virtual ipe rotation... · 1.outline features and benefits of virtual patient simulations for ipe...
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NCIPE Summit, MN August 21 2017
Diana Jacobson, PhD, RN, PPCNP-BC, PMHS, FAANP
Arizona State University,
College of Nursing and Health Innovation.
Lise McCoy, EdD,
A.T. Still University,
School of Osteopathic Medicine in Arizona (ATSU-SOMA)
Virtual IPE Rotation: Let’s Meet Online to Discuss Patient Case Araceli Gamboa,
an Adolescent with Obesity
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also
funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents
of the University of Minnesota, All Rights Reserved.
This activity has been planned and implemented
by the National Center for
Interprofessional Practice and Education.
In support of improving patient care, the National Center for Interprofessional Practice and Education is jointly
accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for
Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education
for the healthcare team.
Physicians: The National Center for Interprofessional Practice and Education designates this live activity for a maximum
of 1.5 AMA PRA Category 1 Credits™.
Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts credit from organizations
accredited by the ACCME.
Nurses: Participants will be awarded up to 1.5 contact hours of credit for attendance at this workshop.
Nurse Practitioners: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit
from organizations accredited by the ACCME and ANCC.
Pharmacists: This activity is approved for 1.5 contact hours (.15 CEU) UAN: 0593-0000-17-013-H04-P
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also
funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents
of the University of Minnesota, All Rights Reserved.
Disclosures
The National Center for Interprofessional Practice and Education has a
conflict of interest policy that requires disclosure of financial interests or
affiliations of organizations with a direct interest in the subject matter of
the presentation.
Lise McCoy and Diana Jacobson
do not have a vested interest in or affiliation with any corporate
organization offering financial support or grant monies for this
interprofessional continuing education activity, or any affiliation with an
organization whose philosophy could potentially bias his/her presentation.
The National Center for Interprofessional Practice and Education is supported by a Health Resources and Services Administration Cooperative Agreement Award No. UE5HP25067. The National Center is also
funded in part by the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, The John A. Hartford Foundation and the University of Minnesota. © 2015 Regents
of the University of Minnesota, All Rights Reserved.
Interprofessional continuing education credit will be awarded
to participants that paid the continuing education credit fee
while registering for the Summit.
All workshop participants are asked to scan their barcode
(from nametag) upon entrance to session and complete the
evaluation distributed at the end of the workshop. Those
who registered to receive continuing education credit will
also receive a certificate of completion following the Summit.
This study was supported by a grant from the American Association of Colleges of
Osteopathic Medicine and the Osteopathic Heritage Foundation.
• We would also like to thank the following colleagues:
• Joy Lewis, DO, PhD – ATSU-SOMA
• Daniel Crawford, DNP, CPNP—ASU CONHI
• Lee Herskowitz DO – ATSU-SOMA
• Curt Bay, PhD--A.T. Still University, Arizona School of Health Sciences.
• Jamie McCauley– ATSU-SOMA
• Bradley Meek and Mark Sivakoff – ATSU-SOMA
Thank you.
Funding Disclosures – Non Corporate
6
Session Learning Objectives
1.Outline features and benefits of virtual patient simulations
for IPE training
2.Review the lesson design and results of the pilot, conducted
in February, 2016
3.Consider assessment tools (pre-post assessment and
debrief)
4.Provide input regarding the Scope of Practice Worksheet as
a tool for practicing IPEC domain “Roles and
Responsibilities”.
Improving Communication between Physicians and Nurse Practitioners
Community Campus Locations and Residency
Sites affiliated with ATSU SOMA
DNP graduates are prepared to practice at
the most advanced level of nursing. ..The
focus is on development of expertise in
providing primary care to individuals of all
ages within traditional, nontraditional and
culturally diverse families.
In AY 2016-2017 we implemented
an IPE project aimed at training
SOMA OMSII and ASU DNP
students to work collaboratively
through a virtual patient
simulation.
VIRTUAL PATIENT SIM
Virtual Patient Simulations (VPS) are
web-based exercises involving simulated
patients in virtual environments.
VIRTUAL COMMUNITY HEALTH CENTER:A TRAINING PROGRAM FOR HEALTHCARE STUDENTS BOUND FOR COMMUNITY-ORIENTED PRIMARY CARE.
https://www.kynectiv.com/
Online Case Platform: DecisionSim
12Interprofessional Education
It sounds easy, right? Getting medical
and DNP students together from two
different schools to complete a case
study?
• Dual IRB
• Technology
• Consensus for objectives & tools
• Schedules
• Developing a Realistic and Culturally
sensitive virtual learning module
Lesson SequencePre-Reading
Scope of NP,
DO and
Dietitian
Participant
Consent
Pretest on IP
competency
Qualtrics
Case
Practice
Case debrief &
open answer
questions
Post-test on IP
competency
Qualtrics
Before Sim: Preview Scope of Practice Worksheets
In terms of caring for an adolescent with
obesity, how confident are you that you
can complete the following tasks
collaboratively, in a team with other
professionals?
Take the Pre-Test
Choose:
Very Unconfident/ Unconfident/ Neutral/ Confident/ Very Confident
• Prioritize actions relevant to the management of the patient.
• Integrate patient’s circumstances, beliefs and values into care
plan.
• Advocate for patient and partners in decision-making process.
• Plan a patient intervention with team members.
• Include relevant health professionals in the patient’s care plan
• Demonstrate respect for others in and outside the team.
• Participate in inter-professional discussion about patient care.
Let’s Go Meet the Patient
https://vchc.atsu.edu/register-with-vchc
Welcome to Envision Community Health Center!
Meet with Healthcare Team at the Clinical Site
20
Debrief Discussion:
After completing the e-case, please complete a community-oriented primary care
debrief discussion.
It is estimated that overall health is affected by each of the following factors:
•40% socioeconomic
•30% health behaviors
•20% clinical care
•10% physical environment
1.What are some of the socioeconomic determinants that influence
obesity?
2.What are some of the community, or physical environmental factors that
influence obesity?
3.Select a profession from this case. DO/DNP/Dietitian. Discuss three
things you learned about this profession.
Study Results
Ten teams of DO-NP students successfully completed the case study
activity together.
The entire cohort of SOMA OMS2 (paired sample n= 92) gained 4.11 to
4.39 on the pre-post assessment, significant at p=.000. Effect size was .73.
ASU DNP students (n=6) gained 4.47 to 4.71 on the survey,
though results were not significant.
REFERENCES
1. Balough EP M, BT, Ball JR. Improving Diagnosis in Health Care. Washington DC: National Academies Press; 2015.
2. G L. Care Coordination: the Game Changer. Silver Spring, MD: American Nurses Association; 2013.
3. Trilla F PA. Physicians and Nurse Practitioners in Collaborative Practice. Harvard Risk Management Foundation. 1998(Winter):9-10.
4. Panel IECIE. Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative; 2011.
5. Ziv A, Small SD, Wolpe PR. Patient safety and simulation-based medical education. Med Teach. 2000;22(5):489-495.
6. McCoy L PR, Lewis JH, Bennett T, Carrasco N, Brysacz S, Makin IR, Hutman R and Schwartz FN. Developing technology-enhanced active learning for medical education:
Challenges, solutions, and future directions. JAOA. 2015;115(4):202-211.
7. McCoy L, Lewis JH, Dalton D. Gamification and Multimedia for Undergraduate and Graduate Medical Education. J Am Osteopath Assoc. 2015;In Press.
8. McCoy L PR, Lewis JH, Allgood JA, Bay C, Schwartz FN. Evaluating medical student engagement during virtual patient simulations: a sequential, mixed methods study.
BMC Med Ed. 2016;16(20):1-15.
9. Huwendiek S, Reichert F, Bosse H, de Leng BA, van der Vleuten C,Haag M, Hoffman GF, Tonshoff B. Design principles for virtual patients: a focus group study among
students. Med Ed. 2009;43:580-588.
10. Lin S, Schillinger, E, Irby DM. Value-added medical education: Engaging future doctors to transform health care delivery today. J Gen Intern Med. 2014;30(2):150-151.
11. Stewart T, Wubbena ZC. Groundwork: A systematic review of service-learning in medical education: 1998-2012. Teach Learn Med. 2015 27(2):115-122.
12. Garr R, Margalit R, Jameton A, Cerra FB. Educating the present and future health care workforce to provide care to populations. Acad Med. 2012;87:1159–1160.
13. Shalijian M, Moore, J. Managing Populations, Maximizing Technology: Population Health Management in the Medical Neighborhood: The Patient-Centered Primary Care
Collaborative (PCPCC);2013.
14. Bauer S, Niet JD, Timman R, and Kordy H. Enhancement of care through self-monitoring and tailored feedback via text messaging and their use in the treatment of
childhood overweight. Patient Education and Counseling. 2010;79:315-319.
15. Mayer-Davis E, D'Antonio, A, Smith, SM., Kirkner, G et al, Pounds Off With Empowerment (POWER): A Clinical Trial of Weight Management Strategies for Black and White
Adults With Diabetes Who Live in Medically Underserved Rural Communities. Am J Pub Health. 2004;94(10):1736-1742.
16. Taylor RW CA, Knight L, Brown D, Meredit-Jones, K, Haszard JJ et al. A tailored family-based obesity intervention: A randomized trial. Pediatrics. 2015;136(2):281-289.
17. E M. A Childhood Obesity Program in Federally Qualified Community Health Centers. Journal of Health Care for the Poor and Underserved. 2010;21:774-779.
18 Wilkes A JP, Vable A, Campbell A et al. Combating Obesity at Community Health Centers (COACH): A Quality Improvement Collaborative for Weight Management
Programs. Journal Of Health Care for the Poor and Underserved. 2013;24(2 0):47-60.
2.1.5 Family ContextFigure 6: Ten ethnically diverse patient families visit the Envision Clinic.
Lesson Objectives iTOFT Competency
Discuss screening data (Hx, PE) in the evaluation of the
patient’s overall health with a team member.
Prioritize actions relevant to the
management of the patient.
Assess the patient and family’s goals, beliefs, and values. Integrate patient’s circumstances, beliefs
and values into care plan.
Assess the patient’s readiness to change using
motivational interviewing techniques.
Advocate for patient as partner in decision-
making process
Build trust with the adolescent patient, while respecting
parent input.
Advocate for patient as partner in decision-
making process,
Coordinate a patient intervention with team members. Plan a patient intervention with team
members.
Seek bidirectional consultation, from and with other
professionals in the care plan.
Include relevant health professionals in the
patient’s care plan.
Discuss the plan of care with the patient. Share health care information with patient.