MFA Prospectus Defense: Healthcare Student Well-Being within Informal Learning Spaces

Healthcare Student Well-Being within Informal Learning Spaces

Caroline Mozo Prospectus Defense 11.23.20

Introduction

18 Million healthcare workers in the USA

Introduction

(CDC, 2017)

18 Million healthcare workers in the USA

Medical Doctor (MD)

Introduction

Physician Assistant (PA)

(CDC, 2017)

Registered Nurse (RN)

High demand as the USA experiences a growing Healthcare Shortage

(AAMC, 2019; Gdiesing, 2019; Mercer, 2020)

Medical Doctor (MD)

Introduction

Physician Assistant (PA)

Registered Nurse (RN)

Introduction

High attrition rates of healthcare students could contribute to this Growing shortage (Hamshire et al., 2019; Hamshire et al., 2013)

Introduction

Student Well-being is critical to student success + elements of the built environment within

Introduction

Student Well-being is critical to student success + elements of the built environment within

Informal learning spaces can positively influence student well-being (Ashwood et al., 2013; Mokgele & Rothmann, 2014; Tackett et al., 2016)

Introduction

This presentation will review...

The Current State of the Healthcare Profession Healthcare Providers Roles + Responsibilities Healthcare Instruction Educational Environments

This presentation will review...

The Current State of the Healthcare Profession Healthcare Providers Roles + Responsibilities Healthcare Instruction Educational Environments Student Well-Being Well-Being Well-Being + the Built Environment Methodology

The Current State of the Healthcare Profession

3.65 Trillion American dollars spent on healthcare in 2018

(Herman, 2019)

The Current state of the healthcare Profession

3.65 Trillion American dollars spent on healthcare in 2018

(Herman, 2019)

Projected to continue growing at a rate of annually + represent

5.5 percent

19.4 percent of the nation’s GDP by 2027

(Sisko et al., 2019)

The Current state of the healthcare Profession

3.65 Trillion American dollars spent on healthcare in 2018

(Herman, 2019)

Projected to continue growing at a rate of annually + represent

5.5 percent

19.4 percent of the nation’s GDP by 2027

(Sisko et al., 2019) 7% = 55,400 MDs

31% = 37,000 PAs

The Current state of the healthcare Profession

12% = 371,500 RNs

Estimated that by 2025, the USA can expect a workforce gap of approximately

-680,430 workers

(Mercer, 2020)

The Current state of the healthcare Profession

Estimated that by 2025, the USA can expect a workforce gap of

-680,430

approximately workers (Mercer, 2020) This mounting shortage stems from several contributing factors including:

The Current state of the healthcare Profession

Estimated that by 2025, the USA can expect a workforce gap of

-680,430

approximately workers (Mercer, 2020) This mounting shortage stems from several contributing factors including:

aging + retirement of practitioners

practitioner burnout + fatigue

lack of emerging graduates

The Current state of the healthcare Profession

COVID-19

Healthcare Providers Roles and Responsibilities

primary healthcare team

A is typically comprised of physicians, PAs, + RNs (AAFP, 2017; Denver Health, 2011)

Physician (Medical Doctor)

Physician Assistant (PA)

Registered Nurse (RN)

Healthcare Providers Roles and Responsibilities

Physicians, also referred to as doctors, are primary healthcare providers + key members of the team

- approximately 595,491 active MDs (AAMC, 2017) - 4 years towards bachelor’s degree - 4 years towards MD - 3 - 8 years of internship + residency (Denver Health, 2011) - clinicians practice within clinical settings - 3 part United States Medical Licensing Examination (USMLE) aka “the Boards” (AMA, 2020; USMLE, 2020) - pathophysiological perspective - diagnosis + treatment driven - focus on the signs + symptoms (Pangaro & Romano, 2014) Medical Doctor (MD)

Healthcare Providers Roles and Responsibilities

Physician assistants are emerging primary

healthcare providers that work alongside other members of the healthcare team

Physician Assistant (PA)

- relatively new discipline - profession is rapidly growing (AAMC, 2017) - approximately 130,620 certified PAs in the USA - 4 years towards bachelor’s degree - 2-3 years towards master’s degree in Physician Assistant Studies - Physician Assistant National Certifying Examination (PANCE) (AAPA, 2020; Mayo Clinic, 2020; University of Kentucky, 2020) - mid-level practitioner under the supervision of physicians (Kartha, 2014; Shiel, 2018) - provide many of the same services as their supervising physicians

Healthcare Providers Roles and Responsibilities

Registered nurses are critical members of the healthcare team and play a unique and expansive role (Gwynedd Mercy University, 2020)

- estimated 2,951,960 active practitioners (BLS, 2018) - spend the most time engaging with and providing face-to-face care to patients (Pangaro & Romano, 2014) - either a 2 year associate degree in nursing or a 4 year bachelor’s degree in nursing - state-required National Council Licensure Examination for Registered Nurses (NCLEX-RN) (Gwynedd Mercy University, 2020; Mayo Clinic, 2020; NCSBN, 2020)

- RNs deliver direct patient care while also serving as health educators + advocates (ANA, 2020; Davoodvand et al., 2016;

Gerber, 2018)

Registered Nurse (RN)

- sociological perspective (Pangaro & Romano, 2014)

Healthcare Providers Roles and Responsibilities

Healthcare Instruction

Doctor of Medicine (MD) - 19,936 graduates for 2018-2019 (AAMC, 2019) - 4 year curriculum - lecture, laboratory, simulation, + clinicals (AAMC, 2020; The Princeton Review, 2020)

Future MD

Healthcare instruction

- years 1 + 2 involve preclinical education, which focuses on science, physiology, disease processes, + treatment - 4 - 8 hours of class, 5 days a week - years 3 + 4 involve clinical education, including clerkships + clinical rotations at affliliated hospitals or clinics - students typically work 12 hour shifts in clerkships + clinical rotations (AAMC, 2020) - students also begin the process of completing “the Boards� ((AAMC, 2020; BLS, 2017; The Princeton Review, 2020; USMLE, 2020)

Master in Physician assistant studies (MPAS/MS-PAS) - over 9,000 graduates each year (AAPA, 2019) - most programs are approximately 3 years (AAPA, 2020; ARCPA, 2020; PAEA, 2020)

- year 1 focuses on the foundations of medical science, medical therapeutics, + pathophysiology (AAPA, 2020; Tufts University, 2020)

- 6 - 8 hours of class, 5 days a week (Tufts University, 2020) - years 2 + 3 students will complete upwards of 2,000 clinical hours in clinical disciplines (AAPA, 2020; Tufts University, 2020) Future PA

Healthcare Instruction

Bachelor of Science In Nursing (BSN)

- 4 year BSN program - many job opportunities require a BSN - BSN required to attain graduate level nursing degrees - combination of in-class learning and clinical rotations - typical ratio of 3 clinical learning hours per every 1 hour of classroom instruction (Nurse Journal, 2014)

Future RN

Healthcare Instruction

Typical course And Clinical offerings aCross Disciplines Course/Clinical

MD

MPAS/MS-PAS

BSN

x x x x x x x x x

x x x x x x x x x

x x x x x x x x

Anatomy Physiology Microbiology Pharmacology Reproductive Health Psychology Pediatrics Family Medicine Clinical Medicine

Healthcare Instruction

educational Environments

formal learning spaces

In , instructors lead students in dedicated educational spaces (Dowling, 2020)

Educational environments

formal learning spaces

In , instructors lead students in dedicated educational spaces (Dowling, 2020)

Lecture Halls

Classrooms

Educational environments

Laboratories

Clinical Settings

Lecture Halls are large formal learning

environments that can accommodate upwards of 500 occupants (Hanley, 2017)

Learning - passive, active, auditory, + visual

Features

- instructor lead - delineated instructor + student zones

Technology

- microphones - projectors - document cameras - computers Educational environments

Courses

- Anatomy - Physiology - Biology

- Chemistry - Psychology - Nutrition

Classrooms function similarly to lecture halls; however, they are smaller in scale Learning - passive, active, auditory, kinesthetic, + visual

Features

- instructor lead - distinct instructor + student zones - flexible seating

Technology

- smartboards - projectors - document cameras - computers Educational environments

Courses

- Communication - Substance in Health Abuse + Effects - Multicultural on Health Factors + Health

Laboratories (labs) are designed + equipped with specialty equipment to accommodate learning Learning

- passive, active, auditory, kinesthetic, visual, hands-on, + experiment-driven

Features

- instructor lead - teaching, research, wet, dry, + simulation labs

Technology

- specialty equipment - smartboards - projectors - document cameras - computers Educational environments

Courses

- Anatomy Lab - Clinical Lab - Chemistry Lab Science - Biology Lab

Clinical Settings Learning

- passive, active, auditory, kinesthetic, visual, hands-on, + experiential

Features

- variety of healthcare settings (hospitals, outpatient clinics, medical offices)

Technology - specialty medical equipment

Educational environments

Clinicals

- Pediatric - Surgery - Geriatric - Urology - Family Medicine - Emergency Medicine

Distance Learning Learning - passive, active, auditory, + visual

Features

- may be conducted either synchronously or asynchronously

Technology

- websites - web conferences - online textbooks -instructional videos Educational environments

Courses - program offerings vary

Informal learning spaces refer to a variety of spaces that accommodate student-led learning (Smith & Costello, 2018)

ownership of learning belongs to the student

Gathering Spaces

Library Spaces

Corridor Spaces

student centers, student unions, + outdoor spaces

alcoves, lobbies, computer stations, + other unassigned spaces

courtyards, plazas, + transitional spaces

Educational environments

Research has suggested that

built environment elements can support student learning + engagement

(Fisher, 2015; Laage et al., 2019; Lanteigne, 2017)

setting

lighting

noise Educational environments

crowding, personal space, territoriality, + privacy color

environmental competence

S

Student Well-Being

rigor and expectations

Given the of healthcare curriculums, many students struggle to succeed + complete their programs of study (Boylan & Fowler, 2010)

Student Well-being

rigor and expectations

Given the of healthcare curriculums, many students struggle to succeed and complete their programs of study (Boylan & Fowler, 2010)

Stressors

Common involve academic, interpersonal, intrapersonal, or environmental factors (Bulo & Sanchez, 2014)

Student Well-being

rigor and expectations

Given the of healthcare curriculums, many students struggle to succeed and complete their programs of study (Boylan & Fowler, 2010)

Stressors

Common involve academic, interpersonal, intrapersonal, or environmental factors (Bulo & Sanchez, 2014)

1/3 of undergrads

experience mental health issues

Student Well-being

rigor and expectations

Given the of healthcare curriculums, many students struggle to succeed and complete their programs of study (Boylan & Fowler, 2010)

Stressors

Common involve academic, interpersonal, intrapersonal, or environmental factors (Bulo & Sanchez, 2014)

1/3 of undergrads 3rd leading cause experience mental health issues

Student Well-being

of death among young adults is suicide

rigor and expectations

Given the of healthcare curriculums, many students struggle to succeed and complete their programs of study (Boylan & Fowler, 2010)

Stressors

Common involve academic, interpersonal, intrapersonal, or environmental factors (Bulo & Sanchez, 2014)

1/3 of undergrads 3rd leading cause experience mental health issues

Student Well-being

of death among young adults is suicide

1/5 of students

had thought about suicide

rigor and expectations

Given the of healthcare curriculums, many students struggle to succeed and complete their programs of study (Boylan & Fowler, 2010)

Stressors

Common involve academic, interpersonal, intrapersonal, or environmental factors (Bulo & Sanchez, 2014)

1/3 of undergrads 3rd leading cause experience mental health issues

of death among young adults is suicide

1/5 of students

had thought about suicide

Students who do experience mental health issues are especially at risk for reduced (Ashwood et al., 2015)

educational outcomes

Student Well-being

Studies have linked several factors to students’ overall sense of

well-being

course study demands

study resources

burnout and fatigue

general health

alcohol use

satisfaction with life

traumatic experiences

engagement

behavioral issues

sense of control mental health support sense of community

Student Well-being

at risk for reduced well-being Healthcare students may be especially

Student Well-being

at risk for reduced well-being Healthcare students may be especially

Reduced Well-Being = absenteeism, presenteeism, suicide, poor retention, + reduced patient care

Student Well-being

at risk for reduced well-being Healthcare students may be especially

Reduced Well-Being = absenteeism, presenteeism, suicide, poor retention, + reduced patient care

Student Well-being

Healthcare students self-reported lower levels of well-being compared to students of other disciplines at the end of their programs

at risk for reduced well-being Healthcare students may be especially

Reduced Well-Being = absenteeism, presenteeism, suicide, poor retention, + reduced patient care

Student Well-being

Healthcare students self-reported lower levels of well-being compared to students of other disciplines at the end of their programs

Physician suicide rates are reportedly higher than those of the general population

Well-being

Defining well-being A Timeline 1948

“a state of complete physical, mental and social well-being + not merely the absence of disease or infirmity”

WHO

1969

“the degree to which he has an excess of positive over negative affect”

Bradburn

1978

“a global assessment of a person’s quality of life according to his own chosen criteria”

Shin + Johnson

1989

identified its antecedents, including positive interrelationships, self-acceptance, purpose in life, environmental mastery, a realization of potential, + autonomy “pleasant and unpleasant moods and emotions, whereas life satisfaction refers to a cognitive sense of satisfaction with life”

1997 well-being

Ryff Diener + Suh

Current Constructs:

Objective well-being

Objective well-being refers to the external and universal, meaning outside of one’s individualized, personal experience, and is often thought of as meeting basic needs; often associated with quality of life and financial/economic well-being

well-being

Current Constructs:

Subjective well-being

Subjective well-being is associated with the internal, personalized experience of each unique individual, often compared to happiness as it focuses on the perspective of the individual and their feelings; most often measured via self-reported scales related to individual’s perceptions of themselves and the world around them

well-being

Current Constructs of

Well-being

Well-Being

Objective

Eudaimonic

x

Physical

x

Financial/Economic

x

Subjective x

Hedonic

x

Social

x

Emotional

x

Psychological

well-being

x

x

Well-being and the built environment

Roger Ulrich further asserts this relationship

between well-being + the built environment in his theory of supportive design

A Sense of Control

Access to Social Support

Well-being and the built environment

Access to Positive Distractions

Research has suggested that the following

Interior Elements have the greatest potential to support user well-being

circulation + sightlines

lighting

acoustics

Well-being and the built environment

access to natural views + biophilic elements

color

furniture arrangement, choice, + ergonomics

S

Methodology

purpose

This research study aims to investigate the relationship between healthcare student well-being + the built environment within informal learning spaces The goal is to develop design considerations for healthcare informal learning spaces that support student well-being + add to the growing body of knowledge related to well-being + the built environment

Methodology

Research Questions How do informal learning spaces within healthcare instruction facilities affect healthcare student well-being? a. Which elements of the built environment support student well-being? b. Which elements of the built environment negatively impact student well-being? c. How can informal learning spaces be designed to foster community, encourage engagement, + reduce fatigue + burnout in healthcare students?

Methodology

Target Sample Population - university students in MD (medical doctor) degree program, master’s degree in physician assistant studies program, or bachelor’s degree in nursing program - purposive sampling - participants will be recruited from a Carnegie R1 University located in the American Southeast as well as student members of 3 healthcare professional organizations - focus group participants will be a sub-set of approximately 30 survey participants enrolled in the selected university, selected based upon their stated interested in the survey, + qualifying survey responses to inclusion criteria

Methodology

Instruments - Survey - built in Qualtrics - comprised of 4 parts - 73 questions related either to well-being, the assessment of the built environment, + participant demographics - estimated time of completion is 15 minutes - “Ryff Scales of Psychological Well-Being” has been chosen for its reliability + theoretical grounding (Burns & Machin, 2008; Kállay & Rus, 2014; Ryff & Keyes, 1995) - at the completion of the survey, students will be asked if they would be interested/willing to participate in a focus group with offer of an incentive

Methodology

Instruments - Focus Group - remote online focus groups using Zoom - multiple focus groups will be conducted with students recruited from the online survey - each focus group will comprised of 6 students - last between 30 + 60 minutes - all participants will be given basic rules + guidelines at the start - each participant will be given numbers to match them to their survey responses - format will be conversational with high moderator involvement via guided, verbal questions to allow students to expand on the survey topics - questions will focus on the stressors (curriculum-based + environmental), how time is spent, + supports + hinderances in these spaces

Methodology

In conclusion This study serves to investigate the relationship between healthcare students’ perceptions of their own well-being and their informal learning environments. The goal is to develop design considerations that will help support student well-being in order to support their academic and professional development.

One of the interior design profession’s central goals is to enhance the human experience through the design and manipulation of the built environment, ultimately impacting the health and well-being of users (ASID, 2020; NCIDQ, 2020). Healthcare designers have been and continue to be leaders in evidence-based design (EBD) practices that inform their designs (Hamilton, 2016; Peavey & Wyst, 2017; Stichler, 2016). Through continued research and investigation, the interior design profession will continue providing new insights related to the built environment’s impact on the American healthcare industry.

Methodology