• 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
    • 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.