IU Indianapolis ScholarWorks :: Browsing by Author "Hoffmann-Longtin, Krista"

Browsing by Author "Hoffmann-Longtin, Krista"

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Active Learning on Center Stage: Theater as a Tool for Medical Education
(Association of American Medical Colleges, 2019-01-30) Hobson, Wendy L.; Hoffmann-Longtin, Krista; Loue, Sana; Love, Linda M.; Liu, Howard Y.; Power, Christine M.; Pollart, Susan M.; Obstetrics and Gynecology, School of Medicine
Introduction: Knowledge and skill development related to communication must incorporate both affective and behavioral components, which are often difficult to deliver in a learning activity. Using theater techniques and principles can provide medical educators with tools to teach communication concepts. Methods: This 75-minute faculty development workshop presents a variety of techniques from theater and adapts them for use in medical education. Using examples related to diversity and inclusion, this session addresses general educational and theater principles, role-play, sociodrama, applied improvisation, and practical aspects of involving theater partners. The session materials include a PowerPoint presentation with facilitator notes, interactive activities to demonstrate each modality, and an evaluation. The sessions can be extended to longer formats as needed. Results: Forty-five participants at Learn Serve Lead 2016: The AAMC Annual Meeting attended the 75-minute session. We emailed 32 participants 5 months after the conference, and eight responded. Participants reported that their confidence level in using theater techniques as a tool for medical education increased from low-to-medium confidence presession to high confidence postsession. All survey respondents who were actively teaching said they had made changes to their teaching based on the workshop. All commented that they appreciated the active learning in the session. Many indicated they would appreciate video or other follow-up resources. Discussion: Principles and techniques from theater are effective tools to convey difficult-to-teach concepts related to communication. This workshop presents tools to implement activities in teaching these difficult concepts.
Assessing Communication Effectiveness in Interprofessional Healthcare Teams
(2019-07) Binion, Kelsey Elizabeth; Brann, Maria; Goering, Elizabeth; Hoffmann-Longtin, Krista
Interprofessional education and practice is a collaborative approach in equipping health professional students with the skills to become effective team members to improve patient outcomes. This research study used a grounded theory approach to identify the communication characteristics and behaviors that influenced a team’s communication effectiveness. Two-hundred and twenty-two students participated in an interprofessional simulation at a Midwestern university. Ninety-two standardized patients assessed the students’ communication skills and their ability to collaborate as a team using a CARE Patient Feedback form, which served as data for the study. The study found four characteristics of effective interprofessional team experiences: aware of the patient’s situation, participate in the interaction equally, create a safe space, and nurture and strengthen a relationship. Students demonstrated an increase in communication effectiveness between encounter one and two; teams worked collaboratively rather than individually; students demonstrated five of the eight IPEC communication competencies; and negative and positive behaviors had a significant impact on patient outcomes. This study informs educators the need for repeated exposure of interprofessional practice experiences, such as simulation activities. These opportunities allow students to practice, learn, and refine their communication skills before entering their clinical practice.
The Attributes of Nurse Residency Programs Influencing the Newly Licensed Registered Nurse
(2020-12) Kiger, Christina Louise; Otte, Julie L.; DeMeester, Debbie; Draucker, Claire; Hoffmann-Longtin, Krista
New nurses report feeling unprepared, incompetent, and highly stressed, contributing to first-year turnover rates of 25% in some healthcare organizations. Turnover, combined with a preparation-practice gap, has alerted advocacy organizations and researchers to recommend the development of nurse residency programs. Nurse residency programs are a post-graduate training period where new nurses receive enhanced clinical education in the healthcare setting. While highly variable in structure and attributes, programs usually include educational sessions, clinical immersion, and role socialization opportunities. Evidence supports that new nurses participating in nurse residency programs experience positive outcomes, including increased confidence, competence, and decreased turnover rates. Despite this, only half of the hospitals nationwide have implemented a program with most designed around a single health system mission. This dissertation study aimed to identify the attributes of nurse residency programs influencing the newly licensed registered nurse. An integrative review of the literature and evolutionary concept analysis was completed to examine the state of the science of nurse residency programs. Findings revealed a lack of conceptual and theoretical design and variability among program structures, creating a gap in the literature about the attributes of programs that are most influencing new nurses. Based on the literature's noted gaps, a qualitative description study was conducted. Purposive sampling strategies were used to recruit nurses who recently completed varied program models across the United States. New nurses reported the attributes of programs and described how those positively and negatively influenced the transition to practice experience. The overarching themes revealed that new nurses need a cadre of highly supportive individuals across the clinical and educational continuum who espouse astute interpersonal and communication skills. New nurses desire engaging activities with intra and interprofessional team members for clinical skill application, knowledge advancement, and role socialization. New nurses need the structure of meetings at times and in a sequence conducive to learning; and for preceptorship experiences to be facilitated by trained preceptors, on a unit, and of a length that supports confidence for autonomous practice. Future research will include the development and testing of an evaluation tool based on the findings from this study.
Bridging the gap for future clinician‐educators
(Wiley, 2018-12) Dilly, Christen K.; Carlos, W. Graham; Hoffmann-Longtin, Krista; Buckley, John; Burgner, Anna; Medicine, School of Medicine
Background In contrast to the training required in the UK, opportunities for medical education training in the USA are limited. Resident‐as‐teacher programmes are typically insufficient to prepare trainees to be successful clinician‐educators, but few pursue formal education degrees. We sought to assess the need for, and feasibility of, a training pathway for subspecialty fellows in a large Department of Medicine that would prepare our trainees to become effective educators. Methods Quantitative and qualitative methods were used. Previous fellowship applicants and current programme directors were surveyed to determine the potential benefits of the programme. A pilot programme was conducted with fellows interested in education to determine the feasibility of the programme. Pilot participants were interviewed regarding the benefits that they gained from the pilot and the logistical challenges that they experienced. In contrast to the training required in the UK, opportunities for medical education training in the USA are limited Results Five highly ranked fellows would have scored our programmes higher if we offered this training pathway. Pilot participants and fellowship programme directors agreed that there is a compelling need for such a training pathway. A number of themes arose from the interviews that enabled us to build the framework for a strong programme. Discussion Our findings suggest that a clinician‐educator training pathway that draws from multiple subspecialties has the potential to improve recruitment, provide needed career counselling and skills development to trainees, and to build a community of educators that will benefit the institution. Important insights from pilot participant interviews will inform the programme design, in order to keep trainees engaged and overcome logistical challenges.
By chance or by design? How clerkship and course directors navigate academic medicine
(Office of the Vice Chancellor for Research, 2015-04-17) Hoffmann-Longtin, Krista
Academic medical centers (AMCs) are complex, bureaucratic organizations with multiple, interconnected missions and constituencies (Brater, 2010). What happens in the classroom affects the operating room and lab. As the responsibilities to treat patients, discover new medical knowledge, and train future physicians become more complex, it is critical to define and situate the pathways to and roles of medical education leaders within the system, so that institutions can fully benefit from their contributions. This study uses an organizational communication lens to develop a theoretical understanding of the relationship between faculty members who are clerkship and course directors (CDs) and AMCs in the U.S. Clinical faculty who become CDs often do so because they are gifted educators. They are responsible for developing faculty, as well as managing curriculum and assessment. These complex roles often lack clear position descriptions and expectations. Though CDs value education, they may face economic pressures to spend more time in clinical duties at the expense of their education responsibilities (Cooke et al., 2006). This can create conflicts in organizational identity and values, as well as an unclear path to tenure, promotion, and rewards (DeAngelis, 2004). This study uses in-depth interviews to explain how CDs manage the multiple (sometimes competing) values and priorities of their roles. Semi-structured interviews were conducted with eight CDs, from institutions of similar size and type, to investigate three interrelated concepts: how faculty become CDs; how they make sense of their roles and values in relationship to those of the institution; and how the structure of AMCs shapes the roles and values of CDs. A qualitative approach, as applied in this study, is useful to understand behavior in complex organizational contexts (Castillo-Page et al., 2012). Interview findings were aggregated into significant narratives and organized by theme, including: pathways to the role; a conflict in values; inconsistent funding; and structural challenges. A grounded theory was developed to explain the process by which CDs manage their complex roles. Findings from this study indicate that CDs are critical to the education mission and can be powerful in shaping the institution, though they face significant challenges. They can feel isolated, because each institution might only have a few individuals that serve these functions. Diverse responsibilities of CDs might also mean that their paths to promotion are unclear or tenuous. Further research is necessary to understand the process of socialization and impact of the reward structure for CDs. Clerkship and course directors do seem to value their sense of organizational identification within multiple contexts, including the medical school, discipline, and the hospital system. In the same vein, it would be helpful to have a better understanding of the connections among their multiple identifications. Additionally, exploring the identification of university faculty in multiple settings may serve to expose subtle differences for identification management used in different contexts for faculty with different roles. Results of the study can be used to shape policies and faculty development efforts for CDs, leading to a clearer sense of purpose and reward system. A deeper understanding of the experiences of CDs benefits both faculty and institutions. Faculty receive more role clarity and individual agency, and AMCs receive information on how to better meet the needs of this population, thus improving the efficacy of medical education.
The Conscientious Use of Images Illustrating Diversity in Medical Education Marketing
(Wolters Kluwer, 2020) Hernandez, Rachael; Hoffmann-Longtin, Krista; Patrick, Shawn; Tucker-Edmonds, Brownsyne; Livingston, Nikki; Communication Studies, School of Liberal Arts
An institution's marketing materials are an important part of presenting its culture. In 2018, communication professionals in the Office of Faculty Affairs, Professional Development, and Diversity at the Indiana University School of Medicine recognized after reviewing the literature that using images illustrating diversity in marketing materials may have unintended negative consequences and could potentially reflect poorly on the institution. Representations of diversity that are discordant with the actual demographics of an institution can create distrust among faculty, students, and staff who discover an institution is not as diverse or supportive of diversity as their marketing materials suggest. If institutions adopt an aspirational approach to images and depict more diversity than actual demographics reflect, the authors of this Perspective recommend that they both develop marketing materials that present a widely diverse selection of images and demonstrate transparency in their communication strategies.To improve their promotional materials, the authors conducted an analysis of their institution's strategy for selecting images for these materials, identified institutional goals related to the strategic use of images, created training materials for staff, and drafted a public-facing statement about diversity in images. These measures are a significant step forward in cultivating the ethical use of images illustrating diversity. In the future, institutions should highlight their approaches to using images to portray diversity, as well as photograph and document a wide range of events that represent diverse topics and individuals. When these images are used for marketing purposes, it is also important to ensure that they are used in an appropriate context and not selected with the single goal of presenting diversity. Future research should focus on how underrepresented students and faculty interpret the use of diverse images in marketing, as well as their preferences for the use of their own images in marketing materials portraying diversity.
Development of an empathy and clarity rating scale to measure the effect of medical improv on end-of-first-year OCSE performance: a pilot study
(Taylor & Francis Open, 2019-12) Terregino, Carol A.; Copeland, H. Liesel; Sarfaty, Suzanne C.; Lantz-Gefroh, Valeri; Hoffmann-Longtin, Krista; Medicine, School of Medicine
Patients want empathetic physicians who listen and understand. How do you teach and measure empathy? Medical educators, including those inspired by Alan Alda, have turned to theater to teach skills in empathetic communication. Improvisation-informedcurriculum (medical improv) draws upon foundational actors training: deep listening, emotional understanding, connections, authenticity. Arating scale to measure the impact of medical improv on empathetic and clear communication does not exist. Objective: To develop aframework and instrument, the Empathy and Clarity Rating Scale (ECRS), for measuring communication elements used by actors and physicians, and pilot ECRS to test effectiveness of medical improv on first-yearstudents' communication skills. Design: Four medical schools collaborated. USMLE Step 2 Communication and Interpersonal Skills (CIS) domains were used as framework for discussion among three focus groups, each with clinicians, actors, communication experts, and community members with patient experience. Audiotaped discussions were transcribed; open coding procedures located emerging themes. The initial coding scheme was compared with the Consultation and Relational Empathy (CARE) measure. ECRS content was aligned with CARE, CIS and focus group themes. Modified nominal processes were conducted to finalize the scale. We implemented procedures to establish content validity and interrater reliability. Final ECRS was used to study student performance across three levels of experience with medical improv. Results: The final ECRS was comprised of seven five-pointscale items. Narrative comments precede behaviorally anchored ratings: 5=desired, 1=ineffective, 2-4=developing based upon adjustment needed. Rater agreement across all items was 84%. There was asmall correlation between the ECRS and another measure interviewing (r=0.262, p=0.003). Students with advanced medical improv training outperformed those without (F=3.51, p=.042). Conclusion: Acommunication scale enlightened by experiences of actors, clinicians, scholars and patients has been developed. The ECRS has potential to detect the impact of medical improv on development of empathetic and clear communication.
Fostering Interdisciplinary Boundary Spanning in Health Communication: A Call for a Paradigm Shift
(Taylor & Francis, 2022) Hoffmann-Longtin, Krista; Kerr, Anna M.; Shaunfield, Sara; Koenig, Christopher J.; Bylund, Carma L.; Clayton, Margaret F.; Communication Studies, School of Liberal Arts
Scholarship in the field of health communication is broad, with interdisciplinary contributions from researchers trained in a variety of fields including communication, nursing, medicine, pharmacy, public health, and social work. In this paper, we explore the role of “health communication boundary spanners” (HCBS), individuals whose scholarly work and academic appointment reflect dual citizenship in both the communication discipline and the health professions or public health. Using a process of critical reflective inquiry, we elucidate opportunities and challenges associated with HCBS across the spectrum of health communication in order to provide guidance for individuals pursuing boundary spanning roles and those who supervise and mentor them. This dual citizen role suggests that HCBS have unique skills, identities, perspectives, and practices that contribute new ways of being and knowing that transcend traditional disciplinary boundaries. The health communication field is evolving in response to the need to address significant healthcare and policy problems. No one discipline has the ability to single-handedly fix our current healthcare systems. Narrative data from this study illustrate the importance of seeing HCBS work beyond simply being informed by disciplinary knowledge. Rather, we suggest that adapting ways of knowing and definitions of expertise is an integral part of the solution to solving persistent health problems.
Hearing Is Believing: Using Audio Feedback in the Online Interpersonal Communication Course
(CSCA, 2019) Hoffmann-Longtin, Krista; Communication Studies, School of Liberal Arts
The introduction to interpersonal communication course (IPC) is popular for both communication majors and nonmajors alike, and as such, many departments have designed online versions of the course. Teaching IPC in this format has challenges, given its dual emphasis on theoretical understanding and skill-building. This reflection essay explores the efficacy of providing audio feedback on essays in the online IPC course, as a way to create a positive online presence, manage the grading load, and encourage students to implement the feedback. The rationale for this approach to feedback and implementation strategies are provided, as well as a discussion of outcomes from the intervention. A review of course data and perceptions indicated gains in student application of course material and satisfaction with the audio feedback mechanism.
I'm Fine: Systemic Affect of Critical Incidents in Emergency Medical Service Personnel Communication
(2020-07) Deason, Aaron Sterling; Parrish-Sprowl, John; Goering, Elizabeth; Pike, Lynn; Hoffmann-Longtin, Krista
EMS personnel experience emotionally charged calls, such as CPR, trauma, or domestic violence. This study examined the changes on communication by these events. Communication Complex metaframework allowed use of other disciplines. There is a lack of scholarship surrounding EMS communication. Research from other military and other fields was translated into the EMS community. Mental illness is a growing concern in EMS as 37% contemplate suicide and 6% complete it. Part of understanding the affect is an exploration of how the culture of EMS (i.e. training, traditions, machismo) shapes the way new EMS are acculturated. EMS have repeated exposure to trauma over a career. These exposures change communication patterns. Using a three-chapter autoethnography, I was able to examine my communication and mental status changes from rookie until retiring 14 years later with PTSD and constant suicidal ideation. Ethnographic interviews of veteran EMS provided insight into the old school ideology of emotional repression and shelving. I analyzed using the NREMT Patient Assessment skill sheet as a guide in a three-step process to discover and reassess themes. The primary survey indicated common job-related stressors- pedi calls and staffing problems. The secondary survey revealed themes of emotions, senses, and support. Finally, the reassessment revealed subtle changes in EMS culture, including decreased PTSD stigma, increased resiliency training, and increased administrative support. Future research could examine the effect of spousal support and changes in cultural emotional suppression. The goal is to develop programs to help allies understand the emotionality in EMS and create dedicated support structures to increase EMS mental health.

Browsing by Author "Hoffmann-Longtin, Krista"

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