Kevin F Moynahan

Interests

Research

Medical Education and learning communities within medical education

Teaching

Clinical medicine, clinical thinking and decision making, clinical skills training, learning communities

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• Moynahan, K. F. (2023).

  Development and evaluation of a pre-clerkship spiral curriculum: data from three medical school classes.

  . Medical Education Online, 28(1). doi:10.1080/10872981.2023.2167258
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  Pre-clerkship curricula of most Liaison Committee on Medical Education (LCME)-accredited medical schools are divided into blocks by organ system, leaving a significant amount of information susceptible to loss due to prolonged nonuse. We describe the implementation of a formal Spiral Curriculum that periodically revisits material from previous blocks. Learners were surveyed on receptivity to the curriculum across three graduating classes at a single medical school. Medical school graduate classes of 2020, 2021, and 2022 were surveyed at the end of their pre-clerkship years (2018-2020). The class of 2022 actually received the Spiraled Curriculum intervention, for which the authors created 500 board exam style multiple-choice questions, periodically administered via mandatory in-class sessions ranging from 10 to 20 questions reviewing content from previous blocks with designated expert faculty. Response rates were 36% (n = 46), 45% (n = 52), and 32% (n = 40) for classes of 2020, 2021, and 2022, respectively. On a Likert scale (1 = strongly disagree, 5 = neutral, 10 = strongly agree), the classes of 2020, 2021, and 2022 provided statistically significant differences in their belief that a Spiraled Curriculum would/did help them retain information as 8.2 (SD 1.7), 8.2 (SD 2.2), and 5.0 (SD 3.0) (n < 0.05). All classes endorsed neutral confidence in the existing pre-clerkship curriculum in themselves to prepare for United Stated Medical Licensing Examination (USMLE) Step 1, and in their retention of previous block material with no statistically significant differences between classes. USMLE Step 1 scores did not differ significantly between classes (n = 0.21). Those who did not receive the Spiral Curriculum were highly receptive to it in theory, while those who actually received the intervention gave a neutral rating. Per survey comments, implementation of a Spiraling Curriculum would ideally be administered as either team-based or self-directed activities, and a Spiraling Curriculum may be difficult to implement in accelerated (18 month) pre-clerkship formats.Practice points Question: What is the receptivity of medical students to a formal Spiral curriculum that uses time-spaced repetition sessions of board exam style questions to revisit previous block content of their pre-clerkship years?Findings: In this single-center, quasi-experimental study, the two control group medical school classes had very positive theoretical reception to a Spiral curriculum proposal (rated 8 out of 10) while the class who actually received the Spiral curriculum provided a statistically significant lower neutral rating (rated 5 out of 10), citing preference for a team-based or self-directed format.Meaning: Medical students are strongly in favor of structured time-spaced repetition with board exam style questions to revisit previous material but prefer a format that does not interfere with time to personalize their medical school experience.
• Moynahan, K. F. (2023).

  Development and evaluation of a pre-clerkship spiral curriculum: data from three medical school classes

  . Medical Education Online, 28(1). doi:10.1080/10872981.2023.2167258
• Moynahan, K. F., Givens, R. H., Fantry, G., & Elliott, S. P. (2020). University of Arizona College of Medicine-Tucson.. Academic medicine : journal of the Association of American Medical Colleges, 95(9S A Snapshot of Medical Student Education in the United States and Canada: Reports From 145 Schools), S22-S25. doi:10.1097/acm.0000000000003258
• Gliatto, P., Colbert-Getz, J. M., Bhutiani, M., Cutrer, W. B., Edwards, S., Fleming, A., Keeley, M., Osterberg, L., Pilla, M. A., & Moynahan, K. (2019). Too Many Hats? Conflicts of Interest in Learning Community Faculty Roles. Journal of Medical Education and Curricular Development, 6, 1-5.
• Moynahan, K. F. (2019).

  Defining Learning Communities in Undergraduate Medical Education: A National Study

  . Journal of Medical Education and Curricular Development, 6, 238212051982791. doi:10.1177/2382120519827911
• Moynahan, K. F. (2019). In Reply to Coda. Academic Medicine, 94(7), 924-925.
• Shochet, R., Fleming, A., Wagner, J., Colbert-Getz, J., Bhutiani, M., Moynahan, K., & Keeley, M. (2019). Defining Learning Communities in Undergraduate Medical Education: A National Study. Journal of Medical Education and Curricular Development, 6, 1-9.
• Moynahan, K. F. (2018). The Current Use of United States Medical Licensing Examination Step 1 Scores: Holistic Admissions and Student Well-Being Are in the Balance. Academic medicine : journal of the Association of American Medical Colleges, 93(7), 963-965.
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  United States Medical Licensing Examination Step 1 scores increasingly are being used by graduate medical education programs to "screen out" applicants to invite for an interview; medical students with scores below a certain (usually unpublished) point are not considered for an interview. Conversely, many students are extended an interview invitation based solely on their Step 1 scores, prior to the release of their Medical Student Performance Evaluation. In this Invited Commentary, the author discusses why this practice has gained popularity as well as the unintended effects it has had in multiple domains-holistic undergraduate medical education admissions practices, student well-being, and medical school curricula. Possible solutions are considered, including a pass/fail reporting structure, a national basic science curriculum, and better alignment between undergraduate and graduate medical education admissions processes and values. Through collaborative work between the Association of American Medical Colleges, the National Board of Medical Examiners, the Accreditation Council for Graduate Medical Education, and medical educators, an alternative, more holistic standardized metric by which to compare students' applications should be developed.
• Moynahan, K. F. (2016).

  Back to the Future: What Learning Communities Offer to Medical Education

  . Journal of Medical Education and Curricular Development, 3, JMECD.S39420. doi:10.4137/jmecd.s39420
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  Learning communities (LCs) have increasingly been incorporated into undergraduate medical education at a number of medical schools in the United States over the past decade. In an Association of Medical Colleges survey of 140 medical schools, 102 schools indicated that they had LC (described as colleges or mentorship groups; https://www.aamc.org/initiatives/cir/425510/19a.html ). LCs share an overarching principle of establishing longitudinal relationships with students and faculty, but differ in the emphasis on specific components that may include curriculum delivery, advising/ mentoring, student wellness, and community. The creation of LCs requires institutional commitment to reorganize educational processes to become more student centered. LCs are beginning to show positive outcomes for students including benefits related to clinical skills development, advising, and student wellness, in addition to positive outcomes for LC faculty.
• Moynahan, K. F., Osterberg, L. G., Goldstein, E., Hatem, D. S., & Shochet, R. (2016). Back to the Future: What Learning Communities Offer to Medical Education. Journal of Medical Education and Curricular Development, 3, 67-70.
• Smith, S. D., Dunham, L., Dekhtyar, M., Dinh, A., Lanken, P. N., Moynahan, K. F., Stuber, M. L., & Skochelak, S. E. (2016). Medical Student Perceptions of the Learning Environment: Learning Communities Are Associated With a More Positive Learning Environment in a Multi-Institutional Medical School Study. Academic medicine : journal of the Association of American Medical Colleges, 91(9), 1263-9.
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  Many medical schools have implemented learning communities (LCs) to improve the learning environment (LE) for students. The authors conducted this study to determine whether a relationship exists between medical student perceptions of the LE and presence of LCs during the preclerkship years.
• Moynahan, K. F. (2017). The Current Use of United States Medical Licensing Examination Step 1 Scores: Holistic Admissions and Student Well-being are in the Balance. Academic Medicine.
• Wagner, J. M., Fleming, A. E., Moynahan, K. F., Keeley, M. G., Bernstein, I. H., & Shochet, R. B. (2015). Benefits to faculty involved in medical school learning communities. Medical teacher, 37(5), 476-81.
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  Job satisfaction plays a large role in enhancing retention and minimizing loss of physicians from careers in academic medicine. The authors explored the effect of learning communities (LCs) on the faculty members' job satisfaction.
• Moynahan, K. F. (2014).

  Benefits to faculty involved in medical school learning communities

  . Medical Teacher. doi:10.3109/0142159x.2014.947940
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  Purpose: Job satisfaction plays a large role in enhancing retention and minimizing loss of physicians from careers in academic medicine. The authors explored the effect of learning communities (LCs) on the faculty members’ job satisfaction.Methods: Between October 2011 and May 2012, the authors surveyed 150 academic clinical faculty members serving as LC mentors for students at five US medical schools. Factor analysis was used to explore satisfaction themes and relationships between these themes and other characteristics.Results: Factor analysis revealed two major sources of this satisfaction: a Campus Engagement factor (e.g., feeling happier, improved sense of community, better communication skills, and feeling more productive) and a skills factor (e.g., improved clinical skills, being a better doctor). Higher Campus Engagement factor satisfaction was associated with less desire to leave the learning community (p = 0.01) and more FTE support for role in LC (p = 0.01). Higher skills factor satisfaction was associated with the school that provided more structured faculty development (p = 0.0001).Conclusion: Academic clinical faculty members reported serving as a mentor in an LC was a strong source of job satisfaction. LC may be a tool for retaining clinical faculty members in academic careers.
• Moynahan, K. F. (2014).

  The Growth of Learning Communities in Undergraduate Medical Education

  . Academic Medicine. doi:10.1097/acm.0000000000000239
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  Purpose To determine the presence and characteristics of learning communities (LCs) in undergraduate medical education. Method The authors updated an earlier Web-based survey to assess LCs in medical education. Using a cross-sectional study design, they sent the survey to an LC leader or dean at each Association of American Medical Colleges member medical school (n = 151) between October 2011 and March 2012. The first survey item asked respondents to indicate if their institution had LCs. Those with LCs were asked to provide details regarding the structure, governance, funding, space, curricular components, extracurricular activities, and areas addressed as part of the LCs. Those without LCs were asked only if they were considering developing them. The full survey instrument contained 35 items including yes/no, multiple-choice, and open-ended questions. The authors analyzed data using descriptive statistics and examined open-ended responses for recurrent themes. Results The response rate was 83.4% (126/151). Sixty-six schools (52.4%) had LCs. Of the 60 remaining schools without LCs, 29 (48.3%) indicated that they were considering creating them. Of the 52 schools that provided the year their LCs were established, 27 (51.9%) indicated they began in 2007 or later. LC characteristics varied widely. Conclusions The number of medical schools with LCs is increasing rapidly. LCs provide an opportunity to transform medical education through longitudinal relationships and mentoring. Further study is needed to document outcomes and best practices for LCs in medical education.
• Smith, S., Shochet, R., Keeley, M., Fleming, A., & Moynahan, K. (2014). The growth of learning communities in undergraduate medical education. Academic medicine : journal of the Association of American Medical Colleges, 89(6), 928-33.
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  To determine the presence and characteristics of learning communities (LCs) in undergraduate medical education.
• Moynahan, K. F. (2012).

  Continuing Medical Education: Looking Back, Planning Ahead

  . JAMA. doi:10.1001/jama.2012.106
• Moscaliuc, M. L., & Moynahan, K. F. (2011).

  An Unusual Cause of Leg Ulcerations

  . Americal Journal of Medicine. doi:10.1016/j.amjmed.2010.09.026
• Moscaliuc, M. L., & Moynahan, K. F. (2011). An unusual cause of leg ulcerations. The American journal of medicine, 124(4), e3-4.
• Chadwick, J. A., Moynahan, K. F., & Koff, N. A. (2010). University of Arizona College of Medicine: Tucson and Phoenix. Academic medicine : journal of the Association of American Medical Colleges, 85(9 Suppl), S78-83.
• Moynahan, K. F., & Gordon, P. R. (2010). Societies Program at the University of Arizona College of Medicine Design, Implementation and Lessons Learned. Journal of the International Association of Medical Science Educators, 20(2), 124-142.
• Moynahan, K. F., & Yoshino, M. T. (1993).

  Aortic and Renal Atherosclerotic Calcifications Seen on Computed Tomography of the Spine

  . Investigative Radiology. doi:10.1097/00004424-199328090-00009
• Moynahan, K., & Yoshino, M. T. (1993). Aortic and renal atherosclerotic calcifications seen on computed tomography of the spine. A positive predictor of hypertension. Investigative radiology, 28(9), 811-3.
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  This study was undertaken to determine if there is an association between hypertension and aortic or renal atherosclerotic calcifications seen on computed tomography (CT) of the spine.
• Yoshino, M. T., & Moynahan, K. F. (1993). AORTIC AND RENAL ATHEROSCLEROTIC CALCIFICATIONS SEEN ON COMPUTED TOMOGRAPHY OF THE SPINE : A POSITIVE PREDICTOR OF HYPERTENSION. Investigative Radiology, 28(9), 811-813. doi:10.1097/00004424-199309000-00009
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  RATIONALE AND OBJECTIVES This study was undertaken to determine if there is an association between hypertension and aortic or renal atherosclerotic calcifications seen on computed tomography (CT) of the spine. METHODS The lumbar CTs of 93 sequential patients were evaluated without knowledge of their blood pressures. Aortic and renal atherosclerosis was graded on a scale of 0-3. The patients' charts were reviewed for the presence of hypertension and diseases that might cause hypertension. RESULTS Sixty-five patients had atherosclerotic calcifications. Forty-four of these were hypertensive. Logistic regression analysis revealed that calcifications in the left renal artery (P = .003), the right renal artery (P = .010) and the abdominal aorta (P = .001) are statistically significant positive predictors of hypertension. Renal artery calcifications are better predictors of hypertension than aortic calcifications. CONCLUSIONS Renal and abdominal aortic calcifications are significant radiographic findings in lumbar spine CT examinations and their presence should be routinely included in the radiographic report.

Presentations

• Cagno, C. K., Karra, R., Viscusi, C. D., & Moynahan, K. F. (2023). ‘Sustaining Mentoring Relationships Longitudinally: One LC’s Intervention’. Learning Communities Institute 20th Annual Meeting.
• Moynahan, K. F. (2019, November). Difficult Conversations with our mentees: Helping students and mentors grapple with Academic challenges, Professionalism & Boundary issues. Learning Communities Institute Annual Meeting. Kansas City: Learning Communities Institute.
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  Workshop
• Clemens, C. J., Moynahan, K. F., Spear-Ellinwood, K. C., Knox, K. S., Martinez, G. F., Clemens, C. J., Moynahan, K. F., Spear-Ellinwood, K. C., Knox, K. S., Martinez, G. F., Clemens, C. J., Moynahan, K. F., Spear-Ellinwood, K. C., Knox, K. S., & Martinez, G. F. (2017, February). The GME program conundrum: A grounded theory of valued characteristics.. AAMC-WGEA Conference 2017AAMC.
• Moynahan, K. F. (2017, October 20). Challenges & Solutions: Medical Education. ACP-Faculty Medical Education Consortium Luncheon. Doubletree Hotel, Tucson AZ: American College of Physicians.
• Moynahan, K. F. (2016, September). Prioritizing Resources to Support the Academic Mission. 2016 AAMC - Principal Business Officers' Meeting. Vancouver, British Columbia: Association of American Medical Colleges.
• Moynahan, K. F. (2015, November). Update in Medical Education: Learning Communities Institute. AAMC-Medical Education Meeting.
• Moynahan, K. F. (2004, May). Update in Hypertension 2004. Medical Management Conference. Tucson, AZ: Southern Arizona Veterans Administration Medical Center.
• Moynahan, K. F. (2003, November). Update in Clinical Medicine. National Heart, Lung and Blood Institute. Scottsdale, AZ.
• Moynahan, K. F. (2003, October 2003). Evidence Based Medicine Break. American College of Physicians-Arizona Chapter Meeting. Tucson, AZ: ACP.
• Moynahan, K. F. (2002, August). Hypertension Update. Medical Grand Rounds. Phoenix, AZ: St. Joseph's Medical Center.
• Moynahan, K. F. (2002, October). Hypertension Update. American College of Physicians - Arizona State Meeting. Scottsdale, AZ: American College of Physicians.
• Moynahan, K. F. (2001, April). Hypertension 2001. Medical Grand Rounds. Tucson, AZ: University of Arizona College of Medicine.
• Moynahan, K. F. (2000, February). Hypercoagulable States: An Internist's Perspective. Medical Grand Rounds. Tucson, AZ: University of Arizona College of Medicine.
• Moynahan, K. F. (2000, March). Hypercoagulable States. Neurology Grand Rounds. Tucson, AZ: University of Arizona College of Medicine.
• Moynahan, K. F. (1996, April). Dyspnea and Abdominal Pain in a 54-Year Old Male. Medical Grand Rounds - Clinical Pathologic Conference. Tucson, AZ: University of Arizona College of Medicine.

Poster Presentations

• Clemens, C. J., Moynahan, K. F., Spear-Ellinwood, K. C., Knox, K. S., & Martinez, G. F. (2017, February). The GME program conundrum: A grounded theory of valued characteristics.. AAMC-WGEA Conference 2017. Salt Lake City, UT: AAMC.

Creative Productions

• Moynahan, K. F. (2018. Video: Cardiac Auscultation and the Left Ventricular Impulse Exam. MedLearn/Panopto. Tucson: University of Arizona College of Medicine. https://arizona.hosted.panopto.com/Panopto/Pages/Viewer.aspx?id=c5f8e676-91bb-4587-91c3-832f6c1a19c4
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  Video demonstrating an evidence-based approach to cardiac auscultation and examination of the left ventricular impulse.

Other Teaching Materials

• Moynahan, K. F. (2017. Cardiac Tamponade: Video Collaboration-Faculty Reviewer/Content Expert. OSMOSIS.
• Moynahan, K. F. (2017. Pulmonary Hypertension: Video Collaboration-Faculty Reviewer/Content Expert. OSMOSIS.

Others

• Morrison, A., Moynahan, K. F., Smith, K. W., Parikh, T., & Clemens, C. (2019, March). Panel Discussion: The Role of the United States Medical Licensing Exam in the Residency Selection Process and Unintended Consequences for Undergraduate Medical Education: Are There Lessons To Be Learned from Our Experience with Holistic Admissions?. WGEA-Western Group on Educational Affairs (AAMC).
• Osterberg, L., Austin, B., Moynahan, K. F., & Jackson, M. (2018, March). Workshop: Developing your Best Practices in Education on Diversity, Inclusion and Bias. WGEA 2018 (AAMC) Regional Meeting.
• Osterberg, L., Moynahan, K. F., Jackson, M., & Kaplan, E. A. (2018, September). Workshop: Using the Safety of Learning Communities to Educate on Bias. 15th Annual Learning Communities Institute Meeting.
• Moynahan, K. F. (2017, February). Oral Presentation: The GME program conundrum: A grounded theory of valued characteristics (Multicenter Evaluation). WGEA/WGSA/WOSR 2017 (AAMC) Regional Meeting.
• Moynahan, K. F. (2017, February). Small Group Discussion: Let's Talk About it: Facilitating Discussions with Medical Students on Implicit Bias. WGEA/WGSA/WOSR 2017 (AAMC) Regional Meeting.
• Moynahan, K. F. (2016, November). Small Group Facilitator: Hot Topics in Learning Communities. Learning Communities Institute.
• Moynahan, K. F. (2015, March). SJT Effectiveness Ratings and Healthcare Experience Review. WGEA-Western Group on Educational Affairs (AAMC).
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  From: Amy Addams Date: Monday, April 13, 2015 at 7:28 AMTo: Kevin Moynahan Cc: Thomas Geiger , Admissions Initiative , Amy Addams Subject: Invitation: Participate in SJT effectiveness ratings and healthcare experience review? Hi Kevin,As you may know, the AAMC is currently exploring the viability of a situational judgment test (SJT) for medical school admissions. Dana Dunleavy and Tom Geiger are leading that work. They are gearing up to conduct effectiveness ratings and healthcare experience reviews of SJT candidate items, having recently concluded the bias and sensitivity reviews. With your rich experience working closely with medical students, we think you would make an ideal reviewer. Would you be interested in serving as a reviewer in this effectiveness ratings and healthcare experience review?In order to engage a wide range of reviewers, we're planning to conduct these reviews at the upcoming GSA spring regional meetings. We will have a work room reserved during the WGEA/WGSA meetingat The U.S. Grant Hotel from 1 pm until 5 pm on Thursday, April 23rd, and from 8 am to 12 pm on Friday, April 24th in order to accommodate reviewers' schedule. Additional details, including the full purpose of this review and the anticipated time commitment, are included in Tom's letter below. He's coordinating these reviews and is the primary contact. If you have any questions, please don't hesitate to contact us (Tom, tgeiger@aamc.org or me).I hope all's well in Tucson. Looking forward to seeing you next week. Thanks much,Amy Hi Dr. Moynahan, I am writing you today to ask whether you would assist the AAMC by participating in a Situational Judgment Test (SJT) review task at the Western GEA/GSA/OSR Regional Spring Meeting in San Diego. As you may know, the AAMC is exploring the viability of using an SJT in medical school admissions. An SJT is a test that presents examinees with hypothetical dilemmas and a series of response options that reflect possible ways to resolve that dilemma. The test is designed to assess the AAMC’s core inter and intra-personal competencies for entering medical students (click here for additional information). One upcoming task for this project is our effectiveness ratings and healthcare experience review. This review entails two important tasks. First, test reviewers are asked to read scenarios and provide effectiveness ratings for individual behavioral responses. Second, reviewers are asked to read through the scenarios and think about the minimum level of familiarity with healthcare needed to understand and respond to the scenario set. Together, these tasks will inform the scoring key for the SJT, and will help minimize the potential influence of prior healthcare experience on test performance.My colleague Amy Addams nominated you as a reviewer due to your experience and unique perspective working with medical students. If you decide to participate, further guidance and instructions will be provided in order to help you progress through this task. The task will be administered using a paper-and-pencil handout and will likely require 60 - 75 minutes to complete. We will have a work room reserved at The U.S. Grant Hotel from 1 pm until 5 pm on Thursday, April 23rd, and from 8 am to 12 pm on Friday, April 24th. If you are able to participate, we can schedule a 60 - 75 minute block during one of those sessions. If you are interested in or have questions about participating in this review, please contact me at tgeiger@aamc.org. I will then follow-up with you to determine a review time that best fits your schedule. We are hopeful that you will participate in this exciting new research project. Thank you,Tom
• Moynahan, K. F. (2015, March). Small Group Discussion: Starting or Improving Learning Communities at your Medical School. WGEA-Western Group on Educational Affairs (AAMC).
• Moynahan, K. F. (2015, March). Small Group Discussion: Teaching Clinical Skills and Faculty Development in Learning Communities. WGEA-Western Group on Educational Affairs (AAMC).