Patient Centered Medical Home: Creating A Blueprint for Quality Healthcare Through Illustrative Simulation

The advent of healthcare reform in the U.S. presents an unprecedented challenge to academic institutions that are striving to prepare a workforce to interact with individuals needing care in a variety of new practice settings. Patient-centered care is a core objective of these evolving settings which enhance access to a variety professionals and services in one location. This study was conducted over a period of three years and describes how illustrative simulation can be employed as a learning intervention to prepare graduate students for the expanded scope of practice necessary to function in the Patient Centered Medical Home healthcare delivery setting. The authors’ evaluation revealed that doctor of nursing practice students’ perceived illustrative simulation strengthened their understanding of: (a) the Institute of Medicine Core Competencies for a New Vision for Health Professionals, (b) the four competency domains identified by the Interprofessional Education Collaborative, and (c) the eligibility standards for National Committee for Quality Assurance – Patient Centered Medical Home recognition

Patient Centered Medical Home: Creating A Blueprint For Quality Healthcare Through Illustrative Simulation

The advent of healthcare reform in the U.S. presents an unprecedented challenge to academic institutions that are striving to prepare a workforce to interact with individuals needing care in a variety of new practice settings.  Patient-centered care is a core objective of these evolving settings which enhance access to a variety professionals and services in one location. This study was conducted over a period of three years and describes how illustrative simulation can be employed as a learning intervention to prepare graduate students for the expanded scope of practice necessary to function in the Patient Centered Medical Home healthcare delivery setting. The authors’ evaluation revealed that doctor of nursing practice students’ perceived illustrative simulation strengthened their understanding of: (a) the Institute of Medicine Core Competencies for a New Vision for Health Professionals, (b) the four competency domains identified by the Interprofessional Education Collaborative, and (c) the eligibility standards for National Committee for Quality Assurance – Patient Centered Medical Home recognition

The importance of resistance training in the treatment of sarcopenia

Utilizing individualized exercise training programs that are inclusive of appropriate resistance training protocols can attenuate the deleterious effects of sarcopenia and enhance quality of life, functional capacity and also diminish its negative effect on independence. Nurses should be educated in how the utilization of proper resistance training (RT) in individuals can be used to ameliorate the effect of sarcopenia, especially considering its relationship to Quality of Life (QoL), functional capacity and independence. In part, this educational process should include how to refer patients to an appropriate healthcare provider trained in assessing sarcopenia and the use of resistance training. However, it is especially important that the provider be an expert on RT that enhances lean muscle, muscular strength, muscular endurance, power, balance and stamina. Therefore, it is vital that nurses have an opportunity to define and recognize how resistance training can be prescribed, ultimately for primary prevention but also as an effective treatment module in enhancing the health outcomes related to QoL, functional capacity and independence

The Impact of an Advance Care Planning Simulation on the Communication Skills of Palliative Care Nurse Practitioner Students

Background: Effective communication is the cornerstone of a therapeutic relationship, especially when dealing with serious, life threatening illness. Decisions based upon a patient and family’s wishes, goals and values need to be guided by clinicians equipped to engage in complex advance care planning (ACP) conversations. Given its importance, communication skill proficiency has been identified as a core competency for the Advanced Practice Registered Nurse (APRN) in palliative care. Although simulation utilizing a standardized patient model has been employed for communication skills training in healthcare education, little is known about its usefulness in preparing palliative care nurse practitioner students for these challenging ACP discussions. Objectives: The purpose of this pilot study was to evaluate the impact of advance care planning simulations upon the communication skills and self-efficacy of palliative care nurse practitioner students enrolled in a college of nursing. Methods: A prospective, quantitative study using a one-group pretest-posttest design was implemented to measure student communication skills and self-confidence. A convenience sample (N=19) of students enrolled in New York University’s College of Nursing was obtained for the study. Students engaged in two ACP discussion simulations with actors playing the role of a newly diagnosed oncology patient. In addition to demographic information, the participants completed a self-confidence tool prior to the first and after the second simulation. An independent faculty member scored the students’ performances for each simulation using a communication skills checklist based on the SPIKES protocol. Statistical analysis of the study variables was performed using paired t test and Wilcoxon signed-rank test measurements. Statistical significance was set at p \u3c .05. Results: The majority of participants were between the ages of 20-30, had 4-10 years of nursing experience and reported having exposure to patient discussions surrounding healthcare proxy, code status and breaking bad news during their clinical rotations. Fifty-six percent (n =5) of the participants demonstrated improvement in communication skills (t = -.098, p = .924), while ninety-three percent (n = 14) reported increased self-confidence (t = 4.725, p\u3c .001) after completion of the second simulation encounter. Statistical significance for nine of the 14 self-confidence tool items was confirmed by the Wilcoxon signed-rank test. Study limitations included attrition, sample size, intervention timing and scheduling. Conclusion: Despite mixed results, this pilot provided key insights into the potential for repetitive simulation in communication skills education and the feasibility for future research of this pedagogy in the palliative care nurse practitioner student population