Inside Wake PA Fall 2017

INSIDE WAKE PA IQ p4 Innovation Quarter:

A vibrant community

to learn, work, live 7 The arts and PA school 8 Telemedicine

FALL 2017

FROM THE MEDICAL DIRECTOR

CONFLICTED MEDICINE The practice of medicine is a unique joy. Our patients invite us into the complicated worlds where they live; we see their secret places; our discoveries help us forge the connections we need to be effective healers.

That is not how we are assessed, though. Our efforts to understand our patients are too difficult to quantitate.

Instead — perversely — the number of people we herd through each clinic session (by limiting the time spent with each one) is the prevailing measure of our worth.

This dissonance between our professional values and the business office’s metric is the reality of 21st century medicine.

Not surprisingly, burnout has become rampant.

What is our preventative for burnout? As a starting place, let’s not desert our values.

As Sir William Osler pointed out, “The practice of medicine is not a business and can never be one . . .. Our fellow creatures cannot be dealt with as a man deals in corn and coal.”

If we are to excel at what we do, we must continue to visit our patients’ worlds and stay as long as necessary. In their worlds, we will find the stories that help us understand who they are and how we can help them. We will also learn who we are and validate our own humanity. Our patients are the antitoxin for burnout.

Recently, a farmer from southern Virginia consulted me about a thyroid problem, which is part of my specialty. We talked about the growing of pumpkins, which is part of his specialty. His history of orthopedic injuries seemed excessive, so I asked more questions about it, and he gave me answers. I played a lot of sports when I was younger. Any favorite sport? Baseball. What position? Pitcher. Any good at it? Yeah, I played some professional ball for a while. Where? I made it up to AAA for the White Sox before I wrecked my shoulder. Then he told me of the greatest accomplishment of his life. He pitched to Jose Canseco. (Canseco hit a homerun.) It was 1985, just before Canseco moved up to the American League to become Rookie of the Year, followed by a career of multiple All-Star appearances and homerun championships. The homerun my patient served up to Jose Canseco was a monster of a hit, the longest homerun he had ever seen. “In fact,” he told me with a grin, “I don’t think that ball has come down yet.”

I received a remarkable gift that day. I learned another lesson in dealing with adversity through resilience, humility, and humor. Magically, my patient turned the grandest defeat of his life into his greatest accomplishment. I now have a new metaphor to describe my next severe failure: “I don’t think that ball has come down yet.” Each time I use it, I will smile as I think of the relationship I formed with my pumpkin-growing patient who has been waiting patiently since 1985 for Jose Canseco’s homerun to land.

The practice of medicine is a unique joy.

K. Patrick Ober, MD Professor and Medical Director

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CONTENTS

I N S I D E W A K E PA Spring Fall 2017 2017 • Volume • Volume 1 •1 Number • Number 4 2

Department of PA Studies, Wake Forest School of Medicine Associate Professor and Chair L. Gail Curtis, MPAS, PA-C Associate Professor and Program Director Suzanne Reich, MPAS, PA-C

FEATURES 4

ED I T O RS

I nnovation Quarter: A vibrant community for working, learning and living

Teri Capshaw, MBA Tanya Gregory, PhD

OF NOTE

C O NT R IBU TORS

7 The Sacred 7: The arts’ role in PA school

Bryan T. Bushardt, Reamer Arkwright,PharmD, MHA PA-C Carol Erich Grant, Cooper, MMS, MEdPA-C Andrew Megan Curan Gray (’18) (’19) Andrew Carol Hildebrandt Gray (’18) Carol Sobia Hildebrandt Hussaini, MHA Sobia Laura Laxton Hussaini, MHA Alyssa Olivia Jones Murray (’19) (’18) K. Patrick Ober, MD

DEPARTMENTS 8

iewpoint: PAs and the growth of V telemedicine

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Alumni Profile: Lia Ferreira McNamee (’08)

P HO T OGRAPHY

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Spotlight: Faculty Facts and Student News

Teri Lauren Carroll, P HOCapshaw, T OGRAPHY Cameron Dennis Lauren Carroll, Carol Cooper, Lori

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New Faces

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Preceptor Profile: Sage Haresnape (’14)

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Student News

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Alumni News

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Photo Album

Cook, Cameron Dennis, Sage D ESI G N Haresnape (’14) MMA, PA-C; Olivia Creative Communications Jones (’19), Lia Ferreira McNamee Wake Forest Baptist Medical Center (’08), MMS, PA; Suzanne Reich, MPAS, PA-C INSIDE WAKE PA is a digital quarterly INSIDE WAKE PA is a digital quarterly publication for students, faculty, staff, alumni, publication staff, alumni, preceptors, for andstudents, friends offaculty, the Department of preceptors, and friends the Department of PA Studies, Wake ForestofSchool of Medicine.

PA Studies, Wake Forest School of Medicine.

Please send correspondence to: PA Studies, Please correspondence to: PA Studies, Medicalsend Center Boulevard, Winston-Salem, Medical Center Boulevard, Winston-Salem, NC 27157 or email PAAlumNews@ NC 27157 or email PAAlumNews@ wakehealth.edu. wakehealth.edu.

Wake Forest School of Medicine is an equal The Wake Forest School of Medicine action and the opportunity/equal access/affirmative Department ofcommitted PA Studies to areachieving committed employer fully a to diversity, inclusion and and complies the spirit with of Pro diverse workforce all Humanitate.

In adherence federal and North Carolinawith stateapplicable laws, laws and as provided

by School ofregarding Medicine regulations, and executive orders and Department ofand PA affirmative Studies policies, nondiscrimination action.the School of Medicine discrimination Wake Forest Schoolprohibits of Medicine does not in its educational programs, admissions, and discriminate on the basis of race, age, color, activities on the basis of race, color, religion, religion, national origin or ancestry, sex, nationaldisability, origin, sex, age, sexual gender, veteran status,orientation, genetic gender identity andorientation, expression, or genetic information, sexual gender information, disability and veteran status. identity or expression.

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F E AT U R E S T O R Y

Innovation Quarter: a vibrant community for working, learning and living Sunset salutations on the lawn, lunch at the food truck court, free movies under the stars, networking events, music concerts and cycle races—that’s just a sampling of what goes on at Wake Forest Innovation Quarter, home of the PA program’s Winston-Salem campus.

Attracting applicants to the fast-growing PA profession has never been a problem for Wake Forest, but the unique setting for the Winston-Salem program has become a draw for potential students.

“Over and over again, we get applicants saying how impressed they are with the space here at Innovation Quarter,” said Elise Gmuca, admissions systems manager for the PA program. “They are excited to learn and study alongside other medical students.”

Ryan O’Hara (’18) said, “I’ve lived and known Winston-Salem throughout my life.

Innovation Quarter has reinvigorated and brightened up downtown Winston-Salem.

It brings with it new jobs, new opportunities to learn and grow, and a beautiful new downtown.

The spring of 2017 marked the third anniversary of the Wake Forest PA program’s move to Innovation Quarter. Since relocating here, the program has witnessed changes in the collaboration of Wake Forest Baptist Medical Center with private developers, the City of Winston-Salem and Forsyth County, N.C. “There are two principal reasons for having the Innovation Quarter: to help drive economic growth for this region and to build a community that is inclusive and vibrant,” said Eric Tomlinson, Innovation Quarter’s president. “The activities that go on in the Quarter are business, education and research. In addition, there is information technology, with Inmar and Wells Fargo; and health sciences with Wake Forest Baptist Medical Center and also Advanced Materials, and Clinical Services.”

Eric Tomlinson

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As an educational enterprise, the quarter counts among its tenants programs teaching undergraduate, MD, PA, Certified Registered Nurse Anesthetist (CRNA) and PhD students, among others. Survey data reveals that for PA students, having the ability to network with their medical and CRNA colleagues is a great advantage.

Interprofessional education is an important hallmark of the PA program and one of the school’s accreditation standards. With the accessibility to the different Wake Forest medical education programs, learning at Innovation Quarter makes interaction

and collaboration more convenient and also opens up an abundance of ambient study and meeting spaces to students.

has been incredible to see how the city, especially IQ, has grown and developed its own personality and voice.”

People who work in Innovation Quarter often describe a feeling of community and express pride in the area and all that it represents to Winston-Salem and Forsyth County. And PA students, although here only for a limited time, express similar sentiments.

Creating a vibrant community is essential to Tomlinson. Innovation Quarter’s future plans include an expansion that will encompass approximately 2.5 million square feet of additional office, laboratory, residential and retail space.

Current construction projects under way are the Bailey Power Plant, Phase A, 110,800 square feet of office, entertainment and retail space opening in 2018; and the Link Apartments Innovation Quarter Complex and Parking Deck, which will include 340 apartments, 5,000

“I lived in Winston Factory Lofts during my first year and it was amazing to see the energy come to life in the area,” said Matthew Colner (’18). “I went to high school outside of Winston and it

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Wake Forest Innovation Quarter

feet of retail space and 850 parking spaces, planned for completion in 2019.

The Long Branch Trail Greenway is also under construction with its opening slated for this month. The trail will eventually connect to the Salem Creek Greenway to form a 20-mile loop from Martin Luther King Jr. Boulevard to Salem Lake. The name “Long Branch” has historical significance originating in the late 1880s when tobacco was booming and Winston’s east end was growing. The portion of the route going through Innovation Quarter will be a 2.1-mile, publicly accessible walking/ running/biking trail.

The dynamic enterprises encompassed at Innovation Quarter help ensure that Wake Forest PA students broaden their educational experience and study in an interprofessional learning environment.

IQ by the numbers 330+ ACRES $713 MILLION DEVELOPMENT COST TO DATE 120+ COMPANIES 5 ACADEMIC INSTITUTIONS 9 ACADEMIC RESEARCH DEPAR TMENTS 3 ACADEMIC EDUCATION DEPAR TMENTS OF WAKE FOREST SCHOOL OF MEDICINE 1 DOWNTOWN HEALTH PLAZA 3,400+ WORKERS 10,000 STUDENTS AND TRAINEES 1.9 MILLION SQUARE FEET OF WORK SPACE

OF NOTE

Yes, the arts do have a role to play in PA school What do literature, painting, film and other arts have to do with the process of helping medical learners turn into excellent PAs? More than you might think, as PA Studies discovered from the responses of graduates who completed the program’s health humanities elective, The Sacred 7.

This innovative course, created and taught by faculty members Tanya Gregory, PhD, and Jill Grant (’05), MS, MMS, PA-C, uses literature, film, visual arts, writing, reflection, meditation and discussion to help students access, explore and deepen their empathy, compassion, humility, integrity, reflection, resilience and self-awareness – the qualities that constitute the Sacred 7. So far, 18 students from the Class of 2016 and 36 students from the Class of 2017 have completed the course; and another 48 students from the Class of 2018 are expected to complete it before they graduate. The growth in enrollment suggests that the course is meeting its overall goal, which is to help students become PAs who can care humanely for patients and themselves.

In course evaluations and reflections, students said that the course expanded their perspective and their appreciation of the value of different viewpoints. “This [course] has challenged me to think more deeply, broadly, and widely about simple and complex issues,” said one Class of 2016 student. “Differing opinions and backgrounds were always respected even when perspectives may have been completely opposite on controversial topics,” added another.

A consistent theme in the feedback was that students appreciated being able to build relationships as they shared experiences within what one student described as “a safe space.” Several students noted that it’s easy to feel isolated in PA school, to “feel like no one else is experiencing what you are experiencing.”As one put it, “it was comforting to know that I was not alone in some of my feelings as I heard much of my own fears and doubts in the voices of others.”

Students valued the environment Sacred 7 provided to process and reflect upon experience and to grow in self-awareness and resilience. One said, “I appreciated . . . time . . . to discuss the personal challenges of being a provider, the difficulties of processing loss, the techniques of effective communication.”

Another wrote, “this course forced me to actively work through some of the emotional rigor that comes with learning to work with patients who are sick and dying. I would not have pursued activities . . . that forced me to focus on the emotional pain I was feeling as a provider. I would not have anticipated [these activities] being so useful . . . for self-care.” A third student summed it up this way: “I think this course is my single best tool against burnout at the present time.”

Gregory and Grant said they were uncertain how the course would turn out when they started it. “We didn’t know if it would succeed in achieving its objectives,” Gregory said.

“Witnessing its growth over three cohorts and hearing from students how meaningful they have found it has been encouraging beyond words. It seems we have ended up exactly where we hoped we would — having created an experience that was truly perspective altering for students and yet one more piece of evidence demonstrating the uniqueness of our program.“ In the words of two students: “I loved that Sacred 7 reminded me why I’m in PA school. It . . . laid the foundation for me to be more thoughtful and considerate to my patients, to take care of myself through hard times at work, and to find meaning in the stories of my patients.”

“Sacred 7 . . . at Wake . . . really distinguished it from other programs. The fact that the program is providing time and space to allow students to continue to grow as empathic, reflective people as we train to be clinicians . . . it’s huge! Thank you.”

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VIEWPOINT

PAs and the growth of telemedicine You’ve likely heard of telemedicine, or telehealth, and you may even be using it in your practice. But did you know that the strong market growth associated with telehealth is creating new opportunities for physician assistants in the U.S. and abroad?

A Zion Market Research Study estimated the telehealth global market at $18.2 billion in 2016, and forecasts the field to grow to $38 billion by 2022. Regardless of specialty or care setting (inpatient, outpatient, surgical), there are a number of opportunities where PAs can take action or make an impact via telehealth.

• Process Improvement — PAs are ideally positioned in health care settings to accurately assess and lead process improvement changes utilizing telehealth.

Implementing telehealth, regardless of the care setting, is an ideal time to assess and adjust current state care processes where waste, inefficiencies and patient or provider dis-satisfiers exist. It is important to understand the current process of care and how telehealth will affect it; with improvements in cost, quality and access being the main goals. The patient and the care process is the primary focus, and the telehealth technology utilized is secondary;

Emerging telehealth opportunities for PAs include:

• Expertise — PAs are key influencers in both patient care and leadership decisions within their

• Jobs — PAs are in demand. A number of hospitals, organizations. Telehealth represents opportunities health systems and telehealth service providers and challenges, but informed PAs can be a source of (niche telehealth service providers and/or telehealth knowledge by attending telehealth CME opportunities technology platforms) are actively hiring PAs and Advanced Practice Providers for U.S. and international at conferences to inform their organization’s efforts. The work. Candidates with international experience or who American Telemedicine Assn. and a national network of 12 regional Telehealth Resource Centers all hold regular are multi-lingual are especially in demand. Many of conferences and education opportunities for clinical these positions can be full or part time, and offer and administrative leaders. PAs who are aware and flexible work from home arrangements; active with industry groups can ensure their organizations • New Access — PAs can use telehealth to serve are avoiding regulatory and compliance pitfalls existing communities better or expand their service associated with telehealth. For more information, visit area to new communities. Consider an urban-based the American Telemedicine Association and Telehealth specialty practice that serves a large multi-county Resource Centers websites. service area, but sees high no-show rates from the

By Bryan T. Arkwright, managing consultant for Schumacher Clinical more distant counties they serve. Establishing a Partners, adjunct faculty at Wake Forest School of Law and editorial telehealth location in a distant county can improve board member for Telehealth and Medicine Today Digital Journal. no-show rates, care outcomes and open new access Arkwright has 11 years of domestic and international experience in to serve more patients; digital health, telehealth/telemedicine, project management, business development, mHealth, strategic planning, interim leadership, start-ups and process improvement.

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ALUMNI PROFILE

Lia Ferreira McNamee: A pioneer for PAs in Northern Ireland Lia Ferreira McNamee (’08) is passionate about being a PA, so much so that she’s dedicated the last seven years to paving a path for the profession in Northern Ireland.

“This really is my dream job,” McNamee said.

A fortuitous series of events brought McNamee to Northern Ireland. A native of Rio De Janeiro, McNamee moved to the United States, settling in Montgomery County, Md., with her family when she was nine years old. She graduated from the University of Maryland at College Park in 2005 with majors in physiology and neurobiology and a minor in French. She did a year of work as a medical assistant in Washington, D.C., to get her clinical hours before entering PA school in 2006.

During her clinical rotations, one of McNamee’s elective rotations took her to an ICU in Melbourne, Australia, where she met her now husband, James. After she graduated from the PA program in 2008, the couple married and moved to James’s hometown of Belfast, Northern Ireland.

“When I arrived in Belfast, they had not heard of PAs at all,” McNamee recalled. Upon moving to the region, McNamee worked as a clinical researcher in the critical care ICU for seven years. “The research position was my only way to stay as close to clinical care as possible without being able to practice as a PA,” she said. In January 2017, McNamee was hired by Royal Victoria Hospital as the first Physician Associate (the professional title for PAs in the United Kingdom) in Northern Ireland. McNamee is also working with Ulster University in Jordanstown, Northern Ireland, which began the first PA program in the region in January of this year.

“I’m excited to finally be doing what I’ve always wanted to do and what I’m trained to do,” she said. However, McNamee admits that it is tough to be a pioneer for the profession. She is currently experiencing a steep learning curve as she adjusts to working in an emergency department in a major trauma hospital for the first time. McNamee continues to advocate for the PA profession in Northern Ireland, especially regarding statutory regulations for prescribing and ordering tests with ionizing radiation, such as chest X-rays or CT scans. “Once the first class of PAs graduates and there is an increased presence in numbers in Northern Ireland, there will be more of an impact,” she said. “It will be easier to advocate for what we need.”

Despite the professional challenges, McNamee has greatly enjoyed her time in Northern Ireland. She has travelled through most of Europe with her husband and three-year-old daughter, Lana. She stays in touch with a tight knit group of friends from her PA class, several of whom have visited her in Belfast.

McNamee reflects fondly on her time at Wake Forest and remembers the faculty and staff who helped make it a rewarding experience. She’s determined to carve a path for PAs in Northern Ireland and finally be able to take care of patients the way she has been trained. Her personal philosophy is “If at first you don’t succeed, try, try again,” which provides a fitting narrative for her professional career and drive to practice as a PA in Belfast.

Get to Know Lia Ferreira McNamee What’s at the top of your bucket list?

One of my main items is to see the Great Wall of China. It’s one of the last wonders of the world that I have not seen yet. I’ve lived on four continents, been skydiving and bungee jumping, so I’ve been fortunate to cross many items off my bucket list already.

Most memorable job?

I worked as the Easter Bunny and as Santa’s helper at the photo kiosk at a mall in Maryland growing up.

What is something that you couldn’t live without?

My family. Oh, and chocolate!

How do you define success?

It’s not all about work. It’s about finding a nice work-life balance, where you’re happy in all of the important aspects of your life.

What is one fun fact about you?

I speak four languages; I should put that on my resume! (English, French, Spanish and Portuguese) What inspires you?

At the moment, I am inspired by innovators and pioneers. I was motivated by “Hidden Figures,” the movie that tells the story of female African-American mathematicians who worked at NASA in the 1950s and 1960s.

What three words would you use to describe yourself?

Determined, adventurous and fun

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SPOTLIGHT

FACULTYFACTS Daniel Bertrams (’14), MMS, PA-C, has been promoted from instructor to assistant professor.

Gayle Bodner, MMS, PA-C, assistant professor, has been named Director of Clinical Education. She recently completed The Office of Women in Medicine and Science Early Career Development Program for Women.

Alisha DeTroye (’04), MMS, PA-C, has completed The Office of Women in Medicine and Science Early Career Development Program for Women.

Sarah Garvick, MS, MPAS, PA-C, assistant professor, will present a poster at PAEA in October, “Enhancing a Platform for an Internal Faculty Development Program.”

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STUDENTNEWS K. Patrick Ober, MD, professor and medical director, was inducted into the University of Florida College of Medicine Wall of Fame in September. The honor, given by the Medical Alumni Association, recognizes Ober’s significant contributions to the practice of medicine and the remarkable impact he has had as an educator. Ober was featured in the summer issue of Florida Physician, the alumni magazine of the College of Medicine.

In August, Ober presented a paper, “Mark Twain & the Society for the Suppression of Unnecessary Noise,” at the 8th International Conference on the State of Mark Twain Studies at Elmira College in Elmira N.Y. Also last summer, Ober was named a Q3 Top Decile Physician from WFBMC for the fourth consecutive quarter. He was one of 25 doctors rated by their patients in the 90th percentile or higher nationally in Press Ganey surveys for a one-year period ending in March.

Caroline Bell Sisson (’13), MMS, PA-C, assistant professor, published, “Adjuvant steroid therapy in community-acquired pneumonia,” in JAAPA 2017; 7: 52-54. A poem she wrote, “I have hair,” will be published in the Mindful Practice department in the November issue of JAAPA.

Menzies gets high school honor Alison Menzies (’18) has been inducted into the Reagan High School Hall of Fame for diving accomplishments.

Menzies holds the Pfafftown, N.C., school record for 1 meter diving.

During her high school career, she won the North Carolina High School Athletic Association (NCHSAA) 3A 1 meter diving competition in 2008 and 2009, as well as NCHSAA 4A 1 meter diving in 2011.

TRANSITIONS

NEWFACES

McDaniel to leave program

Staff member joins Winston-Salem campus

Longtime faculty member Janie McDaniel is leaving PA Studies.

Assistant Professor McDaniel, MS, MLS(ASCP) SC, will leave the program in November to join Yale University’s online PA program.

“I have such mixed emotions,” McDaniel said.

“This was probably one of the hardest decisions of my life, truly. I’ve been here for 22 years and this was my first faculty position. The opportunity, though, to be able to teach wherever I am and to be a founding faculty member at an Ivy League school and part of an exciting new venture in PA education was something I couldn’t pass up.”

“Wake forest faculty, staff, students and alumni will always be like family to me,” she added.

McDaniel is looking forward to being able to teach in Yale’s new program from her home in West Virginia or even Hawaii, where one of her daughters and her first grandchild live.

McDaniel joined Wake Forest PA in 1995 as a lecturer and course director. In 2000, she was named an instructor. She served as registrar for the program from 2003 to 2006 and as admissions director from 2003 to 2016. In 2014, McDaniel was named an assistant professor.

You could say Debbie McDermott is a member of the Class of 2019.

McDermott isn’t studying to be a PA, but her first day as administrative secretary coincided with the students’ first day of orientation in May. That situation might have thrown some new employees, but not McDermott. Her personal philosophy of living each day to its fullest and not sweating the small stuff made for a smooth transition.

“My journey began exactly when their journey began,” McDermott recalled. “I liked that my first day was their first day — it made me feel at ease that we were in this together, but on totally different paths.”

A native of Long Island, N.Y., McDermott relocated to North Carolina five years ago. She worked as an executive assistant for more than 20 years in manufacturing and health care before joining PA Studies.

“I have always loved helping others, and the PA program sounded really exciting,” she said.

“I’m enjoying being part of the amazing team here. Everyone has been very welcoming and helpful.”

Outside of work, McDermott enjoys spending time with her husband and their almost 5-year-old son Tristan and the family pet, a Yorkshire Terrier named Madison. Her perfect day? “Sunshine, birds chirping, preferably doing something with my family on a beach,” she said.

She is a fan of beaches and tropical islands, so it’s no surprise that her bucket list includes travel. “I would love to travel around the world someday,” she said. Australia and Bora Bora are at the top of her destinations list.

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PRECEPTOR PROFILE

SAGE HARESNAPE Sage Haresnape (’14) remembers how as a student she sometimes felt like a nuisance while on rotations. Fast forward three years where now as a preceptor to Wake Forest PA students, Haresnape purposefully makes them feel comfortable and part of the team.

“I hope students will never leave my rotation feeling that they could have learned more from reading at home than they did working alongside of me,” Haresnape said. Her strategy is obviously successful because the Class of 2017 named Haresnape Preceptor of the Year during commencement exercises in May. Haresnape, the second in a family of five kids, was raised in Cary, N.C. She attended the University of North Carolina at Chapel Hill as an undergraduate and originally planned to attend medical school. She was introduced to PAs by a childhood friend and her desire for flexibility led her to choose a career as a PA. Although not originally intending to remain in Winston-Salem upon graduating in 2014, after interviewing with the Chief of Hospital Medicine at Wake Forest Baptist Medical Center, she signed on the dotted line. Haresnape has since moved to the Lexington campus as a hospitalist. She has precepted PA students for two years and hopes to continue because she truly enjoys teaching them.

The feeling is mutual from PA students and alumni.

“She was incredibly knowledgeable, gave such great constructive feedback, afforded tons of experience with writing notes, doing admissions and discharges, and overall related to us so well since she was just in our shoes,” said Dara Seelig (’17). “She also had a fantastic bedside manner, and did a wonderful job at explaining complex medical situations to patients in ways that they could understand. She routinely would go above and beyond her job roles, all with a smile on

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her face AND balancing the task of precepting two students at a time. Sage truly represents the type of PA I aspire to become.”

Megan Smith (’17) said of Haresnape, “She was an incredible teacher, extremely patient, and very willing to help teach and explain things.” Justin Ratcliffe (’17) added, “She went above and beyond to teach and provide feedback but still maintained a relaxed and friendly environment.”

Medicine is a family affair for the newlywed PA and her husband Joseph Stringfellow, an attending at Thomasville OB-GYN Assoc PA. When Haresnape isn’t practicing medicine or precepting students, she volunteers at her church’s nursery, enjoys staying active, indulging in sci-fi movies, reading and dinners of chips and guacamole.

Tortilla chips aside, though, Haresnape has an interest in healthy lifestyles and said, “When I was little, my mother had a potholder that said, ‘You are what you eat.’ I thoroughly believe that. Man was not meant to live on artificial sweeteners and prepackaged foods.”

“From the perspective of a medical professional, if I could change one or two things about how we practice medicine in the U.S., I would radically reduce the outpatient use of opioids and bolster our efforts on preventive medicine, which I feel starts with cleaning up our diets,” she added.

Preceptors wanted!

The Wake Forest PA program is always looking for preceptors to work with second-year students during their clinical rotations.

If you’re a physician, PA or NP and are interested in helping train our PAs, please contact Lori Cook, program coordinator for the clinical year: lcook@wakehealth.edu or 336-716-2023.

We’re grateful for your support!

Student named Tillman Scholar

STUDENTNEWS

Candice Creecy (’19) of Woodland Park, Colo., has been named a 2017 Tillman Scholar by the Pat Tillman Foundation.

Creecy is one of 61 U.S. service members, veterans and military spouses chosen for the honor in recognition of their service, leadership and potential. The scholars receive more than $1.1 million in scholarships to pursue higher education.

“It is an incredible honor to be named as a scholar and have the opportunity to carry on the altruistic legacy of Pat Tillman,” Creecy said. “The Pat Tillman Foundation is unlike any other organization I have been a part of, and I feel so humbled that they selected me to join the team.”

Creecy grew up in a military family, where she says she gained a deep sense of service from her father, an Air Force Aircraft Technician. She joined the U.S. Marine Corps in 2005, earned her aviation “Wings of Gold” in 2008 and was designated a F/A-18 Weapon Systems Officer in 2010. Her service included fighting terrorism and training high-risk-of-capture personnel at Survival, Evasion, Resistance and Escape School – East.

In 2013, Creecy founded “Rise Above Seven Summits” to bring attention to the struggles she witnessed in communities while traveling abroad both in uniform and out. The project seeks to create awareness through climbing the highest peaks on each continent while simultaneously providing peer-based fiscal support to grassroots charities within the region. To date, Creecy has climbed Mt. Kilimanjaro and Denali, raising more than $10,000 for projects in Tanzania and the United States.

She is already showing leadership in the PA program, having been elected Katherine Anderson Society president of the Boone, N.C., campus. As a PA, Creecy hopes to combine her love for adventure and passion for service to help remote communities.

Founded in 2008, the Tillman Scholars program supports active-duty service members, veterans and military spouses by investing in their higher education.

Boone students settle into mountain life Claire Porter (’19) is used to the big-city sights and sounds of her native Dallas. So, being a PA student in Boone, N.C., with a population 18,834 and nary a skyscraper in sight, has taken some getting used to.

“Life in Boone has definitely been an adjustment, mostly because there is not a Target around the corner, but I love the environment and small-town feel of Boone,” Porter said. “It is refreshing after spending so many hours in the classroom to be able to be outside enjoying the sunshine in minutes.”

Porter and her 23 classmates at the Boone campus have taken to the outdoor lifestyle that the town offers in the Appalachian Mountains. Porter said students like having easy access to the outdoors, especially hiking, tubing on the New River and running on the Greenway. The Claire Porter Class of 2019 Boone cohort represents many states, including North Carolina, California, Vermont, Colorado, Virginia, Minnesota, Florida, Massachusetts, Arizona, Connecticut, Texas and Oregon. North Carolina native Megan Curan said the diverse group is enjoying the weather, views and wildlife that the highcountry offers.

For Savannah Nohr (’19), a six-year Boone resident and Appalachian State University graduate, Boone already feels like home. Growing up in a military family where she moved often, six years is the longest time Nohr has ever spent in one town. “I love the hiking spots and mountain views, as well as the comfort that Boone brings” she said.

Nohr said she decided to attend the PA program at Wake Forest because she wants to connect with patients every day and make an impact on her community. Many of her classmates share Nohr’s motivation.

Chloe Decklever (’19) of Lakeville, Minn., has a background as a personal care assistant for adults with disabilities and as a physical therapy clinic assistant. Decklever said she realized her passion for quality patient care through her work with a physician. “He was meticulous to details and had the utmost compassion for every patient,” she recalled. “I admired the way he made his patients feel heard and confident in their physician’s ability to find a solution to their problems.”

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Class of 2019 receives white coats in annual ceremony

INSIDE WAKE PA

The 88 members of the Class of 2019 marched across a brightly lit stage and donned their white coats for the first time on a June day at the Arts Council Theater in Winston-Salem. Friends and family spilled out of their seats and aisles, holding cameras aloft and with craned necks tried to glimpse their future PA beaming at them in a fresh white coat. The ceremony came at the end of the PA program’s intense introductory unit of study, where students pored over anatomy in cadaver lab and completed a sweeping overview of human physiology.

“I felt the proudest I’ve ever felt,” Catherine Cadmus (’19) said of the ceremony. “It’s an honor that’s hard to describe. When I wear my white coat, I feel another level of responsibility for the confidence that patients show in letting us get close to them.”

“It made me begin to imagine myself as a provider rather than just a student,” Cadmus added.

Uchenna Nwoko (’19) confessed to initially feeling confused as to why he received his white coat early in his PA studies rather than at graduation. “Now I understand it’s held earlier so that even on the days when you don’t feel deserving, it gives you the motivation to better yourself, and to earn it,” Nwoko observed.

He said it was meaningful for his family members as well, who were “proud of what I had to do to get to this point.”

The white coat first gained popularity as a garment among physicians at the turn of the 19th century, as the practice of medicine shifted from traditional therapies to those based on scientific evidence. To distinguish themselves from older, uncredentialled practitioners, physicians began to wear a white lab coat as a symbol of the alignment of medicine with science. Though the White Coat Ceremony is a relatively modern tradition of medical education—harkening back to Columbia University in just 1993—its ritual and symbolism confers immense power in marking the transformation from layperson to medical learner and provider.

K. Patrick Ober, MD, professor and medical director of the PA program, delivered his annual address exhorting students in their new profession. Ober spoke first about the practical use for the white coat, and the inevitable swelling of its pockets with pens, medical equipment and quick reference materials. He quoted from A.A. Milne’s Winnie-the-Pooh and recited a poem from the perspective of a student feeling unprepared for rounds. He closed with his annual, moving story of a resident who is unable to save a young mother and must relay this news to her spouse and young children. The story poignantly captured the heavy responsibility students will one day shoulder as they begin to care for patients.

Assistant Professor Ian Smith (’11), MMS, PA-C, who serves as director of admissions was tasked with reading each student’s name as they received their white coat. Afterwards, Smith recalled his own white coat experience at Wake Forest PA in 2009, “I felt like I hadn’t done anything to deserve getting my white coat.” He remembered Ober’s address and said it was as touching then as it was this year, eight years later. “I also remember thinking Dr. Ober’s impression of Piglet was pretty good,” he added.

Though not all clinical environments warrant its use, Smith said he wears his white coat often, because “it carries an implied trust; patients think, ‘you have the white coat on so I can tell you things.’ ” “To me, it’s practical, protective, but it’s also a signal to myself that it’s time to assume the patient’s trust. Be here in the moment. Focus on what they need right now.”

STUDENTNEWS Class of 2019 by the numbers 1,494

TOTAL APPLICANTS

284 INTER VIEWED 88 ADMITTED:

64 AT WINSTON-SALEM CAMPUS

24 AT BOONE CAMPUS 77 WOMEN 11 MEN 31 FROM NC

20 FROM THE SOUTH

13 FROM THE NOR THEAST

13 FROM THE MIDWEST

10 FROM THE WEST 1 FROM CANADA 3.54 AVERAGE TOTAL GPA 25.3 AVERAGE AGE 2,664 AVERAGE CLINICAL HOURS 25 WITH ADVANCED DEGREES

(1 PhD, 1 OD, 2 MPH, 5 MS, 16 MA)

26 WFU GRADS 6 APPALACHIAN STATE UNIVERSTIY GRADS

Students walk to fund Alzheimer’s disease research Alzheimer’s disease is a devastating form of dementia. There are very few families that have not been impacted by its unrelenting progression. Researchers at Wake Forest School of Medicine are working to slow or halt that progression at its source.

Wake Forest PA students are doing their part, too, by raising money for Alzheimer’s research. For the second year in a row, students have organized a team, Wake Walks, to take part in the nationwide Walk to End Alzheimer’s. About 20 first- and second-year PA students have signed up for the October 21 walk in Greensboro, N.C., and more are expected to participate.

Last year, 12 PA students raised $10,365 toward Alzheimer’s research. “It is our goal to build our team of walkers and eclipse that number in 2017,” said Andrew Gray (’18), one of the organizers. “To walk with us, or to donate to the cause, please visit http://act.alz.org/ goto/WakeWalks for more information.”

On the research front, rather than focusing solely on the pharmacological responses to Alzheimer’s disease, WFSM scientists are studying preventative measures that could reduce its prevalence.

In 2018, Laura Baker, PhD, an associate professor in gerontology and geriatric medicine, will embark on a two-year, $20 million study to discover the effectiveness of preventative medicine techniques. Baker’s research will look at the impact of these techniques on cognitive function in older adults at an increased risk for cognitive decline and dementia. Similar ongoing studies have taken place in Finland, Singapore, Australia and other countries.

Wake Forest will lead the pursuit in the United States. Baker’s study will include 2,500 patients and will explore the effect of a specific combination of physical exercise, nutritional modification, cognitive and social stimulation, and the improved management of specific co-morbidities on global cognitive function and short-term memory.

Learn more about the study here.

FALL 2017

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STUDENTNEWS 16

Parent to Parent connection with Boone students going strong Melissa Shore and her family consider the Parent to Parent Family Support Network in Boone, N.C., a safe haven.

Shore, a seven-year member of the organization, appreciates the accepting environment she, her husband and their autistic son experience at Parent to Parent. She also appreciates Wake Forest PA students from the Boone campus who attend the group’s events.

“The students are always positive and outgoing with great attitudes and excitement to meet everyone,” Shore said. “It is important for medical professionals and different professionals, like therapists, to see the family unit and understand the children at a different level than just seeing them in the office.”

Parent to Parent brings together families of special needs children and works to enhance their skills and increase resources to support the children. The group focuses on providing information, referrals, training and resources to families of special needs children throughout western North Carolina. Parent to Parent promotes collaboration of families and service providers, supports foster families, participates in service learning projects and advocates family-centered care and education for special needs children.

Wake Forest PA students have been involved with Parent to Parent since the Boone campus’ inception in 2014. As a part Melissa Shore and her son Tyler of the Caring for Caregivers aspect of the “VITALS of Being a PA” course, Boone PA students learn about the stress and obstacles parents face as caregivers of their special needs children through Parent to Parent activities. Eight Boone students attended a pot-luck picnic in August with Parent to Parent members to kick off the school year.

“I had so much fun interacting with the kids and I’m looking forward to engaging with them at future events,” said PA student Caitlin Joyce (’19).

Megan Miller (’19) said she appreciates the opportunity to get involved in the Boone community and to interact and learn from Parent to Parent members. “Interacting with family members who are primary caregivers of children with disabilities allows us a unique perspective which will be beneficial to us as future health care providers,” Miller said.

Boone students will attend monthly Parent to Parent meetings and participate in counselor-led discussions with parents. Throughout the didactic year, the students will go in groups of four to listen, participate and learn first-hand about the hurdles, barriers and stressors parents of special needs children face.

In a world where it can be “difficult to relate to people because they just don’t have a clue what you’re going through,” Ms. Shore said she finds Parent to Parent a great outlet.

Kaaren Hayes, director of Parent to Parent, describes the organization as “another family which provides the opportunity to be with a group of people who are not going to judge you, who are going to understand you, and who are going to accept you, without question.” Hayes stresses the importance of providing a place for families to “truly be themselves and be able to talk about anything, and also, of course, laugh.”

Hayes was a recipient of the Wake Forest PA Studies’ Community Partnership Award this year. The award, presented at commencement in May, recognizes organizations that have made significant contributions to students’ educational experiences.

The strategy behind PA students’ involvement with Parent to Parent is furthering their development into empathetic, understanding medical professionals. “I’m excited for the opportunity to begin fostering connections with the Parent to Parent Support Network and making a difference in the community,” said Boone student Megan Curan (’19).

Parent to Parent is part of the Reich College of Education at Appalachian State University.

INSIDE WAKE PA

STUDENTNEWS Students work alongside faculty at weekly free clinic Every Wednesday night, a rotating roster of Wake Forest PA students step away from their academic demands to help treat medically underserved patients under the watchful eyes of clinician proctors at the DEAC clinic in Winston-Salem.

Founded in 2006, DEAC, which stands for Delivering Equal Access to Care, is a free clinic run by students and faculty at Wake Forest School of Medicine for anyone who’s uninsured and doesn’t qualify for government assistance. Its mission is simple: to provide for people left stranded by gaps in health care coverage, to allow students the opportunity to care for real patients and to practice the values of service and compassion. PA and medical students volunteer to help where they’re able while faculty and providers from the community guide the appropriate diagnostics, treatment and counseling for each patient.

Instructor Kristin Lindaman, MMS, PA-C, of the PA program, is the PA

faculty adviser for the DEAC clinic. “We support students as they manage the clinic, and help provide resources for the needs that students identify in the patient population,” Lindaman said.

“Involved faculty also serve as preceptors on clinic nights.”

The DEAC clinic goes beyond the scope of most student-led free clinics by providing long-term continuity of care.

DEAC hosts specialty clinics in cardiology, dermatology and sports medicine in addition to providing routine office visits, social work, mental health services and free onsite medications. Students with previous lab training often perform bloodwork and other lab tests at the clinic, while others serve as interpreters, triage or on the medical team alongside a licensed provider.

Jennifer Nall (’19) recently volunteered at DEAC for the first time.

Due to her professional background in public health, she was assigned to perform health and wellness counseling focused on smoking cessation, STI

prevention and exercise and nutrition habits. “It forces you to really think through practical treatment options,” Nall said. “If they are a diabetic and you want them to eat vegetables, you have to think; do they actually have access to fresh vegetables?”

Nall’s question led one student to collect and distribute donated fresh produce at the clinic. That night, each patient left with a fresh peach.

“For me, volunteering in the community health setting teaches you not to make assumptions about your patients,” Nall said. “You have people who’ve already overcome so many obstacles before they even reach the door. It’s important to develop an awareness that your patient might have to take three different buses, find childcare and scrape together money to pay for treatment, and how that all impacts their health.”

PA student Xiao Fu Liu examines a patient’s foot at the DEAC Clinic while medical student Carter Devlin observes.

FALL 2017

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ALUMNINEWS 1980s Marisa Faircloth (’82) notes that this fall marks the second anniversary of opening her Restoration MedSpa practice in Winston-Salem and January will mark a year for her Greensboro location.

Restoration MedSpa has been awarded Diamond Status by Allergen which gives her practice the distinction of being placed in the top four percent of all Allergen practices in the nation.

1990s Karen J. Hills (’99) has accepted a position with the Physician Assistant Education Association (PAEA) as Chief of Education Development. The position starts in October.

Jeff Hinshaw (’92), chief PA in emergency medicine at Wake Forest Baptist Medical Center, was awarded the John Burwell Excellence in EMS Award by the Region I Advisory Council. The award recognizes Hinshaw’s impact on EMS within Region I (Forsyth, Davie, Stokes, Surry and Yadkin counties). Hinshaw was nominated and selected for the award by colleagues in the advisory council. The award is named in memory of Burwell of Stokes County, who worked to improve hospital care and the regional EMS system.

2000s Kaye Brownlee Rickman (‘07) recently left her full-time clinical position to become an Assistant Professor in the Department of PA studies at North Greenville University in Tigerville, S.C. She is enjoying her new role and looks forward to catching up with classmates and former faculty in the near future.

Anne (Chlebowski) Johnson (’11) and her husband welcomed a son, Nolan Alexander Johnson, on August 3.

Steven Ward (‘12) has joined the Mount St. Joseph University PA Program as a principal faculty member. The program, located in Cincinnati, will matriculate its first class in January of 2018. Ward continues to work clinically for the University of Cincinnati in the Emergency Department and resides in Loveland, Ohio, with his wife and three children.

Allison Petrilli Knox (‘14) welcomed a baby girl, Emery Gray Knox, on May 17.

Anne Victoria Mack (’15) has been nationally recognized for earning a Certificate of Added Qualifications (CAQ) from the National Commission on Certification of Physician Assistants (NCCPA). Mack received the CAQ in emergency medicine, a distinction earned by meeting licensure, experience and substantial continuing medical education requirements and then passing a national exam in the specialty.

Mack, a former employee of Wake Forest Baptist Medical Center, has joined Spartanburg Regional Healthcare System in Spartanburg, S.C. John Ramos (’16) is the co-author of “Foot Exams in a Student-run Clinic” which was published in the August issue of the Journal of Student-Run Clinics.

Eric R. Bifolck (’17) has completed an ophthalmologic training course in Maine.

Bifolck reports that he is the first PA to go through the course, which was attended by ophthalmologists from around the world, and that he did his best to represent the profession well. “It has been an extraordinary experience,” he said.

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PHOTO ALBUM

Rite of Passage Transitions within clinical training are often complex, but there’s one that Wake Forest PA students always enjoy: the rite of passage from the preclinical year to clinical year.

At the end of the month-long clinical year prep course for the Class of 2018, faculty and staff gathered in the classroom at the end of June for an informal ceremony to celebrate and encourage students as they head out to start rotations. There is much cheering, pom-pom waving and clapping.

Each student’s name is called, and they pass a gauntlet of faculty and staff where their white coat pockets are filled with snacks and treats to get them through long shifts with no lunch. A clinical year pin is affixed to their white coats, and they are all wished well.

Brian Peacock (’10), MMS, PA-C, summed it up for all faculty and staff, “It is my favorite day of the 24-months of PA school.”

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First-year students enjoy a team-building event in Bailey Park

Happy Fall Spring from from thethe Wake Wake Forest Forest School School of Medicine of Medicine Department Department of PA of PA Studies!

Studies!

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AR E A

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Teri Capshaw, Tanya Gregory,departmental assistant professor, projectdirector manager

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