• Getting Down and Dirty with Lead Apparel

      Schmuck, Heather; Smith, Jeremy; Cook, Joy; Reddington, Amanda
      Topic/Problem statement While it is common practice to utilize lead apparel in the radiologic technology, dental hygiene, or dental assisting professions for acquiring radiographic images, the appropriate care and use of lead apparel may sometimes falter through complacency or lack of knowledge. Complicating this matter is the lack of manufacturers recommended use and care instructions for the lead apparel never making it to the end users. This study sought to examine how much do students truly know about the appropriate care and use of lead apparel. Context This scholarship of teaching and learning project involved three disciplines: dental assisting, dental hygiene, and radiologic technology. Faculty from each course came together to develop an interprofessional learning activity surrounding units of study on radiographic quality control. Part of radiographic quality control involves lead apparel inspection. Additionally, two of the researchers were previously involved in a study on examining bioburden of lead apparel leading to this additional focus in the learning activity. The proposed student outcomes focused on students learning more about bioburden present on lead apparel, appropriate cleaning for lead apparel, and visual, tactile, and radiographic lead integrity inspection. Institutional review board approval was obtained for data collection related to students knowledge about the care and use of lead apparel and radiation knowledge. Grounding Olson and Bialocerkowski (2014) note that little research has been conducted on IPE effectiveness in allied health profession fields and what has been done is limited more to improvement in attitudes toward other professions and teamwork rather than actual changes in learning. Reeves, Goldman, and Oandasan (2007), do establish that prelicensure IPE can play a pivotal role in reducing negative effects of professional socialization, mitigating negative stereotypes of other health care professional groups. Cook, Schmuck, and Hollingsworth (2019) indicate that end users of the lead apparel protective devices may not be made aware of the appropriate care and use instructions for the lead apparel related to integrity inspections and maintaining cleanliness of the apparel. As both the radiology and dental professions utilize lead aprons, it seemed appropriate to bring these groups together to focus on learning knowledge regarding the importance of proper use and care of lead prior to their professional practice. Approach Faculty from the Radiologic Technology, Dental Hygiene, and Dental Assisting programs developed an innovative Interprofessional learning activity focused on students knowledge surrounding the care and use of lead apparel. The care and use of lead apparel is often not a primary focus in professional practice even though all three of the represented professions utilize lead apparel. The activity involved 52 students representing a cohort from each of the respective programs; 19 from radiologic technology, 21 from dental hygiene, and 12 from dental assisting. The activity involved an IRB approved research focus utilizing a pre and post survey tool previously piloted by the researchers. This survey tool measures learning gains through knowledge scale responses on the care and use of lead apparel and student responses on Likert survey items related to radiation knowledge. Students were randomly selected into two different groups who completed a pre-survey then rotated through two activities: a lead apparel hygiene laboratory activity to measure bioburden on lead apparel and a laboratory activity to examine lead integrity. Each group had opportunity to be actively involved in the examination of one piece of lead apparel through both lab activities. Faculty were present in each lab to guide the activity and assist with interpreting the results for each piece of lead apparel. Students then completed a post survey. This study will present the data for learning gains. Reflection/Discussion/Lessons Learned A total of 45 complete surveys were returned. Any surveys with missing data on either the pre or post survey section for knowledge scale responses (n = 7) were excluded from analysis. Results from knowledge scale responses indicated a significant increase (p = <.01) in the mean score between the pre (m = 4.53) and post (m = 5.58) survey responses. Additional analysis determined this increase in the mean score occurred across all three disciplines. Student learning was positively impacted through this activity and addressed an area of knowledge gap that students can carry with them into practice. While dental hygiene, dental assisting, and radiologic technology may be viewed as unlikely partners in an interprofessional activity, finding commonalities among professions to bring together the disciplines into an active learning situation can prove beneficial to increasing students knowledge. References Cook, J. A., Schmuck, H., & Hollingsworth, A. (2019). Care and use of lead apparel. The Dental Assistant, 88(3), 9-11. Retrieved from www.ada.ausa.org Olson, R., & Bialocerkowski, A. (2014). Interprofessional education in allied health: A systematic review. Medical Education, 48(3), 236-246. https://doi.org/10.1111/medu.12290 Reeves, S., Goldman, J., & Oandasan, I., (2007). Key factors in planning and implementing interprofessional education in health care settings. Journal of Allied Health, 36(4), 231-5. Retrieved from http://www.asahp.org/journal-of-allied-health
    • It Takes a Team to Teach Teamwork

      Kalb, Elizabeth; Chen, Chen; Rinks, Bonnie; Opatrny Pease, Marie; Rathee, Ekka; Hall, Melissa; Kalb, Elizabeth; Chen, Chen; Rinks, Bonnie; Opatrny Pease, Marie; et al.
      Evidence supports reduced medical error when teamwork is the base for collaborative decision making. Interprofessional education (IPE), which is when students from two or more professions learn from one another and effectively collaborate to improve outcomes, has become a standard in health profession education. There are multiple ways of integrating this approach into curricula, but there must be cooperation, collaboration and coordination among educators in different disciplines to make it possible. This presentation will provide an overview of a coordinated team effort on the part of faculty to bring together students from different healthcare approaches and different disciplines within the university to work as teams in primary care clinics. This collaboration will help students (a) develop an appreciation of what each discipline contributes to improve patient care, and (b) work together as a team to plan recommendations for patients and families for the purpose of improving health and lifestyle. Graduate students in social work and different specialties within the graduate nursing program have been involved. The focus of the presentation will be the strategies used to motivate students to come together across disciplines and collaborate. This includes an overview of TeamSTEPPS® training during an eight-hour orientation to the project, design and promotion of learning modules to be used by the IPE teams while in clinics, use of case studies to form collaborative interaction among students, scheduled pharmacology consultations for the IPE teams with a pharmacist, and recruitment of students through development of a class that promoted the importance of IPE along with student reflection.  Since January 2017, 18 student teams have worked together at different community sites established through academic partnerships. These student teams as well as site personnel have provided valuable feedback to the project team regarding their experiences. Student feedback has helped in understanding how better to motivate and enhance student learning for the future of the IPE project.
    • Let's Get "Down on the Pharm"

      Riedford, Kathy
      Topic/Problem statement Effective communication and collaboration among professional caregivers from various disciplines is a necessary platform in any healthcare setting and it is essential for safe, effective patient care and optimal outcomes. An essential component that introduces risk for safety in all these settings is prescribing, administration, and education for medication management. Greater understanding of these issues among members of the healthcare team can promote greater understanding for patients and lead to improved health and decreased costs. Context The project involves students completing a Master of Social Work degree and nurse practitioner students in three different specialty tracks in the Master of Science in Nursing Program. The goal of the project was to make pharmacy consultations available to all interested students to encourage discussion among disciplines and help them integrate knowledge and experiences they were exposed to in clinical settings. Grounding There is evidence that student reflection and engagement of students in the learning process are important to achieve academic success. It has long been recognized in nursing that reflective practice is inherent to the learning process, but the intentional incorporation of reflection into curriculums has not been consistent. This project incorporated student participation and reflection as part of active learning. Approach Students across disciplines receive communication about general topics for each of the 12 pharmacy consultations for the upcoming semester. Students are encouraged to reflect on the topics and submit reflection questions related to the topics based on gaps in their knowledge and based on patient cases to which they have been exposed. Students working in interprofessional teams are encouraged to work together to reflect on and submit case questions. Students are sent the pharmacy online weblinks a week prior to each consultation and again encouraged to submit relevant questions for the registered pharmacist. Reflection/Discussion/Lessons Learned It was anticipated that interprofessional student teams would work together on difficult patient cases and reflect on gaps in knowledge of pharmacotherapeutics so they could learn from one anothers perspectives to enrich their understanding individually and as a team while benefiting patients in their caseloads. Reflections on various issues in pharmacology based on topics disseminated at the beginning of the semester was open to other students in the courses, but the first order was on those interdisciplinary students working in interprofessional teams in the community. It was a coordinated effort to maintain communication among student groups so they could arrange time for the pharmacy consultations. The most significant barrier was unanticipated issues arising for the pharmacist, which led to occasional rescheduling, making it difficult for students who had arranged their time so they could participate. The other barrier was occasional technological issues that hindered ability to open the online consultations. References Agency for Healthcare Research and Quality. (2016, February). TeamSTEPPS Curriculum Materials. Retrieved from https://www.ahrq.gov/teamstepps/curriculum-materials.html Enuku, C., & Evawoma-Enuku, U. (2015). Importance of reflective practice in nursing education. West African Journal of Nursing, 26, 52-59. Peixoto, N.M., & Peixoto, T.A. (2016). Reflective practice among nursing students in clinical teaching. Revista de Enfermagem Referencia, 4(11), 121-131.
    • Occupational Therapy/Respiratory Therapy Collaboration: Understanding Roles and Early Mobility Simulation

      Mason, Jessica; Arvin, Mary Kay; Delp, Jody; Morgan, Julie; Phy, Wesley; Mason, Jessica; Arvin, Mary Kay; Delp, Jody; Morgan, Julie; Phy, Wesley
      Topic/Problem Statement: Students enrolled in healthcare programs must learn to work collaboratively to best serve patients. Outside of one’s own profession, roles of additional team members may not be clearly understood. Occupational and respiratory therapists work collaboratively as part of early mobility teams in intensive care units. Students of identified programs need to learn each other’s roles and purpose to best work collaboratively within these teams. They must also learn to communicate effectively to ensure patient safety. Context: Occupational therapy students and respiratory students both presented on their roles and scope of practice to the other discipline. Additionally, handouts were created to aid each discipline in the practice of early mobility. Following the presentations, the students completed two early mobility simulation activities. From this experience, student outcomes involved role and scope of practice recognition, the benefits of interprofessional peer teaching, and identifying the components of interprofessional collaboration and teamwork. Approach: The occupational therapy profession will need to focus on interprofessional education in the classroom to be better prepared for evolving healthcare reform impacted by emerging areas of practice within the profession (Mroz, Pitonyak, Fogelberg, & Leland, 2015). The Institute of Medicine (2003) endorsed peer-to-peer teaching to better improve healthcare quality (Buring et al., 2009). The occupational therapy students presented to the respiratory therapy students the role of occupational therapy, importance of functional and early mobility, and how to perform a stand-pivot transfer. Next, respiratory therapy students presented the role of respiratory therapy, an overview of different types of oxygen equipment, and knowledge of oxygen parameters. All students then participated in two interprofessional simulation activities requiring teamwork to transfer a patient safely while maintaining all necessary equipment, monitoring vital signs, and assessing the patient appropriately. Reflection/Discussion: At the end of the simulation, students debriefed with occupational and respiratory therapy faculty and the standardized patient. Students voiced a better understanding of one another’s roles and scope of practice. They emphasized the need for teamwork and communication when working with any patient. Many students voiced learning from the other discipline during both the presentation and simulation. The students were asked to participate in a survey at the end of the debriefing focused on the peer teaching experience. Results indicate most students agreed the interprofessional activity will help with their therapy role in the future, was time and effort well spent, and that each discipline has a responsibility to teach others. Faculty plan to continue the interprofessional activity in the future. References: Buring, S. M., Bhushan, A., Broeseker, A., Conway, S., Duncan-Hewitt, W., Hansen, L., & Westberg, S. (2009). Interprofessional education: Definitions, student competencies, and guidelines for implementation. American Journal of Pharmaceutical Education, 73(4), article 59. Mroz, T.M., Pitonyak, J.S., Fogelberg, D., & Leland, N.E. (2015). Health policy perspectives – Client centeredness and health reform: Key issues for occupational therapy. American Journal of Occupational Therapy, 69, 6905090010.  Retrieved from http://ajot.aota.org/article.aspx?articleid=2436567  
    • Same-Day Dental Procedures with Questions Requiring Immediate Responses: An IPE Assignment

      Hall, Mellissa; Coan, Lorinda; Holt, Emily
      Research Question/Context Does an interprofessional assignment support learning between two student groups: Dental Hygiene/Dental Assisting and graduate nursing students in a family nurse practitioner specialty? The interprofessional assignment was developed to simulate a real-life experience using a “patient” waiting for a dental procedure. The goal of the assignment was to emphasize shared patient responsibility between dental and primary care professionals. Clinical scenarios included commonly encountered concerns: uncontrolled diabetes, uncontrolled blood pressure, or daily use of medications associated with bleeding risk. Grounding The theoretical foundation of the assignment was derived from E.E. Bayles’ discussion of theories supporting learning (1966). Bayles’ emphasized five tenets of learning: learning as a mental discipline, learning as conditioning, learning as preparation for life, learning as development of insight, and learning as operant conditioning. The interprofessional assignment focused on the third and fourth tenets as presented by Bayle. Students were assigned commonly presenting patient scenarios they will deal with daily in their professional lives. With the patient scenario, students were led to develop insight on how to ask or provide answers supported by current literature/standards of patient care. Methods An interprofessional site was opened through the Blackboard Learning Management System for both dental hygiene/assistant students and graduate nursing students. IRB ruling was received from the University of Southern Indiana. The Blackboard site provided details about the assignment for both student groups and explained informed consent. Students could opt out of the study, but all were required to complete the assignment. The pre/post questionnaires focused on the value of the IPE assignment (King, Shaw, Orchard & Miller, 2010). Data from pre and post questionnaires were compared to determine the effectiveness of the assignment. Pre-IPE assignment responses (N = 71) and post-IPE responses (N = 50) were compared. Discussion/Lessons Learned Pre and post student surveys included quantitative and qualitative questions. Findings from the quantitative questions supported > 98% of students reported the IPE assignment was of value and helped them to understand the other profession’s role in patient care. The majority of both students groups responded the assignment helped understand how classroom content would be applied to their future work setting. Most qualitative responses were positive as well. Other disciplines could adapt a similar IPE assignment based upon anticipated collaboration between professions and the necessity for timely answers to assure patients/customers receive appropriate and timely services. References Bayles, E. (1966). Theories of Learning and Classroom Methods. Theory Into Practice, 5(2), 71-76. King, G., Shaw, L. Orchard, C.A. & Miller, S. (2010). ISVS: The interprofessional socialization and valuing scale: A tool for evaluating the shift toward collaborative care approached in health care settings. Work, 35 (1), 77-85.
    • Shaping a collaborative model of food services and public health: A multipronged approach using interprofessional education

      Nimkar, Swateja; Ramos, Elizabeth; Borowiecki, Chris; Nimkar, Swateja; Ramos, Elizabeth; Borowiecki, Chris
      Topic: The purpose of this interprofessional education (IPE) project was to introduce and encourage collaborative learning across the two professions of public health and food service management using community expertise. The intended learning outcomes for students were improved communication, collaboration, and conflict resolution skills. Additionally, students were also expected to identify and negotiate specific roles and responsibilities while working with members of another profession. Context: The project was conceptualized by two faculty from Food and Nutrition, and Health Services programs at the University of Southern Indiana (USI). Undergraduate students and faculty from Quantity Food Production and Purchasing and Public Health courses collaborated with the Vanderburgh County Health Department (VCHD) to ensure best food safety and sanitation practice in a real world environment. Approach: The faculty partnered with VCHD to provide students with the training and resources related to food safety and public health issues in the area of commercial and quantity food production. Quantity food students were ServSafe certified and public health students study food safety topics for this project while engaging in five IPE activities spread out during one academic semester at the College of Nursing and Health Professions (CNHP). Following the initial meetings and education sessions, students engaged in a final project, where public health students served as food safety inspectors as quantity foods students prepared elaborate cultural meals offered to members from the campus community. Finally, students conducted a debate on food safety issues as a culminating experience for the IPE project. Reflection and Discussion: Through this inter-professional collaboration, public health students learned the various aspects of reducing risk for foodborne illnesses and quantity foods production students experienced using Hazard Analysis and Critical Control Points (HACCP) plans to maintain food safety while preparing cultural meals. Both groups utilized an audit system that was discussed in advance by them to identify, analyze, and minimize hazards associated with foodborne illnesses. This project was conducted with direct supervision from faculty teaching the two classes. Thus, faculty and students are using IPE as an innovative approach to develop critical work skills among the future generations of food service and public health workers. References: Brown, A. (2019). Understanding Food: Principles and Preparation (6th ed.). Boston, MA: Cengage. National Restaurant Association Educational Foundation. (2017). ServSafe Coursebook (7th ed.). Chicago, IL: National Restaurant Association. Riegelman, R., & Kirkwood, B. (2014). Public Health 101: Healthy People-Healthy Populations (2nd ed.). Burlington, MA: Jones & Bartlett Learning. 
    • Summer Fun with IPE: Lesson Learned - Don't Get Burned

      Peak, Katherine; Doerner, Mary; Schmuck, Heather; Andrews, Carly; Cook, Joy
      Healthcare is an increasingly complex environment, comprised of multiple disciplines and clients with various disease processes and psychosocial issues. This complexity requires that all healthcare professionals, regardless of their discipline, be able to effectively work together within teams. The inability to function within a team as well as the inability to communicate effectively and share vital information, prioritize, and make appropriate decisions can result in patient harm and negative outcomes. Competency for effective teamwork is having knowledge of each healthcare professional's roles and responsibilities (Interprofessional Education Collaboration Expert Panel, 2011). While this information can be learned on the job, the ability to prepare future healthcare professionals for working in interprofessional/interdisciplinary teams is crucial. Promoting effective teams and team dynamics requires faculty to provide opportunities for healthcare professions students to have experiences that support interdisciplinary teamwork. Context This scholarly teaching activity evolved from a need to incorporate more interprofessional activities for students during the summer semester. Three disciplines from NURS488, DMS347, and RADT415 came together during the summer 2019 semester to develop an interprofessional activity with a focus on effective communication and teamwork in a simulated environment. The intended student outcomes were to practice effective communication amongst healthcare team members in order to facilitate positive patient outcomes in a triage scenario and to promote mutual respect and increased awareness of roles and responsibilities amongst the team members. Grounding Medical Errors are currently the third leading cause of death in the United States. The most common root cause of medical error is failure to communicate, thus further highlighting the need for simulation based interprofessional education (IPE) activities. Designing simulations by applying the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: Simulation-Enhanced Interprofessional Education (SIM-IPE) required criteria, faculty can begin to develop simulations that allow students of multiple professionals to come together to accomplish the same objectives by communicating clearly and effectively. Simulation based interprofessional education can be supported and guided with Kolbs Experiential Learning Theory. This theory consists of four major parts, all of which can be used to guide the entire simulation process: a concrete experience (simulation), reflective observation (debrief), An abstract conceptualization (post-simulation evaluation), and active experimentation (follow-up simulations, clinical experience, and work experience) (INACSL Standards Committee, 2016). Approach For the scenario, faculty enlisted the help of USIs Public Safety officers to act as Emergency Medical Technicians (EMTs) who were transporting three simulated patients from the field into the simulated hospital emergency room environment. Each EMT presented one of the three patients cases to the receiving team comprised of 1-2 nursing leadership students and either radiography students or diagnostic medical sonography students. One patient was received only by nursing students. Nursing leadership students were then tasked with deciding what triage imaging orders might be necessary for the patient. Two radiography and two diagnostic medical sonography student representatives were present in the simulated hospital emergency room and proceeded to simulate image acquisition and provide radiologists reports on the imaging exams. The remainder of the nursing, diagnostic medical sonography students, and radiography students from the involved courses were in a classroom setting observing a live video feed of each simulation room scenario. The teams of students in the simulation center each took a turn advocating for their patient to the lead surgical nurse as the patient whose condition was most critical, therefore requiring the next available surgical intervention. Following the live simulation, the students from the simulation center joined the other students in the classroom setting for a full debriefing of the activity. This was the first attempt at such a scenario ever attempted in our college. Although simulation has a long history of utilization in single discipline formats for a variety of purposes, bringing together these particular disciplines for an interprofessional learning experience was innovative; especially when combining the collaboration of our public safety officers into the scenario. None of these particular courses had ever had an IPE activity implemented prior to this scenario even though literature supports the multiple benefits of interprofessional education through simulation. Reflection/discussions/lessons learned When reflecting on this interprofessional simulation there were aspects that went well and aspects that presented challenges. When debriefing, simulation leaders conducted a SWOT analysis to discuss what went well and what could be improved. Leadership incorporated their own observations as well as student comments during the debriefing session to help drive the analysis. Strengths included the communication and cooperation of the leadership members involved in designing and implementing the simulation, as well as their strong commitment to an interprofessional learning experience. Another strength was the availability of the colleges state-of-the-art simulation center and the staff member who organizes and administers the simulation process. Lack of clear knowledge about each others profession proved to be a weakness. Students also felt that the simulation should include certain equipment to make it more realistic. In light of these reflections, faculty propose that students create video projects highlighting the scope of practice of their respective professions as an opportunity for future interprofessional simulations. Additional ancillary equipment will be included to promote a more realistic feeling to the simulation. Threats include the reluctance of some students to fully engage in the interprofessional experience. Faculty plan to stress the importance of interprofessional education and collaboration and their roles in the team approach to healthcare. Faculty will thoroughly explain the objectives of the simulation and debrief with students at the conclusion to elicit feedback from all parties involved. Overall, faculty learned that simulations do not go perfectly the first time. Many unexpected circumstances may occur. Debriefing and careful observation are essential to the learning process so that errors can be corrected and a more robust experience can be conducted in the future. References: INACSL Standards Committee (2016, December). INACSL Standards of Best Practice: SimulationSM Simulation-enhanced interprofessional education (sim-IPE). Clinical Simulation in Nursing, 12(S), S34-S38. http://dx.doi.org/10.1016/j.ecns.2016.09.011. Murphy, Joseph G., and William F. Dunn. Medical Errors and Poor Communication. Chest, vol. 138, no. 6, 2010, pp. 1292-1293., doi:10.1378/chest.10-2263. Poore, J. A., Cullen, D. L., & Schaar, G. L. (2014, May). Simulation-based interprofessional education guided by Kolbs experiential learning theory. Clinical Simulation in Nursing, 10(5), e241-e247. http://dx.doi.org/10.1016/j.ecns.2014.01.004.