Expanding Health Professional Education in the Rio Grande Valley during the COVID-19 Pandemic

Purpose: The COVID-19 Pandemic has prompted innovation in health professional education, such that learners are able to recognize and mitigate healthcare disparities in the outcomes of vulnerable populations. The objective of our project was to increase education on preventing, preparing for, and responding to COVID-19 and other locally prevalent infectious diseases that disproportionately affect RGV communities. Description: This project had 3 goals: (1) provide learners with virtual patient-interaction simulations (2) provide interactive training modules on the identification, prevention, and treatment of infectious diseases affecting South TX and strategies to increase child vaccinations, and (3) provide learners an opportunity to coordinate community health promotion via PPE and COVID-19 information distribution. Partners: Collaborative stakeholders included the AHEC Scholars Program and the Department of Pediatrics at UTRGV SOM. Both functioned as sponsoring bodies overseeing this operation. Mursion and Nearpod were consulted regarding how the use of their technologies could advance Goals 1 & 2. UT Health RGV patients and RGV colonia populations were the rationale for completion of Goal 3 and the project as a whole, as we sought to aid in improving their overall health. Looking Ahead: Our approach integrated content learning and practice with regard to identifying, preventing, and addressing regionally prevalent infectious/non-infectious diseases and sensitive health topics affecting all age groups. The multifaceted nature of the project helped to solidify the knowledge gleaned and revealed possible avenues for health professional curriculum that can further learning in areas that are difficult to address in a traditional standardized manner, from pediatric patient encounters to community health interventions

A community-engaged interprofessional project led by medical students, school of social work students, and resident physicians: lessons learned and recommendations for success

Addressing health disparities through community engagement and interprofessional partnerships is increasingly critical. However, learner-led approaches that integrate medical students, resident physicians, and social work students are not well-studied. We designed a learner-led, interprofessional, public health campaign for a majority Hispanic community, with the goals of building interprofessional leadership skills, engaging learners to address COVID-19 inequities, and disseminating lessons learned. Faculty and students from the University of Texas Rio Grande Valley Schools of Medicine and Social Work partnered with community leaders to pilot an interprofessional project supported by the American Association of Medical Colleges’ Nurturing Experiences for Tomorrow’s Community Leaders (AAMC NEXT) Award. We describe the process of selection of a 12-member learner team of medical students, resident physicians, and social work students, and how we enacted the project from December 2020 to June 2021. Lessons learned in implementing our learner-led, community-engaged, interprofessional approach included: building interprofessional leadership skills, setting member roles and responsibilities, instilling requisite knowledge and skills, engaging with the community, and disseminating research findings. These lessons can guide other institutions seeking community-engaged interprofessional projects with learners

Patient Navigation Services in the Rio Grande Valley: Impacts on Clinicians, Students, and Patients

Purpose: Health professions students of the UTRGV AHEC Scholars Program sought to improve coordination of care and reduce barriers to care recommendations for patients of the UTHealthRGV AHEC clinics. We enacted a student-run multidisciplinary health care system navigation intervention, to address health disparities experienced by residents of colonias in the RGV. Description: Health professions students voluntarily signed up to become “health care system navigators” (HCSNs) as part of a community-engagement activity sponsored by the AHEC Scholars Program. Students received informal training from AHEC staff in the use of the clinic EMR related to identifying patient contact information, documenting patient tele-encounters, and messaging clinic staff. Student navigators interacted via phone with clinician-identified at-risk patients on a regular basis to discuss care recommendations, care progress, and any barriers present in addressing recommendations. Using a student-created community resource directory, navigators connected patients to needed resources and services according to their identified care recommendations and barriers to care. Students met virtually on a weekly basis with clinic providers of AHEC clinics to discuss patient care updates, concerns, and questions. To determine initiative feasibility and effectiveness, three stakeholder groups were surveyed: clinicians, HCSNs, and patients who completed their use of patient navigation services. Each stakeholder group was surveyed monthly for the first three months of program implementation to account for possible addition of members and/or a shift in opinion over time. Survey results revealed uniformly positive feedback from clinicians, HCSNs, and patients. Partners: The AHEC Scholars Program and its community engagement activities, including the HCSN initiative, are financially supported by UTRGV SOM and HRSA. The AHEC Clinic staff at the San Carlos, Bob Clark, and La Victoria locations facilitated clinician and patient interactions with HCSNs. Looking Ahead: Standardized communication procedures and formal HCSN trainings are areas for refinement as the program matures. Stakeholder feedback suggests that the HCSN intervention is a promising and acceptable link between patients, providers, and community resources to address barriers to care and to instill the importance of addressing social determinants of health for health professional trainees. Expansion of this pilot program to other UTHealthRGV clinics awaits future implementation

Learners Engaging with Hispanic Communities to address COVID19 Inequities by Developing a Cultural Competence Guide for Public Health Messaging

Introduction: The Rio Grande Valley (RGV) has the highest rates of obesity and diabetes nationwide which have compounded the impact of COVID-19. We propose addressing underlying mistrust and systemic racism through a resident-and-student-learner-led, community-engaged, educational public health campaign targeting the Hispanic community in the RGV. Methods: Twelve students were provided interdisciplinary leadership skills in a community-engaged public messaging campaign covering issues of COVID-19 inequities. Learners used these skills to engage with clinic community partners in qualitative interviews regarding the patient population to guide the creation of a culturally competent public health messaging rubric for the Hispanic community. Results: Pre-intervention survey results showed that the patient population was 97% Hispanic/Latino with a 73% language preference for Spanish and a 98% uninsured status. Clinic leaders described 67% of their patient population as being high risk for COVID-19 with multiple underlying risk factors, including obesity, hypertension, and diabetes. Surveyed clinic leaders selected that PSAs need to have clarity of the message and availability in the patient’s preferred language. Our team created two focused, culturally competent rubrics for the Hispanic community. Discussion: This research has shown that it is imperative to be able to evaluate which PSAs are effective in delivering their intended message as well as being able to monitor the effects on their target audience. The Hispanic and Spanish-speaking communities needs more effective public health messaging to decrease testing fears, improve contact tracing, motivate individuals to seek medical care, and to ultimately address the rampant COVID-19 inequities that exist

Heart Rate Variability (HRV) Loss and other EKG Changes prior to a Cardiopulmonary Event in Children admitted to the ICU at a Tertiary Care Children’s Hospital

Introduction: HRV and EKG changes prior to cardiopulmonary events (CPEs) occurring in children in intensive care unit (ICU) settings is not well documented. We assess if substantial losses of HRV and/or other EKG changes, if any, may be detectable prior to a CPE occurring in children admitted to the ICU. Methods: A prospective observational cohort study was conducted in the ICU from January to February of 2023 at Driscoll Children’s Hospital. A “CPE” was defined as a change in the clinical status of a child warranting a cardiopulmonary intervention. Demographic and clinical data from each patient was collected, along with EKG central monitor tracings prior to a CPE occurring. To assess HRV, R-R intervals will be manually measured, and HRV-specific metrics will be calculated using LabChart Pro software. To asses other EKG parameter changes, other EKG intervals and positions will be recorded. We will compare our obtained data with standard reference HRV and EKG parameter values for age and sex. Results: 34 children admitted to the pediatric and cardiac ICUs in Driscoll Children’s Hospital during January and February of 2023 were studied, with a total of 128 CPEs. Study population was 17 females (50%) and 17 males (50%). Median (IQR) age was 7.36 (0.86-75.55) months. 27 (79.41%) patients were White/Hispanic. Primary pathologies were mainly cardiac or respiratory in origin (18 (52.94%) cardiac, 9 (26.47%) respiratory). 15 (11.72%) CPEs were primarily cardiac, 113 (88.28%) CPEs were primarily respiratory. Discussion: EKG tracing measurements remaining ongoing. Results regarding HRV metrics and other EKG parameter analyses are pending