Developing a Structured Training on Responding to Discrimination from Patients

Discrimination against clinicians is increasingly common. Few educational opportunities exist on how to respond to discrimination from patients and visitors. The authors developed and presented an interactive training on this problem, potential strategies for how to respond, and creating solutions. During an educational meeting, faculty presented a video about Times Up Healthcare then participants read a JAMA article about discrimination and the need for allies to speak up. Participants then engaged in think-pair-share on the article and experiences with speaking up. Next, faculty presented a peer-reviewed journal article on a qualitative analysis of semi-structured interviews that provides a framework for responding to discrimination from patients. Using guidance from existing literature, potential approaches for addressing the problem were presented. These included strategies for faculty, trainee, and frontline clinician development and institutional involvement. Next, participants read another JAMA article on calling-out inappropriate behavior that includes recommending being prepared for how to respond to discrimination and then performed think–pair–share on the article with discussion prompts. The session concluded with solicitation of best next steps, and the group developed a task force that would champion training for faculty and learners, measure how often the problem occurs in the institution, and develop policy and education on escalation/the chain of command. Lessons learned and next steps: (a) There is a need for training on responding to discrimination from patients and visitors. Faculty and trainees can lead education and empower others through sharing informational materials. (b) Future directions include studying the effects of these efforts on implementing a process, policy, and training for responding to discrimination. (c) Education Day participants can use and adapt these materials to conduct trainings in their environment

Implementation of the Obesity Prevention and Management (OPM) Guideline to Increase Recognition and Treatment of Childhood Overweight and Obesity in an Urgent Care Setting

Childhood obesity carries multiple significant and costly health associated risk factors. Obese children have a higher risk of cardiovascular disease, diabetes, sleep apnea, bone and joint problems, as well as self-esteem issues. Childhood overweight and obesity are associated with $14.1 billion in healthcare utilization each year. New Mexico (NM) has experienced significant increase in overweight and obesity with associated chronic illnesses over the past 15 years. Addressing the public health crisis of childhood overweight and obesity requires an innovative and broad approach beyond primary care and health policy changes. Urgent care settings are highly accessed by pediatric patients. To address the epidemic of childhood overweight and obesity in NM, a Doctor of Nursing Practice candidate provided Obesity Prevention and Management clinical guideline training to medical staff in an urgent care clinic in northern NM. The goal of this training was to increase the identification of and intervention for childhood overweight and obesity in urgent care. Using Lewin’s Change Theory and the Adult Learning Theory as a framework for the project, the project leader presented change as necessary and created motivation to learn by the clinical staff. Overall, there was an increased trend towards higher frequency of screening, diagnosing, and intervention for childhood overweight and obesity in the urgent care setting, as well as a trend towards increasing the frequency of self- reported behaviors. These findings suggest that an education intervention for medical staff may be successful in increasing the recognition and treatment of childhood obesity in an urgent care setting