Pi Mu Professional Day: Impacts of Birth Plans on Maternal Satisfaction

April 4, 20172016-2017, Pi MuC. Schubert

Impacts of Birth Plans on Maternal Satisfaction – Kaylyn Brooks (one of my Honors students!)

Common topics

pain management
surgical interventions
health care provider
location of birth

Midwife focus group themes

flexible plan or preference sheet, not a locked down contract
birth plan provides options to present health literacy issues
plan does not always meet their wants in the moment

Pi Mu Professional Day 2017: Male Nursing Student Experience

April 4, 20172016-2017, Pi MuC. Schubert

An exploration of the male nursing student experience: promoting success in a predominantly female profession – Betsy Heron

research based on work with
9.2% of RNs in US are male
male student enrollment increased from 10 to 15%
therefore, issues remain related to retention
11 interviews of male former nursing students
Georgie’s methods of
Coding completed across four researchers
Themes
- gender bias exists
- patients refusing care
  - often occurring in the maternity/women’s health rotation
  - disbelief that patients were okay with male doctors but not male nurses
  - attitude of the instructor affects the experience, either reinforcing the barrier or setting norm for patients
- singled out by instructors
  - better know to faculty since there were fewer
  - called on more often
- doing the “manly” stuff
  - lift, turn, move patients
- no male role models
  - mixed responses regarding participation in a male nursing student organization

Presentation notes

theme presentations with short quotes
follow up focus on each theme with additional, longer quotes

Questions

How do these experiences compare to other health profession fields with a majority gender? For example, what about OT?
There is still a pay gap between male and female nursing students. How does hiring occur? Does the minority status of male nurses factor into this pay gap?

Virginia Geo Teachers Institute: Roots & Shoots project for Jane Goodall Institute

March 10, 20172016-2017, conference, Geo-mappingC. Schubert

Jane Goodall’s Roots & Shoots

Step 1: Get engaged
Step 2: Community mapping — to visually see the local community and determine areas of high potential impact
- Micro-mapping sprint — 1 time service project
- Mapping for young children — longer term campaign
- Community mapping 101
- Digital mapping (MyMaps)
- Digital mapping (ARCGIS)
Step 3: Take action
- how to ID a campaign, plan a project, connect with community resources
- most time spent in this phase
Step 4: Celebrate & Reflect
- re-map the community to see change in comparison to earlier map

Curricular work

have students first observe what is happening — don’t give them a map or tell them what to look for
marking community characteristics (with the map, categorize them into human things, animal things, environmental things)
marking community resources (with the map, mark where human resources, animal resource, environmental resources from) — ex: grocery stores, vet, river

Ideas

Free food on campus – such as http://www.universitylunchbox.com/#app

Virginia Geo Teacher Institute: Storytelling with Earth Imagery

March 10, 20172016-2017, conference, Geo-mappingC. Schubert

Tools:

Agenda

create a tour in Google Earth
- free Google Earth Pro download (no license key needed)
- EOL Arctic Tern Tour
- 4 methods: freestyle, create tour from line, create tour from folder, hand-edit KML code
- Can use the camera icon to record my actions and steps in Google Earth around points
- Can use the Preferences>Touring to adjust items like time at features, time between features, Fly Along Line, camera tilt angle to raise view
- Tools>Movie Maker to record a movie
create a story with Google Tour Builder
- can customize icons or use initial set of icons
- can use Google Earth or Street View to develop
- Can add notes about a location
- Share — need to clarify if Google Classroom syncs with this automatically instead of having to re-enter student information each time; not a collaborative tour building tool, but you can copy the map for someone else to work on
Storytelling with Timelapse
- Not as high resolution images
- 1 pixel = 30 meters
- better for large scale changes like glacier change, deforestation, etc
- Time magazine article
- Earth Timelapse
- Tour Editor http://bit.ly/toureditor
- Virginia-based examples Nassawadox, Cobb Island, Hog Island (John Porter @ UVA)
My Maps vs Google Earth
- GE has Street View but My Maps does not

Ideas:

journey map of a liaison librarian, student, faculty member, etc
map the nursing students in the research study across locations
possibly map nursing research data with survey/interview notes by location
conference town mapping (Staunton Google Earth = 2015, Street View = 2012)

Virginia Geo Teacher Institute: Raleigh Seamster keynote

March 10, 20172016-2017, conference, Geo-mappingC. Schubert

background in cultural anthropology
works at Google Earth Outreach
Technology used to solve problems
- Brazilian rainforest + illegal logging
- DiSARM Malaria — UCSF news entry about the infectious disease mapping work
Exploring a different culture
- The Khumbu, Nepal
- Colonial maps vs indigenous peoples maps
Google timelapse animations

Ideas:

Transportation maps for CWS refugees to be able to get around Harrisonburg and surrounding area easier

MACMLA 2016: Diversity and Disparities: Opportunities and Challenges for 21st-Century Health Care

September 28, 20162016-2017, MACC. Schubert

Under-represented groups represent 34% of the total population
Diversity in health care work force
- Physicians: 7%
- Nurses: 3%
- Pharmacists: 3%
No Ivy League schools are among top medical schools that American Indians, Alaska Natives, or African Americans apply
Top medical schools for Hispanic or Latino schools are all in Puerto Rico
Business case for diversity in science
- Birds of a feather research together — and produce research in journals with lower impact factors and less cited
Implicit association test https://implicit.harvard.edu/implicit/takeatest.html
16% of NIH grant applications from black researchers succeed vs 29% from whites
AAMC report on state of women in medicine lacked any mention of intersectionality
Four patterns of gender bias
- Feel need to “prove” our competence
- Walking the tightrope between too aggressive vs too feminine/weak
- Motherhood penalty
- Queen bee syndrome (women who refuse to mentor the next generation)
JHU Institutional Plan to address
- Faculty Diversity Action Plan
- Diversity Advocate
- $25M JHU Diversity Initiative
- 54 URM Faculty hired in FY15-16
- 3 women dept directors
- 3 URM dept directors
- Pipeline programs -HCOP, SARE

MACMLA 2016: Paper Session 1

September 27, 20162016-2017, MACC. Schubert

Building a Critical Mass of Systematic Review Authors and Teachers: A Collaboration between Librarians and Faculty

What is the rate of systematic reviews for comparable institutions (those without med schools)?
Need to meet with Deans, Directors, Faculty to determine needs
Work with researchers on currently publishing SRs & MAs
Interest in non-HS programs like Educational Technology, Psychology/Counseling, Statistics, & College of Liberal Arts (ex: Health Care Ethics)
Grant from NNLM for on-campus event for training on SRs
Created LibGuide and online community for on-going support (basic focus but decent guide usage even before official launch)
Speakers were a combination of experts and local researchers
Workshop topics
- Importance of SRs, process
- Breakout sessions on meta-analysis, integrating EBP into teaching
- Panel discussion on opportunities and barriers
Librarian training
- 3 options: UofMichigan workshop, Pitt program, applied project for university conference
Workshop attendance filled in days (n=27)
SRs in Education
- class presentation, UG research symposium, critically appraised topics, IPE Health Research Skills course

Assessing Value of Library Services on Research, Clinical Practice, Education, and Administration

Had done Library Values survey 5 years prior
Benefits of informationists services (overall results, but different audiences have different rates per category)
- information search (56%)
- point of use instruction (19%)
- citation management (9%)
- publication/grant prep (4%)
students rank coursework as the highest indicator for intended use of library resources
What resources people used with and without informationists
- with Informationists, more likely to use more resources, and resources like CINAHL, Embase, etc
- without, more likely to use Google or Dynamed

MEDLIB 2011-2016

5 year analysis of content and comparison with 1997 article analysis
as of 2016, MEDLIB-L has ~2000 subscribers (35% education domains, 23% healthcare orgs/hospitals)

One systematic review software to rule them all — NOT!

EndNote web works terribly for researchers across different institutions
Mendeley sinks beautifully across users but does not have as much space for PDF space (without payment)
RefWorks crashed with large RIS file due to timeout
SRAssistant deduplication – unsure how well it works
**checkout expert searching listserv
RefMan only available to Cochrane reviewers
SRDR wonderful but clunky due to framing
Covidence – can’t have more than 1 person assigned to an article; after 2nd reviewer, then the article moves out of the pool of review

MACMLA 2016: Using Data to Improve Clinical Outcomes — Examples and Lessons Learned from Cleveland OH

September 27, 20162016-2017, MACC. Schubert

Started with EHR in 1999 (some patients have up to 17 years worth of data in the EHR)
Broader use with 2012 for enterprise-wide EHR adoption – starting with Meaningful Use 1 and progressed forward
Paper health records:Hammer :: Electronic health records:Power nail gun — increased power due to tech, but also large potential for more problematic outcomes
Case #1 of EHR’s potential – identifying the significant underdiagnosis of hypertension in children — data was available but just not applied
- Response: Put in an alert to better identify/highlight existence of data
- Baking the evidence based guidelines into the EHR (CDSS)
  - 38% decrease in false positives
  - 100% increase in provider recognition of abnormal blood pressure
- Answer: Alerting helps, but not the total fix
Case #2 – Immunizations
- Over 300 immunization rules for children — how do you know if your patient has completed their schedule?
- Messaging algorithm to reach out to patients using TeleVox about immunization follow up
- Messages helped increase results by 1/4, but not a perfect fix for the other 3/4
- Number needed to message 4 people to get 1 immunized
- $5k in messaging costs led to $200k clinical revenue
- Personal Health Records
  - Patients will be the biggest amount of EHR users in the future
  - PHR allows for reminders, health info exchange (ex: immunization)
Case #3 – Meeting referral drop-off between obesity clinic to specialist
- 76% referred but never seen
- So what is the actual appointment follow through within a month after referral? 48%
- Solutions: self-scheduling + giving specialists a list of patients so they know who is referred and they can take over outreach
- Moved to 61% after new interventions (6700/month initial consults = $1mil
Case #4 – Depression Screening
- Advanced CDSS for subjective data
- Use PHQ-9
Case #5 – Health Information Exchange
- Who is likely to have their data exchanged?
  - Older people, female, African Americans, Medicare/Medicaid
- +1 mil patient records a day exchanged among those on EPIC system
Case #6 – Longitudinal diabetes data
- Synopsis report of data overtime

Q&A notes

Information is getting smarter to not just be one click away to Micromedex or UpToDate as a general resource, but one click away from the specific drug entry in Micromedex or UpToDate
People in health care do not value information and its integration well into clinical practice — how do we change this paradigm? Informaticists
What are the opportunities for librarians to offer education on informatics/EHR competencies
Re: alert fatigue – who should the alert be going to? Is adding more info to the 15 min visit overload? What would be a better time? How actionable are these alerts that are provided in the visit?
100% of privacy/security is not realistic, but we need processes in place like credit reports to help manage the inevitable

Follow up readings

All of Kaelber’s articles
IHI Triple Aim
The Learning Healthcare System from IOM (2012)

MACMLA 2016: Leading from the Library, Anne-Marie Deitering

September 26, 20162016-2017, MACC. Schubert

In a unusual twist, MACMLA started the conference with a presentation from a undergraduate-focused librarian with expertise in qualitative research. I found her exploration of learning as a performance vs learning as mastery a great way to frame different motivations present in our students.

Continue reading MACMLA 2016: Leading from the Library, Anne-Marie Deitering →