Interprofessional Education Commons^™

Interdisciplinary Workshop To Increase Collaboration Between Medical Students And Standardized Patient Instructors In Teaching Physical Diagnosis To Novices, Tanakorn Kittisarapong, Benjamin Blatt, Karen Lewis, Jennifer Owens, Larrie Greenberg

Medicine Faculty Publications

Traditionally, full-time faculty members have assumed major responsibility for teaching physical examination skills to first- and second-year medical students. Problems with faculty recruitment and adhering to a standardized way of teaching have challenged educators to seek alternatives to teaching the physical examination to novices. To address these problems, we created and implemented a novel curriculum that has standardized the teaching of physical examination skills to novice students by using standardized patient instructors and fourth-year medical students working as an interdisciplinary team (known as a dyad). Feedback after the first iteration of this course revealed confusion about roles, goals, and responsibilities …

Population Health Improvement Through Coordination Of Care, Trevey Davis

Muskie School Capstones and Dissertations

The objective of this Capstone Project is to work with the Mercy Gap in Care Coordinators (GCCs) to document the value of the care coordination at Mercy Health System. A key element of this project was to develop a workflow diagram alongside the GCC in order to track patient outcomes. Additionally, the team developed a system for documenting patient outcomes that is crucial to measuring the impact of care coordination. From the data collected there are a number of outcomes that can be measured. The number of patients who are contacted for screening is measurement of patient experience. Following initial …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso

Student Research Posters

According to the Annals of Family Medicine, the amount of babies born via cesarean section has increased from 4.5% in 1965 to 26.1% in 2002 and nearly 40% of all cesarean sections are repeats. After an extensive literature review, results showed that patients need to be educated about the risks and benefits of vaginal delivery and cesarean delivery. It was also found that there needs to be policy changes to decrease the amount of cesarean sections done and increase the labor and delivery support without using interventions. Further study should be focused on morbidity and mortality very low birth weight …

Chiropractic Care In A System Dynamics Model For Minimizing Opioid Abuse For Chronic Non-Malignant Pain Patients, Marion Mcgregor, Alexandra Nielsen, Chadwick Chung, Mark Fillery, Wayne W. Wakeland, Silvano Mior

Complex Systems Faculty Publications and Presentations

No abstract provided.

Perspectives On Teaching The International Classification Of Functioning, Disability, And Health Model To Physical Therapy Students, Cherie Peters-Brinkerhof

Physical Therapy Collection

BACKGROUND: During a re-accreditation visit, deficiencies were discovered in the clinical education curriculum regarding patient-centered care in a Doctorate of Physical Therapy program. To understand the problem and address those deficiencies, the clinical internship experience was examined using the International Classification of Functioning, Disability, and Health (ICF) model as a conceptual framework for clinical reasoning.

OBJECTIVE: This qualitative case study aimed to study (1) perceptions of physical therapy (PT) students regarding their knowledge and learning experiences during clinical affiliations and what knowledge they acquired of the ICF as applied to patient-centered care during their internship, and (2) the perceptions of …

Exploring The Importance Of Team Psychological Safety In The Development Of Two Interprofessional Teams, Denise O'Leary

Articles

It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making, and knowledge sharing. This article outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer, and a client at two residential care facilities for older people in Ireland. The theoretical concept of team psychological safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without …

Grant Application: Compassionate Touch Short Film, Jessfor Baugh, Riddhi Daftary

Compassionate Touch

IPEC Mini-grant application for funding of UNE student project Compassionate Touch.UNE Dental Medicine students collaborated with Creative and Fine Arts faculty and Dental Medicine faculty to create the film Compassionate Touch, focusing on five stages associated with anxious dental patients, as depicted through artwork, interprofessional interviews and scholarly sources. The film highlights the current understanding and management of the dental needs for high fear patients before, during, and after their visit to the dentist, and how interprofessional health care providers can assist patients to achieve quality patient-centered care.

Compassionate Touch Artworks: Listen To Identify, Validation, Everyone Has A Story, Not Alone, The Compassionate Touch, Jessfor Baugh

Compassionate Touch

Artworks created during the course of UNE student project Compassionate Touch. UNE Dental Medicine students collaborated with Creative and Fine Arts faculty and Dental Medicine faculty to create the film Compassionate Touch, focusing on five stages associated with anxious dental patients, as depicted through artwork, interprofessional interviews and scholarly sources. The film highlights the current understanding and management of the dental needs for high fear patients before, during, and after their visit to the dentist, and how interprofessional health care providers can assist patients to achieve quality patient-centered care.

Artwork Descriptions

First image is a photograph of the five artworks …

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …

A Debriefing Technique In High-Fidelity Patient Simulation And Competent Decision-Making Abilities Among Nursing Students, Trena Seago

Theses and Dissertations--Curriculum and Instruction

Nursing faculty are utilizing high-fidelity patient simulation (HPS) with debriefing to help engage nursing students in making competent clinical decisions. This quasi-experimental study examined the use of HPS with debriefing and students’ ability to make nursing care decisions using standardized exams. The experimental group received debriefing after HPS and the control group did not receive debriefing after HPS. The pre- and post-test assessed participants’ ability to make clinical care decisions. The analysis of the pre-test and post-test HESI scores showed that there was no significant difference between the two groups.

A Simulation To Improve The Clinical Nursing Instructor’S Teaching Of Ethics To Students In The Clinical Setting, Cynthia S. Randall Dnp

All Student Scholarship

Ethical knowledge and skill is crucial to the discipline of nursing and is considered foundational knowledge for nursing practice (American Nurses Association [ANA], 2008). Nurses who assume roles in clinical teaching may be clinically competent but may have limited nursing education experience or knowledge in clinical instruction. The purpose of this project was to improve the educational experience of clinical instructors in the teaching of ethics to students in the clinical setting. This DNP capstone was a quality improvement project with a mixed method design using simulation as a teaching strategy. Eight clinical instructors from a university based baccalaureate nursing …

Transforming Health Professions' Education Through In-Country Collaboration: Examining The Consortia Between African Medical Schools Catalyzed By The Medical Education Partnership Initiative, Zohray Talib, Elsie Kiguli-Malwadde, Hannah Wohltjen, Millard Derbew, Yakub Mulla, David Olaleye, Nelson Sewankambo

Medicine Faculty Publications

Background African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning.

Methods Semistructured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These …

Attitudes Towards An Evidence-Based Clinical Decision Support Tool To Reduce Exposure To Ionizing Radiation, Raymond Zakhari

Faculty Publications and Presentations

Patients who suffer minor brain injuries experience unnecessary ionizing radiation in the form of a non-contrast head CT scan despite the dearth of evidence supporting standard CT scans for all brain injuries. Exposure to ionizing radiation increases the incidence of certain types of cancer. This evidence-based practice change project assesses the attitude of clinicians towards evidence-based clinical decision support tools, specifically the Canadian CT head rule. The use of highly sensitive clinical decision support tools is supported in the literature to help healthcare providers mitigate the risk associated with unnecessary use of CT scan imaging studies. The project was conducted …

Implications Of Epigenetic Variability Within A Cell Population For "Cell Type" Classification, I. Tabansky, J. N.H. Stern, D. W. Pfaff

Journal Articles

Here, we propose a new approach to defining nerve "cell types" in reaction to recent advances in single cell analysis. Among cells previously thought to be equivalent, considerable differences in global gene expression and biased tendencies among differing developmental fates have been demonstrated within multiple lineages. The model of classifying cells into distinct types thus has to be revised to account for this intrinsic variability. A "cell type" could be a group of cells that possess similar, but not necessarily identical properties, variable within a spectrum of epigenetic adjustments that permit its developmental path toward a specific function to be …

Do You Understand What I Mean? How Cognitive Interviewing Can Strengthen Valid, Reliable Study Instruments And Dissemination Products, Anne Hofmeyer, Brenda H. Sheingold, Ruth Taylor

Nursing Faculty Publications

It is now well accepted that working in research teams that span universities, jurisdictions and countries can be rewarding and economically prudent. To this end, investigators collaborate in the pursuit of knowledge to address human and societal problems and translate results into local and global contexts. This implies that investigators need to develop study instruments that are fit for purpose and strategically manage issues arising from geographical, linguistic and cultural diversity. A proven method is cognitive interviewing to pre-test the study materials to ensure clarity and relevance in the study population. This paper describes the steps taken to increase the …

Neutralizing Antibodies Against West Nile Virus Identified Directly From Human B Cells By Single-Cell Analysis And Next Generation Sequencing, K. Tsioris, N. T. Gupta, A. O. Ogunniyi, R. M. Zimnisky, F. Qian, Y. Yao, X. Wang, J. N. Stern, R. Chari, J. C. Love, +8 Additional Authors

Journal Articles

West Nile virus (WNV) infection is an emerging mosquito-borne disease that can lead to severe neurological illness and currently has no available treatment or vaccine. Using microengraving, an integrated single-cell analysis method, we analyzed a cohort of subjects infected with WNV - recently infected and post-convalescent subjects - and efficiently identified four novel WNV neutralizing antibodies. We also assessed the humoral response to WNV on a single-cell and repertoire level by integrating next generation sequencing (NGS) into our analysis. The results from single-cell analysis indicate persistence of WNV-specific memory B cells and antibody-secreting cells in post-convalescent subjects. These cells exhibited …

10 Steps To Medical-Dental Collaboration, American Dental Association

Action for Dental Health

No abstract provided.

Patient Centered Medical Home: Creating A Blueprint For Quality Healthcare Through Illustrative Simulation, Brenda Helen Sheingold, Deborah W. Chapa, Esther Emard

Nursing Faculty Publications

The advent of healthcare reform in the U.S. presents an unprecedented challenge to academic institutions that are striving to prepare a workforce to interact with individuals needing care in a variety of new practice settings. Patient-centered care is a core objective of these evolving settings which enhance access to a variety professionals and services in one location. This study was conducted over a period of three years and describes how illustrative simulation can be employed as a learning intervention to prepare graduate students for the expanded scope of practice necessary to function in the Patient Centered Medical Home healthcare delivery …

The Noncompete Clause And The Nurse Anethetist: An Assessment Of Knowledge, Perception, And Experience, Briana K. Meseroll, Nathaniel M. Apatov, Carolyn M. Rutledge

Ellmer School of Nursing Faculty Publications

Economic pressures and the challenge to maintain competitive advantage have resulted in many health-care entities requiring their practitioners to contractually enter into noncompete clauses (NCCs). Many student registered nurse anesthetists (SRNAs) and Certified Registered Nurse Anesthetists (CRNAs) are unaware of NCCs in employee contracts.

An anonymous, web-based questionnaire regard-ing NCCs was distributed to SRNAs and CRNAs nation-wide. Of 242 practicing CRNAs who responded, 147 (60.7%) were employed without a noncompete clause and 22 (9.1%) were unaware whether they had such a provision in their employment contracts. The knowledge level of the nurse anesthetist respondents was low (average score of 55.3%). …

Availability And Perceived Value Of Bachelor Of Science Programs In Pharmaceutical Marketing And Management In The United States, Omar F. Attarabeen, Fadi M. Alkhateeb

Pharmacy Practice & Administration

Several academic institutions across the United States offer Bachelor of Science degree programs in Pharmaceutical Marketing and/or Management. In general, these programs are designed to provide students with stronger foundations and a broader understanding of the business side of pharmacy. The purpose of this study was to explore the availability of the Bachelor of Science programs in pharmaceutical marketing and management in the United States. Internet search was conducted in order to collect information about the programs of interest. Results showed that a total of 8 schools and colleges offer the Bachelor of Science degree programs. The total number of …

How To Be A Super Model: Using Role Modeling To Become An Exemplary Educator, Priti Bhansali, Geeta Singhal, Helen Fromme, Melissa Held

E-Learning Modules

Over the past several years, published studies have described the qualities and skills of exemplary medical educators. Despite its inclusion in these lists, role modeling is a skill that is not often developed as a skill for use as an educational method. The purpose of this workshop is to assist participants in better understanding the characteristics of effective role modeling and create a paradigm for how to consciously incorporate role modeling into the daily education of students, residents, and colleagues in varied domains, including teaching, professionalism, communication, and patient care.

In this workshop, participants are introduced to the concept of …

Acquisition Of Medical Immunology Knowledge: A Preliminary Study Of The Knowledge Structures Of Medical Students, Charles A. Gullo Phd

Biochemistry and Microbiology

Medical students from both Duke-NUS and NUS participated in a study that attempted to assess their knowledge structure in the medical immunology domain. Students had to perform a sorting task with a list of concepts derived from immunology experts. We collected demographic information as well as sorting data and the diversity of the sorts are presented in this article.

Differential Diagnosis: Approaches And Pitfalls - A Pediatric Case-Based Session For 3rd Year Medical Students, Zev Waldman, Mary Ottolini

E-Learning Modules

This ninety minute session seeks to provide a systematic framework for medical students relatively new to the differential diagnosis process. Via a combined lecture/case-based approach, the session presents basic clinical reasoning concepts and specific heuristics to guide the differential process followed by an opportunity to apply the tools to simulated pediatric cases. It also introduces the concept of cognitive biases and presents strategies to mitigate their effects. The session has been successfully used with third year medical students during the first week of their pediatrics clerkship. However, with minor adaptation, a similar approach could be used at other levels of …

Lessons Learnt: Pilot Of Mid Rotation Feedback., Tabassum Zehra, Shazia Sadaf

Department of Medicine

The Aga Khan University went through an external review of its undergraduate medical education in December 2006 based on the accreditation guidelines by the Liaison Committee for Medical Education (LCME). The external review panel comprised of international and local experts which developed a comprehensive report on its findings with regards to LCME standards of accreditation. In the final report of the external review one of the areas highlighted as not meeting the standards of LCME was documentation of formal mid-rotation feedback of the students by the faculty in AKU clerkships through years 3 to 5. A four hour faculty development …

Introduction To Health Research Methods, Kathryn H. Jacobsen

Health Studies Faculty Publications

Introduction to Health Research Methods is required for all students enrolled in a master of public health (M.P.H.) or master of science (M.S.) program in public health at a large public university with a diverse student body, including a high proportion of international students. The M.P.H. and M.S. programs cater to students who work full-time, so each class meets for a 3-hour block one evening each week during a 15-week semester. This course is the third of a three-course research methods sequence; students are expected to have completed a biostatistics and an epidemiology course prior to enrolling in research methods.

The Decompensating Pediatric Inpatient Simulation Scenarios, Aisha Davis, Pavan P. Zaveri

E-Learning Modules

Introduction: In July of 2009, Children’s National Medical Center (CNMC) Hospitalist and Emergency Department (ED) educators collaborated to create and implement unique simulation scenarios for trainees rotating on the pediatric hospitalist teams. The goal of this educational intervention is to teach and allow rehearsal of an approach to the unstable patient across three scenarios. Trainees use this high-fidelity, low-risksimulation to apply targeted clinical reasoning and their initial assessment and management strategies to core clinical problems. The three scenarios included in this resource cover altered mental status and seizure, respiratory distress and anaphylaxis, and refractory status asthmaticus, respectively.

Methods:This resource …

Narrative Reflection In The Family Medicine Clerkship-Cultural Competence In The Third Year Required Clerkships, Donna Elliott, Pamela Schaff, Theresa Woehrle, Anne Walsh, Janet Trial

Physician Assistant Studies Faculty Articles and Research

This resource cultivates effective cross-cultural communication skills, which requires an understanding of culture that includes both the physician's and the patient's perspectives. Building on a foundation of cultural awareness, knowledge, and skills students have acquired during the preclinical curriculum, this exercise provides an opportunity for students to continue to refine their narrative reflection skills as they interact with patients in the clinical setting. During the family medicine clerkship, students participate in learning activities that provide the opportunity to explore the rich opportunities of thoughtful reflection and narrative practice. Students also participate in a formative narrative reflection exercise during the clerkship …

The Narrative Exercise: Introduction To Therapeutic Communication In The Psychiatry Clerkship, David A. Garrison, Julia Frank

E-Learning Modules

Introduction: In medical school, much time is devoted to teaching students to elicit disease-centered histories from their patients. The narrative exercise supplements this traditional focus by requiring students to develop a person-centered narrative for one patient under their care. While the ultimate test of a diagnosis is the verification of the diagnosis by tests or treatment outcome, the ultimate test of a patient-centered narrative is whether the patient accepts it as a legitimate characterization of his or her experience.

Methods: The psychiatry clerkship directors at the University of Rochester School of Medicine and George Washington University School of Medicine have …

Handbook On Sensitive Practice For Health Care Practitioners: Lessons From Adult Survivors Of Childhood Sexual Abuse, Candice L. Schachter, Carol A. Stalker, Eli Teram, Gerri C. Lasiuk, Alanna Danilkewich

Lyle S. Hallman Social Work Faculty Publications

This handbook is the culmination of a multiphase, multidisciplinary research project that used grounded theory and participatory action research to illuminate ways that healthcare providers can work sensitively (in a trauma-informed way) with adult survivors of childhood sexual abuse.

The research identified nine Principles of Sensitive Practice: respect, rapport, taking time, sharing information and control, respecting boundaries, fostering mutual learning, understanding non-linear healing and demonstrating an understanding of trauma to patients. Specific guidelines were developed for a wide variety of issues pertinent to clinical practice such as, removal of clothing, touch, responding to disclosures of abuse, managing triggers among others. …