The National Challenge

Meeting the Challenge of the Pandemic Head-on

COVID-19 presents a systemic risk that must be managed, and a disruptive force that will continue to change health professions education and patient care for many years to come. These are revolutionary times, and we face them with great confidence. We have been preparing and innovating under nearly two decades of bold leadership that has anticipated change and envisioned possibility.

We have been proactive in adopting learning technology and investing in models that help our students navigate the future of health and science, a future in which advances in technology help drive change. We train for what we know now, but we also look ahead to train for where health is going. That’s a strength that has helped us stay on mission during the coronavirus pandemic.

Our DeWitt C. Baldwin Institute for Interprofessional Education and its three centers of excellence — Clinical Anatomy, Interprofessional Education and Research, and Advanced Simulation in Healthcare — keep us at the leading edge of technologies, trends and innovations that are essential to interprofessional education and practice. We’re prioritizing teaching students how to work within a technological framework. We’re using telesimulation to model emerging telehealth practices and to teach students decision-making in a digital health environment. These technologies are not solidified in the mainstream, but when they cement, RFU graduates will be facile and fluent in the skills needed to incorporate them into their decision-making process. Our students understand that they will graduate into a world where health care at every level is increasingly personalized, portable and preventive.

Artificial intelligence, computer simulations and predictive analytics are already impacting the way health and biomedical professionals reason through problems. We continue to grapple with and help our students understand how bioinformatics will inform clinical and scientific judgment. We’re moving toward a new level of understanding on emerging technologies, and we’re exposing students to those eHealth technologies they will need to master.

One of the great challenges posed by COVID is its potential impact on the interprofessional mission of RFU. We have discovered that we can overcome time and distance — the biggest barriers to IP learning and collaborative practice — because it’s easier to gather online as a team to discuss, for instance, the patient whose creatinine levels are spiking and for whom dialysis might be required. Virtual discussion among the pharmacist, nurse and ICU or primary care physician can be quickly scheduled and quickly held. That type of teleconsultation is already changing the way interprofessional teams work. As time and location cease to be barriers, we continue to change how we teach, collaborate and practice.

Our students have been incredibly insightful on the use of telemedicine and telehealth technologies. They are quick to grasp that the social determinants of health might pose barriers in accessing those innovations. They question if new tools will serve the cause of health equity. They discuss how the determinants factor into overall health and wellness and COVID-19 outcomes. They recognize the key role of prevention in health and health care, and that their job is to help keep people free of disease and out of the hospital.

The pursuit of wellness seeds much of the innovation and interprofessionalism that are driving change in healthcare practice and delivery, and that helps RFU embrace the challenge of change. We are driven by our need to break down barriers to health and well-being. That need is a must.

National Trends in Medicare Beneficiary Telehealth Utilization During COVID-19

Essential Education

‘Webside Manner’ and Other Keys to Telehealth Education.

The Department of Healthcare Simulation provides simulation-based learning activities to help students master clinical skills, preparing them to provide effective patient care in a safe environment that won’t compromise the well-being of patients.

At the university’s simulation centers, different facets of clinical practice are approximated through manikin technology. These progressive anatomical models can display heart and lung sounds and a pulse, as well as more complex actions, like pupils reacting to light and the reproduction of tears.

In March, when the university shifted to remote learning due to COVID-19, the department quickly adapted its delivery, with students and staff working mostly through telesimulation via Zoom to address the same learning objectives.

Interprofessionalism is the thing that’s been driving us all. Not just the IP we think of in health care, but the IP of people who work as a team to achieve a common goal. In this particular case, it’s our students.

As the practice of medicine moved to a virtual environment, simulation shifted to tele-education. The previously scripted simulations now include protocols to meet communication objectives, including speaking clearly, angling the camera so patients can see their provider’s face and using lights that appropriately illuminate the provider.

“We call it webside manner,” said Amy Pabst, MD, MHPE, the simulation department’s medical director.

At the Interprofessional Community Clinic (ICC), which welcomes underserved patients and provides a unique clinical educational experience, students created the telehealth delivery system with faculty oversight.

“Tele-education becomes a much more active learning process for students when they are responsible,” said Melissa Chen, MD, clinical director of the ICC. “Our students learned the technology and developed training protocols, front desk checklists, workflows — everything necessary for a smooth visit for patients who might be technologically challenged.”

Jim Carlson, PhD, PA-C, vice president for interprofessional education and simulation, said students need to learn how to use those telehealth tools, because many patients in the aftermath of COVID will choose telemedicine. Recognizing this, the student-led Interprofessional Clinic Initiative voted in September to make telehealth a permanent service at the ICC.

RFU Classroom Adaptations to COVID-19