West Virginia Rural Health Education Partnerships/

Area Health Education Centers

Joint Community Outreach/Curriculum Committee

Monday, February 9, 2009

Web AT Conference Call

Chair: Kathleen Bors

In attendance: Carla See, Derrick Day, JoAnn Raines, Kathleen Bors, Kendra Sullivan, Richard Meckstroth, David Bowyer, Patricia Crawford

Guests: Malinda Turner, Penny Asbury, Amanda Heaton

Staff: Derrick Day, April Vestal, Sandra Y. Pope, Jacki Novacich, Hilda R. Heady

Kathenn Bors brought the meeting to order.

Consent agenda: Motion to approve the November 10, 2008 meeting minutes (JoAnn Raines/ Richard Meckstroth) Motion Approved.

Unfinished Business:

Service-Learning Objectives:

There were additional changes made during the meeting to the Service Learning Definitions Matrix. Marshall University School of Medicine (MU-SOM), West Virginia University School of Dentistry (WVU-SOD) and School of Medicine (WVU- SOM) all added definitions that are part of their curriculum. (see Appendix A, red X’s mark additions made during the meeting)

The next step for the Matrix is for it to be reviewed by the Schools Committee. Once reviewed by them, the matrix will be reviewed by the Rural Health Advisory Panel.

New Business:

Proposed online service-learning projects:

April Vestal reviewed the sections of a service-learning project. She discussed what each section should have and what the committee should look for when reviewing the projects. If you have questions concerning the service-learning sections, please contact April at 304-438-3009 or by e-mail at avestal@hsc.wvu.edu.

April distinguished that these online service-learning modules are a separate experience from the SOLE-based IDS assignments. The eventual goal is to catalog ALL service-learning/community service/IDE projects in an online library, alphabetically listed.

The Committee reviewed one of the five service-learning projects that were submitted through the new online submission option. You can view the draft projects in Appendix B.

The committee reviewed “Senior Center Program”. It was discussed that the Description section needed a more universal explanation of the clinical problem, ie, Fall Risk, and the student's role in this project. It also needs to make the connection from outset re: Student’s learning, action, experience. The objectives will need to contain the student's awareness of interdependent skill sets as basic to an IDE project, and why it's important that the student does a service-learning project.

Sandra Pope brought up that the Outcomes needed to contain more substantial wording for student experience, ie "achievement" of skills, and knowledge. We also need to ensure that the components of the project match the outcomes, and that the outcome is a reasonable one in light of the single experience. Much discussion also occurred over the Evaluation Questions. It was suggested that one or more be required, with discipline-specific curricular input ie, how does this project meet the curricular objectives of your discipline. Dave Bowyer was concerned about the quality control with the student’s option in creating their own questions.

It was decided by the committee that the projects would be reviewed by smaller groups first, and then brought to the Joint Community Outreach and Curriculum Committee for final approval. The smaller groups are to make sure the projects have a description, a purpose, and a strong outcome.

Volunteers were accepted for the review of the projects. Here is the list of those that volunteered and the projects they will review:

1. JoAnn Raines and Patricia Crawford- Senior Center Program

(Carla See volunteered to write a second project for the Senior Center)

2. Hilda R. Heady and Kathleen Bors- Uninsured and Underinsured in WV

3. Carla See- Training Teachers on School Health Emergencies

Next Steps for Monday, June 8, 2009 Meeting in Flatwoods:

1. Service Learning Grid presented by April and Hilda; discussed and updated/corrected by committee.

Next steps include:

- presentation at Schools committee (2/09; KB) and Advisory panel(2/09? Hilda?)

- use as tool for quality review of proposed SL Modules

- presentation of SL Modules at each campus annual RHEP Orientation session (KB)

2. A proposed Service Learning Module was reviewed by committee, utilizing the SL grid objectives; much dialogue ensued, with major points addressing

3. Description - more universal explanation of the clinical problem, ie, Fall Risk, and the student's role in this project (Joanne, Patti); be sure to make the connection from outset re: STUDENT's learning, action, experience (Hilda)

4. Objectives - add the student's awareness of interdependent skill sets as basic to an IDE project (Hilda R. Heady); why it's important that the student to do a SL project

5. Outcomes - more substantial wording for student experience, ie "Achievement" of skills, knowledge (Sandra Pope); ensure that the components of the project match the outcomes (JoAnn Raines); ensure that the outcome is a reasonable one in light of the single experience (Kathleen Bors)

6. Eval Questions - much discussion; suggestion that one or more be required, with discipline-specific curricular input (Hilda R. Heady, Richard Meckstroth) ie, how does this project met the curricular objectives of your discipline; concern for quality control with student option to create own questions (Dave)

With no further business, the meeting was adjourned.

Appendix A

West Virginia Rural Health Education Partnerships/AHEC

Service-Learning Definitions/Policies of Schools

Schools
Components of Definition	MU-SoM	WVSOM	WVU-SoD	WVU-SoM	WVU-SoN	WVU-SoP	WVU-SoPT
1.) Structured learning experienced/ Student Learning objectives	X	X	X	X	X	X	X
2.) Responds to and/or meets identified Community needs	X		X	X	X	X	X
3.) Carried out in or through an academic community partnership (sufficient opportunities)	X	X	X		X	X	X
4.) Learner develops reflection and reflection is reviewed by faculty.	X		X	X	X	X	X
5.) Links to/ Connects coursework/ integrated into curriculum.	X	X	X	X	X	X	X
6.) Cultural competence civic/social responsibility sense of caring for others/values	X	X	X	X	X	X	X
7.) Opportunities for interdisciplinary interaction and learning	X		X	X		X	X

Legend:
MU-SoM	Marshall School of Medicine (Joan C. Edwards SoM)	WVSOM	West Virginia School of Osteopathic Medicine	WVU-SoD	West Virginia University School of Dentistry	WVU-SoM	West Virginia University School of Medicine
WVU-SoN	West Virginia University School of Nursing	WVU-SoP	West Virginia University School of Pharmacy	WVU-SoPT	West Virginia University School of Physical Therapy

WV Rural Health Education Partnerships/Area Health Education Centers Definition of Service Learning

*Community service/Service -Learning, in terms of the WVRHEP requirements means student involvement in community based activities that provide opportunities for reflective learning. Students should be able to reflect upon their leadership role in the community that may go beyond their professional or clinical role to connect their service role as a professional to their civic role within the community. The best community service activities to facilitate this learning are those where: (1) students learn about the "big picture", i.e. the community

Appendix A

(Continued)

context within which they treat individuals and families, (2.) students are exposed to, and encourages to see, community values on operation and the characteristics of the community, which have both positive and negative impacts on its residents, (3.) students reflecton problems within the community context within the community, families and individuals in their most interdependent and complex (not

just simplistic) relationships, (4.) students are provided opportunities to see their future role as change agents to improve health outcomes and the health care delivery system, and their social responsibility as professional leaders within the community, and (5.) students are exposed to the wide range of needs and services within the whole health care delivery system, especially those that use population based service methods and include wellness prevention. **

* Community Outreach Manual for Health Professions Students and incorporated into WVRHEP/AHEC Policy 2008-03

** The Health Professions Schools in Service to the Nation is a program of the Pew Health Professions Commission and the National Fund for Medical Education. The program is jointly funded by the Pew Charitable Trusts, the Corporation for National Service and the Bureau of Health Professions. This program defines community service, as "the engagement of students in activities and primarily focus on the services being provided as well as benefits the service activities have on recipients." This same program defines service learning as: ...a structure learning experience which combines community service with preparation and reflection. Students participating in service-learning activities are not only expected to provide direct community service but also to learn about the context in which the service is provided, and to understand the connection between the service and their academic course work. Service leaning experiences are: developed in collaboration with the community, address community needs and build on community strengths and assets, enhance the standard curriculum by extending learning beyond the lecture hall, allow students to apply what they are learning in real world situations, provide time for reflection, leadership development and discussion (Community Outreach Manual for Health Professions Students and incorporated into WVRHEP/AHEC Policy 2008-03)

Appendix B

Senior Center Program

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Description:

Senior Centers are multipurpose facilities that serve as focal points for older adults in a community and which offer a wide variety of services and activities from a single location, such as transportation, case management, insurance, and nutrition.

Purpose:

The purpose of this program is to decrease the number of falls among the elderly; increase awareness of osteoporosis risk factors

What we expect from you:

· Plan and present 15-30 minute presentation on fall prevention and/or

· osteoporosis risk factors

· Disseminate literature

· Answer questions

Address Healthy People 2010 Objectives:

· Objective 2 - Arthritis, Osteoporosis and Chronic Back Conditions

· Objective 15 - Injury and Violence Prevention

· Objective 19 - Nutrition and Overweight

· Objective 22 - Physical Activity and Fitness

· Objective 29 - End of Life

Target Audience:

Adult and over 60

Outcomes:

At the end of this service-learning project, I will be able to:

1. Participate in a program for the elderly that will enhance my skills in educating my patients about fall prevention and risk factors leading to osteoporosis.

2. Describe how this project fits into West Virginia’s public health agenda as articulated in the WV Healthy People 2010 Objectives.

ASSIGNMENT:

Review the following questions and choose 3 questions, or come up with your own question you are interested in exploring more about while participating in this project.

1. What are the guidelines for calcium intake for the elderly?

2. What precautions should be considered when taking calcium with other medications?

3. What tests can be used during a community screening or a patient office visit to assess risk of falls?

4. What changes can be made to a person’s home to reduce fall risk?

5. Psychological impact on the elderly concerning fears of falling?

6. What is the state and national economic impact for falls in the elderly?

7. What resources are available in your community to assist seniors and/or handicapped individuals?

Uninsured & Underinsured in WV

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Description:

Discuss the issue of underinsured and uninsured with your preceptor.  How does this affect patients being served in the clinic, hospital or private practice facility where you are doing your rotation?  Investigate some of the resources available for patients to receive health care services, dental or pharmacy services where you are doing your rotation or within the community setting.  Is there a sliding scale fee?  What are the requirements?

Purpose:

The purpose of this program is to help future health profession students better understand the issue of the uninsured and underinsured in WV and be able to competently explain this to other groups within the community setting.

What we expect from you:

· Plan and present 15-30 minute presentation on the uninsured or underinsured in WV to an interdisciplinary group of students during a planned meeting or present to a medical group within the hospital, clinic or private practice where you are doing your rotation.

· Disseminate and discuss information regarding the uninsured/underinsured in WV

· Answer questions/provide suggestions

Addresses Healthy People 2010 Objectives:

· Objective 1 – Access to Quality Health Service

Target Audience:

Adult and over 60

Outcomes:

At the end of this service-learning project, I will be able to:

1. Understand the issue of health care in West Virginia as it relates to the uninsured and underinsured in WV.

2. Describe how this project fits into West Virginia’s public health agenda as articulated in the WV Healthy People 2010 Objectives.

Assignment:

Review the following questions and choose 3 questions, or come up with your own question you are interested in exploring more about while participating in this project.

1. What are the guidelines for sliding fee?

2. What are the resources for health care services within the community for those who cannot afford or do not have health insurance coverage?

3. What types of prescription coverage are available for the indigent?

4. What dental offices in the area offer patients sliding scale or reduced fees? What are the guidelines?

The Dining with Diabetes

Description:

The Dining with Diabetes program helps adults make lifestyle changes through community education on nutrition and physical activity. It is a free program for those with diabetes and their family members. The series of 4 classes and a 3 month follow up includes clinical testing, nutrition information, recipe demonstrations, exercise, and group support. The program is conducted by an extension service educator, a health care provider, and community volunteers. Diabetes is a costly and serious disease. Many complications of diabetes can be controlled or prevented by making lifestyle changes, improving eating habits, increasing physical activity, and weight management.

Purpose:

The purpose of this project is to educate patient and their family members about diabetes care and prevent further complications of the disease.

What we expect from you:

· Call during the first week of your rotation to set up schedule‑ call and reschedule if necessary

· Arrive prepared with appropriate items including white coat and name tag and plan to stay for entire program

· Conduct A1C finger sticks and blood pressure checks‑ please bring cuffs and stethoscopes

· Actively participate with staff through observation, dialogue, and other requested tasks

Addresses Healthy People 210 Objectives:

· Objective 5 - Diabetes

· Objective 7 - Education/Community Programs

· Objective 11 - Health Communication

· Objective 12 - Heart Disease/Stroke

· Objective 19 - Nutrition and Overweight

· Objective 22 - Physical Activity and Fitness

Target Audience:

Adult

Outcomes:

1. Achieve greater understanding of challenges and resources of families living with diabetes

2. Demonstrate clinical competencies of blood pressure and A1C screening procedures

Assignment:

Review the following questions and choose 3 questions, or come up with you own questions you are interested in exploring more about while participating in this project.

1. What is the correct way to conduct a blood pressure screening and A1C test?

2. What are some of the specific challenges of diabetics and their caregivers?

3. What other community resources are available for diabetic patients and their caregivers?

Health Fair

Description:

Purpose:

Assist in the annual ‘Health and Safety Fair’ at Pocahontas Memorial Hospital by setting up a booth to provide information on physical activity and by assisting resident physicians in sports physicals.

What we expect from you:

· Hand out brochures on physical activity

· Talk to participants about different types of physical activity

· Assist resident physicians in conducting and assessing the participants in sports physical

Addresses Healthy People 210 Objectives:

· Objective 1 - Access to Quality Health Service

· Objective 2 - Arthritis, Osteoporosis, and Chronic Back Conditions

· Objective 6 - Disability and Secondary Conditions

· Objective 12 - Heart Disease and Stroke

· Objective 15 - Injury and Violence Prevention

· Objective 16 - Maternal, Infant, and Child Health

· Objective 19 - Nutrition and Overweight

· Objective 20 - Occupational Health and Safety

· Objective 21 - Physical Activity and Fitness

Target Audience:

Outcomes:

Assignment:

Training Teachers on School Health Emergencies

Description:

This SL Project was created to be presented in schools for teachers because the nurse to student ratio in WV does not meet HP 2010 objectives of 1:750. Consequently, teachers are often the first line of defense with management of student health concerns. Additionally, in rural areas, chronic illnesses occur in 30% of school aged children, compared to national estimates of 15%. This project will provide information for teachers regarding the management of asthma, diabetes, seizure disorders and allergies with risk for anaphylaxis.

Purpose:

The purpose of the study was to educate faculty and staff regarding the management of health conditions most prevalent in school settings. This will ultimately ensure optimal care and safety in the school setting.

What we expect from you:

Presenters who use this project would be required to:

1. Familiarize themselves with a created power point and handout that address the management of the above mentioned conditions.

2. Each session would last approximately 1 hour.

3. Presenters would need to duplicate handouts for participants as well.

Addresses Healthy People 210 Objectives:

· Objective 23‑10 - To increase the proportion of public health agencies that provide continuing education to develop competency in essential public health for their employees.

· Objective 7‑4 - To increase the proportion of schools that have a nurse to student ratio of at least 1:750.

· Objective 5‑ Diabetes

· Objective 24‑13 - Asthma.

Target Audience:

Other

Outcomes:

The participants will be able to:

1. Verbalize symptoms of an asthma attack, seizure, hypoglycemia and hyperglycemia and anaphylaxis.

2. Correctly identify the proper steps for emergency management for asthma, allergies with risk for anaphylaxis, seizures and diabetes.

3. Demonstrate an increase in comfort and confidence in dealing with student health emergencies in the school setting, through comparison of the pre and post surveys.

Assignment: