key: cord-0708563-cqjs48wf authors: Michener, Alyson; Fessler, Emily; Gonzalez, Mariana; Miller, Rachel K. title: 5M’s and More: A New Geriatric Medical Student Virtual Curriculum during the COVID‐19 Pandemic date: 2020-09-21 journal: J Am Geriatr Soc DOI: 10.1111/jgs.16855 sha: a05472dc52d7819ef520b6cc3386b448467b2d1e doc_id: 708563 cord_uid: cqjs48wf nan pandemic on older adults triggered a focus on geriatric populations often underrepresented in medical education. We developed a two-week virtual elective for clerkship students to meet the increased demand for both online learning and geriatrics education. The Geriatric 5Ms is a way to succinctly describe the core competencies of Geriatric Medicine. 1 This framework consolidates many tenets of geriatrics into five topics (medications, mobility, mind, multi-complexity, and matters most) and has been used as a teaching tool at all levels of medical education. We utilized the 5Ms and the context of the COVID-19 pandemic to structure our curriculum. Given previous work showing that medical students prefer multiple learning styles 2 , we intentionally incorporated a combination of synchronous and asynchronous modalities to meet the needs of learners within the confines of a virtual educational environment. Here we describe the design, implementation, and evaluation of our novel virtual geriatrics elective. We developed a two-week, multimodal, virtual geriatrics elective (table 1, supplemental table 1) . Each day of course instruction included a combination of short online didactics (presented live or pre-recorded), readings, podcasts, interactive cases, discussion board posts, and virtual group discussions. We used a learning management system (Canvas Ó ) to organize the course. Assignments encouraged students to reflect on the relevance of 5M principles in the COVID-19 pandemic to underscore the importance of course content. The curriculum was offered as an optional elective; our institution does not require geriatrics rotations during the pre-clinical or clinical years. We selected articles, podcasts, and other online resources that corresponded to each of the 5Ms (supplemental table 2). Students were asked to review material independently and respond to discussion prompts on Canvas Ó for both preceptor and peer review. Aquifer Geriatrics is a set of 26 virtual patient cases designed to help students learn principles of geriatric medicine. 3 We selected six cases that fit with the themes of the course for independent completion. Students worked in groups of 3 to 8 for select course assignments and discussions (supplemental table 3). All group meetings were virtual. Some occurred as breakout groups within a scheduled large group meeting and others were coordinated by students. The course faculty hosted 2-3 large group meetings per week on a virtual meeting platform. This included short slide presentations and discussion of small group work. Students identified and interviewed a relative, community member, or primary care patient by telephone during the second week of the course using selected question prompts (supplemental table 4). Two geriatrics faculty and two geriatrics fellows created and led the course. While the course was running, feedback for assignments was divided among course leaders. Course leaders also Accepted Article This article is protected by copyright. All rights reserved. divided four hours of synchronous instruction during week one of the course and eight hours during week two. We used a designated Canvas Ó discussion board for real-time feedback throughout the course including any technical difficulties. At the end of the elective, we distributed an optional and anonymous survey via Qualtrics Ó asking students to rate course components and their experience on a 5-point Likert scale. The University of Pennsylvania Institutional Review Board (IRB) determined that the project qualified as Quality Improvement work and thus was exempt from full IRB review. Qualtrics Ó (67.6%). All students had completed at least one clinical clerkship and were in their second (n=25), third (n=8), or fourth (n=1) year of medical school. 95.6% of respondents agreed (somewhat agreed or strongly agreed) that the course was well organized and objectives were clear (n=22). We asked respondents to evaluate the different course modalities. 74% agreed that the discussion posts enhanced learning (n=17), 83% agreed that the Aquifer cases enhanced learning (n=19), 74% agreed that the group activities enhanced learning (n=17), and 87% agreed that the large group virtual meetings enhanced learning (n=20). After taking the course, almost all respondents felt more prepared to take care of older adults (96%, n=22). In addition, almost all felt more aware of the impact of the pandemic on older adults (91%, n=21). Open-ended course feedback highlighted new appreciation for geriatric principles, especially the 5Ms framework and polypharmacy/deprescribing. Feedback also included a range of opinions Accepted Article This article is protected by copyright. All rights reserved. regarding different teaching modalities. One recurring theme was a preference for small group discussion (Table 1 ). Our virtual geriatrics elective made students feel more prepared to care for older adults by increasing students' appreciation of geriatric principles represented by the 5Ms framework. The context of COVID-19 increased student engagement with course content. Moreover, the multimodal format allowed for both synchronous and asynchronous learning. Consistent with prior research, comments from learners highlighted individual preferences for different learning modalities 2 Notably, many favored interactive small group sessions using virtual meeting software. From a faculty perspective, asynchronous assignments such as discussion board posts allowed course instructors to participate around clinical obligations. One limitation to this format is the time-intensive nature of providing written feedback to multiple student assignments. When this was noted, we did alternate between individual and class-wide comments. Both were wellreceived. Based on real-time feedback we were able to convert one written assignment to an additional small group session, and plan to include more group-based virtual learning in future iterations of the curriculum. Geriatrics has long been underrepresented in medical education. This course demonstrates that broadening medical student exposure to geriatrics through multi-modal online learning is both feasible and well-received. Moving forward, we must continue to foster student awareness of geriatric principles after the COVID-19 pandemic has passed from the national spotlight. -"Will recognize the importance of representation of geriatricians on policy committees/boards" -"Considering the number of geriatric patients we see throughout our rotations, I"m honestly surprised it"s only an elective" A, Asynchronous learning; S, Synchronous learning Wrap-up This article is protected by copyright. All rights reserved. The Geriatrics 5M's: A New Way of Communicating What We Do First-year medical students prefer multiple learning styles Introducing Aquifer Geriatrics, the American Geriatrics Society National Online Curriculum Supplemental Table 4: Prompt for day 9 activity This article is protected by copyright. All rights reserved.We gratefully acknowledge the University of Pennsylvania medical students who participated in our course and submitted feedback through our course evaluation. Sponsor's Role: None.