Health Sciences Education Symposium

First Author Information

Brian Cassel, PhD, VCU School of Medicine

Additional Author(s) Information

Robert DeGrazia Jr MD MHS FACP, VCU School of Medicine

Tim Aro, VCU Wright Center

Patrick Shi, VCU Wright Center

Presentation Format

Poster

Type of Activity

Innovation

Original Presentation Date

2023

Date of Submission

March 2023

Abstract/Short Description

Purpose and background: While VCU is an R1 university, many students graduate without first-hand research experience. We sought to create a new learning opportunity for second year medical students (M2s) through access to real-world clinical data from a federated research network of healthcare organizations, TriNetX. TriNetX gives users access to millions of de-identified patient records for a wide variety of purposes: cohort discovery; determining possible enrollment rates for clinical trials; evaluating outcomes; and evaluating disparities. Several VCU researchers have published studies using TriNetX data [i]. Prior to our project, TriNetX access and instruction had not been pushed out to medical students. Our project offered access and instruction in TriNetX to M2 students in the Population Health & Evidence-Based Medicine (PopHealth) course, and we encouraged them to use TriNetX to fulfill a research project requirement.

Innovative Practice: We automated access to TriNetX for all 185 M2s students before their first PopHealth session in early August. We developed and delivered instructional sessions on TriNetX including demonstrations and an in-depth review of a TriNetX study conducted by VCU researchers [ii]. We re-designed the self-directed research project to allow students to choose either the traditional research proposal or a TriNetX-based mini-study. We aligned the project deliverables for the two pathways to make them equitable. Mid-semester, we reviewed teams’ descriptions of their intended project and offered support and suggestions.

Results: Eight teams (20%) conducted a mini-study using TriNetX. All of them made use of additional faculty meeting time for help. Topics included:

Outcomes of new drug for chronic Hepatitis-C Heart failure outcomes in pediatric populations Disparities in advanced HIV disease

End-of-semester evaluations regarding TriNetX were mixed:

“I was also really excited to learn about TriNetX. I didn’t know databases like that existed before I took this class. It is definitely a component of the course that should be included for next year’s M2s. Even though my group did not end up using this for our project, I hope to use TriNetX in the future.” “I enjoyed using TRINETX for the assignment!” “I think having a [full] class dedicated to TriNetX could be helpful and might address the disparity in groups choosing research proposal over TriNetX.” “I feel like we should have had more sessions on how to use trinex”

Conclusion: Professionalism in medicine today requires the ability to access, interrogate, and evaluate data in order to provide evidence-based care to all patients. Health professionals should know how to access secondary datasets to evaluate quality of care, conduct independent research, determine feasibility of clinical trial enrollment, detect disparities, and evaluate real-world implementation of new treatments. Our own reflections on this experiment are largely concordant with the students’ feedback. Our plans for modifying our approach include:

Set aside more classroom time for TriNetX instruction, demonstration, and student practice. Divide the class into smaller groups for student-led explorations of TriNetX. Develop worksheets to guide self-directed learning outside of the classroom.

Future research: We will conduct a survey of the M2 students to get additional feedback. We will create and offer an elective for medical students on using TriNetX for research, and will evaluate students’ experience. We believe that other Health Sciences schools could explore similar innovations, perhaps in an inter-professional context, on which we would enthusiastically collaborate.

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VCU Medical Education Symposium

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