Alice A Min Simpkins

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Scholarly Contributions

Journals/Publications

• Min Simpkins, A. A., Koch, B. D., Spear-Ellinwood, K. C., & St. John, P. (2019). A developmental assessment of clinical reasoning in preclinical medical education.. Medical Education Online.
• St. John, P., St. John, P., Spear-Ellinwood, K. C., Spear-Ellinwood, K. C., Koch, B. D., Koch, B. D., Min Simpkins, A. A., & Min Simpkins, A. A. (2019). A developmental assessment of clinical reasoning in preclinical medical education. Medical Education Online, 24(1), 10. doi:10.1080/10872981.2019.1591257
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  Alice A. Min Simpkins, Bryna Koch, Karen Spear-Ellinwood & Paul St. John (2019) A developmental assessment of clinical reasoning in preclinical medical education, Medical Education Online, 24:1, DOI: 10.1080/10872981.2019.1591257 ABSTRACT Background: Clinical reasoning is an essential skill to be learned during medical education. A developmental framework for the assessment and measurement of this skill has not yet been described in the literature. Objective: The authors describe the creation and pilot implementation of a rubric designed to assess the development of clinical reasoning skills in pre-clinical medical education. Design: The multi-disciplinary course team used Backwards Design to develop course goals, objectives, and assessment for a new Clinical Reasoning Course. The team focused on behaviors that students were expected to demonstrate, identifying each as a ‘desired result’ element and aligning these with three levels of performance: emerging, acquiring, and mastering. Results: The first draft of the rubric was reviewed and piloted by faculty using sample student entries; this provided feedback on ease of use and appropriateness. After the first semester, the course team evaluated whether the rubric distinguished between different levels of student performance in each competency. A systematic approach based on descriptive analysis of mid- and end of semester assessments of student performance revealed that from mid- to end-of-semester, over half the students received higher competency scores at semester end. Conclusion: The assessment rubric allowed students in the early stages of clinical reasoning development to understand their trajectory and provided faculty a framework from which to give meaningful feedback. The multi-disciplinary background of the course team supported a systematic and robust course and assessment design process. The authors strongly encourage other colleges to support the use of collaborative and multi-disciplinary course teams.
• Min Simpkins, A. A. (2018). Academic Life in Emergency Medicine (ALiEM) Blog and Podcast Watch: Renal and Genitourinary Emergencies. Cureus.
• Min Simpkins, A. A. (2018). Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies. Advances in Medical Education and Practice.
• Min, A. A., Jordan, J., Swaminathan, A., Hennings, J., & Grock, A. (2018). Academic Life in Emergency Medicine (ALiEM) Blog and Podcast Watch: Renal and Genitourinary Emergencies. Cureus, 10(12), e3756.
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  The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) series and Approved Instruction Resources Professional (AIR-Pro) series were created in 2014 and 2015, respectively, to address the need for the curation of online educational content as well as a nationally available curriculum that meets individualized interactive instruction criteria. These two programs identify high-quality educational blog and podcast content using an expert-based approach. The AIR series is a continuously building curriculum originally based on the Council of Emergency Medicine Directors (CORD) testing schedule. Using the ALiEM AIR scoring instrument, 49 blog posts and podcasts relevant to renal and genitourinary emergencies published within the previous 12 months were evaluated by eight attending physicians. We summarize the 13 posts that met our a priori determined quality criteria per evaluation by the reviewers. The ALiEM Blog and Podcast Watch series identifies high-quality educational blogs and podcasts for emergency medicine clinicians through its expert panel, using a validated scoring instrument. While this article focuses on renal and genitourinary emergencies, additional AIR modules address other topics in emergency medicine. The AIR and AIR-Pro series provide post-publication accreditation and curation of recent online content to identify and recommend high-quality educational social media content for the EM clinician.
• Min, A. A., Morley, E. J., Rezaie, S. R., Fox, S. M., & Grock, A. (2018). Academic Life in Emergency Medicine Blog and Podcast Watch: Respiratory Emergencies. Cureus, 10(6), e2812.
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  The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) Series and Approved Instruction Resources Professional (AIR-Pro) Series were created in 2014 and 2015, respectively, to address the need for curation of online educational content as well as a nationally available curriculum that meets individualized interactive instruction criteria. These two programs identify high-quality educational blog and podcast content using an expert-based approach. We summarize the accredited posts on respiratory emergencies that met our a priori determined quality criteria per evaluation by eight experienced faculty educators in emergency medicine.
• Waterbrook, A. L., Spear Ellinwood, K. C., Pritchard, T. G., Bertels, K., Johnson, A. C., Min, A., & Stoneking, L. R. (2018). Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies. Advances in medical education and practice, 9, 307-315.
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  Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills.
• Grock, A., Rezaie, S., Swaminathan, A., Min Simpkins, A. A., Shah, K., & Lin, M. (2017). Blog and podcast watch: Orthopedic emergencies. Western Journal of Emergency Medicine.
• Grock, A., Rezaie, S., Swaminathan, A., Min, A., Shah, K. H., & Lin, M. (2017). Blog and Podcast Watch: Orthopedic Emergencies. The western journal of emergency medicine, 18(3), 531-538.
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  The Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing ALiEM Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of orthopedic emergencies from the AIR series.
• Min, A. A. (2016). Development of a novel sports medicine rotation for emergency medicine residents. Journal of Advances in Medical Education and Practice.
• Min, A. A., Leetch, A., Nuno, T., & Fiorello, A. B. (2016). Will you FIT? Use of a modified MMI by an emergency medicine residency program. Medical Education Online.
• Min, A. A., Leetch, A., Nuño, T., & Fiorello, A. B. (2016). How well will you FIT? Use of a modified MMI to assess applicants' compatibility with an emergency medicine residency program. Medical education online, 21, 29587.
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  Emergency medicine residency programs have evaluated the use of Multiple Mini Interviews (MMIs) for applicants. The authors developed an MMI-style method called the Fast Interview Track (FIT) to predict an applicant's 'fit' within an individual residency program.
• Min, A. A., Spear-Ellinwood, K. C., Berman, M., Nisson, P., & Rhodes, S. M. (2016). Social worker assessment of bad news delivery by emergency medicine residents: a novel direct-observation milestone assessment. Internal and Emergency Medicine.
• Min, A. A., Spear-Ellinwood, K., Berman, M., Nisson, P., & Rhodes, S. M. (2016). Social worker assessment of bad news delivery by emergency medicine residents: a novel direct-observation milestone assessment. Internal and emergency medicine, 11(6), 843-52.
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  The skill of delivering bad news is difficult to teach and evaluate. Residents may practice in simulated settings; however, this may not translate to confidence or competence during real experiences. We investigated the acceptability and feasibility of social workers as evaluators of residents' delivery of bad news during patient encounters, and assessed the attitudes of both groups regarding this process. From August 2013 to June 2014, emergency medicine residents completed self-assessments after delivering bad news. Social workers completed evaluations after observing these conversations. The Assessment tools were designed by modifying the global Breaking Bad News Assessment Scale. Residents and social workers completed post-study surveys. 37 evaluations were received, 20 completed by social workers and 17 resident self-evaluations. Social workers reported discussing plans with residents prior to conversations 90 % of the time (18/20, 95 % CI 64.5, 97.8). Social workers who had previously observed the resident delivering bad news reported that the resident was more skilled on subsequent encounters 90 % of the time (95 % CI 42.2, 99). Both social workers and residents felt that prior training or experience was important. First-year residents valued advice from social workers less than advice from attending physicians, whereas more experienced residents perceived advice from social workers to be equivalent with that of attending physicians (40 versus 2.9 %, p = 0.002). Social worker assessment of residents' abilities to deliver bad news is feasible and acceptable to both groups. This formalized self-assessment and evaluation process highlights the importance of social workers' involvement in delivery of bad news, and the teaching of this skill. This method may also be used as direct-observation for resident milestone assessment.
• Waterbrook, A. L., Pritchard, T. G., Lane, A. D., Stoneking, L. R., Koch, B. D., McAtee, R., Grall, K. H., Min, A. A., Prior, J., Farrell, I. J., McNulty, H. G., & Stolz, U. (2016). Development of a novel sports medicine rotation for emergency medicine residents. Advances in medical education and practice, 7, 249-55. doi:https://doi.org/10.2147/AMEP.S92428
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  Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.
• Min, A. A., Sbarra, D. A., & Keim, S. M. (2015). Sleep disturbances predict prospective declines in resident physicians' psychological well-being. Medical education online, 20, 28530.
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  Medical residency can be a time of increased psychological stress and sleep disturbance. We examine the prospective associations between self-reported sleep quality and resident wellness across a single training year.
• Beskind, D. L., Hiller, K. M., Stolz, U., Bradshaw, H., Berkman, M., Stoneking, L. R., Fiorello, A., Min, A., Viscusi, C., & Grall, K. J. (2014). Does the experience of the writer affect the evaluative components on the standardized letter of recommendation in emergency medicine?. The Journal of emergency medicine, 46(4), 544-50.
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  The Standardized Letter of Recommendation (SLOR) was developed in an attempt to standardize the evaluation of applicants to an emergency medicine (EM) residency.
• Min, A. A., Stoneking, L. R., Grall, K. H., & Spear-Ellinwood, K. (2014). Implementation of the Introductory Clinician Development Series: an optional boot camp for Emergency Medicine interns. Advances in medical education and practice, 5, 275-9.
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  The transition from medical student to first-year intern can be challenging. The stress of increased responsibilities, the gap between performance expectations and varying levels of clinical skills, and the need to adapt to a new institutional space and culture can make this transition overwhelming. Orientation programs intend to help new residents prepare for their new training environment.
• Stoneking, L. R., Grall, K. H., Min, A., Dreifuss, B., & Spear Ellinwood, K. C. (2014). Role of an audience response system in didactic attendance and assessment. Journal of graduate medical education, 6(2), 335-7.
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  The Residency Review Committee for Emergency Medicine mandates conference participation, but tracking attendance is difficult and fraught with errors. Feedback on didactic sessions, if not collected in real time, is challenging to obtain.
• Hiller, K. M., Stoneking, L., Min, A., & Rhodes, S. M. (2013). Syndromic surveillance for influenza in the emergency department-A systematic review. PloS one, 8(9), e73832.
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  The science of surveillance is rapidly evolving due to changes in public health information and preparedness as national security issues, new information technologies and health reform. As the Emergency Department has become a much more utilized venue for acute care, it has also become a more attractive data source for disease surveillance. In recent years, influenza surveillance from the Emergency Department has increased in scope and breadth and has resulted in innovative and increasingly accepted methods of surveillance for influenza and influenza-like-illness (ILI). We undertook a systematic review of published Emergency Department-based influenza and ILI syndromic surveillance systems. A PubMed search using the keywords "syndromic", "surveillance", "influenza" and "emergency" was performed. Manuscripts were included in the analysis if they described (1) data from an Emergency Department (2) surveillance of influenza or ILI and (3) syndromic or clinical data. Meeting abstracts were excluded. The references of included manuscripts were examined for additional studies. A total of 38 manuscripts met the inclusion criteria, describing 24 discrete syndromic surveillance systems. Emergency Department-based influenza syndromic surveillance has been described worldwide. A wide variety of clinical data was used for surveillance, including chief complaint/presentation, preliminary or discharge diagnosis, free text analysis of the entire medical record, Google flu trends, calls to teletriage and help lines, ambulance dispatch calls, case reports of H1N1 in the media, markers of ED crowding, admission and Left Without Being Seen rates. Syndromes used to capture influenza rates were nearly always related to ILI (i.e. fever +/- a respiratory or constitutional complaint), however, other syndromes used for surveillance included fever alone, "respiratory complaint" and seizure. Two very large surveillance networks, the North American DiSTRIBuTE network and the European Triple S system have collected large-scale Emergency Department-based influenza and ILI syndromic surveillance data. Syndromic surveillance for influenza and ILI from the Emergency Department is becoming more prevalent as a measure of yearly influenza outbreaks.
• Stoneking, L. R., Grall, K. H., Min, A. A., & Panchal, A. R. (2013). Online research article discussion board to increase knowledge translation during emergency medicine residency. Advances in medical education and practice, 4, 17-21.
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  Many clinicians have difficulties reading current best practice journal articles on a regular basis. Discussion boards are one method of online asynchronous learning that facilitates active learning and participation. We hypothesized that an online repository of best practice articles with a discussion board would increase journal article reading by emergency medicine residents.
• Wang, H. E., Min, A., Hostler, D., Chang, C. H., & Callaway, C. W. (2005). Differential effects of out-of-hospital interventions on short- and long-term survival after cardiopulmonary arrest. Resuscitation, 67(1), 69-74.
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  The aim of this study was to describe the relationship between prehospital clinical variables, interventions and survival time after cardiac arrest and to determine whether various factors affect the risk of death differently at early and late time periods.

Presentations

• Min Simpkins, A. A., Parikh, T. M., & Ricker, M. A. (2019, October). Individual and Organizational Resiliency through Mentorship: Tools to Effect Change. 2019 Strategies to Promote the Well-being of Health Professionals in the Learning and Work Environments. Washington, DC: The Center for Innovation and Leadership in Education - Georgetown University.
• Min Simpkins, A. A. (2018, February). The CoPE Project. Society of Academic Emergency Medicine Western Regional Annual Meeting. Albuquerque, NM.
• Gordon, H., St. John, P., & Min, A. A. (2016, April). Facilitating in a Hybrid Learning Environment – Live Demo!. Western Group on Educational AffairsAmerican Association of Medical Colleges.
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  Workshop where UACOM-T med students demonstrated a clinical reasoning ThinkShare + live session before an audience.
• Hiller, K. M., Beskind, D. L., Bradshaw, H. R., Berkman, M. R., Viscusi, C. D., Min, A. A., Grall, K., & Stoneking, L. R. (2013, June). How Much do Students Cost? Clinical Productivity in the Academic Emergency Department. Western Regional Society for Academic Emergency Medicine Annual Conference.
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  Long Beach, CA

Poster Presentations

• Gordon, H., Min Simpkins, A. A., & Cooley, J. H. (2018, July). Creation and Assessment of an Interprofessional Activity Using Thinkshare. AACP Annual Meeting. Boston, MA: American Association of Colleges of Pharmacy.

Creative Productions

• Min Simpkins, A. A., Ricker, M. A., & Rice, A. (2020. FLEXcast - EPISODE 6: Negotiations.
• Min Simpkins, A. A., Ricker, M. A., Clemens, C. J., & Rice, A. (2020. FLEXcast - EPISODE 1: Personal Mission and Vision.
• Min Simpkins, A. A., Ricker, M. A., Rice, A., & Nfonsam, V. N. (2020. FLEXcast - EPISODE 4: Racism and Privilege in Medicine.
• Min Simpkins, A. A., Ricker, M. A., Rice, A., & Smith, K. W. (2020. FLEXcast - EPISODE 5: Mentorship.
• Min Simpkins, A. A., Ricker, M. A., Rice, A., & Vanderah, T. W. (2020. FLEXcast - EPISODE 2: Time Management.
• Min Simpkins, A. A., Rice, A., & Ricker, M. (2015. FLEXcast (Faculty Learning Exchange podcast). Podcast.
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  Faculty Learning EXchange Podcast - Mari Ricker, MD, Amber Rice, MD and I designed, created, implemented, edited, and continue to produce this ongoing resource for Faculty Development. FLEXcast is the College of Medicine - Tucson podcast dedicated to sharing ideas and practices for career development and wellbeing for faculty. Faculty discuss their experiences, challenges, and successes in their professional growth and bring attention to resources in the literature, in our own institution, and in the community. We hope this exchange of ideas and knowledge will benefit all faculty in reaching their professional goals. https://medicine.arizona.edu/faculty-staff/offices/faculty-affairs/career-development/flexcastEpisode #1: Creating a Personal Vision, December 2019Episode #2: Time Management, February 2020Episode #3: Leading in these Complex Times, April 2020Episode #4: Racism in Medicine, August 2020Episode #5: Mentorship, November 2020Episode #6: Negotiations, December 2020

Other Teaching Materials

• Leetch, A. N., Drummond, B., Min Simpkins, A. A., & Hiller, K. M. (2018. Influenza. University of Arizona Residency in Emergency Medicine Podcast.
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  Podcast about influenza
• Min Simpkins, A. A. (2018. Cervical Spine injury Part 2. University of Arizona Residency Emergency Medicine Podcast.

Others

• Hiller, K. M., Beskind, D. L., Bradshaw, H. R., Berkman, M. R., Viscusi, C. D., Min, A. A., Grall, K., & Stoneking, L. R. (2013, June). How Much do Students Cost? Clinical Productivity in the Academic Emergency Department. Western Regional Society for Academic Emergency Medicine Annual Conference.
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  Long Beach, CA