wellness beliefs.

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A Survey of Medical Student Knowledge of Eating Disorders and Their Treatment

Kellan Martin, B.S.¹, Jaime Taylor, D.O.², Virginia Uhley, Ph.D.³

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Associate Professor, Oakland University William Beaumont School of Medicine, Rochester, MI
³Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Eating disorders (EDs) impact both mental and physical health, and are responsible for roughly 10,200 annual deaths in the U.S. Nine percent of people living in the U.S. will be affected by an ED during their lifetime. Studies have explored physician knowledge of EDs, but there is little-to-no literature on medical student knowledge of EDs. This study aims to assess medical student knowledge of eating disorders and their treatment.

METHODS
Four classes of medical students were invited to participate in a 52-question survey. Responses were anonymous and collected through Qualtrics. The survey evaluated students’ knowledge of ED definitions, statistics, treatment guidelines, and biases. Participants also indicated how much education they had received on EDs in medical school. A summary analysis, as well as a comparison analyses between preclinical (M1/M2) and clinical (M3/M4) students was completed.

RESULTS
Fifty medical students participated in the study, but only 80% (n=40) completed the survey to entirety and were included in analysis (37.5 % clinical and 62.5% preclinical). Participants were most familiar with anorexia nervosa, but least familiar with binge eating disorder (p=.0071). Regarding bias, 72% of preclinical medical students, compared to 87% of clinical students, agreed that EDs are treatable medical conditions (p=0.045). Twenty-three students (57.5%) reported receiving no more than 2 hours of eating disorder education during medical school, and only 1 participant reported receiving 5-10 hours of ED education. 61.5% (clinical) and 75% (preclinical) students felt that that they would benefit from additional eating disorder education.

CONCLUSIONS
Compared to anorexia nervosa, medical students are less familiar with binge-eating disorder, which is the most prevalent ED in the U.S. Students felt that increased eating disorder education would benefit their training and future success as physicians. Our results support the need and importance of including eating disorder education in the medical school curriculum.

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The Impact of Concise, Whiteboard-style Educational Videos in Cardiology

Raywa Masti, B.S.¹, Diedre Brunk, R.N.², Sula Mazimba, M.D.³, Anil Goel, M.D. ², Kavitha Chinnaiyan, M.D.², James Goldstein, M.D. ², Simon Dixon, M.D.², Ilana Kutinsky, M.D. ², Brian Williamson, M.D. ², Nishaki Mehta, M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Cardiology, Corewell Health William Beaumont University Hospital, Royal Oak, MI
³AdventHealth Transplant Institute, Orlando, FL}

INTRODUCTION
Understanding cardiovascular conditions can be challenging for patients. Prior dermatology and oncology studies have demonstrated the utility of educational videos to boost understanding. Concise, whiteboard-style educational videos (cWEV) have improved understanding in students. However, there have been little studies on the impact of cWEV use for cardiac patients. We hypothesized that novel cWEV would significantly increase patients’ understanding about their cardiovascular disease, test, or procedure. 

METHODS
As a quality improvement initiative, a compendium of 35 videos was created on cardiovascular diseases, testing, and procedures. Patients were randomized to a control group where the baseline understanding was assessed after the physician encounter (scale from 1 to 5) or to an intervention group, where the patients were additionally shown a cWEV, and the questionnaire was repeated shortly after. 23 cWEV were shown 93 times to 78 patients, all of whom were surveyed in person. A comparison of assessment scores was done by using paired t-tests. 

RESULTS
The mean baseline level of patient understanding was similar for the control and intervention groups (4.09 vs 4.02, p= 0.5969). After watching the video, the intervention group showed a statistically increased understanding (4.62, p <0.0001). This difference was driven by procedural videos (pre-video: 3.84, post-video: 4.57, p <0.001, n=67) compared to videos on disease (pre-video: 4.46, post-video: 4.62, p= 0.1654, n=13) and testing (pre-video: 4.54, post-video: 4.92, p= 0.0544, n=13). Additionally, the improved understanding from videos was similar in patients seen by invasive and non-invasive physicians (p= 0.1337). 

CONCLUSIONS
Therefore, even shortly after physician education, the short, cWEV incrementally augmented patient understanding. This was especially seen for patients undergoing procedures and was independent of whether education was done by an invasive or
non-invasive cardiologist.

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Gender Differences in Stroke Recovery

Gayaneh Nazarian, B.S.¹, Vardan T. Karmayan, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine}

INTRODUCTION
Stroke remains the world’s second leading cause of long-term disability, with more than 13 million new cases and 5.5 million deaths reported annually [1,2].  Despite advances in acute care, nearly half of stroke survivors experience lasting functional challenges[3]. While rehabilitation is central to post-stroke recovery, outcomes differ significantly between men and women, influenced by biological and social factors[4,5].This study explores gender-based disparities in functional outcomes, rehabilitation responses and emerging neurorestorative therapies[6-8].

METHODS
A narrative systemic review was conducted, incorporating population-based studies, prospective cohorts, systemic reviews, and randomized clinical trials[3,4,6,8-10]. Studies assessed post stroke functional outcomes, physical activity patterns, rehabilitation effectiveness, quality of life, and neurorestorative interventions such as vagus nerve stimulation (VNS), non-invasive brain stimulation, task specific motor therapy, and pharmacologic adjuncts[8,9]. Both ischemic and hemorrhagic stroke populations were included to reflect real-world recovery patterns[6].

RESULTS
Women consistently experience poorer post-stroke functional recovery than men, despite similar or higher survival rates. In a prospective study of 1,055 acute stroke patients, poor functional outcomes were more frequent among women than men at hospital discharge at 3 months and at 1 year3. Women presented with worse functional status and higher pain scores on admission, achieving comparable rehabilitation gains but still leaving therapy with worse outcomes11.
 Men were more likely to increase and sustain physical activity post-stroke, associated with improved recovery during the first six months after stroke, a factor associated with improved recovery[6,9]. Women also reported lower long-term quality of life and were more likely to require institutional care[11,12]. Biological factors such as postmenopausal hormonal changes and social determinants, including limited caregiver availability, further exacerbate disparities[5,15]. 

CONCLUSIONS
Women experience greater disability, slower recovery, and lower quality of life after stroke. Incorporating sex-specific analyses in clinical trials and tailoring rehabilitation to hormonal and social differences could improve functional outcomes and reduce long-term disabilities[4,5,9,10].

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Assessment of Self-Directed Learning Tools in Undergraduate Medical Education: A Systematic Review

Bryan Noirot, B.S.¹, Michelle Rau, MLIS², Misa Mi, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
The LCME has mandated the incorporation of self-directed learning (SDL) into undergraduate medical education. This systematic review seeks to investigate the psychometric properties of the SDL assessment tools that are being utilized in medical education. 

METHODS
The Prisma guidelines were used to guide this systematic review. Comprehensive literature searches were conducted with PubMed, Embase, PsycINFO, ERIC, and SCOPUS to retrieve peer-reviewed journal articles with empirical data, published in English, describing self-directed learning assessment instruments in undergraduate medical education, and that included instrument validation information. A two-step approach to screening was conducted utilizing Covidence, consisting of title and abstract screening followed by full text article selection. Data extracted included the study setting, participants, SDL assessment tool used, psychometric properties, and outcomes. 

RESULTS
Out of 907 studies retrieved, 119 studies from title and abstract screening underwent full text screening, with 31 studies selected for this review. Selected studies were conducted across diverse regions mostly in India, and primarily involved first-year medical students. Assessment measures were variable, with surveys/questionnaires most frequently used, followed by multiple-choice questions/exams. Evidence supporting measurement rigor was inconsistent, with only 6 studies reporting both validity and reliability for SDL assessment tools. Only 1 study reported observed behavioral measures via faculty/resident evaluation of SDL behaviors. Evidence of validated educational outcomes was limited, with only 2 studies reporting statistically significant standardized exam outcomes. The majority of studies inferred SDL behaviors through self-reports or reflections.

CONCLUSIONS
SDL interventions are assessed via predominantly learner-reported measures. Learners consistently reported increased SDL confidence and educational value, but these findings were largely self-reported and not corroborated by objective measures. This highlights a gap between SDL implementation and rigorous SDL assessment. Future research should prioritize validated measurement instruments, and the incorporation of objective behavior outcomes to strengthen the evidence for SDL in undergraduate medical education. 

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Dynamic Identification Checklists In The Anatomy Dissection Lab – Approach to Enhance Formative Feedback Through Multi-Faceted Communication and Self-Monitoring

Giuliano Romano, B.S.¹, Stefanie Attardi, Ph.D.², Jickssa Gemechu, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Large-group sessions in medical curricula, coupled with high content volume, make it challenging for students to monitor progress and communicate with peers and faculty. Checklists clarify learning expectations but often lack real-time communication capabilities. This study developed and evaluated a dynamic checklist system using Google Workspaces to enhance formative feedback through improved communication and self-monitoring. We compared student perceptions of self-monitoring, peer communication, and student-faculty communication when using dynamic Lab Identification Checklists (LICs) versus static LICs.

METHODS
In a quasi-experimental, cross-sectional study at a U.S. allopathic medical school, two first-year cohorts completed a dissection-based course using either static LICs (Class of 2026; n=125) or dynamic Google Sheets LICs that aggregated team progress in real time (Class of 2027; n=125). An anonymous 19-item Likert survey assessed agreement (use) and helpfulness of LIC functions. Responses from students in 2026 (n=50; 40% response) and 2027 (n=46; 36.8% response) were compared with Mann–Whitney U tests (α&lt;0.05).

RESULTS
Compared to static LICs, students using dynamic LICs reported greater agreement with viewing the LICs as communication tools and found them more helpful in communicating dissection progress to other teams and faculty, and preparing for examinations.

CONCLUSIONS
This study demonstrates that dynamic LICs utilizing accessible technology can enhance communication during gross anatomy dissection. This work serves as the foundation for developing low-cost, widely available formative feedback tools that could be applied in other health professions education contexts. 

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Analysis of ChatGPT-3.5’s Potential in Generating NBME-Standard Pharmacology Questions: What Can Be Improved?

Marwa Saad, B.S.¹, Wesam Almasri, B.A.¹, Tanvirul Hye, Ph.D.², Monzurul Roni, Ph.D.³, Changiz Mohiyeddini, Ph.D.⁴

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Roseman University College of Medicine, Las Vegas, NV
³University of Illinois College of Medicine Peoria, Peoria, IL
⁴Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
ChatGPT by OpenAI is an AI model designed to generate human-like responses based on diverse datasets. Our study evaluates ChatGPT-3.5's capability to generate pharmacology multiple-choice questions adhering to the NBME guidelines for USMLE Step exams. Initial findings show ChatGPT's rapid adoption and potential in healthcare education and practice. However, concerns about its accuracy and depth of understanding prompted this evaluation.

METHODS
Using a structured prompt engineering process, ChatGPT was tasked to generate questions across various organ systems, which were then reviewed by pharmacology experts.

RESULTS
ChatGPT consistently met NBME criteria, achieving an average score of 13.7 out of 16 (85.6%) from expert 1 and 14.5 out of 16 (90.6%) from expert 2, with a combined average of 14.1 out of 16 (88.1%) (Kappa coefficient = 0.76). Despite these high scores, challenges in medical accuracy and depth were noted, often producing "pseudo vignettes" instead of in-depth clinical questions.

CONCLUSIONS
ChatGPT-3.5 shows potential for generating NBME-style questions, but improvements in medical accuracy and understanding are crucial for reliable use in medical education. This study underscores the need for AI models tailored to the medical domain to enhance educational tools for medical students.

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How Do Intrinsic and Extrinsic Factors Influence Medical Professionals in Work-Family Conflicts?: A Pilot Single Health System Investigation

Evan Sangster, B.S.¹, Mark Whitton, B.S.¹, Abram Brummett, Ph.D.², Cameron Davidson, Ph.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
With physician burnout and suicidality present at alarming rates, there is increased concern for the contribution of work-family conflicts in the mental strains experienced by medical professionals. In order to address such concerns, there is a need for studies that analyze factors related to moral decision making in work-family conflicts and for studies that extrapolate how such factors protect or add to the mental and emotional strain of medical professionals. 

METHODS
This study utilizes a pilot, scenario-based survey with high- and low-pressure modifiers to quantify respondent decision making, outcome guilt, and decision confidence in medical professionals from a single health system.

RESULTS
Utilizing the responses of 37 participants, results demonstrate significant moral influences due to understaffed rural environments, family visitation frequency, family event importance, and level of training. Increased respondent guilt and confidence were found to have significant association with high pressure family stressors while decreased guilt and confidence significantly associated with increased professional stressors. Significant influences were not found pertaining to gender, year of graduation (students only), ethnicity, marital status, presence of children in household, religion, generation of citizenship, medical specialty, number of hours studied (students only), hours worked per week (professionals only), and subjective workplace support (professionals only).

CONCLUSIONS
Through a scenario-based survey, we identified significant relationships between contextual pressures and measures of confidence and guilt, offering preliminary insight into how professional and personal stressors shape moral tendencies and potential burnout risk. Understanding how these medical professionals navigate competing moral pressures between work and family provides a foundation for designing future investigations and interventions. Programs emphasizing supportive teams, moral resilience, structured mentorship, and institutional flexibility may help mitigate the emotional consequences of these conflicts. 

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Medical Student Perceptions of Substance Use Disorders

Yunjoo Shin, M.D.¹, Adam Shammami, D.O.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Family Medicine and Community Health, Corewell Health William Beaumont University Hospital, Troy, MI}

INTRODUCTION
Substance use disorders (SUDs) remain a major public health concern, yet negative attitudes among healthcare providers often perpetuate stigma and impede effective treatment. This study aims to characterize levels of stigma among pre-clinical medical students at Oakland University William Beaumont School of Medicine (OUWB). Specifically, we sought to assess current attitudes toward patients with SUDs and compare these attitudes with perceptions of patients with non-stigmatized conditions.

METHODS
A cross-sectional survey was administered to pre-clinical students. The Medical Condition Regard Scale (MCRS), an 11-item validated instrument, was used to assess attitudes toward SUDs and comparators. Responses were analyzed using descriptive statistics, ANOVAs, and multivariate regression to compare mean MCRS scores across conditions and subgroups.

RESULTS
Of 250 eligible students, 62 (24.8%) completed the survey. A one-way ANOVA was conducted to compare mean MCRS scores among conditions. There was a significant effect of condition on MCRS scores, F(2, 183) = 69.58, p < .001. Post-hoc Tukey HSD tests revealed that all pairwise group differences were statistically significant (p < .05). Students expressed the most positive attitudes toward patients with cancer (M = 57.17, SD = 4.46), followed by substance use disorder (M = 49.29, SD = 6.02), and then diabetes (M = 47.48, SD = 3.84).

CONCLUSIONS
Pre-clinical medical students demonstrated attitudinal differences toward patients with SUDs compared to other chronic illnesses. This is in line with findings from previous studies that identified differences in perspectives towards patients with stigmatized disorders versus patients with other chronic conditions such as TIIDM and cancer. The current study found the largest attitudinal difference between SUDs and cancer. There was low survey response rate, which could have introduced response bias. Incorporating targeted stigma-reduction and addiction-medicine education early in medical training may promote empathy, reduce bias, and enhance future patient care outcomes.

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Patterns of Academic Productivity at OUWB School of Medicine: Insights from a Decade of Departmental Trends (2013–2024)

Lauren Troppens, B.S.¹, Louis Zingas , M.S.¹, Varna Taranikanti, M.D.²

_{¹Oakland University William Beaumont School of Medicine, Rochester, MI
²Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI}

INTRODUCTION
Academic productivity is a critical measure of institutional success, reflecting research, innovation, and contributions to medical education. This study analyzes publication trends across departments at Oakland University William Beaumont (OUWB) School of Medicine from 2013 to 2024, with a focus on cumulative contributions, growth rates, and key areas of excellence. Insights aim to identify high-performing departments and opportunities for targeted support.

METHODS
Data were collected from the OUWB medical library by analyzing annual publication lists from 2013 to 2024. These lists included various publication types, such as peer-reviewed articles, books and book chapters, MedEd Portal submissions, meeting abstracts, and miscellaneous publications. Cumulative totals and year-over-year growth rates were calculated for each department. Trends were visualized using line graphs, bar charts, and combined visualizations of total output and growth rates.

RESULTS
Internal Medicine was the top-performing department with 1,590 cumulative publications and an average annual growth rate of 4.26%. Surgery and Urology followed with 1,035 and 794 total publications, respectively, and average growth rates of 7.98% and 7.37%. Emergency Medicine demonstrated the highest growth rate at 10.71%, reflecting rapid increases in output. Other departments, such as Pathology (577 total publications) and Radiology (507 total publications), showed steady contributions but moderate growth rates. MedEd Portal submissions and meeting abstracts exhibited variability, suggesting targeted areas for strategic focus.

CONCLUSIONS
Internal Medicine leads in overall productivity, while departments like Emergency Medicine show the greatest growth potential. Tailored interventions, such as grant-writing workshops and interdisciplinary collaborations, could further enhance output. Tracking trends over time provides a framework for fostering equitable academic contributions across departments.

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