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Teaching the APP Teachers - Shared screen with speaker view
Benjamin Cook
27:05
Experience
Whitney Taheri, NP
27:06
expertise
Bruce Peyser
27:07
helpful
Leanne Owens (PA)
27:07
Prespective
Melissa Fike
27:09
better together
Chris Fink, DO Int Med
27:10
collaboration
jenicarrico(NP)
27:12
perspectives
Christianna Karr (NP)
27:13
Knowledge
Margaret Shanley
27:13
Perspective
Anna White, PA-C, MPH
27:14
support
James Smith
27:16
Collaboration
Priscila Tomlin, NP
27:18
teamwork
Chasity Godwin, FNP-C
27:20
collaboration
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
27:22
Collegiality
Erica Shelly
27:24
support
geeta ramchandani
27:27
Share
Jake Lagomarcino
27:28
all those answers
Margaret Shanley
28:14
Coordination
Leanne Owens (PA)
28:15
communication
Chasity Godwin, FNP-C
28:23
coordination
Melissa Fike
28:24
communication
Bruce Peyser
28:27
Handoffs can be tricky
jenicarrico(NP)
28:28
unfamiliar with expected role
Priscila Tomlin, NP
28:31
communication
Erica Shelly
28:31
stubborn
Whitney Taheri, NP
28:33
differences (in approach)
Chris Fink, DO Int Med
28:47
Personalities
Jake Lagomarcino
29:01
personalities
Anna White, PA-C, MPH
29:02
A possible hierachy
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
29:08
low expectations of APP from some
Benjamin Cook
33:32
Provider, Nursing, MA, RT
Erica Shelly, DNP, FNP-BC
33:42
MD DO NP RN MA
Christianna Karr (NP)
33:42
Medical Assistants, MDs, Pharmacists, Lab, RNs/LPNs
Whitney Taheri, NP
33:43
CMA, PSA, MD, DO, LPN, RN, HCA
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
33:45
MD, NP, Pop health nurse, RN, LPN, MA, SW
Chasity Godwin, FNP-C
33:47
nursing staff, referral coordinators, PSA's
Leanne Owens (PA)
33:48
MA, PSA, RN, LPN, learners, management
Priscila Tomlin, NP
33:50
providers, CMAs, triage team
Anna White, PA-C, MPH
33:54
Providers, manager, nurses, and HAs (everyone at work)
Chris Fink, DO Int Med
33:55
NP, PA, MA, LPN, BSN, MSN, MD, CMA
Melissa Fike
33:55
provider, nurse, CMA and hca
geeta ramchandani
33:56
App cma RT RN
Priscila Tomlin, NP
34:00
hca,
Margaret Shanley
34:00
Phn, clinical pharmacist, pa, np, nurse, ma
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
34:02
and students
jenicarrico(NP)
34:07
social work, nursing, PT/OT/SLP; medicine, sometimes community members
Bruce Peyser
42:45
To obtain CME credit for your time today, please send an email to Charlene Clay at Duke with your total time and she will record this and send you a link so that you can register officially for your hours. Obviously, this will need to occur after the conference is completed. Thank you!
Diana McNeill
44:20
Huddles help the team sourcing and complementary care -we just need to identify time in the clinic day to have such meetings.
Diana McNeill
49:20
Please discuss how the clinic space affects team based care-number of exam rooms and meeting areas, proximity to nursing, availability of computers, printers, etc. This may be an opportunity to improve interprofessional practice in real time if addressed.
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
55:15
I love the idea of the IPE clinics... can you talk a bit more about the development of this idea?
geeta ramchandani
57:38
We use chat at urgent care with nursing staff and front desk to coordinate patient care and preorders
Melissa Fike
01:00:43
this was amazing! thank you!
Melinda Blazar
01:01:51
@BeWellMel- feel free to ride with me!
Bruce Peyser
01:05:04
Thinking about differentials
Christianna Karr (NP)
01:05:05
Looking at all aspects of patients care - not just medically what the patient needs but also social support, transportation, finances
Benjamin Cook
01:05:05
Reaching appropriate differential diagnosis with complex HPI
Margaret Shanley
01:05:06
Keep differential diagnosis wide,
Melissa Fike
01:05:17
thinking about multiple variables
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
01:05:23
emerging judgement for students to incorporate what they have learned in didactic content to the patient they are seeing
Benjamin Cook
01:11:04
Presentation time is efficient
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
01:11:22
ability or lack thereof to report pertinent positives and negatives
Priscila Tomlin, NP
01:11:47
Good HPI
Chris Fink, DO Int Med
01:11:57
Listening to patients. Not just hearing what they say.
Leanne Owens (PA)
01:11:57
Using pertinent previous labs, procedures and noting it with current complaint
Margaret Shanley
01:12:19
Thinking of treatment options and pt health behaviors and outcomes
Anna White, PA-C, MPH
01:12:31
A broad differential. Able to state their assessment and plan
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
01:13:07
also talking about what they need to make a decision or stating why they don't know which way to go with an evaluation
jenicarrico(NP)
01:19:00
ask them why would you do that
Benjamin Cook
01:19:05
Remove barrier of concern about being right, but more of doing the process
Priscila Tomlin, NP
01:19:09
and why
Christianna Karr (NP)
01:19:16
If they don’t have an answer, have them look it up
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
01:19:24
asking them "so...what is you assessment? Why?"
Bruce Peyser
01:19:25
We make learners justify their diagnosis in the assessment part of their notes- and if they don’t do this, we make them redo their notes
Margaret Shanley
01:19:37
Have student interact with other team members
Jake Lagomarcino
01:19:54
encouraging more utilization of clinical judgement rather than labs and tests
Anna White, PA-C, MPH
01:20:08
Always giving them the opportunity to ask questions during clinic or at the end of the day
Leanne Owens (PA)
01:20:15
asking them to add their thinking to their note.
Diana McNeill
01:22:28
Might you discuss how critical thinking can be enhanced(or occur) with telehealth or video visits?
Mitchell T. Heflin, M.D.
01:28:31
Private chat during telehealth visits can be a great way to pose questions or prompt students.
Bruce Peyser
01:29:45
I like to let students start Telehealth visits before I jump in, so they have time to connect with patients and their families
Melinda Blazar
01:31:13
https://www.youtube.com/watch?app=desktop&v=MOUV8c9esuI
Leanne Owens (PA)
01:39:28
This was a very good talk, motivates me!
Benjamin Cook
01:39:35
Great job, Illness scripts will be very helpful
Anne Derouin
01:39:39
^^^
Margaret Shanley
01:40:28
Excellent!
Diana McNeill
01:40:33
How important is the written documentation versus the oral communication in assessing critical thinking in our learners?
Bruce Peyser
02:09:20
This is so helpful, I think we don’t do enough on the first day.
Allex Granger, FNP
02:14:56
can you send the link in the chart of by email?
Allex Granger, FNP
02:15:00
chat*
Diana McNeill
02:15:20
How do you manage the time pressure some clinicians feel when they have learners in the clinic when there are patients waiting; also what do you do if patient says they don't want a learner in the room?
Bruce Peyser
02:17:14
File:///C:/Users/derou001/AppData/Local/Temp/One-minute-Preceptor-1.pdf
Priscila Tomlin, NP
02:18:28
They usually know...
Anna White, PA-C, MPH
02:23:13
Where can we access recommended podcasts?
Benjamin Cook
02:24:39
Overly confident and wrong
Melissa Fike
02:25:43
struggle with the transition from nurse to provider, not wanting to make a final diagnosis. I have started to ask them after their presentation "what is your plan?"
Allex Granger, FNP
02:26:14
Agree Melissa--I always ask "So what do you want to do?"
Jake Lagomarcino
02:29:01
what would you suggest if you had a similar individual but they weren't a student, they were a new provider?
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
02:29:27
set clear expectations
Jake Lagomarcino
02:31:14
thank you, good suggestion
geeta ramchandani
02:32:33
Always struggle with key words to use to give right feedback
Chris Fink, DO Int Med
02:32:34
With a provider need to have a sit down discussion with the new provider and the PMD. This needs to be an approach to set expectations and to document this approach. Very touchy situation as documentation needs to be done for ongoing mentoring and even possible HR intervention (worst case scenario) in the future.
geeta ramchandani
02:33:22
Also I have same question as Dr McNeill
Jake Lagomarcino
02:34:53
Your right Dr. Fink, learned my lesson about getting PMD involved early.
geeta ramchandani
02:35:49
This is a great topic at all student levelThankyou Dr Fink for your feedback may be supervising doc as well.
James Smith
02:36:15
Excellent talk, Anne.
Allex Granger, FNP
02:36:17
Great talk! Thank you so much!
geeta ramchandani
02:37:00
Very helpful. Thankyou Anne.Congratulations.
Jake Lagomarcino
02:37:23
excellent talk, thank you very much
Bruce Peyser
02:38:52
Thank you Anne for your comments and insights
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
02:43:33
Ellen Lauria
Benjamin Cook
02:43:41
PA - Cohen. Relatable, engaging, personable
Erica Shelly, DNP, FNP-BC
02:43:41
Dr. Bell...Patience
Nick Hudak
02:43:46
John A., kind and specific
Christianna Karr (NP)
02:43:46
Pediatrics preceptor - lots of feedback, diverse experiences
Priscila Tomlin, NP
02:43:52
Peyser
Leanne Owens (PA)
02:43:52
A resident in endocrinology, she pushed me to take a direct roll in the patients care
jenicarrico(NP)
02:43:54
chris kindness
Chasity Godwin, FNP-C
02:43:58
Heather Smith. Inviting. Gave constructive feedback. Approachable
Margaret Shanley
02:44:00
Pediatric preceptor. Taught how to interact with parents effectively
Melissa Fike
02:44:07
Brinkley Sugg, pushed me to get out of my own way and gave a lot of specific feedback
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
02:44:08
Honed in on what it was I needed to know
Whitney Taheri, NP
02:44:09
Dr. Peyser -- made me think much more about differentials than I had prior to that rotation
Bruce Peyser
02:44:15
Chief resident on internal medicine service at New York Hospital, was able to involve everyone in discussion with questions appropriate to each persons level of training
Priscila Tomlin, NP
02:44:23
Alice Cooper
Anne Derouin
02:44:23
Dennis Clements-- kind, receptive and wise
geeta ramchandani
02:44:25
Dr Gary Greenberg and Dr Bonin Duke family medicine residency program- always available, looking out of the box , excellent examsMy best teachers
Chris Fink, DO Int Med
02:46:41
Dr. Grady. IM Clinic instructor with ALS. He would sit in his chair barely able to speak. Listen to the case and hear the differential. And tell me I was wrong and go back to the drawing board. As he had issues with his speech it was all about listening for him. His short and concise insight and direction was awesome.
Leanne Owens (PA)
02:50:10
Can be uncomfortable
Priscila Tomlin, NP
02:50:14
when students become defensive
Margaret Shanley
02:50:15
Time, fear of rejection
Christianna Karr (NP)
02:50:17
Time.
Nick Hudak
02:50:24
Time for direct observation of encounter
jenicarrico(NP)
02:50:25
causing hurt feeling
Chasity Godwin, FNP-C
02:50:42
same as above
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
02:50:46
sometimes carving out time in the clinical day, sometimes the student who is not receptive to constructive criticism
Jake Lagomarcino
02:50:58
you can give the same feedback and each individual will take it differently
Priscila Tomlin, NP
02:51:25
agree with jake
Benjamin Cook
03:22:15
Great summary Erica 🙂
Melissa Fike
03:27:03
specifc feedback
Benjamin Cook
03:27:07
Illness scripts
Erica Shelly, DNP, FNP-BC
03:27:17
Thanks Mr. Cook
geeta ramchandani
03:27:31
Constructive feedback
Margaret Shanley
03:28:08
Ask student now they want to receive feedback
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
03:28:23
writing your note when acting as scribe and observing student... genius
Bruce Peyser
03:30:22
If you have questions for the group or for an individual, please write it down!
Priscila Tomlin, NP
03:31:29
asking them how they are doing throughout the day
Margaret Shanley
03:36:05
Our whole practice precepts so I might only have the student once a week. At the beginning of the session I as the student what they feel they currently need to work on.
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
03:42:37
I do not typically do that in front of the patient
Whitney Taheri, NP
03:43:58
similar question: how do you (or what is the best way to) help a student come back from a big blunder or really jarring patient experience... and help them realize the world has not ended and that they can, in fact, come back from this?
Nick Hudak
03:44:42
James, I really appreciate how you establish psychological safety with the students very overtly at the start of the rotation. In professions where our professional practice is expected to be Perfect, it is important to remind our students (and ourselves) that we don't learn through being perfect.
Benjamin Cook
03:45:47
Encourage a cry out/stress relief with reassurance
Diana McNeill
03:45:52
Stoddard HA, O'Dell DV. Would Socrates Have Actually Used the "Socratic Method" for Clinical Teaching? J Gen Intern Med. 2016 Sep;31(9):1092-6. doi: 10.1007/s11606-016-3722-2. Epub 2016 Apr 29. PMID: 27130623; PMCID: PMC4978680.
Whitney Taheri, NP
03:46:17
thanks, jake. I think the personal examples help a lot
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
03:46:39
I think you just need to recognize it for what it was... if the patient was difficult you reassure that it would have been difficult for anyone
Margaret Shanley
03:47:06
I agree with Kathleen
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
03:47:50
If it was a true blunder on the student's part you just point out the importance of it as a learning experience, how you might do things differently, what steps they can take to have more success in a similar situation in the future
Whitney Taheri, NP
03:48:54
great suggestions, thanks!
Diana McNeill
03:50:39
Do you think your clinic schedule should be shortened if you have learners?
Diana McNeill
03:52:38
I also say I will be teaching as I talk to the patient.
Bruce Peyser
03:53:53
Please let us know if you have questions that you want the panelists to address
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
03:57:10
RE Diana's question... well, you could work with more students or with more challenging students with an extra block or two in your schedule...
Nick Hudak
03:59:54
I agree Diana, if providers had committed time to teach during clinic sessions these two core components of our institution's mission would be in LESS conflict.
Diana McNeill
04:00:14
It has been a wonderful 3 and 1/2 hours-thank you for letting me join you-we appreciate all you do!!! Thank you may not be enough to express our gratitude!
Bruce Peyser
04:02:37
Remember to send an email to Charlene.Clay@duke.edu with your time so that you can get cme credit
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
04:05:46
Agree, Priscila... you know where they need to be, but can only start with them where they are
Margaret Shanley
04:05:54
Is there any way to ensure students have a worthwhile experience on all their rotations
Nick Hudak
04:05:58
Thank you panelists for your candor and practical suggestions. To everyone here, your commitment to the education of ALL health professions students is making a positive difference and better preparing them for interprofessional, collaborative practice! And thanks to Bruce for his thoughtful facilitation and inimitable leadership.
Leanne Owens (PA)
04:06:04
This was a great morning, thank you!
Kathleen Murphy RN, MSN, CPNP (Pediatric Nurse Practitioner)
04:06:23
Yes, great to hear from and see you all
Whitney Taheri
04:06:25
Great conversations and presentations! Thanks to everyone!
James Smith
04:06:27
Thanks Bruce. Excellent conference!
Margaret Shanley
04:06:40
Thanks everyone!
Erica Shelly, DNP, FNP-BC
04:06:47
Thank you everyone !
Chasity Godwin
04:07:51
Thank you!!!