Graduate Thesis: Healthcare Student Well-Being within Informal Learning Spaces

HEALTHCARE STUDENT WELL-BEING within Informal Learning Spaces

Caroline Mozo Thesis Defense 6.28.21

INTRODUCTION

18 MILLION healthcare workers in the USA

INTRODUCTION

(CDC, 2017)

18 MILLION healthcare workers in the USA

INTRODUCTION

(CDC, 2017)

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 Introduction

STUDENT WELL-BEING is critical to student

success + elements of the built environment within

INTRODUCTION 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 INTRODUCTION

This presentation will review...

Summary of the Literature Review Summary of the Original Research Design Solution - Floor 1 Design Solution - Floor 2

This presentation will review...

Summary of the Literature Review Summary of the Original Research Design Solution - Floor 1 Design Solution - Floor 2 Design Solution - Floor 3 Design Solution - Floor 4 Design Solution - Floor 5 Design Solution - Rooftop

Summary of the

The Current State of the Healthcare Profession LITERATURE REVIEW

The literature review investigated...

The Current State of the Healthcare Profession Healthcare Provider Roles and Responsibilities Healthcare Instruction Educational Environments

LITERATURE REVIEW

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

-680,430 workers

(Mercer, 2020)

LITERATURE REVIEW state of the healthcare Profession The Current

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

-680,430 workers

(Mercer, 2020)

This mounting shortage stems from several contributing factors including:

LITERATURE REVIEW state of the healthcare Profession The Current

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

-680,430 workers

(Mercer, 2020)

This mounting shortage stems from several contributing factors including:

aging + retirement of practitioners

practitioner burnout + fatigue

lack of emerging graduates

LITERATURE REVIEW state of the healthcare Profession The Current

COVID-19

PRIMARY HEALTHCARE TEAM is typically comprised of

A physicians, PAs, + RNs (AAFP, 2017; Denver Health, 2011)

Physician (Medical Doctor)

Physician Assistant (PA)

Registered Nurse (RN)

LITERATURE REVIEW Providers The Current state of the healthcare Profession Healthcare Roles and Responsibilities

TYPICAL COURSE And CLINICAL OFFERINGS ACROSS DISCIPLINES Course/Clinical Anatomy Physiology Microbiology Pharmacology Reproductive Health Psychology Pediatrics Family Medicine Clinical Medicine

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

LITERATURE REVIEW Providers The Current state of the healthcare Profession Healthcare Roles and Responsibilities Instruction

FORMAL LEARNING SPACES, instructors lead students in

In dedicated educational spaces

(Dowling, 2020)

LITERATURE REVIEW Providers The Current state of the healthcare Profession Healthcare Roles and Responsibilities Instruction Educational environments

FORMAL LEARNING SPACES, instructors lead students in

In dedicated educational spaces

Lecture Halls

(Dowling, 2020)

Classrooms

Laboratories

LITERATURE REVIEW Providers The Current state of the healthcare Profession Healthcare Roles and Responsibilities Instruction Educational environments

Clinical Settings

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

LITERATURE REVIEW Providers The Current state of the healthcare Profession Healthcare Roles and Responsibilities Instruction 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

crowding, personal space, territoriality, + privacy color

LITERATURE REVIEW Providers The Current state of the healthcare Profession Healthcare Roles and Responsibilities Instruction Educational environments

environmental competence

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 LITERATURE REVIEW The Current state of the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments

Healthcare students may be especially

AT RISK for

REDUCED WELL-BEING

Student Well-being LITERATURE REVIEW The Current state of the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments

Healthcare students may be especially

AT RISK for

REDUCED WELL-BEING

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

Student Well-being LITERATURE REVIEW The Current state of the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments

Healthcare students may be especially

AT RISK for

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

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

Student Well-being LITERATURE REVIEW The Current state of the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments

Healthcare students may be especially

AT RISK for

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

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

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

Student Well-being LITERATURE REVIEW The Current state of the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments

Research has suggested that the following

INTERIOR ELEMENTS have the greatest potential to support user

well-being

circulation + sightlines

acoustics

lighting

access to natural views + biophilic elements

color

Student Well-being LITERATURE REVIEW The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments well-being Well-being and the environment

furniture arrangement, choice,

S

ORIGINAL RESEARCH

PURPOSE This research study aimed to investigate the relationship between healthcare student well-being + the built environment within informal learning spaces The goal was 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 well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

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 well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

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 (N = 31) were recruited from Florida State University as well as student members of 3 healthcare professional organizations (American Academy of Physician Assistants, Asian Pacific American Medical Student Association, Catholic Medical Association) - interview participants were a sub-set of approximately 2 survey participants enrolled in the selected university, selected based upon their stated interested in the survey, + qualifying survey responses to inclusion criteria (year in school, program of study, and relatively high scores on Ryff’s well-being assessment)

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

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” was chosen for its reliability + theoretical grounding (Burns & Machin, 2008; Kállay & Rus, 2014; Ryff & Keyes, 1995) - at the completion of the survey, students were asked if they would be interested/willing to participate in a focus group with offer of an incentive

Methodology Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments well-being Well-being and the environment

INSTRUMENTS - INTERVIEWS - remote online interviews using Zoom - 2 student interveiwees - lasted between 30 + 60 minutes - questions will focus on the stressors (curriculum-based + environmental), how time is spent, + supports + hinderances in these spaces

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

SAMPLE POPULATION CHARACTERISTICS

Program of Study

4.35%

Other

8.7%

4.35%

Fourth Year and Beyond (Graduate)

Medical (MD)

4.35%

Third Year (Graduate)

43.48%

Nursing (BSN)

8.7%

Second Year (Graduate)

43.48%

Physician Assistant

34.78%

First Year (Graduate)

34.78%

Fourth Year and Beyond (Undergraduate)

8.7%

Third Year (Undergraduate)

4.35%

Second Year (Undergraduate)

0%

First Year (Undergraduate)

Year in School

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

SAMPLE POPULATION CHARACTERISTICS

Institution

21.74%

Other

8.7%

Male

78.26%

Florida State University

91.3%

Female

Gender Identity

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

SAMPLE POPULATION CHARACTERISTICS 4.17%

Native American

4.17%

Asian

4.17% 4.17% 83.33%

Latino or Hispanic African-American Caucasian

Ethnic Identity

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS Which Elements of the Built Environment Support Student Well-Being?

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS Which Elements of the Built Environment Support Student Well-Being?

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS Which Elements of the Built Environment Support Negatively Impact Student Well-Being?

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS How Can Informal Learning Spaces Be Designed to Foster Community, Encourgae Engagement, and Reduce Fatigue and Burnout in Healthcare Students?

A. Fostering Community

Noisy

Quiet

Crowded

Uncrowded Cool Color Palette

Warm Color Palette

Bright Color Palette

Neutral Color Palette Private Setting

Public Setting

Informal Learning Space

Formal Learning Space

Elements of the Built Environment That Support Connection With Others

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS How Can Informal Learning Spaces Be Designed to Foster Community, Encourgae Engagement, and Reduce Fatigue and Burnout in Healthcare Students?

A. Fostering Community

Methodology Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments well-being Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS How Can Informal Learning Spaces Be Designed to Foster Community, Encourgae Engagement, and Reduce Fatigue and Burnout in Healthcare Students?

B. Encouraging Engagement

Noisy

Quiet

Crowded

Uncrowded Cool Color Palette

Warm Color Palette

Bright Color Palette

Neutral Color Palette Private Setting

Public Setting

Informal Learning Space

Formal Learning Space

Elements of the Built Environment That Support Engagement With Course Content

Methodology well-being Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS How Can Informal Learning Spaces Be Designed to Foster Community, Encourgae Engagement, and Reduce Fatigue and Burnout in Healthcare Students?

B. Encouraging Engagement

Methodology Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments well-being Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS How Can Informal Learning Spaces Be Designed to Foster Community, Encourgae Engagement, and Reduce Fatigue and Burnout in Healthcare Students?

C. Reducing Fatigue and Burnout

Noisy

Quiet

Crowded

Uncrowded Cool Color Palette

Warm Color Palette

Bright Color Palette

Neutral Color Palette Private Setting

Public Setting

Informal Learning Space

Formal Learning Space

Elements of the Built Environment That Mitigate Burnout & Fatigue

Methodology Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments well-being Well-being and the environment

FINDINGS RELATED TO RESEARCH QUESTIONS How Can Informal Learning Spaces Be Designed to Foster Community, Encourgae Engagement, and Reduce Fatigue and Burnout in Healthcare Students?

C. Reducing Fatigue and Burnout

Methodology Student Well-being ORIGINAL RESEARCH The Current state ofbuilt the healthcare Profession Healthcare Providers Roles and Responsibilities Instruction Educational environments well-being Well-being and the environment

DESIGN SOLUTION

BOCA RATON, FL

tropical storms.

800 Meadows Rd

The building is surrounding by other medical buildings including those affiliated with the hospital & private practices. This is also a largely affluent, residential area.

coastal climate with high levels of as rain, wind, salt, & harsh conditions such as hurricanes &

Located in Boca Raton, FL, the building is subject to a

humidity & heat

as well

College of Nursing

“Keeping the Promise” campaign for Boca Raton Regional Hospital, the As part of the

design calls for the construction of a new educational facility on the hospital’s campus. Just 3 miles from

College of Medicine

Boca Raton, FL

Proposed Educational Facility

Florida Atlantic University,

this facility will service both FAU healthcare students (nursing, PA, & medical) as well as the hospital staff.

Proposed Educational Facility

VIEW OF PROJECT SITE

sympathy

SYN-/SYMFROM GREEK MEANING “TOGETHER” An evironment that celebraates the patterns & connections present in the relationships with one’s self, others, & the world around them

synergy

synaptic

symbosis

synthesis

WELCOME!

DINING HALL

STUDENT LOUNGE

REAR COURTYARD

ATRIUM

CONFERENCE CENTER

MAIN COURTYARD

STUDENT SERVICES BOOKSTORE

ADVISING ADMIN LOADING

N

FLOOR 1

SCOPE OF WORK

ATRIUM

STUDENT LOUNGE

DINING HALL

MAIN COURTYARD

MONUMENTAL STAIR slat wood

FLOOR 5 brass

DINING HALL

STUDENT LOUNGE

FLOOR 4

REAR COURTYARD

ATRIUM

STUDENT SERVICES

CONFERENCE CENTER

ADVISING ADMIN.

LAN VIEW - SCALE: 1/16” = 1’-0”

N

FLOOR 1 - SCALE: 1/32” =1/16” 1’-0”= 1’-0” PLAN VIEW - SCALE: 0”

N

glass MONUMENTAL STAIR - SCALE: 1/8” = 1’-0”

terrazzo

MAIN COURTYARD

FLOOR 3 BOOKSTORE

LOADING

FLOOR 2 FLOOR 1

1-B.

1-E.

1-K.

1-L.

1-F.

1-G.

1-C. 1-D.

1-A.

1-H. 1-I.

1-M.

1-N.

1-J. 1-P.

1-R. 1-Q. 1-S. 1-O.

FLOOR ONE

LECTURE HALL

STUDENT LOUNGE

BREEZEWAY

LECTURE HALL

OTB

OTB

ATRIUM

OTB

LIBRARY

OTB

N

FLOOR 2

CAFE

ATRIUM

LIBRARY

CAFE

STUDENT LOUNGE

2-B.

2-C. 2-D.

2-A.

2-G.

2-E. 2-F.

2-H. 2-J. 2-K.

2-L.

2-I. 2-N. 2-M.

FLOOR TWO

OTB TEACH LAB MED ROOM

GALLERY

COUNSEL CENTER OTB

OTB

ATRIUM

OTB

OTB

CLASS PA LIBRARY

N

FLOOR 3

OTB

MEDITATION ROOM ATRIUM

LIBRARY

CORRIDOR

3-H.

3-A. 3-B.

3-J.

3-G. 3-I.

3-C.

3-K.

3-D. 3-E.

3-L.

3-F. 3-M. 3-P. 3-O.

3-N.

FLOOR THREE

BRIDGE TO HOSPITAL STUDENT LOUNGE

SIM CENTER

CLASS SIM LAB OTB

ATRIUM OTB

NURSING

N

FLOOR 4

ATRIUM CORRIDOR STUDENT LOUNGE

STUDENT LOUNGE

RESEARCH LAB

CLASS

OTB OTB

ATRIUM

MED

N

FLOOR 5

OTB

GARDEN

N

ROOFTOP

GARDEN

5-C.

4-C. 4-B.

5-A.

4-A.

5-B.

4-E.

5-D. 4-D.

6-C.

6-A.

6-B.

FLOORS FOUR THROUGH ROOFTOP

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2122 23 24 25 26 27 28 29 30

31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60

VIEW OF CORRIDOR - SCALE: 1/4” = 1’-0”

THANK YOU!

1 2 3 4 5 6 7 8 910 1112

VIEW OF STUDENT AMENITIES - SCALE: 3/16” = 1’-0”