NUR 1130 Clinical Assignment case study

NUR 1130 Clinical Assignment case study

Kalliopi Parginos

Nursing/New York City Tech College

NUR1130

Activity Description: Provide a brief description of the activity

Interactive Case study on Type 1 Diabetes with short answers

Learning Goals: What do you aim to achieve with this activity?

Top 5 Ways Nurses Can Improve Critical Thinking Skills
Case based approach
Practice self-reflection
Developing a questioning mind
Practice self-awareness in the moment
Use a process

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

The Importance of Enhancing Critical Thinking Behavior
Independence of thought
Impartiality
Perspicacity into Personal and Social Factors
Humble Cerebration and Deferral Crisis

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

review the case study
answer the 4 questions
Choose the correct answer for two multiple choice questions

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

Grade the questions
Plan to include it future clinical sessions either on the pre or post conference with the students

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

6/6 students completed the questionnaire
The case study will be repeated on the fall semester 2024
Plan to incorporate it different interactive case studies
Students work as a team

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Rubric: Critical Thinking Value Rubric was utilized

Please share a helpful link to a pages or post on the OpenLab

NUR1130 Clinical Assignmemt

NUR1130 Clinical Assignmemt

Kalliopi Parginos

NURSING DEPARTMENT/City Tech

Living lab

Activity Description: Provide a brief description of the activity

Clinical assignment for students

Learning Goals: What do you aim to achieve with this activity?

Improve the understanding in Diabetes and the administration off different insulins

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

Close to the end of the semester

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

Study of Diabetes pathophysiology
Difference between Type 1 and Type 2
Administration of different insulins

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

Case study and Multiple choice questions

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

No challenges were identified

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

N/A

Please share a helpful link to a pages or post on the OpenLab

Promoting the SBAR Communication Tool with Nursing Students

Promoting the SBAR Communication Tool with Nursing Students

Konstantina Caris

New York City College of Technology/Nursing

NUR-1110/Caring for Clients with Common Alterations in Functional Needs

Activity Description: Provide a brief description of the activity

Knowing that patient handover is often poorly performed, with critical detail being omitted and irrelevant information included at patient handoff this activity stresses on implementing the use of the ISBAR tool with nursing students during clinicals. SBAR stands for situation (clearly and briefly describe the current patient’s situation), background (provide clear, relevant background information on the patient), assessment (state your professional conclusion, based on the situation and background), and recommendation (telling the person with whom you’re communicating what would you recommend correcting the problem).

This format ensures clinicians communicating significant information in continuity of patient care, preventing errors and harm in hospital settings or community settings. It provides a standardized approach to communication which is a core skill that needs to be taught to nursing students and junior clinicians. It highlights key elements and explores teaching techniques that aim to ensure the framework is rooted in practice effectively resulting in patient’s safety and better patient outcomes.

Learning Goals: What do you aim to achieve with this activity?

The goal of this activity is to develop the student’s critical thinking and communication skills during patient’s handover by following the SBAR format. The need to assess, understand, analyze, prioritize patient health issues, and recommend solutions, is imperative among clinicians in healthcare. Communicating accurate patient information from team to team is an essential component of good patient care, effective management of the patient’s condition, and teamwork. However, critical thinking skills does not happen overnight. Students need to practice this format constantly during clinical rotations to enhance critical thinking and communication skills and at the same time prevent patient errors.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This activity was implemented step by step during clinical rotations the entire semester. For two weeks we devoted 60 minutes learning and understanding the importance of the SBAR tool and how it works.

Next, for four clinical days students practiced the format taking into consideration the information they obtained while caring and assessing assigned patients. Their report emphasized on the patient’s main problem, on communicating appropriate patient’s history, the right examination/observation, and creating a clear recommendation.

At midsemester, while each student gave report, the other students listen and observed. At post conference they had the opportunity to critique the report by asking questions, make suggestions, and reflect if the sequence of the SBAR format was followed. For example: “If the student highlighted key elements of effective clinical information”, “Did they give excess information or too little”, “How did they feel being the presenter as opposed to observer”, or “What they would have done differently and why”. This activity took between 30-45 minutes.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

This is an ongoing interactive high stakes assignment where the instructor assigned a patient to the student to assess and care the entire clinical day. During this time the student must think critically when deciding what patient information should be communicated to other healthcare professionals according to their assessment, knowledge, analysis, problem solving, and reflection. Practicing the ISBAR format during nursing clinicals increases their capacity to share key information, be mindful of their role as well as their team members, enhance their confidence on patient assessments, and implement optimal patient interventions.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

High stakes assignment=level of engagement.
Students who observed as well as the instructor had to complete a four-point scale ranging “Not performed the SBAR format competently”, to “Able to perform format under minimal direction”. Student’s performance focused on “What is going on with the patient”, “ What was the patient’s clinical background or context”, “If appropriate assessment/observation was done”, and “ What would they recommend to correct the problem”.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

A continuous effort to stress the importance to communicate key elements of effective clinical handover emphasized during clinicals with nursing students. By following the use of the SBAR format during clinical, prepares them not only for the clinical demands of the job, but also focuses on their critical thinking and communication skills that are so important for improving patient outcomes and recognizing a decline in a patient’s condition. At the same time instructors can explore teaching techniques that aim to ensure the framework is embedded in practice effectively.

Involving students to learn a structured way to communicate relevant patient information to other healthcare professionals was challenging due to overwhelming nursing material they had to cover during their semester. However, at the end of their clinicals they expressed that the SBAR format helped them organize patient information in a structured way saving time. Prioritizing on what information should they handover was also challenging because they had to focus on what is going on currently and taking into consideration patient’s general health status.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

SBAR

Situation-Background-Assessment-Recommendation

Example

Mr. Barnes is a 72 y/o admitted to the oncology unit yesterday for his 5th cycle of in-patient chemotherapy for gastric cancer. He has a fever of 102.5 F. He’s receiving a continuous 48-hour infusion of Oxaliplatin and 5-FU. other than the fever, his vital signs are all normal: BP 124/64, HR 62, RR16, O2 98%. He has no complaint of pain or discomfort, NKA. As the primary nurse you’re concerned about the fever and neutropenia. You would like and order for Tylenol, blood cultures, and a CBC.

Organized structured format for SBAR

Situation-Background-Assessment-Recommendation

S=This is Jane Doe, the primary nurse for Mr. Barnes, on the medical oncology unit. He is febrile, 102.5 F.

B- He was admitted yesterday for his 5th cycle of in-patient chemotherapy for gastric cancer. He’s receiving a continuous 48 hors infusion of Oxaliplatin and 5-FU. He has no known allergies.

A-Other than the fever, his vital signs are all normal: BP 124/64, HR 62, RR 16,02 98%. He has no complaint of pain or discomfort.

R- I am concerned about the fever and neutropenia, I recommend an order for Tylenol, blood cultures, and a CBC. Is there anything ales you would recommend at this time?

Please share a helpful link to a pages or post on the OpenLab

Critical thinking

Critical thinking

Wenhsing Yang

City Tech

NUR 2110

Activity Description: Provide a brief description of the activity

Critical thinking through writing assignments-understand the patient care with their needs

Learning Goals: What do you aim to achieve with this activity?

familiar with priority, delegation, quality of care

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

I used half hours in class and lab for students to think about patient care and how to intervene with their needs.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

students need to be familiar with the disease process and its influence to patients quality of life.
some are low-stakes, some are high-stakes, because it was being use in the simulation

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I use Gen. rubric.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

i will repeat it but I will use different scenarios because every patients is different

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

Case studies -in class assignment

Case studies -in class assignment

Wenhsing Yang

Nursing

Medical-Surgical Nursing

Activity Description: Provide a brief description of the activity

You will be assigned to a group (4 to 5 students) and discuss this case study with a Google link. This activity will take 30 minutes. After that, you have 10 minutes to present your answer to the class. You will need to use textbooks and online resources to provide your answers and rationales. This presentation will take 10 minutes per group. Feedback is welcome.
The link is here https://docs.google.com/presentation/d/1ZXzJYcymsyznni6tVvNWhUbW8V1EsekWJWQhF9rdraM/edit?usp=sharing

Learning Goals: What do you aim to achieve with this activity?

The goals of this assignment are based on ACEN requirement (critical thinking) as follows:
The goal is to avoid having your decision cause injury to anyone
With critical thinking skills, you can weigh many factors and skillfully solve problems, making good decisions a majority of the time
Operating in a critical thinking model while pursuing nursing studies helps develop the clinical judgment needed to practice safe nursing
Nursing uses a knowledge base to make decisions, generate new ideas, and solve problems

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This assignment will be used at the end of the cancer chapter (week five).
This activity will take 30 minutes. After that, you will present your answer to the class.
You have ten minutes to present your answers to the class.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

I will need to create a scenario and questions for students to complete the assignment. You have 30 minutes to complete the assignment and present it to the class.
This is a group assignment; you will be assigned to a group to discuss your answer. Please note, you will need to provide evidence-based on your answer. Please feel free to use online resources and textbooks.
This is a low-stakes assignment because it does not cause danger to people. Instead, the students will have the opportunity to share the answers with the class and ask for feedback

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I use the Value rubric -critical thinking. This is part of a college-wide general education assessment.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Yes, I will repeat this activity with different classes. Different case studies will be provided based on the course objective and outcome.
Only a few students discuss in the class, so I will need to facilitate the activity and ask other students for their input.
I will give each group different case studies, so the students will have different understanding of each disease and their nursing interventions.
Students like to hear from other groups with their answers and rationales. Because each group has different answers based on their priority and information. Additionally, students will be able to work with other students. In nursing, teamwork is necessary.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

N/A

Please share a helpful link to a pages or post on the OpenLab

Critical thinking

Critical thinking

Wenhsing Yang (Annie)

Nursing

Nur 2110

Activity Description: Provide a brief description of the activity

You will be assigned to a group (4 to 5 students) and discuss this case study. This activity will take 30 minutes. After that, you have ten minutes to present your answer to the class. You will need to use textbooks and online resources to provide your answers and rationales. Feedback is welcome.

Learning Goals: What do you aim to achieve with this activity?

The goal of this assignment is based on ACEN requirement (critical thinking) as follow:
1.Goal is to avoid having your decision cause injury to anyone
2.With critical thinking skills, you can weight many factors and skillfully solve problems, making good decisions a majority of the time
3.Operating in critical thinking model while pursuing nursing studies helps develop clinical judgement needed to practice safe nursing
4.Nursing use a knowledge base to make decision, generate new ideas, and solve problems.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This assignment will be used at the end of the cancer chapter (week five).
This activity will take 30 minutes. After that, you will present your answer to the class.
This presentation will take 10 minutes per group.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

I will need to create a scenario and questions for students to complete the assignment. You have 30 minutes to complete the assignment and present it to the class.
This is a group assignment; you will be assigned to a group to discuss your answer. Please note, you will need to provide evidence-based on your answer. Please feel free to use online resources and textbooks.
This is a low-stakes assignment because it does not cause danger to people. Instead, students have the opportunity to share the answers with the class and ask for feedback.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I use the Value rubric -critical thinking. This is part of a college-wide general education assessment.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Yes, I will repeat this activity with different classes. Different case studies will be provided based on the course objective and outcome.
Only a few students discuss in the class, so I will need to facilitate the activity and ask other students for their input.
I will give each group different case studies, so the students will have different understanding of each disease and their nursing interventions.
Students like to hear from other groups with their answers and rationales. Because each group has different answers based on their priority and information. Additionally, students will be able to work with other students. In nursing, teamwork is necessary.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

N/A

Please share a helpful link to a pages or post on the OpenLab

A Mock Cultural interaction between a Hmong immigrant family and American Doctor

A Mock Cultural interaction between a Hmong immigrant family and American Doctor

Lisa Pope Fischer

Social Science

ANTH 2000: Medical Anthropology

Activity Description: Provide a brief description of the activity

This is a teaching exercise, or module, that will lead up to a mock interaction between a Hmong patient and American doctor. Essential to Anthropology is the ability to be sensitive to cultural differences. In terms of understandings of illness, one culture may have a different interpretation of, and different treatment for particular illnesses. I designed this exercise by drawing on issues and concerns presented in Ann Fadiman’s work with Hmong immigrants (1997, 2000). The objective of this module is to teach students skills of perception and interpretation. The module begins with reviewing some basic anthropological concepts and key terms. The duration of the exercise requires preliminary preparation such as assigning the readings to the students. The in class activity should allow time to discuss and review the material. This exercise would be suitable for smaller class sizes no larger than 40 but perhaps could be modified for a lecture demonstration or online learning if students handed in written descriptions.

Learning Goals: What do you aim to achieve with this activity?

The General Education Outcomes that the assignment aims to achieve are: Intercultural knowledge and Competence.
This lesson addresses: Cultural self-awareness, knowledge of cultural worldviews, empathy, shared forms of communication, curiosity, and openness .The objective of this module is to briefly outline the anthropological concepts of “cultural relativism,” “worldview” and “emic/etic” as tools for understanding that different cultures may interpret illness differently. This is important in terms of making diagnoses as well as treating patients in a culturally sensitive manner. Cultural relativism is an approach in anthropology that tries to maintain a neutral non-judgmental stance, showing both “empathy” for cultural differences, as well as “openness” to see cultures that are different from our own without bias. This exercise looks at beliefs regarding health and illness from Hmong culture teaching “openness” to other perceptions of health. A young girl is misdiagnosed due to cultural misinterpretation causing dire consequences, so the aim is that students can imagine their perspective, to learn “empathy.” “Worldview” is a concept central to anthropology, looking at how individuals perceive their world and their place in it, which can be different in different cultures. Emic and Etic are common concepts in anthropology that try to show differences in perception, “cultural self-awareness,” the emic being the perspective of the people we study, and etic being the outsider’s perspective, the perspective of the anthropologist who analyzes the culture. This assignment in particular looks at an example where communication between cultures lead to a horrible outcome for one little girl, and the aim is to try to understand and create “shared forms of communication” to avoid such a tragedy again. As a mock patient and doctor interaction, the students learn “curiosity” and “critical thinking” as, they articulate responses based on two different cultural worldviews related to health and healing showing ability to see things from multiple cultural perspectives. In terms of High Impact Educational Practices (HIEP), this exercise uses collaborative learning. Diversity and global learning, and community based learning. It will become part of my Open Lab site for ANTH 2000: Medical Anthropology, and Blackboard.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

The in class activity should allow time to present the concepts and themes, and have students perform the mock patient and healthcare practitioner scenario, followed by discussion of the issues raised in the reading and presentation. One standard hour –fifteen-minute class period would suffice but allowing a class period to view the film might expand the topic. This exercise would be suitable for smaller class sizes no larger than 40 but perhaps could be modified for a lecture demonstration if students handed in written responses to the discussion questions.

Film Suggestion:
“Split Horn: Journey of a Hmong Shaman” (2001, 56 minutes)

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

The module begins with reviewing some basic anthropological concepts and key terms. The Fadiman book The Spirit Catches You, wonderfully exemplifies issues of cultural difference and perceptions of illness, but she also has a short article that focuses on epilepsy that can also be used to illustrate cultural difference. A full-length film documents the story of a Hmong shaman, (Split Horn), but you can also use short video clips to illustrate the point of cultural difference. The duration of the exercise requires preliminary preparation such as assigning the readings to the students and handouts for the mock patient/healthcare practitioner interaction.

Fadiman, Ann. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus, & Giroux, 1997.

Fadiman, Ann. "The Spirit Catches You and You Fall Down": Epilepsy and the Hmong. Epilepsy & Behavior: E&B [Epilepsy Behav] 2000 Feb; Vol. 1 (1), pp. S3-S8.

Activity: Cultural Perceptions
I.Review the Anthropological concepts either using PowerPoint or in handouts. This exercise gets students to think about how we might be quick to judge other cultures (ethnocentrism), yet also understand how others might perceive us.

KEY TERMS/ CONCEPTS:
Cultural Relativism: Anthropologists attempt to be neutral non-judgmental observers that take into account the culture’s practices relative to their own cultural understandings.

Ethnocentrism: People might judge a culture’s practices in a negative manner simply because they might be different from their own. Anthropologists try not to be “ethnocentric” or “Western centric” as it is important to understand why a culture might perceive or do something rather than judge it in a prejudice manner.

Emic/Etic: Anthropologists use the concept “emic” to explain the perspective of the people one studies. How do the people perceive their culture? How do they interpret the world in which they live? In contrast, the anthropologist must also retain the “etic” perspective, the view of the scientific observer. The etic perspective allows the anthropologist to step back and analyze the culture using the various theories in which to interpret a culture’s practices (i.e. Cultural Marxism/social conflict theory, Functionalism, Practice theory, Reflexive Anthropology/writing culture, etc.)

Worldview: Refers to how a person views their world and their place within it. Whereas some people may define themselves and behave according to a religious worldview, an atheist can also have a worldview. Different cultures may have different types of worldviews that affect perceptions of time and space, feelings about moral behavior, how they think about and how they seem themselves within their society.

Culture Bound illnesses: These are illness that might be found within particular societies.

Mind/Body dualism: Western medicine tends to separate understandings of how illness in the body might be separated from the mind whereas many cultures see the two as closely related.

II. Give illustrative examples to spur discussion about ethnocentrism and cultural relativism. Encourage students to look at cultures in a culturally relative way by reminding them that people outside our own culture may view American practices as unusual as well.

1. Female brutality or beauty? Female circumcision is a practice in which elders cut off a young woman’s clitoris to prepare her for womanhood. Some refer to this as Female Genital Mutilation (FGM). This practice evokes much debate about brutality and mutilation of women, yet studies indicate that women from these societies may perceive this practice as a means to obtain purity and femininity (Gruenbaum 2006). Ask students in what ways do American women brutalize their bodies in the pursuit of femininity or beauty? To shock them you might show an image of the Cat lady who has had too many plastic surgeries, or a hyper thin anorexic looking fashion model. (See suggested short video clips from youtube below – following the bibliography)

2.Food delicacy or garbage? Students often cringe when they hear that in some cultures grub worms or monkey brains might be considered a delicacy, however, there are foods that Americans eat that other cultures might find repulsive. How, for example are grub worms similar to shrimp? For people outside the United States, peanut butter might look like mud or feces. People might perceive fine cheese as smelly rotten dairy. In the south, or even at the Coney Island Nathans, one can buy fried frog legs. Americans often perceive French food as elite fine food, yet they make “escargot” from common snails, and they perceive horsemeat as a healthy specialty.

III. Discuss how the above examples illustrate an understanding of “ethnocentrism,” but also connect to the idea of “emic” and “etic” as a matter of different cultural perceptions. Expand their understanding of emic /etic by connecting to an example of interpretations of cultural illness.

In Freed’s (1999) work, “Taraka’s Ghost”, a young bride in a strange new village experiences spirit possession, but is this a form of anxiety attack or depression? Would anti-depressants work if she truly believed she needed a shaman to remove the spirit? Several anthropologists have looked at the culture bound illness “Susto” prevalent among Mexican and other Hispanic communities in which they believe a person who has a sudden fright or trauma may develop loss of energy, loss of appetite, sleeplessness, and depression. Whereas from a Western medical perspective “susto” might be explained as a psychosocial illness in which the person becomes antisocial and uses the excuse of illness to withdraw, “susto” also has underlying physical symptoms that may be covering up serious illnesses such as diabetes (Poss & Jezewszi 2002) or tuberculosis (Rubel and Moore 2001), or hypoglycemia (Bolton 1981).

IV. Instigate discussion of the suggested Fadimon reading with a mock patient and doctor interaction exercise. You can have student volunteers improvise a discussion between an ill person and a healthcare practitioner or have the students all do the exercise in pairs. The exercise creates a scenario between a Hmong immigrant family with a sick daughter and a Western medical practitioner. Discussion should follow the exercise.

HANDOUT FOR STUDENTS:
Each student will improvise or act out a “scene” that depicts a Hmong patient with a healthcare practitioner. We will discuss the reading in light of themes that result from this mock patient/doctor exercise.

PERSON ONE: You are a Hmong immigrant whose baby daughter is sick. Based on what you read in Fadiman’s article or book, how might a Hmong patient describe and present their illness.

Consider the following:
The immigrants understanding of the illness or self-diagnosis: The spirit catches you and you fall down. Her older sister slammed the door so loudly that her spirit was scared out of her and she fell down. Illness may have many causes but can be due to a loss of the soul to a malevolent spirit. It might be a sign that she will grow up to be a high status Shaman who can go into a trance and see the spirits and in this regard this illness (epilepsy) is highly distinguished and should not be cured as it may lead to prestige later in life.

Cultural perception of illness and health:
• Will not take pills if the colors are inauspicious.
• Will refuse surgery, anesthesia, autopsies, blood tests, and spinal taps.
•May wear a white “spirit string” on wrist that can’t be cut off while they are ill as their soul might endlessly wander.
• Hmong traditional medicine may include herbs, amulets, and animal sacrifices.

PERSON TWO: you are a health care professional and you are trying to understand or interpret what the person is saying to develop a diagnosis. Based on what you read in Fadiman’s article or book, how might a Western Doctor describe and interpret the illness.

Consider the following:
Western Medicines cultural understanding of illness:
• Customs and traditions – desensitized empathy.
• Cultural taboos- perception that only Western medicine can cure and to look at “alternative” practices would be inappropriate. There may be legal rules or “taboos” in treating patients, especially children.
• Hierarchies—tend to be “rational” and controlling.
•Have their own language that an ordinary patient might not understand.

What type of questions does a typical healthcare practitioner ask?
• What is your name, your date of birth
• What brought you in today? What is your illness?
• What kind of symptoms are you experiencing?
• What is your medical history? Do you have prior ailments, surgeries, and/or allergies?
• What medications do you take?
• Is there a family history of illness? Does heart disease or diabetes run in your family?
• Can your occupation play a role in your illness?
•Review of systems: do you have headaches, vision troubles, trouble swallowing, nausea, etc.

How might a Western doctor interpret the Hmong explanation about a malevolent spirit causing the illness?
Symptoms /diagnosis from Doctor’s perspective: At first the doctors did not understand the parents and thought Lia had bronchitis or pneumonia and prescribed antibiotics. After the third time taking Lia to the hospital they saw she was suffering from a sudden attack of seizures or convulsions.

DISCUSSION QUESTIONS AFTER MOCK PATIENT/DOCTOR INTERACTION:

1. How might differences in language affect diagnosis and treatment? Why is it important to have access to skilled interpreters? What might be the challenges of having an interpreter?

2. How might cultural differences affect diagnosis and treatment? How might it be helpful to practice both allopathic and folk medicine? What are the challenges?

3. How did the patient interpret the doctor? What did they think about the doctor and his/her treatment of them?

4. How did the doctor interpret the patient? What did the doctor think about the patient? (I.e. “noncompliance” – patient’s refusal to disregard instructions)

5. What is the “culture of medicine”? How do Western doctors perceive health, illness, diagnosis and treatment?

6. How is Western medicine linked to legal practices (i.e. Child protective services/child endangerment, Brain dead = death) and how might this conflict with the patient’s perspective?

7. Why is the patient’s view of their illness important even if it is culturally different from the Western Medical perspective?

8. How might there be inequality between doctor and patient? How might a patient’s perception of doctor’s as authority figures impact their interaction with the doctor?

9. Why is it important, as Fadiman suggests, for health care practitioners to “develop certain habits of listening, empathy, and flexibility” (2000: 6).

10. Why does Fadiman suggest doctors to ask : What do you think caused this illness? What do you call this illness? What are you most afraid of?

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

Assessment for Intercultural Knowledge and Competence:
Student Learning Outcomes (SLO): Cultural Self Awareness, Cultural Worldview, Empathy, Verbal and Non-verbal communication, Curiosity/critical thinking, Openness.

(SLO) Knowledge: Cultural Self Awareness.
Intercultural Experience.
“The experience of an interaction with an individual or groups of people whose culture is different from your own. Intercultural/cultural differences: The differences in rules, behaviors, communication and biases, based on cultural values that are different from one's own culture(AAC&U).”

Assessment of Cultural Self Awareness:
Emic and Etic are common concepts in anthropology that try to show differences in perception, “cultural self-awareness,” the emic being the perspective of the people we study, and etic being the outsider’s perspective, the perspective of the anthropologist who analyzes the culture. The exercise tries to get students to understand Hmong cultural beliefs from their perspective (emic) but also be able to analyze and interpret them from an etic perspective (The anthropologist or doctor)

(SLO) Knowledge: Knowledge of cultural worldview frameworks.
“Worldview is the cognitive and affective lens through which people construe their experiences and make sense of the world around them(AAC&U).”

Assessment of cultural worldview frameworks.
“Worldview” is a concept central to anthropology, looking at how individuals perceive their world and their place in it, which can be different in different cultures. This exercise looks at the worldview from American culture in contrast to Hmong culture.

(SLO) Skills: Empathy.
"Empathy is the imaginary participation in another person’s experience, including emotional and intellectual dimensions, by imagining his or her perspective (not by assuming the person’s position). (Bennett 1998)"

Assessment of Empathy.
Cultural relativism is an approach in anthropology that tries to maintain a neutral non-judgmental stance, showing “empathy” for cultural differences. This exercises looks at beliefs regarding health and illness from Hmong culture. A young girl is misdiagnosed due to cultural misinterpretation causing dire consequences, so the aim is that students can imagine their perspective.

(SLO) Skills: Verbal and nonverbal communication.
Articulates cultural understanding of verbal & nonverbal forms of communication and show ability to create shared understandings.

Assessment of Verbal and nonverbal communication.
This assignment in particular looks at an example where communication between cultures lead to a horrible outcome for one little girl, and the aim is to try to understand and create “shared forms of communication” to avoid such a tragedy again.

(SLO) Attitudes: Curiosity/critical thinking.
Able to question and articulate responses showing ability to see things from multiple cultural perspectives.

Assessment of Curiosity/critical thinking
As a mock patient and doctor interaction, the students learn “curiosity” and “critical thinking” as, they articulate responses based on two different cultural worldviews related to health and healing showing ability to see things from multiple cultural perspectives.

(SLO) Attitudes: Openness.
Suspends Judgment in valuing their interaction with culturally different others.
“Postpones assessment or evaluation (positive or negative) of interactions with people culturally different from one self. Disconnecting from the process of automatic judgment and taking time to reflect on possibly multiple meanings” (AAC&U).”.

Assessment of Openness.
Cultural relativism is an approach in anthropology that tries to maintain a neutral non-judgmental stance, showing “openness” to see cultures that are different from our own without bias. This exercises looks at beliefs regarding health and illness from Hmong culture.

Association of American Colleges and Universities. "Intercultural Knowledge and Competence VALUE Rubric." 2009. https://www.aacu.org/value/rubrics/intercultural-knowledge.

Bennett, J. 1998. Transition shock: Putting culture shock in perspective. In Basic concepts of intercultural communication, ed. M. Bennett, 215-224. Yarmouth, ME: Intercultural Press.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

I have not been able to run the ANTH 2000 “Medical Anthropology” class yet for lack of enrollment, but I hope to try to offer it in the Spring 2021. I am not sure how I could adapt this lesson for online learning if that should continue, but perhaps have students write response papers.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Materials needed
1) Anthropology key terms
2) Readings:
Book: Fadiman, Ann. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus, & Giroux, 1997.
OR
Article: Fadiman, Ann. "The Spirit Catches You and You Fall Down": Epilepsy and the Hmong. Epilepsy & Behavior: E&B [Epilepsy Behav] 2000 Feb; Vol. 1 (1), pp. S3-S8.
(Available thru City Tech library article database EBSCO)
3) Xerox of mock patient/healthcare practitioner scenario (https://openlab.citytech.cuny.edu/popefischeranth2000medicalanthro/files/2020/06/Intercultural-Knowledge-and-Competence-for-ANTH-2000-Medical-Anthro-.pdf)
4) Optional: Video “Split Horn: Journey of a Hmong Shaman”. Or you might show a short video clip from youtube that shows a Hmong Shaman doing a ritual cure (See suggestions below after bibliography of references and suggested reading).

Other Resources
Possible links:
•Pdf course notes
•Powerpoint slides
•List of online resources
• Google images are a good way to find pictures AND Youtube.com has a number of short video clips.

REFERENCES AND SUGGESTED READING:
Arntfield, Shannon L., Kristen Slesar, Jennifer Dickson, Rita Charon “Narrative medicine as a means of training medical students toward residency competencies” Patient Education and Counseling. Volume 91, Issue 3, June 2013, Pages 280–286

Bolton, Ralph (1981) “Susto, Hostility, and Hypoglycemia” Ethnology , Vol. 20, No. 4 (Oct., 1981), pp. 261-276.

Fadiman, Ann. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus, & Giroux, 1997.

Fadiman, Ann. "The Spirit Catches You and You Fall Down": Epilepsy and the Hmong. Epilepsy & Behavior: E&B [Epilepsy Behav] 2000 Feb; Vol. 1 (1), pp. S3-S8.

Freed, Stanley A. and Ruth Freed (1999) “Taraka’s Ghost,” Natural History, October 1999, pp. 84-91.

Gruenbaum, Ellen. “Sexuality Issues In the Movement to Abolish Female Genital Cutting in Sudan.” Medical Anthropology Quarterly, Vol. 20, Number 1, (2006) pp. 121-138

Hahn, Robert A. and Marcia Inhorn (eds.) (2010) Anthropology and Public Health, Second Edition: Bridging Differences in Culture and Society.Oxford University Press.

Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med 1978;88:251–8

Oubre, Alondra. Shamanic trance and the placebo effect: The case for a study in psychobiological anthropology. PSI Research, Vol 5(1-2), Mar-Jun, 1986. pp. 116-144.

Poss, Jane and Mary Ann Jezewski (2002) “The Role and Meaning of Susto in Mexican Americans' Explanatory Model of Type 2 Diabetes” Medical Anthropology Quarterly , New Series, Vol. 16, No. 3 (Sep., 2002), pp. 360-377

Rubel, Arthur J. and Carmella C. Moore (2001)”The Contribution of Medical Anthropology to a Comparative Study of Culture: Susto and Tuberculosis” Medical Anthropology Quarterly, New Series, Vol. 15, No. 4, Special Issue: The Contributions of Medical Anthropology to Anthropology and Beyond (Dec., 2001), pp. 440-454

Thompson, Jennifer Jo Ritenbaugh, Cheryl Nichter, Mark. Reconsidering the placebo response from a broad anthropological perspective. Culture, Medicine and Psychiatry, Vol 33(1), Mar, 2009. pp. 112-152.

Suggested photograph images or videolinks:
Film Suggestion:
Split Horn: Journey of a Hmong Shaman

The spiritual healing of Hmong Shamanism (7:28)
https://www.youtube.com/watch?v=ymJnUHxqRpE

ASA Documentary: Second Generation Hmong Shaman (33:39)
https://www.youtube.com/watch?v=OrSZBsGn-4M

Anorexic Models: The curse of fashion modeling (2:47)
https://www.youtube.com/watch?v=ZK-Lhy-HqCs

Extreme Plastic Surgery (8:42)
https://www.youtube.com/watch?v=9R149OXxsGg

The link on Open lab includes the handout I would give students:

Click to access Intercultural-Knowledge-and-Competence-for-ANTH-2000-Medical-Anthro-.pdf

Please share a helpful link to a pages or post on the OpenLab

Click to access Intercultural-Knowledge-and-Competence-for-ANTH-2000-Medical-Anthro-.pdf

A Peek on the Inside: Place Based Learning at Body World Exhibit

A Peek on the Inside: Place Based Learning at Body World Exhibit

Linda Bradley

Nursing/School of Professional Studies

Phyiscal Assessment NUR 3010

Activity Description: Provide a brief description of the activity

The Bodies exhibit provides a fun and engaging way to provide the students with the ability to take abstract concepts and make them into a tangible reality. This will impact their practice and thus the thousands of people they will come in to contact for their lifetime as a nurse. There is no grade for this I would consider this low stakes.

Learning Goals: What do you aim to achieve with this activity?

Physical Assessment course includes review of anatomy and physiology, description of alterations in a system and assessment techniques which the student practice. As with most courses it does so in sections, thus providing the students with this learning experience it will:
1. analyze the connections between the organ locations and physical assessment techniques
2. understand the body’s normal and abnormal function
3. appreciate stress and lifestyle impact on the body

General Education SLOs:
Which of City Tech’s General Education Student Learning Outcomes does this activity address? Please be as precise as possible.

Information Literacy is the Learning outcome that this activity addresses: The ability to know when there is a need for information, to be able to identify, locate, evaluate, and effectively and responsibly use and share that information for the problem at hand.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

1. On first day of class during introduction of the course, devote time to introduce the students to the planned experience

2. Schedule the experience toward the end of 2/3rd of the course

3. Offer the course during one of the online course days or if your department allows students to participate in learning as part of their course offsite on their own then schedule it based on your departments abilities

4. State length of experience expectations which is approximately 2 hours at the exhibit

5. Provide pre and post experience assignment documents for student’s completion

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

1. Discuss and gain consensus for this experience with fellow course faculty and Chair of your department. Decide how you will fund this experience, if this would enhance a portion of your course or would replace an assignment, low stakes or high stakes, grade or not, the class schedule and best possible time that would allow this experience to occur. This then would require that you consider this experience well in advance of the beginning of the semester to receive the maximum amount of participation.
2. Contact the Body World Exhibit group number and discuss date, time, number of students and faculty and other pertinent instructions. Ask for a Group sales account representative 866.987.9692 info@tsxnyc.com 226 W. 44th Street New York, NY 10036
3. Once you have completed your initial discussions and have gained consensus in all areas required for the success of this endeavor next steps would be to provide the students with an overview of the experience, expectations, pre-experience assignment, in class discussion and post experience assignment. Generate a list of students and faculty who will attend. Provide everyone with the required Travel Waiver. (If your students are under 18 there is specific instructions on the document)
4. Obtain final list of all attendees and all must complete Travel Waiver and submit to Evening office more than two weeks before the trip.
5. Complete and send travel waivers to of which your Chair and your Dean/Provost would sign for approval of the off campus trip
6. Faculty must have complete a current Title IX training and signed document which must be included in the forms send to the Evening office along with all of the travel waivers.
7. Meet the students at the site at the specified time (If your students are under 18 there is specific instructions on the document)
8. Enjoy the experience! But be sure to seek opportunities to turn the students attention to areas related to course content, SLOs and any other area you deem valuable
9. Provide the students with an expected due date for their assignment

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

Assessment of this place-based learning experience would be through:
1. I would provide the students with a question prompt within the course Open Lab site. Prior to this I would utilize the computer lab at the beginning of the course to provide Blackboard and Open Lab orientation
2. Students would then add their own question for consideration prior to the experience. I
3. Students would choose those most appropriate and post them.
4. We would then meet at the exhibit and then they would return to those questions and complete them. I would also provide them with an opportunity to provide a reflection of their experience.
5. I would use the Information Literacy Value rubric
6. This course would be a part of the college-wide general education assessment initiative.
.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?
I most definitely would repeat this experience. The challenge will be funding, scheduling and timing so that the majority of the students would be able to attend, obtaining signed travel forms in advance of the experience. The change I would make is to include more student input as noted in the assessment process indicated above.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Why is this change different?
*It will incorporate student’s decisions as to what will be the area of focus related to the planned experience
*Students will be provided with an opportunity to determine the scope of the questions and key concepts before the experience and use them post experience
*Systematically analyze their own and others assumptions and evaluate the relevance of contexts when they present their positions.

What inspired the change?
* Incorporation of importance of classroom climate—adding humor and fun into the classroom
*Teaching to the needs and learning styles of the students and not that of the faculty
* Need to make abstract scientific and clinical information into tangible transferable information

Please share a helpful link to a pages or post on the OpenLab