6/8/2016. Students Perception of a Short Term Medical Mission to Jamaica, W.I. Acknowledgements

Transcription

1 Students Perception of a Short Term Medical Mission to Jamaica, W.I. 1 Joan Ginty DNP, APRN, ANP-BC Ethel Ulrich DNP, APRN, ANP-BC Acknowledgements Sister Grace Yap, OSF PRN Relief International Molloy College School of Nursing and the Department of Communication Sciences, and Disorders The wonderful people of Jamaica, W.I. 2 Medical mission, don t know what to expect, Would I find a country full of neglect? As the plane draws near and land comes into view, I find myself asking, what can I do? Excerpt from a student s poetry 1

2 Global health is a component of core knowledge for 21 st century nursing professionals.1 Nursing students can gain valuable knowledge and experience in global health by participating in short term medical missions Bosworth et al., 2006; Wagner & Christensen, Levi, Several studies have demonstrated the positive effects of STMMs on student learning outcomes Byrne, Collins, & Martelly,

3 7 Epidemiology Population of Jamaica, WI -2,769,000 2% of the population live in urban areas Non-communicable diseases (NCD) are estimated to account for 79% of total deaths The probability of dying between ages from the four main NCD s is 17% 4 8 7% CVD 3% 14% 37% Cancers Diabetes Other NCD's 11% Chronic Respiratory 11% 17% Communicable, Maternal, Perinatal, Nutritional Injuries Proportional Mortality Jamaica 4. WHO (World Health Organization ) Non-communicable Diseases (NCD) Country Profiles 9 3

4 Overview of the Experience Molloy College visits twice per year. Mobile Clinics Primary Care Established In conjunction with PRN and 2 additional schools Primary Care is provided to low resource areas in Urban and Rural Jamaica. Clinics are visited every 6 months Returning students had previously responded positively and enthusiastically to the experiences, but their response were purely anecdotal in nature. 11 There are three types of Short Term International Health Missions: relief care, surgical-dental teams, mobile clinics.1 First established in the 190 s, Short Term International Health Mission Trips have increased dramatically in the past two decades.1 1.Bajkiewicz (2009) 12 4

5 Literature Review Global experiences which meet the needs of underserved populations, as well as the students themselves, have been offered to undergraduate nursing students, but are not commonly offered to nurse practitioner students.2 Studies predominately done on undergraduate nursing students.3,4,,6 Primary care experience in service learning settings abroad can be a transformational experience for NP students 2 2.Byrne, Collins, & Martelly (2014) 3.Kelleher (2013) 4.Cadwell &Purtzer (201). Wilcox, Taylor-Thompson (2012) 6.Wagner & Christensen (201) 13 Research Question What are student perceptions after participating in a Short Term International Health Mission to Jamaica, W.I.? 14 Purpose of the Project Evaluate student perceptions of the short term international health missions, while providing much needed health care to low resource communities in Jamaica, W.I. Improve future mission planning Identify further areas of study 1

6 6/8/2016 Framework: Emancipatory Knowing empiric ethical Emancipatory personal aesthetic 7. Chin and Kramer (2011) 16 Project Design From October 2013-October 201 Convenience Sample of first time student participants completed the International Health Mission Questionnaire Descriptive and qualitative analysis 17 Tool Perception of an International Health Mission Questionnaire Three Part Tool: Demographic Data Point Likert Scale questions 1=no change, =Tremendous Change Nine Open ended questions. 8. Marquart, M. In Geelhoed (2009) 18 6

7 Sample of Students Discipline N=1 36% N=7 8% N=23, 6% Nurse Practitioner Students Under Grad Nursing Students Speech Pathology Students N=3 6.7% N=6 13.3% N=4 8.9% N=1 2.2% N= % Caucasian African American/Black Hispanic/Latina Asian Pacific Islander 21 7

8 Data Analysis-Likert Scale 1. New knowledge 2. Improvement in thinking/cognitive skills 3. Change in ideas about the US healthcare system 4. Change in self confidence. Ability to perform professional tasks 6. Change in awareness 7. Change in feelings 8. How personally affected 22 How much new knowledge? no change 12 minimal 9 moderate significant tremendous Different country Healthcare other country Different Culture Health Beliefs Healthcare Professional Health History 23 Moderate to Tremendous Change NP students Speech Pathology Undergrad Nursing 0 Healthcare Different Culture Other Country Health Beliefs 24 8

9 4.% N=2 Moderate to Tremendous No Change-Minimal 9.% N=43 Confidence Caring for Patients, and Being Part of a Multi-disciplinary Team 2 4.% N=2 9.% N=43 Moderate to Tremendous No Change-Minimal Respect for Patients, and Caring for Patients from Another Country % N=3 93.3% N=42 Moderate to Tremendous no change Opinion of US Healthcare More Positive 27 9

10 Help Learn About Self, & Help Reflect on Own Beliefs minimal moderate significant tremendous 28 Change Feelings About Adaptability in Different Situations no change minimal moderate significant tremendous % N=3 93.3% N=42 Moderate to Tremendous no change Gain Respect for Peers and Interdisciplinary Healthcare Team Members 30

11 31 Themes Confidence Awareness Compassion Appreciation Vulnerability 32 Another significant change was my increased confidence level as a soon to be NP. With the dive right in environment, you learn to prioritize and be a more flexible practitioner 33 11

12 It helped me realize that I come from a country that is very blessed in terms of available healthcare, and allowed me to become more aware of my surroundings Seeing the dire need in this population made me more compassionate towards others in need as well as the awareness that there is such a need for us to help 34 I have become more tolerant and humble in the way I treat others It makes you want to do so much more than you can I am more sensitive to people s needs 3 This experience was once in a lifetime; to expose myself to something totally unfamiliar The mission grounded me. I really appreciate the little things like toilet paper, garbage bags and water 36 12

13 I was fearful that I would get sick and not be able to receive adequate healthcare I was more anxious about my own skills and expectations. I was worried that I would not know how to face complications 37 Discussion Results of the IHMQ revealed significant benefits for the students. Qualitative analysis of the open-ended questions provided a deeper understanding of the students perception of their experience, substantiated the quantitative findings, and revealed themes of awareness, compassion, confidence, appreciation and vulnerability. 38 Limitations Small sample Inability to generalize, establish cause and effect relationship Threat to validity 39 13

14 Implications There is agreement that participation in short term medical missions offers many benefits to students. Patients benefit, through medical care, education, medication, and supplies. The results of this study will inform the development, design, and implementation of future global programs. 40 Recommendations for Future Research More research needs to be done on NP s and NP students providing primary care on these missions. Research evaluating patient outcomes, especially the long term effects, is needed. Longitudinal study to determine impact on future practice 41 We went and we saw And were changed to the core. The human spirit is so strong, It persevered with all that went wrong. We went to help and to learn And acquired life s lessons in return. Our intention was to heal and show, Yet their grace and courage helped US grow! 42 14

15 43 References Bajkicwicz, C. (2009). Evaluating short-term missions. How can we improve. JCN, 26(2), Byrne, S., Collins, S., & Martelly, M. (2014). Sustainable global health outreach in Haiti: Learning for primary care nurse practitioner students. The Journal of Nurse Practitioners, (8), e33-e40. Caldwell, P., & Purtzer, M. (201). Long-term learning in a short-term study abroad program: Are we really truly helping the community?. Public Health Nursing, 32(), Chinn, P.L., & Kramer, M.K. (2011). Integrated theory and nursing (8 th ed.). St. Louis, MO: Mosby knowledge development in Geelhoed, G. (2009). Transformational learning in health care students through international service in developing world environments. Retrieved from gradworks.umi.com Kelleher, S. (2013). Perceived benefits of study abroad programs for nursing students: an integrative review. Journal of Nursing Education, 2(12), Wagner, L. & Christiansen, S. (201). Establishment of a short-term global health nursing education experience: Impact on students ways of knowing. Journal of Nursing Education, 2(), Wilcox, J., & Taylor-Thompson, K. (2012). Lived experiences of nursing students engaged in an international service learning project. Online Journal of Cultural Competence in Nursing and Healthcare, 2(3), 1-. World Health Organization (2014). Non-communicable diseases country profile