PRACTICUM MATTERS The UIC SPH Public Health Practice Newsletter – Spring 2015 Appreciating the Big Picture of Public Health Practicum experiences come in all different shapes and sizes. They can encompass literature reviews, data analysis, job shadowing, and a whole host of other tasks that make for a successful practice-based experience to round out the public health degree here at UIC. Some of the tasks can be completely new for the student, while others may start to feel repetitive or mundane. Epidemiology student Michael Ray reminds us of the importance of the practicum experience—not just on a professional level, but to the ongoing saga of public health in general. When viewed this way, no practicum objective can be considered trivial. “What drew me to my practicum site was a name: the Collaborative Research Unit of Cook County (CRU). I am a person with many academic and career interests, so I often find it difficult to narrow down my goals in any discernable way. This is why the notion of “collaborative research” was so appealing. Essentially, researchers from a variety of disciplines spanning public health, medicine, and information technology have teamed up in order to process and disseminate public health information in a useful and meaningful way. I was eager to meet with the CRU’s director, Dr. William Trick, to see if there was a potential practicum opportunity within the organization. Dr. Trick took the time to sit down with me and discuss all of the projects that were underway, and we were able to identify one that best fit my interests and skills. The CRU recently launched the XDRO Registry, where healthcare facilities around the state report occurrences of extremely drug-resistant organisms (XDROs), which are unfortunately cropping up all over in health care settings. These organisms present a major public health problem and building this registry is a step toward a public health solution. “For my practicum, I was presented with the task of using modern software to make sense of the XDRO Registry information as I received it. My learning objectives consisted of learning this new software, namely Arc-GIS and SaTScan, and then presenting my findings to both the CRU and the Illinois Department of Public Health (which also had a hand in developing the XDRO Registry). I used Arc-GIS to map out all of the healthcare facilities in the state and SaTScan, which is software that detects spatial and temporal clustering from case information, to determine where these organisms are cropping up the most. Our end goal was to create an automated flagging system so we can detect XDRO clusters earlier. Michael Ray (r.) reviews data with his preceptor, Dr. William Trick “My practicum was not without its frustrations. Often times you get so wrapped up in your work that it is easy to forget how it is contributing to public health. I sometimes felt as if I was staring at a computer screen all day to no end. However, when Dr. Trick came to check my progress, he was so full of enthusiasm that I was reminded to take a step back and look at the bigger picture. This was really important work that, to our knowledge, had not been done before. This could have major public health implications, which of course is why I am studying public health in the first place. “As I look back at the laundry list of skills I have acquired in the past year I am amazed. I have learned many things from my practicum (cont’d on next page) 2 experience that will translate into my career, and for that I am grateful. I have worked with software and analytic methods that I never thought I would learn. I also learned to self-motivate and to always say “yes” when asked if I want to take a crack at learning yet another computer program. It was a great summer practicum experience and I cannot wait to see how the skills I have learned influence my career.” What have you learned about public health that isn’t a part of your learning objectives? I learned how to work productively with other people to develop successful partnerships and solutions. To understand the organizational, political, economic, and social contexts that can promote or constrain public policy interventions. What have you learned about the internal workings of your agency? Balancing Individuality and Teamwork at Stroeger Hospital Sonia Guleria, an Epidemiology student, had the opportunity to carry out her practicum experience with the Division of Family Planning at Stroeger Hospital. Over the course of the experience, she had the chance to work in a supportive environment that will serve as a springboard to her professional career in public health. The following question-and-answer section gave Sonia a chance to reflect on the key learning objectives that she cultivated over the course of her practicum. The agency works as a team and although a hierarchy exists, the lines of demarcation are not very rigid. They believe in being constructive in your career advancement and individuality. What were the objectives of your practicum? After completion of the core courses in epidemiology, I felt the need to apply specific public health skills, knowledge, and experience to the real world. Having worked in clinical settings in the past with an inclination toward women’s health, the Family Planning department at Stroeger Hospital seemed the right place to fulfill my objectives and enhance my skills. In the broader sense my objective was to learn how clinical reproductive health intersects with public health and epidemiology. I was keen to learn how to build a strong foundation for a research topic by conducting adequate literature review, implementing suitable study design, learning data collection techniques, and applying different data analytical approaches in a research study. Did you make progress toward these objectives? Yes, my project deals with finding rates and factors of adherence to a vaccination schedule. This is a small project with a sample size of about 300 subjects. Hence, in spite of time constraints, I could work on the project from start to finish and move it through various stages, from conception to the final written presentation while completing the purpose of a practicum. Sonia Guleria (far left) poses with Preceptor Dr. Aslesha Patel and UIC SPH alumna Lindsay Zimmerman What was the favorite part of your practicum? I have always enjoyed meeting people and hearing their views. The agency conducts one research meeting every week, which is attended by the Principal Investigator and her team, including students or volunteers working on various projects and the medical faculty. During these meetings we discuss the progress of the projects already on the floor and any suggestions for new topics. I think this was a melting pot where recommendations flowed in from all directions, resulting in the amalgamation of experience/evidence-based and descriptive/analytical-based knowledge. What were the challenges? I thought the plan to carry out a project individually would be a challenge. However, I had the full support of the team that guided me through the whole process. This challenge ended up boosting my confidence to deal with complex study-related issues, which will be a useful asset in my professional career. 3 Treatment Meets Prevention at University Health Services Many people are aware that the UIC School of Public Health offers a joint MD/MPH degree program. The SPH had the somewhat unusual occasion to have four MD/MPH students complete their practicum experiences simultaneously at University Health Services on campus. These EOHS students, Sonya Meyers, Andrew Gordon, Sumeet Batra, and Michelle Wueste had the opportunity to work with Dr. David Marder, Director of the clinic. Since the public health practicum is not clinical in nature, these students explored the area of occupational health from the public health perspective. What follows are the reflections from two of the four students. Sonya Meyers “My practicum location was the University Health Services Clinic, which is the home of UIC Employee Health and the main clinic for the UIC Occupational Medicine Residency. I evaluated and treated musculoskeletal injuries in the workplace; sutured lacerations; returned people to work after illness or other medical leaves; evaluated medical risks for travelers; and educated workers about the hazards in their workplace and how to address exposures. The treatment plans are tailored to each individual’s symptoms and examination findings with guidance from panels of experts within the American College of Occupational and Environmental Medicine. “I saw people from all age ranges, from university students going overseas for an exchange program to septuagenarians who are finally free to travel abroad, and the workers who injured themselves while working in physically demanding jobs. I think this variety is delightful and is one of my favorite parts of the practicum. Sumeet Batra, Andrew Gordon, Dr. David Marder, Sonya Meyers, and Michelle Wueste take a break from their work at University Health Services “There were many challenges during the practicum, ranging from patient approach to balancing the demands of employers vs. care for the injured employee. By far, staying neutral was the most challenging. “One thing that I learned from my practicum that was not covered in my MPH course work was medical surveillance protocols. In the MPH program, I learned to look up information from government health Web sites, but updating protocols for an organization and translating them into changes for the organization is more of a communication process. We learned the theoretical skills for approaching this process in many classes, but the actual process of doing it takes place in the practicum.” Andrew Gordon “We had four main objectives for our field practicum here at UIC’s University Health Services that similarly applied to other rotation sites, namely (1) providing patient care (e.g., injury management, return-to-work restrictions, travel medicine, etc.) (2) improving medical knowledge (e.g., literature reviews, journal club, board review, etc.) (3) practice-based learning and improvement, and (4) interpersonal and communication skills. Each of these objectives was vital in helping me continue to provide excellent patient care with the main goals involving the prevention of injuries or illness, and the promotion of wellness and health in our work force. In turn, the field experience demonstrated the real impact of what workers face when it comes to disability, work injuries, exposures, health effects, and preventive measures. “I enjoyed the field practicum because as a resident, this is what I love doing. I enjoy seeing patients in clinical settings and learning each day. I have learned that for a clinic facility to be efficient, it takes a well-motivated staff who are knowledgeable in their practice and have many years of experience. It also takes the internal workings to be an integrated care center, where there exists good communication amongst different healthcare providers. Some of the challenges faced during the field practicum are no different from what we all face in the healthcare system— specifically, how do we reach workers who don’t have access to efficient care and proper followups?” 4 Tackling Practicum Challenges One of the many values of the practicum experience is that a student can get exposed to the challenges of working in the field of public health that he/she would not learn from reading a textbook. Darci Cabezas, a Master of Health Administration student, definitely learned this over the course of her practicum with the Engeye Health Clinic in Uganda. Darci experienced some frustrations as well as humbling, eye-opening moments that taught her much about the field. “This past summer I had the opportunity to fulfill my field practicum with the Engeye Health Clinic located in the Ddegeye village of Uganda, Africa. I was part of a team of four UIC medical students and two other public health students. The Engeye Health Clinic had identified a need to evaluate the current typhoid diagnosis and antibiotic-prescribing habits to ensure that antibiotic resistance does not occur. Since Engeye Health Clinic was established, it had never conducted typhoid treatment quality assurance activities and had expressed a need for the development and implementation of these types of tools. Darci Cabezas (standing to the right of the sign) poses with other UIC students as well as the clinic’s staff “One thing that I learned from my experience was different data collection methods. I did not have much experience with this, and I had to learn different ways of coding the data and entering it into Excel so that it would be easily transferred into programs such as SAS. This was no easy task. Often times I was learning from my mistakes and having to go back again and again to “clean up” the data. Upon my return from Uganda, I also partnered with a Biostatistics student to help me organize the data and determine what we wanted to find. This aspect of my practicum was very valuable but was an unexpected challenge. “Typhoid fever is a challenging disease to diagnose due to the fact that there is no cheap or non-invasive procedure to confirm if someone is infected. The laboratory at Engeye does not have the ability to perform typhoid fever screenings and even if they could, there is really no test that is completely accurate. However, what I observed from the clinic staff is their dedication to the surrounding community and the patients they see each day. It is inspiring to see how people who are challenged with limited resources are able to overcome these challenges. While performing interviews with the clinic staff there is no doubt that they are appreciative for the research I was doing to help contribute to the improvement of Engeye. Darci (far right) stands with clinic staff and SPH student Rachel Yantzi (second from left, seated) “I feel that my practicum experience helped me gain incredible insight into the world of global public health and research. I learned the challenges of working in policy and administration in these types of settings and even though I may have not come up with solutions, I now know what to prepare for and areas that I can focus on for improvement, not only internationally but also in the United States. I feel that I have gained a great deal of cultural competence and understanding of the world in which I live. This whole experience has not only helped me grow and develop professionally, but has also made an impact on me personally. I see the world differently and will carry this experience with me into my future career.” Future public health professionals? Children from the community visit with the Engeye staff. 5 Learning the Art of Collaboration It often happens that a student learns a good deal more during a practicum than just the objectives on the learning agreement. Frequently, a practicum involves much in the way of building collaboration with other public health professionals and learning how to pull together as a team to achieve a common goal. This was certainly the case for Sunny Seto who got the chance to work with a number of individuals during the course of her practicum at Presence Health. “After having taken Dr. Jennifer Hebert-Beirne’s Community Health Assessment course in the fall, I was looking forward to working with my preceptor, Stephanie Ryan, MPH, at Presence Health and experience how to conduct a Community Health Needs Assessment (CHNA). The overall goal for a CHNA is to identify strategies to improve the health of communities. After the Affordable Care Act was passed, all tax-exempt hospitals were required to conduct a CHNA every three years. Presence Health was planning its second round of CHNA. I was responsible for developing an original data collection plan for health indicators, assisting with analyzing the data, creating maps to visually display data on health indicators and social determinants, and evaluating a current communitybased program. “I had the opportunity to attend CHNA meetings and attend a class for a community-based program. These were my most memorable experiences because I had the opportunity to meet with dedicated health professionals working collaboratively from different hospitals to conduct a CHNA and nurses who were open to improving their current community-based program to better the health of women. What I learned from this experience is the importance of collaboration, partnerships, and relationship-building. Many times, we were so busy getting work done that we forgot the importance of building relationships. In meetings, I saw individuals slowing down to build community and share best practices. We are in this together and it is important we work together to make this a reality. “The challenge I encountered with my practicum is also the challenge for conducting a CHNA, which is searching for publically available health data at the community level. Information is more accessible than ever, however, easy access to data can be a roadblock. There are plenty of data at the national, state, and local level, but it is more difficult to access information specific to Chicago’s community areas. Despite this, I see the opportunity for creating a better method to store and maintain information in one location. Through my experience at Presence Health, I thoroughly enjoyed the opportunity and appreciate being a part of this exciting work.” Sunny Seto (left) poses with Stephanie Ryan at Presence Health. ********************************************************* To post practicum opportunities, please contact: Annette Clemens, Field Practicum Coordinator UIC School of Public Health Office of Student Affairs (MC 923) 1603 West Taylor Street, 175 SPHPI Chicago, Illinois 60612 312.355.4272 (phone) 312.413.4300 (fax) [email protected] You can find more information at: http://publichealth.uic.edu. Editor Annette Clemens Practicum Matters newsletter is published by the Office of Student Affairs in the UIC School of Public Health. The school is dedicated to protecting and improving the health of people in Chicago, across the nation, and around the world. To this end, UIC SPH faculty, staff, students, and alumni are reaching out to local communities, city and state officials, and international partners with cutting-edge research, community-based health services, and groundbreaking public health policy.
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