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ANN S. BOTASH, MD PROFESSOR, PEDIATRICS JASON PEREZ, MS, FNP GRADUATE, COLLEGE NURSING PATRICIA D. POWERS, DNP, MPA, RN, FNP-C, NPP CLINICAL ASSISTANT.

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Presentation on theme: "ANN S. BOTASH, MD PROFESSOR, PEDIATRICS JASON PEREZ, MS, FNP GRADUATE, COLLEGE NURSING PATRICIA D. POWERS, DNP, MPA, RN, FNP-C, NPP CLINICAL ASSISTANT."— Presentation transcript:

1 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 Distance Faculty Observation Using iPads Upstate Medical University

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

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

4 Percentage Clinical Education

5 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 Education: From Classroom to Clinic

6 Challenges of Clinical Teaching: Juggling Act Variability teaching & learning Lack of effective feedback skills 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 Fosters appreciation & understanding of other disciplines Challenges norms & values of each discipline Promotes student participation Models strategies for future practice Past to Future An Interdisciplinary (Ad)Venture COM CON CPT

9 Literature Review Distance Technology : 1. 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). 2. 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). 3. 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 

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? 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. Student: Preceptor was unfamiliar with the technology.

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 Agree Disagree Unsure Results 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/0B7a8mExE0x3HdnpSUFM1WFpjYW 8/edit?usp=sharing https://docs.google.com/file/d/0B7a8mExE0x3HdnpSUFM1WFpjYW 8/edit?usp=sharing Feedback Checklist: https://docs.google.com/file/d/0B7a8mExE0x3HT1MwVTNUZ045cE U/edit?usp=sharing https://docs.google.com/file/d/0B7a8mExE0x3HT1MwVTNUZ045cE U/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), 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), 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), 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), 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), 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), 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), Robinson, S. (2011). Promote active learning with iPads. Radiologic Technology, 83(2), Smith, C., & Skandalakis, J. (2005). Remote presence proctoring by using a wireless remote- control videoconferencing system. Surgical Innovations, 12(2),

42 Upstate Medical University Any “burning” questions??

43 What we are doing…. CNY Central: jnWaf8 jnWaf8 What's Up at Upstate: use-ipad-facetime-feature-in-teaching-medical-students/ use-ipad-facetime-feature-in-teaching-medical-students/ Student interview: ULFCqa8bXKVc1sjYA&index=1 ULFCqa8bXKVc1sjYA&index=1


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