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ECU CON AGNP/FNP/DNP Team Retreat 6/26/14 and 6/27/14

ECU CON AGNP/FNP/DNP Team Retreat 6/26/14 and 6/27/14. WELCOME!!!!. Thank You to our host The Farm on Salem Church. Pirate Welcome….ARRGH!. Objectives. Day #1. Day #2. Complete curriculum review and evaluation. Demonstrate understanding of CCNE accreditation requirements (11/5-11/7)

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ECU CON AGNP/FNP/DNP Team Retreat 6/26/14 and 6/27/14

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  1. ECU CONAGNP/FNP/DNP Team Retreat6/26/14 and 6/27/14 WELCOME!!!!

  2. Thank You to our hostThe Farm on Salem Church

  3. Pirate Welcome….ARRGH!

  4. Objectives Day #1 Day #2 Complete curriculum review and evaluation. Demonstrate understanding of CCNE accreditation requirements (11/5-11/7) Complete Program/policy revisions relevant to AGNP/FNP/DNP Curriculum. • Enhance team cohesion during time of transition from to new DNP curriculum. • Review IPE Grant • Demonstrate Understanding of interprofessional education competencies in curriculum.

  5. Agenda for Day 19AM-3:30PM • Welcome • Overview • Review of Agenda for both days • Welcome new faculty • Presentation by Dr. Andrea Pfeifle • Enhance team cohesion during transition to new DNP curriculum • Learning activities supporting IPE grant objectives • Wrap up with Dr. Bobby Lowery • *IPE and the AGNP/FNP Curriculum • *Teach-out plan for MSN AGNP/FNP/DNP Curriculum • *Review DNP Curriculum • Certification options • AANP/ANCC (between 8123/20 & 8124) • *Depending on time remaining • Optional Dinner @ Lowery’s 311 Ashworth Dr. Goldsboro, NC 27530

  6. Agenda for Day 29AM-3:30P • Discuss impending CCNE accreditation visit • Peripheral Website • Clinical Placement for IPE Evaluation • Medatrax • Clinical Logs • IPEC Ranking for each pt.& Global IPEC Reflection • Nicaragua Course Development • VC • Clinical Skills Workshop IPEC Vignettes • Faculty Composition/New Team Members • Review teaching assignments/needs • Scholarship • Policies/Procedures • DNP Faculty Meeting Schedule for 2014-15 Academic Year

  7. Welcome New Faculty • Dr. Patricia Crane • Dr. Rebecca Benfield (in new role) • Jan Tillman, FNP • Tamika Williams, ANP/GNP • 2 PhD positions vacant • Dr. K. Newnam, PhD, NNP

  8. Overview of Grant: Enhancing the Primary Care Management of Patients with Multiple Chronic Conditions through Interprofessional Education Bobby Lowery, PhD, FNP-BC, FAANP

  9. What is Interprofessional Education? • Interprofessional Education (IPE) and collaborative Practice • Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. Interprofessional education is a necessary step in preparing a “collaborative practice-ready” health workforce that is better prepared to respond to local health needs • Source: World Health Organization (2010): Framework for Action on Interprofessional Education & collaborative Practice

  10. Collaborative practice • When multiple health workers from different professional backgrounds work together with patients, families, care givers and communities to deliver the highest quality of care. It allows health workers to engage any individual whose skills can help achieve local health goals. • Source: World Health Organization (2010): Framework for Action on Interprofessional Education & collaborative Practice

  11. Why is this Important?Institute for Healthcare Improvementhttp://www.ihi.org/Engage/Initiatives/TripleAim/Pages/MeasuresResults.aspx

  12. Enhancing the Primary Care Management of Patients with Multiple Chronic Conditions through Interprofessional Education Purpose Method IPE strategies/competencies in AGNP & FNP curriculum (yr.1) Interprofessional learning scenarios in VCCLE (yr. 2) Didactic & clinical content in management MCC infused into OSCAE (yr. 2) Promote/evaluate IPE competencies by clinicians/students in rural, underserved community serving diverse, ethnic minority population (yr. [2] & 3) • HRSA Advanced Nursing Education Grant (Grant # D09HP25923) $1,091,723 over 3 yrs. • Address the health care needs of individuals in rural communities with multiple chronic conditions (MCC)

  13. Project Team Members • Dr. Bobby Lowery, Project Director • Dr. Elizabeth Feldhousen, Project Coordinator: • Dr. Andrea Pfeifle, EdD, PT, Consultant • Project Faculty • Dr. Annette Greer • Dr. Carol (Ann) King • Mr. Karl Faser • Dr. Michelle Skipper • Dr. Candace Harrington • Mr. Patrick Merricks • Ms. Eva Meekins, CSE • Project Evaluator—TBA • Advisory Panel • Dr. Grishonra Branch-Mays • Dr. Maria Clay • Dr. Sheila Bunch • Dr. Thomas Irons • Dr. Tomas Maynor

  14. Work Plan—Project Manual p. 27

  15. Work Plan Year #2: p. 28/34

  16. Work Plan P. 29/34 Dr. Andrea Pfeifle

  17. Work Plan Pg. 30/34

  18. Work Plan Pg. 31/34

  19. Work Plan pg. 32/34

  20. Work Plan pg. 33/34

  21. Work Plan Year #3pg. 34/34

  22. Overview of Synergistic IPE Work @ the CON • ACKNOWLEDGEMENT of Contributions:Promoting Interprofessional Education and Collaborative Practice through Web-based Technology: Options for Distance Learning Programs in Graduate Nursing Education(slides 8-28) • Pamela J. Reis, PhD, CNM, NNP-BC • Bobby Lowery, PhD, FNP-BC • Carol Ann King, DNP, FNP-BC • Karl E. Faser, BS

  23. Using a Theoretical Framework forInterprofessional Education:Starting with the End in Mind • Constructivist Theory • Individuals “learn to learn as they learn ” (Langdon, 2009, p. 51). • Experiential Learning – based on Kolb’s (1981) Learning Cycle • Learning through direct encounter, in situ problem solving • Behaviorism • Learning outcomes are expressed as behaviors

  24. Constructs in the Measurement of IPE: The IPEC Core Competencies for Interprofessional Collaborative Practice

  25. Interprofessionality “the process by which professionals reflect on and develop ways of practicing that provides an integrated and cohesive answer to the needs of the client/family/population… It involves continuous interaction and knowledge sharing between professionals, organized to solve or explore a variety of education and care issues all while seeking to optimize the patient’s participation… Interprofessionalityrequires a paradigm shift, since interprofessional practice has unique characteristics in terms of values, codes of conduct, and ways of working. These characteristics must be elucidated” (D’Amour and Oandasan, 2005, p. 9).

  26. Hallmarks of Effective Learning in IPE “Integration of theory and practice, recognition of other professionals’ knowledge and skills, and the need for learners to progress from knowledge acquisition to deep understanding of teamwork are all hallmarks of effective learning.” ~Walsh and van Soeren, 2012, p. 43

  27. Bridging professional silos Interprofessional Education

  28. Inception & Evolution of VCCLE • 2005 HRSA Funding • Purpose: Nursing Leadership in the management of culturally diverse clients in primary care. • Social presence • Virtual Community defined (Giddens, et al 2010).

  29. Virtual Technology in Interprofessional Education Benefits Challenges Costly Long developmental trajectory Potential for technical failures Building new ideas and concepts into a curriculum full of uni-professional content Steep learning curve for faculty, both in technology and IPE content Faculty workload realities Longitudinal outcomes are not yet available regarding the efficacy of virtual technology as a pedagogical approach in IPE • Allows students with disparate schedules and locations to “meet” online asynchronously and synchronously • Can be delivered to an international audience, expanding global health opportunities • Content can be reused over time • Allows students to practice critical thinking and problem-based learning in a low-risk environment

  30. Nurse Practitioner Virtual Clinic Experience • Self-paced patient assessment • Application of information to plan care • Evidence-based feedback/rationale • Includes ECGs, x-rays, lab results, links • SOAP note • Cultural and Ethnic Diversity • Limited only by our imagination!

  31. Technical Staff • Primary architects • - Mr. Yanhao Zhu • - Mr. Kuan Chen • Essential, supporting assistance • - Mr. Jacob Pennock, Unicorn Forest Games • - Mr. Collin Bayard • - Mr. Jonathon Parish • Talented, dedicated, engaged, conscientious • people = success.

  32. Overview: How it works Cast of characters - Receptionist - Preceptor - Patient Classic patient interview/ diagnostic sequence - Chief Complaint - HPI - Review of Systems - Physical Exam - Lab Tests - Differential Diagnosis - Impression - Care Plan The art of the question

  33. VC Components: Technical Front End - Unity 3D engine/web plugin - Ivona text-to-speech engine - Models - Rocket box - Mixamo animations - MS Kinect Back End - Database/ MS SQL server - Admin website - Student section - Instructor Section - Case Builder - XML web service

  34. Directions • - Multi-media • - Billing/Coding • International patients • - Select-a-model

  35. Student Feedback We like it! The VC cases enabled me to: Better understanding of my role as an APRN: 5.29 More effectively implement therapeutic interventions: 5.26 Formulate an appropriate diagnosis: 5.85 Synthesize knowledge, skills, and competencies required for advanced practice nursing: 5.81 N=34/1-7 scale

  36. We Like It! • Fun to do, very realistic for good learning • Helpful to pull all of the pieces together • Great learning tool, wish we had more of this • I really enjoyed the virtual clinic. It is a great tool for distance education in that it gives a different type of learning style than simply reading or listening to a lecture.

  37. Office of Clinical Skills Assessment & Education Michelle Skipper Patrick Merricks HRSA Grant Team Meeting Friday February 14, 2014

  38. Who are Standardized Patients? SPs Enjoy Observing Students Grow & Become Professionals!!

  39. What are Standardized Patients? Howard Barrows .. Southern Illinois University

  40. What’s an OSCE? • Objective Structured Clinical Examination • Learners have limited time to gather and share information, make decisions and foster the relationship. • Script/Scenario: • The patient’s story and background information used to standardize the portrayal. • Standard Scenarios: global content that can support multiple disciplines (“as is” or customized). • Pilot Scenarios: developed for grants, research and licensure preparation. • Checklist • A faculty driven compilation of history, communication skills and/or physical exam items that a learner is expected to explore as they confirm/refute the differential diagnoses (“as is” or customized).

  41. OCSAE Academic Support Unit 6500 sq foot simulated modular unit located at Lakeside Annex 6. The facility includes 15 examination rooms, and 3 conference rooms equipped for basic physical examinations with video recording and data management capabilities. An academic support unit that offers education and assessment to the followingECU programs of study: • Brody School Of Medicine • College of Nursing • College of Allied Health Sciences • Health Services Management • Rehabilitation and Career Counseling • Occupational Therapy • Physician Assistant • Physical Therapy • School of Dental Medicine • College of Education • The School of Social Work • Residency Programs

  42. HRSA Grant & OCSAE • HRSA Grant Objective #3 • Develop and expand clinical and didactic content in the management of individuals with multiple chronic conditions (MCC) living in rural communities through interprofessional experiences with Standardized patient (SP) simulated case scenarios. • Script/Scenario: • The patient’s story and background information used to standardize the portrayal. • Standard Scenarios: global content that can support multiple disciplines (“as is” or customized). • Pilot Scenarios: developed for grants, research and licensure preparation.

  43. Interprofessional Education and Collaboration Partnership Clinical Site Evaluation Thomas E. Maynor, II, MD, MPHDeputy CEO/ Chief Operating Officer Eva Meekins, RN, BSN, MN, MHA Clinical Site Evaluator

  44. Clinical Sites/Interprofessional Education • Clinical Faculty Pre-assessment/Education on IPEC • About Robeson Health Care Corporation • How to Assess Faculty (Staff) at Different Sites • How IPEC may Impact Faculty (Patients with MCC) at Sites

  45. About Robeson Health Care Corporation RHCC premier provider of care Since 1985 Private Nonprofit Primary, Preventative Health Care Substance Abuse Services Federally Qualified Health Center (FQHC) Accredited by The Joint Commission. 60 Commerce Plaza Pembroke, North Carolina 28372

  46. Service Area • Robeson, Columbus, Scotland, Montgomery, Moore, Johnston and Pitt. • RHCC operates the only migrant/seasonal farm worker program in Robeson County • Goal: To provide access to medical, dental, and prenatal care for farm workers and their families.

  47. Maxton Medical Center Eugene Nor, MD Thomas Rinkacs FNP Lumberton Health Center Robin Peace, MD Sonia Duggal, MD Elena Hierseman, PA Shawana Faulk, FNP-C Julian T. Pierce Health Center, Pembroke Allison Jacobs, FNP South Robeson Medical Center, Fairmont Brenda Allen, FNP Leslie Oxendine, FNP

  48. Columbus Co. Community Health Center Kimberly Campbell, PA-C Montgomery Co. Community Health Center Biscoe, NC Scotland Community Health Center Ashley Locklear, PA-C

  49. IPEC | Clinical Site Assessment Plan • Literature Review to Explore Constructs and Concepts of IPEC • Conduct a RHCC Appraisal to Better Understand the: • Full Scope of Services • Providers and Area of Expertise/ Health Care Focus • Population/Patient served with MCC (Multiple Chronic Conditions) • Plan Project “Launch” to Introduce Project to RHCC Providers and Staff • Attend RHCC Scheduled Providers Meeting (Establish a Presence) • Strategically Visit Each Clinical Site/ Service Area to: • Interact w/ Faculty (Providers) and Staff to Determine Level of Impact • Identify IPE Opportunities for ECU Students to Develop IPE Competencies

  50. Interprofessional Education Competencies |Collaboration Opportunities| "At DHHS, we are confronting one of North Carolina's biggest and most important healthcare challenges," said Dr. Wos. "We are partnering with underserved communities … develop innovative solutions that can increase access and quality of health care… [by] providing funding, [and] recruiting health providers to meet unmet needs in local communities." • Dr. Sonia Duggal • HokeCounty • Community Health Center Dr. Thomas Maynor, MD and Jinnie Lowery, President, CEO, both of RHCC stated, "It is important to let people know that all eight of our centers provide health care for residents who are uninsured, as well as, those with Medicaid, Medicare, BCBS, other insurance, and especially TRICARE coverage."

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