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Item Application of a Simulation-Based Interprofessional Teamwork Assessment Tool (SITAT) to Individual Student Performance in a Team-Based Simulation(SAGE, 2021-01-01) Daulton, Brittany J.; Romito, Laura; Weber, Zach; Burba, Jennifer; Ahmed, Rami A.; Emergency Medicine, School of MedicineThere are a very limited number of instruments to assess individual performance in simulation-based interprofessional education (IPE). The purpose of this study was to apply the Simulation-Based Interprofessional Teamwork Assessment Tool (SITAT) to the individualized assessment of medicine, pharmacy, and nursing students (N = 94) in a team-based IPE simulation, as well as to explore potential differences between disciplines, and calculate reliability estimates for utilization of the tool. Results of an analysis of variance provided evidence that there was no statistically significant difference among professions on overall competency (F(2, 91) = 0.756, P = .472). The competency reports for nursing (M = 3.06, SD = 0.45), medicine (M = 3.19, SD = 0.42), and pharmacy (M = 3.08, SD = 0.49) students were comparable across professions. Cronbach's alpha provided a reliability estimate of the tool, with evidence of high internal consistency (α = .92). The interrater reliability of the SITAT was also investigated. There was moderate absolute agreement across the 3 faculty raters using the 2-way mixed model design and “average” unit (kappa = 0.536, P = .000, 95% CI [0.34, 0.68]). The novel SITAT demonstrates internal consistency and interrater reliability when used for evaluation of individual performance during IPE simulation. The SITAT provides value in the education and evaluation of individual students engaged in IPE curriculum.Item A Collaborative Assessment of Barriers to Oral Health Care: Are Social Workers Needed?(IUPUI, 2021-06-14) Lyons, Stephanie; Schrader, Stuart; Galyean, Erika; Romito, Laura; Everidge, Caroline; Smith, Margaret; Mandapati, Surendra Reddy; School of Social WorkOral health disparities are pervasive. Interprofessional education and collaborative practice experiences may be a means to address this problem in oral healthcare settings. This project aimed to determine: (1) barriers involved in patients’ access to oral health care at an academic dental school clinic, (2) dental students’ perceived ability to address patients’ needs and/or care barriers, (3) the ability of current clinical operations’ to address access to care issues, and (4) the potential role of a licensed health care social worker integrated into the clinic. Investigators conducted three focus groups –one student group (n=5), one clinical staff group (n=7), and one clinical faculty group (n=5). Further, investigators administered two needs assessment surveys in the dental school – one with students, staff, and faculty (n=144) and the second with the school’s dental patients (n=150). Investigators employed descriptive and inferential statistical analyses to evaluate the survey data. Five principal barriers to oral health care for dental patients were identified from focus group and survey data, inclusive of patients, students, staff and faculty perspectives: (1) lack of financial means, (2) lack of/inadequate insurance, (3) limited/no transportation, (4) general health problems, and (5) language barriers. More female patients (38.7%) than male patients (8.1%) reported financial barriers to accessing oral care. Including licensed social workers in an academic dental clinic may help address patient barriers to care and support interprofessional collaborative practice.Item Communication tools and strategies for interprofessional teamwork in a comprehensive pain assessment clinic in primary care(Elsevier, 2022-12-01) Glassburn, Susan; Delbridge, Emilee; Loghmani, M. Terry; Newton, April D.; Binion, Kelsey; Romito, Laura; Willis , Deanna R.; School of NursingThe Comprehensive Pain Assessment Clinic (CoPAC) is a grant-funded clinic embedded in a family medicine residency center providing care to an under-resourced urban population. This interprofessional clinic brings together 10 professions, including healthcare professionals, university faculty, and learners to assess patients with chronic pain. The focus of the clinic is to develop a functional and dynamic model of teamwork including communication strategies to facilitate assessment. The communication/teamwork tools and strategies include pre-visit preparation sheets, pre-visit team huddles, “teamlet” visits, handoff communication tools, care plan development, patient education, follow-up care coordination, and post-clinic debriefs, which are used for continuous quality improvement. The process model for the clinic, communication tools, and qualitative comments from learners are described. Lessons learned are discussed, including time management, intentional mentoring, interprofessional education and collaborative practice (IPECP) coordination, and implementation of best practices.Item Financial assessment of the community-based dental education program at the Indiana University School of Dentistry(Wiley, 2022-12) Shukla, Anubhuti; Amrutham, Bhavya Vaishnavi; Romito, Laura; Rodriguez, Andres Alfredo Mantilla; Martinez Mier, E. Angeles; Biomedical Sciences and Comprehensive Care, School of DentistryBackground There is a gap in access to oral health services for millions of Americans residing in health professional shortage areas. The community-based dental education program at the Indiana University School of Dentistry is an innovative model that aims to improve access to oral health services in rural underserved Indiana. Objective With this study, our goal was to assess the financial implications of the program over a period of 3 years (2018–2021). Methods Proxy estimates for the revenue generated by students at the community clinic sites were calculated and compared against the implementation costs of the program as well as revenue lost by the school during the rotation period. Descriptive statistics were used to assess the quantitative impact of the program over the 3 years. Results The total of 7460 patients who were offered care as part of this program were mostly from the uninsured group or were covered under Medicaid. According to our cost-benefit analysis which was conducted during the peak of the coronavirus disease 2019 (COVID-19) pandemic, the total revenue of $1,777,097 was generated by students at the community sites through the 3-year period. The revenue generated was still more than the dollar amount invested in running the program, given the timeline of the study was when elective services were mostly suspended. Conclude We conclude community programs like these have an impact beyond the dollar value; they can be modeled to be cost-effective, improve access to oral health services for millions of Americans in underserved settings and at the same time provide a great learning experience for dental students.Item Impact of a Tobacco CE Program for Indiana Healthcare Providers.(04/13/15) Harvey, Savannah; Romito, Laura; Harvey, Savannah; Romito, Laura; TobaccoPurpose: To assess an evidence-based continuing education (CE) program for Indiana healthcare practitioners focusing on tobacco use and dependence which emphasized team-based tobacco dependence treatment. Methods: Program impact was assessed by changes in participants’ self-reported knowledge and clinical application of course concepts and strategies via a 26-item immediate post- CE survey and a 19 -item 3-month follow-up survey. Surveys included multiple-choice and 5-point Likert-style scaled items. The three month follow-up surveys were mailed / delivered electronically to participants; non-responders were sent two reminders. De-identified data were analyzed in aggregate using descriptive statistics, Spearman correlation coefficients, and Mantel-Haenszel chi-square tests. Results: CE programs were held in Tell City, Madison, Lafayette, Goshen, Richmond and Vincennes with a total of 252 participants. Initial survey response was 98.4% (n=248): dental assistants (2%), dental hygienists (83%), dentists (8.5%), and other healthcare professionals (6.45%). Overall, participants reported less knowledge before than immediately after (p<.0001) and 3 months after (p<.0001) the CE program. Reported knowledge at 3 months was less than immediately after the program (p<.002). Participants planned to apply CE program communication strategies (99%), implement brief tobacco intervention strategies (85%), and refer patients to local cessation resources (95%) or the Indiana Quitline (96%). Response rate for the 3 month survey was 54% (n=136). Respondents reported currently playing an active role in team-based tobacco cessation (48%,78), applying CE communication strategies (85%,109), and implementing brief tobacco interventions (71%,90). Sixty-eight respondents reported referring patients to local counselors; eighty-three referred to the Indiana Quitline. Conclusion: Tobacco dependence CE may be beneficial to enhance health care practitioners’ knowledge and willingness to integrate tobacco interventions in their healthcare settings. However, this does not assure that they will change their practice behaviors by utilizing the learned concepts and tobacco interventions with patients. (Funded by the Indiana State Dept. of Health)Item Initial Efforts to Manage IPE during the COVID-19 Pandemic: Reports from the Big Ten Academic Alliance(NSUWorks, 2022) Smith, Laura J.; Romito, Laura; Congdon, Heather B.; Ascione, Frank J.; Fitzgerald, Mark; Karpa, Kelly; Pfiefle, Andrea; Sick, Brian; Khalili, Hossein; Biomedical Sciences and Comprehensive Care, School of DentistryPurpose: The COVID-19 pandemic required higher education institutions to quickly transition to a virtual platform. This was challenging for those involved in interprofessional education (IPE), given the goal that students from two or more professions learn about, from, and with one another. The Big Ten IPE Alliance is a subgroup of the larger Big Ten Academic Alliance. The purpose of this paper is to share the collective experiences of multiple large, research intensive universities in addressing the challenge of implementing IPE programs under the conditions established by the COVID-19 pandemic. Methods: To better understand how the Big Ten schools dealt with the transition to virtual learning for didactic and clinical IPE given the COVID-19 pandemic, a subset of representatives from the Big Ten IPE Alliance met to discuss best practices for virtual learning in the IPE realm. Each participating university completed an electronic 14 question survey related to their IPE curriculum during the COVID-19 pandemic from March 2020 thru August 2020 and the responses were analyzed. Results: Four categories were identified as needing to be addressed to develop and implement successful interprofessional didactic and clinical experiences. The categories identified included content/assessment, virtual technologies, faculty and facilitators, and learners. Conclusions/Recommendations: Consider including authentic and innovative mechanisms to deliver IPE experiences that meet the learning needs and accreditation requirements. Interinstitutional collaborations such as within the Big Ten IPE Alliance can be beneficial in assessing current and future best practices in IPE.Item Peer Led Team Learning in a Foundational IPE Curriculum(Pacific University Libraries, 2020-09) Romito, Laura; Daulton, Brittany J.; Stone, Cynthia; Pfeifle, Andrea L.; Biomedical Sciences and Comprehensive Care, School of DentistryBACKGROUND The Peer Led Team Learning (PLTL) instructional model utilizes Peer Leaders, advanced students who mentor and guide student teams to collaborate on applied course concepts. PURPOSE To apply a modified PLTL model in the university’s foundational, longitudinal, competency-based interprofessional education (IPE) curriculum. METHODS Twelve Peer Leaders were selected, trained, and deployed as facilitators for interprofessional teams of students during the IPE curriculum’s first three large-scale learning events. Peer Leaders completed an evaluation of training, a facilitation skills survey, and participated in a semi-structured focus group interview process. RESULTS After participating in the PLTL program, Peer Leaders reported increased confidence in their interprofessional knowledge and facilitation skills. The primary challenge for Peer Leaders in facilitating teams was lack of student engagement (n=7, 58%). CONCLUSION PLTL is a feasible model for IPE settings. It has the potential to both increase facilitator capacity in interprofessional learning activities and have a positive impact on Peer Leaders.Item Raising the Bar: Evolution of a Statewide Interprofessional Education Program Following a 5-Year Outcomes Evaluation(JCIPE, 2022) Daulton, Brittany J.; Weber, Zachary A.; Newton, April D.; Romito, Laura; Manz Friesth, Barbara; Family Medicine, School of MedicineIndiana University is a complex campus system across the state of Indiana. IU-Bloomington hosts the main campus with nearly 50,000 students, while Indiana University-Purdue University Indianapolis (IUPUI) has approximately 30,000. Additionally, there are seven regional medical school campuses located throughout the state in Gary, Evansville, Fort Wayne, Muncie, South Bend, Terre Haute, and West Lafayette.Item Snus use and rejection in the USA(BMJ, 2016-07) Biener, Lois; Roman, Anthony M.; McInerney, Scott A.; Bolcic-Jankovic, Dragana; Hatsukami, Dororthy K.; Loukas, Alexandra; O’Connor, Richard J.; Romito, Laura; Biomedical and Applied Sciences, School of DentistryOBJECTIVE: To determine whether snus might become a strategy for reducing the harm associated with cigarette smoking in the USA as appears to be the case in Sweden, we examined receptivity to snus use in two cities with the greatest exposure to the major brands. METHODS: A dual frame, telephone survey and a brief mail survey were conducted in 2011 and 2012 in Indianapolis, Indiana and Dallas/Fort Worth Texas. Over 5000 adults completed surveys. Trial, ever use, current use and reasons for using or quitting snus after trial were measured. RESULTS: Among male smokers, 29.9% had ever tried snus (CI 22.7 to 38.1) and 4.2% were current users (CI 1.6 to 10.7). Among female smokers, 8.5% ever tried snus (CI 4.4 to 15.7) and current use was unknown. Current use was virtually absent among former smokers and never smokers. A major predictor of any level of snus use was current use of conventional smokeless tobacco. Those who tried and gave up snus cited curiosity (41.3%) and the fact that it was available at low or no cost (30%) as reasons for trial; reasons for not continuing included preferring another form of tobacco (75.1%) and disliking the mouth feel (34.6%). Almost all current snus users indicated that they were trying to cut down on cigarettes, but few (3.9%) were using it to quit smoking entirely. CONCLUSIONS: The low rate of adoption of snus suggests that neither the hopes nor the fears surrounding this new product are likely to be realised in the USA with the current marketing patterns.Item Successful Conversion of Simulation-Based Interprofessional Education in a Pandemic(Wiley, 2020-07-15) Romito, Laura; Pfeifle, Andrea L.; Weber, Zachary A.; Daulton, Brittany J.; Biomedical Sciences and Comprehensive Care, School of Dentistry