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Distance Faculty Observation Using iPads Upstate Medical University

Distance Faculty Observation Using iPads Upstate Medical University. Ann S. Botash , MD Professor, Pediatrics Jason Perez, MS, FNP Graduate , College Nursing Patricia D. Powers, DNP, MPA, RN, FNP-C, NPP Clinical Assistant Professor, Nursing Carol Recker -Hughes, PT, PhD

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Distance Faculty Observation Using iPads Upstate Medical University

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  1. Distance Faculty Observation Using iPadsUpstate Medical University Ann S. Botash, MD Professor, Pediatrics Jason Perez, MS, FNP Graduate, College Nursing Patricia D. Powers, DNP, MPA, RN, FNP-C, NPP Clinical Assistant Professor, Nursing Carol Recker-Hughes, PT, PhD Associate Professor, Physical Therapy Carrie Roseamelia, Ma family medicine Pamela Youngs-Maher, M. Ed. Coordinator, Online Learning

  2. Where We Work College of Medicine (Ann) IT (Pam) Family Medicine (Carrie) Physical Therapy (Carol) College of Nursing (Patty)

  3. Background & Purpose 1. Clinical Education 2. Goals of Project 3. Literature Review

  4. Percentage Clinical Education

  5. Education: From Classroom to Clinic Education: From Classroom to Clinic Academic Faculty Clinical Supervisors Clinical teachers in traditional & Practicing clinicians who supervise non-traditional classroom settings students in the clinic

  6. Challenges of Clinical Teaching:Juggling Act Lack of effective feedback skills • Variability • teaching • & learning Time

  7. Goals of the Project • Assess FaceTime as a mechanism to bridge time/distance barriers in observing students • Improve students’ clinical skills through use of formative feedback • Develop a shared observation tool across multiple disciplines to define core, observable clinical skills

  8. An Interdisciplinary (Ad)Venture COM CPT Past to Future CON • Fosters appreciation & understanding of other disciplines • Challenges norms & values of each discipline • Promotes student participation • Models strategies for future practice

  9. Literature Review Distance Technology: • Provides a mechanism for valuable feedback on performance and promote mastery of clinical skills (Bulik, Frye, Callaway, Romero, & Walters, 2002; Clever, Novack, Cohen, Levinson, 2003; Novack, Cohen, Peitzman, Beadenkopf, Gracely, & Morris, 2002). • May be used for long-distance communication assessment for a variety of learners (Bulik, Frye, Callaway, Romero, & Walters, 2002; Clever, Novack, Cohen, Levinson, 2003; Mattheos, Nattestad, & Attström, 2003; Novack, Cohen, Peitzman, Beadenkopf, Gracely, & Morris, 2002). • Can be distracting/problematic (Curran, Aziz, O'Young, Bessell, & Schulz, 2005; Clever, Novack, Cohen, Levinson, 2003).

  10. Description of the Project

  11. Timeline

  12. Planning • IRB Process • Describe what we plan to do & with whom • Seek exempt status • Identify common ground across disciplines for patient examination • Taking a patient history • Create form with essential elements • Define PI Roles

  13. Communication • Communication with: • The project team • Academic Faculty • Students • Clinical sites • Tools • Blackboard • Google Drive • Email

  14. Research Methods • Develop Tools for Data Collection: • Student & Faculty Technology Survey • Student Survey on Faculty Feedback • Create Focus Group Questions for Faculty • Develop Protocols: • Patient Recruitment • Student & Faculty FaceTime Encounters

  15. Recruitment of Sites & Students • Recruitment • Sites • HIPAA • Wi-fi access • Policies & Procedures • Some sites could not participate • Students • Expectations of participants • Overview of the Project and iPad training • Completing 2 Surveys online

  16. Faculty Recruitment • Principal Investigators recruited faculty • iPad was an incentive • Required commitment • 3 hours of faculty development • 1-2 hours/month January-May • Complete survey and focus group • Memorandum of Understanding (MOU)

  17. Faculty Development Workshop

  18. Faculty Training • Set up and use of iPads • 1 hour session (by department) • Introduction to Face Time, Apps, and Settings • Observation/Feedback Workshop • 2 hour session • Simulation in Clinical Skills Center • Practice, Practice, Practice

  19. Feedback Workshop Objectives • Following this workshop, faculty will: • Differentiate between characteristics of effective versus ineffective feedback. • Use open-ended questions to promote student reflection and decision making. • Engage in a formative feedback session using Face Time. • Assess challenges of technology in the delivery of feedback.

  20. Effective Feedback • Promotes self-directed learning and professional development • Facilitates effective problem solving • Requires ability to: • question appropriately • listen actively I’m questioning

  21. Feedback Should

  22. Faculty Development Session

  23. Setting up the iPad (Student)

  24. Pediatric Observation of Student/Standardized Patient

  25. Feedback: Nursing Feedback to Student

  26. Transition SLIDE Data Collection & Results

  27. Data Collection & Analysis • Data Collection and Analysis:1. Faculty Survey 2. Student Surveys 3. Faculty Focus Groups

  28. Results: Technology Surveys Did you experience difficulty connecting to FaceTime? Student: Preceptor was unfamiliar with the technology. Did you experience difficulty staying connected to FaceTime? Faculty: It took multiple attempts before the call went through. Audio was choppy, the camera froze several times.

  29. Results: Technology Surveys FaceTime is an effective mechanism for delivering student feedback I would recommend the use of FaceTime technology on a regular basis Faculty: Promising but doesn't have it's sea-legs yet.

  30. Results: Student Reflections The faculty member provided meaningful feedback about…

  31. Results: Student Reflections The faculty member provided….. “tricks of the trade” advice or helpful tips Students Results • Agree • Disagree • Unsure • 76% • 14% • 10%

  32. Themes: Faculty Focus Groups • What Worked? • Assessing Students • Providing Feedback • Communication with the • Onsite Faculty • What Did Not Work? • Imposition & Scheduling • Connectivity • Viewing Patients & Students • Student Initiative & Accountability

  33. Themes: Faculty Focus Groups • Suggestions • Expand Use of iPad Observations • Earlier & more frequently • History and physical examination • Connect with clinical faculty • Use for Site Visits • Teaching Tools • iPad • Apps • Additional Faculty Development

  34. Lessons Learned

  35. Students • Recruitment • Sample of convenience • “Carrot or Stick”=Participation • Training • Memorandum of understanding • Practice, practice, practice! • In the Clinic • Variable support of instructors • Informed consent process • Survey Completion

  36. A Student’s Experience

  37. Faculty • Recruitment • Training • Commitment • PI Support

  38. Pilot Study…..Next Steps? • Expand use across colleges • Implement “carrot or stick” policies • Consider cross discipline observations • Use, and validate, forms across disciplines • Guidelines for delivery of feedback • Observation tool • Observe history AND physical examination

  39. Next Steps for Faculty Use? • Communication skills workshops • For new and current faculty • Inter professional • Professional development • iPad use • Apps • Use of the iPad for “site” visits • Rural and remote settings

  40. Observation/Feedback Forms…. Observation Form: • https://docs.google.com/file/d/0B7a8mExE0x3HdnpSUFM1WFpjYW8/edit?usp=sharing Feedback Checklist: • https://docs.google.com/file/d/0B7a8mExE0x3HT1MwVTNUZ045cEU/edit?usp=sharing

  41. References • Bulik, R., Frye, A. , Callaway, M., Romero, C., & Walters, D. (2002). Clinical Performance Assessment and Interactive Video Teleconferencing: An Iterative Exploration. Teaching and Learning in Medicine, 14 (2), 124-132. • Clever, S., Novack, D., Cohen, D., Levinson, W. (2003). Evaluating surgeons' informed decision making skills: Pilot test using a videoconferenced standardized patient. Medical Education, 37 (12), 1094-1099. • Curran, V., Aziz, K., O'Young, S., Bessell, C., & Schulz, H. (2005). A comparison of face-to-face versus remote assessment of neonatal resuscitation skills. Journal of Telemedicine and Telecare, 11 (2), 97-102. • Glavaz, G., Parish, T., Byous, R., Chambers, D., Gerdom, L., Leffert, J., & Wright T. (2012). The use of videoconferencing for clinical site evaluations. Journal Physician Assistant Education,23(2), 50-55. • Lentz, L.M., & Fincher, R.M. (1999). Using telemedicine and standardized patients to evaluate off-campus students' skills. Journal of the Association of American Medical Colleges, 74 (5), 598-599. • Mattheos, N., Nattestad, A., & Attström, R. (2003). Feasibility of and satisfaction with the use of low-bandwidth videoconferencing for examination of undergraduate students. Journal of Telemedicine and Telecare, 9(5), 278-281. • Novack, D., Cohen, D., Peitzman, S., Beadenkopf, S., Gracely, E., & Morris, J. (2002). A pilot test of WebOSCE: A system for assessing trainees' clinical skills via teleconference. Medical Teacher, 24 (5), 483-487. • Robinson, S. (2011). Promote active learning with iPads. Radiologic Technology, 83(2), 204-207. • Smith, C. , & Skandalakis, J. (2005). Remote presence proctoring by using a wireless remote-control videoconferencing system. Surgical Innovations, 12(2), 139-143.

  42. Upstate Medical University Any “burning” questions??

  43. What we are doing…. CNY Central: • http://www.cnycentral.com/news/story.aspx?id=878617#.UVnRcjnWaf8 What's Up at Upstate: • http://whatsupatupstate.wordpress.com/2013/04/01/professors-use-ipad-facetime-feature-in-teaching-medical-students/ Student interview: • http://www.youtube.com/watch?v=p7KDIYU3Ngc&list=UUIC6B4ULFCqa8bXKVc1sjYA&index=1

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