Heather Davidson - Academia.edu (original) (raw)

Papers by Heather Davidson

Journal of Interprofessional Care, Apr 24, 2022

Academic Medicine, Apr 1, 2020

BMC Medical Education, Aug 17, 2018

Background: Few global health experiences include intentionally-directed interprofessional traini... more Background: Few global health experiences include intentionally-directed interprofessional training. We aim to prospectively evaluate the impact of a global health elective in facilitating interprofessional education (IPE) and promoting cultural sensitivity. Methods: We included in our study, medical and nursing students who participated in the 2015 and 2016 cohorts of the Nicaragua Global Health course. The course consisted of a 12-week curriculum, and included an in-country immersion where students were organized into small-groups that participated in a variety of interprofessional activities. Students filled out pre-and post-course surveys. We performed quantitative analysis on numeric data and qualitative analysis on open-ended questions. Results: Of 39 total students enrolled in the course, 26 (18 medical and 8 nursing students) participated in the study and filled out the pre-and post-course surveys. Mean competency scores increased for all questions between pre-and post-course surveys, and of these, 5 of 7 reached statistical significance. Qualitative themes identified included: 1) the importance of understanding other team member's roles and relative strengths; 2) the value provided by the breaking down of traditional power dynamics between clinicians. Conclusions: Global health experiences represent a unique and under-utilized opportunity for facilitating IPE.

Journal of Interprofessional Care

Annals of Surgery, 2022

OBJECTIVE To determine whether trauma patients managed by an admitting or consulting service with... more OBJECTIVE To determine whether trauma patients managed by an admitting or consulting service with a high proportion of physicians exhibiting patterns of unprofessional behaviors are at greater risk of complications or death. SUMMARY BACKGROUND DATA Trauma care requires high-functioning interdisciplinary teams where professionalism, particularly modeling respect and communicating effectively, is essential. METHODS This retrospective cohort study used data from nine level I trauma centers that participated in a national trauma registry linked with data from a national database of unsolicited patient complaints. The cohort included trauma patients admitted January 1, 2012 through December 31, 2017. The exposure of interest was care by one or more high-risk services, defined as teams with a greater proportion of physicians with high numbers of patient complaints. The study outcome was death or complications within 30 days. RESULTS Among the 71,046 patients in the cohort, 9,553 (13.4%) experienced the primary outcome of complications or death, including 1,875 of 16,107 patients (11.6%) with 0 high-risk services, 3,788 of 28,085 patients (13.5%) with one high-risk service, and 3,890 of 26,854 patients (14.5%) with 2+ high-risk services (p < .001). In logistic regression models adjusting for relevant patient, injury, and site characteristics, patients who received care from one or more high-risk services were at 24.1% (95% CI 17.2% to 31.3%; P < 0.001) greater risk of experiencing the primary study outcome. CONCLUSIONS Trauma patients who received care from at least one service with a high proportion of physicians modeling unprofessional behavior were at an increased risk of death or complications.

BMJ Leader, 2021

Background Crisis plans for healthcare organisations most often focus on operational needs includ... more Background Crisis plans for healthcare organisations most often focus on operational needs including staffing, supplies and physical plant needs. Less attention is focused on how leaders can support and encourage individual clinical team members to conduct themselves as professionals during a crisis. Methods This qualitative study analysed observations from 79 leaders at 160 hospitals that participate in two national professionalism programmes who shared their observations in focus group discussions about what they believed were the essential elements of leading and addressing professional accountability during a crisis. Results Analysis of focus group responses identified six leadership practices adopted by healthcare organisations, which were felt to be essential for organisations to navigate the crisis successfully. Unique aspects of maintaining professionalism during each phase of the pandemic were identified and described. Conclusions Leaders need a plan to support an organiati...

Journal of the National Medical Association, 2021

INTRODUCTION Microaggressions in the learning environment have been documented at various levels ... more INTRODUCTION Microaggressions in the learning environment have been documented at various levels of medical training. However, there is lack of data detailing the prevalence and effects of racial microaggressions in medical school. This limits interventions that might improve the learning environment for underrepresented minority medical students (URMMS). This study describes the creation and validation of a survey instrument characterizing the experience of microaggressions in medical school and their impact on medical student education and burnout. METHODS An anonymous survey instrument was adapted for medical students from the validated Racial and Ethnic Microaggressions Scale (REMS) and distributed to the national listservs of the Student National Medical Association (SNMA), Latino Medical Student Association (LMSA), and the Asian Pacific American Medical Student Association. Responses were categorized into two cohorts: under-represented minority (URM) and non-URM based on self-reported race or ethnicity. RESULTS A total of 217 responses were collected from medical students across the United States, with 148 (68.2%) students identifying as URM. URM respondents were significantly (p < 0.05) more likely to report experiencing race-related microaggressions during medical school (55% vs 31%), and to report that these microaggressions contributed to feelings of burnout (62% vs 29%) and compromised learning (64% vs 49%). URM students were significantly less likely to feel that adequate resources were available to address microaggressions (26% vs 39%, p < 0.05). CONCLUSIONS Our results suggest that microaggressions experienced by URMMS can be evaluated using an adapted REMS. Additionally, the experience of microaggressions negatively impact the learning environment, and students feel the availability of sufficient resources to address microaggressions and their effects are lacking. Further research is needed to evaluate microaggressions and their impact on a larger scale. This should be followed by interventions to minimize the frequency and impact of these microaggressions.

Comprehensive Healthcare Simulation: InterProfessional Team Training and Simulation, 2020

Interprofessional education (IPE) is an emergent topic that has received considerable attention d... more Interprofessional education (IPE) is an emergent topic that has received considerable attention during the recent years among health science educators in a variety of fields and at all levels. This chapter discusses the present state of simulation in pre-professional interprofessional health science education and describes eight attributes associated with programs that have established successful IPE curricula. Finally, it will discuss relevant concepts necessary to support programs as they work to establish sustainable pre-professional interprofessional simulation experiences.

Patient Education and Counseling, 2020

Objective: This study describes the development of the Health Coaching Index (HCI), an observatio... more Objective: This study describes the development of the Health Coaching Index (HCI), an observational tool for assessing fidelity to implementing health coaching practical skills. Methods: Initial HCI items were developed, adapted following cognitive interviews, and refined during coding training. Participants (n = 42) were trainees who completed a National Board for Health and Wellness Coaching (NBHWC)-approved training program and coached a standardized patient. Interrater reliability for the HCI was determined by calculating interclass correlations from ten videos coded by three raters. Construct validity was evaluated from 42 recordings using Spearman's Rho between HCI and Roter Interaction Analysis System (RIAS) codes.

Journal of Occupational Therapy Education, 2019

The increase in interprofessional education (IPE) opportunities provides an excellent opportunity... more The increase in interprofessional education (IPE) opportunities provides an excellent opportunity for occupational therapy (OT) educators to partner with other health professions to deepen the understanding of how the OT profession adds value to future healthcare teams. The purpose of this study was to describe the development and impact of a curricular unit about the OT profession that was integrated into an established IPE program for medical, advanced practice nursing, pharmacy and social work students. A Needs Assessment was conducted by embedding an OT consultant within interprofessional student teams working in clinical environments over six weeks to observe baseline understanding of how student primary care teams work with OT professionals. From these observations, a curricular unit was designed that included lecture, interactive work stations, and case studies. Students completed pre and post surveys in order to assess their learning. Quantitative and qualitative analysis of pre and post surveys indicated a significant increase in knowledge, application of information, and confidence to refer to and utilize OT in clinical practice. Interprofessional students learned about OT scope of practice, possible interventions, and examples of appropriate referrals. The curricular unit provided an excellent example of how OT professionals can partner with health professions schools to provide content about OT when OT students are not accessible. Future improvements include assessment of longitudinal impact of the curriculum on health professions behavior, including impact on patient referrals to OT by primary care teams.

Journal of Health Care for the Poor and Underserved, 2016

This report describes the role of a clinical pharmacist serving onsite in an interprofessional co... more This report describes the role of a clinical pharmacist serving onsite in an interprofessional collaborative practice care model at an urban underserved primary care clinic. It also overviews current health care legislative policy as it relates to expanding pharmacists roles as an integrated team member in medically underserved, vulnerable populations.

Medical Science Educator, 2014

A plenary session at the annual meeting of the International Association of Medical Science Educa... more A plenary session at the annual meeting of the International Association of Medical Science Educators introduced the challenges and successes experienced with two models of interprofessional education (IPE). Representatives from the Vanderbilt Program in Interprofessional Learning (VPIL) and a five-university IPE consortium, the Southeastern Conference (SEC) for IPE, answered moderated questions from the audience including methods for integrating basic science learning with interprofessional students, in the clinical and digital environment. Online modules for delivering IPE with both asynchronous and synchronous connectivity were introduced. Additional areas of discussion included integration and relevance of IPE integration with basic science, the impact of IPE models on student behavior and career choice, concerns associated with documenting IPE activities for promotion and tenure, and managing difficulties associated with integrating IPE across multiple curricula.

Pedagogy in Health Promotion, 2015

Journal of Graduate Medical Education, 2009

Introduction The Department of Graduate Medical Education at Stanford Hospital and Clinics has de... more Introduction The Department of Graduate Medical Education at Stanford Hospital and Clinics has developed a professional training program for program directors. This paper outlines the goals, structure, and expected outcomes for the one-year Fellowship in Graduate Medical Education Administration program.

Journal of Interprofessional Education & Practice

Abstract Students who participate in the Vanderbilt Program for Interprofessional Learning are re... more Abstract Students who participate in the Vanderbilt Program for Interprofessional Learning are required to attend Immersion, our program of orientation for teams of interprofessional students. Medical, advanced practice nursing, pharmacy, and social work students coming from different institutions are required to complete the 4 day “Immersion” before beginning in their respective academic programs, as a way to decrease the development of professional bias. Many of the students are also new to the Nashville area, and the Immersion program introduces the students to the community and the populations they will be serving in professional school and beyond. Immersion includes a range of activities, including community tours, poverty simulations, creation of life maps, personality identification, team building, patient storytelling, and introduction to professional life. Each day has a specific theme: Self, Community, Professions and the Patient. Student evaluations for Immersion are overwhelmingly positive. The focus of this paper is to describe the curricular design of the Immersion week, report student feedback, and discuss lessons learned that might provide guidance for other educational programs.

Journal of interprofessional care, 2017

It is acknowledged that interprofessional communication and teamwork are foundational for high-qu... more It is acknowledged that interprofessional communication and teamwork are foundational for high-quality, safe medical practice. The theory of distributed knowledge posits that each person has unique knowledge and experiences that can contribute to a broader group perspective. Patient care can be positively influenced by a robust and interprofessionally shared understanding of the complexities of health and illness. One would expect a variety of perspectives to be evident in all healthcare providers, including incoming health science students from different professional fields. To examine this notion, medical, nursing, and pharmacy students (n = 24) at the start of an interprofessional training experience were asked to write an essay on factors that contribute to health and/or illness. Their essays were thematically coded to generate a list of factors considered key to health/illness and compare responses across fields to better understand how knowledge is distributed across entering ...

The Clinic at Mercury Courts employs and interprofessional collaborative team (IPCP) model for pr... more The Clinic at Mercury Courts employs and interprofessional collaborative team (IPCP) model for primary care of an inner city vulnerable population. This nurse practitioner led team includes a physician, social worker and community pharmacist. Health professions students are assigned to the site in similarly composed teams of learners. Patient and provider outcomes have shown improvement over a 2.5 year period. Patient outcomes include: hypertension control, tobacco use cessation rate, diabetes control, establishment of a healthcare home, and patient satisfaction. Provider outcomes include team development and effectiveness measures. Students also provide data based feedback on provider team effectiveness. IPCP Team Development was guided by core competencies identified by the Interprofessional Collaborative Education Expert Panel (2011) and by an IPCP model developed by the University of Toronto Office of Interprofessional Education (2008). Primary Aim Improve disease management amo...

Nursing management (Harrow, London, England : 1994), 2015

Team-based care is often described as the best way to provide health care. However the effective ... more Team-based care is often described as the best way to provide health care. However the effective use of teams in primary care is not yet prevalent in the US and nurse-led interprofessional collaborative teams are rare. Over the past three years the US Department of Health and Human Services has put great emphasis on the development of nurse-led interprofessional teams and this article describes the development of one such team in a primary care setting and the evidence base behind it.

Journal of Professional Nursing, 2015

The Division of Nursing, Bureau of Health Workforce, has spearheaded a 3-year effort to increase ... more The Division of Nursing, Bureau of Health Workforce, has spearheaded a 3-year effort to increase the skills of nurses to lead interprofessional collaborative practice (IPCP) teams. Since 2012, the Nurse Education, Practice, Quality and Retention program has funded 53 sites engaged in this work. The purposes of this report are to describe the IPCP framework undergirding implementation at one such site, describe the evaluation components and approach, describe how health professions students are integrated into this model, and discuss implications of IPCP for future nurse-managed/nurse-led initiatives within an evolving health care environment. Core team members include a family nurse practitioner, physician, pharmacist, social worker, and community health advocate. The clinic is located within a public housing complex; the target population is largely uninsured or underinsured with a historically high rate of emergency department utilization.

Neuropsychologia, 2000

Two cognitive tasks (a letter memory task and a spatial memory task) designed to selectively acti... more Two cognitive tasks (a letter memory task and a spatial memory task) designed to selectively activate the left or right hemisphere were combined with attentional probe tasks to measure how hemispheric activation aects attention to left and right hemi®elds. The probe task in Experiment 1 required the identi®cation of digits in the left and right hemi®eld. During the letter task, male subjects identi®ed more probes from the left hemi®eld than from the right. Their accuracy varied little across the two hemi®elds during the dots task. Experiment 2 tested whether this pattern is due to either spatial attention or interference in character processing. Instead of identifying digits, the probe task required subjects to respond to a black square that appeared in the periphery of the screen. For male subjects, the pattern was opposite of that from Experiment 1. During the letter task they responded faster to the probe in the right hemi®eld than in the left. Their response times were equivalent across the two hemi®elds during the dots task. These results indicate two separate eects of laterality in male subjects. The activation of one hemisphere produced more attention to the contralateral hemi®eld in Experiment 2, and the letter memory task interfered with the processing of other characters in the right visual ®eld more than those in the left visual ®eld in Experiment 1. Neither of these eects appeared in female subjects, corroborating earlier claims that female brains are less lateralized than male brains.