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Sentara Provides Hands-On 'Incubator' Learning Setting For Healthcare Students

By Irv Harrell

In a nondescript building across the light-rail train tracks on Colley Avenue in Norfolk sits the Sentara Ambulatory Care Center, a facility offering free medical services to adults who are low-income, uninsured or underinsured through Medicare and Medicaid.

But that's not all this facility offers.

Twice a month the clinic opens its doors to students from several healthcare disciplines - serving as an incubator of sorts for the future of caregiving. The program is called the Interprofessional Collaborative (IPC) Clinic. It is operated by students and has been improving lives for two years.

After a year of planning - which included development and practice sessions with standardized patients (patient actors) - the IPC Clinic began operating once a month from noon to 4 p.m. for its first year. Now it runs twice a month (every other Tuesday) from 1 to 3:30 p.m. The clinic got its start through grant money for a collaborative effort between Old Dominion University and Eastern Virginia Medical School (EVMS).

"This is truly a joint effort," said Tina Gustin, one of ODU's faculty spearheading the program. "Some faculty are grant funded and some are volunteers. Some of the students that attend the clinic are doing so as part of a class, others are attending as part of their clinical experience."

Gustin is just one of several people who ensures this clinical collaboration works effectively for students, educators, and, of course, patients. The clinic was founded after meetings with Gustin and Carolyn Rutledge from ODU's School of Nursing; Sharon Stull from ODU's School of Dental Hygiene; Dr. Ana Vazquez from Sentara; Drs. Bruce Britton and Jen Ryal from Eastern Virginia Medical School (EVMS); and Karen Kott from ODU's School of Physical Therapy & Athletic Training.

"The focus was to get a group of students together to ask real patients about their social determinants of health," Kott said. "The students would get real-life experiences. The students would learn to talk with patients and then with each other, and then offer recommendations for patient care."

Vazquez specializes in family medicine and is affiliated with several area hospitals, including Sentara Norfolk General and Sentara Virginia Beach General. She facilitates the care at the clinic which serves her patients. Ryal oversees medical students and residents participating in the clinic. ODU School of Nursing's Jamela Martin also has joined the initiative, working with undergraduate nursing students.

"As the students arrive to the clinic, I sit down with them and provide them an overview of the IPC Clinic, which includes a tour of the clinic space, a discussion of the broader purpose of the IPC, and what types of patients are seen," Martin said. "I provide mentorship and guidance to the nursing students during their reports to the interprofessional teams and assist with organizational needs as they arise for the clinic overall."

Among the considerations when addressing social determinants of health for the clinic's patients are transportation, housing, dental health, physical needs such as mobility devices, obtaining food stamps and Medicaid.

Clinic participants include EVMS students and family medicine residents, ODU family nurse practitioner students, adult gerontology clinical nurse specialist students, undergraduate nursing students, physical therapy students, masters level clinical counseling students, ODU dental hygiene students and Hampton University social work students.

"Most importantly, we have a doctor of nurse practitioner (DNP) student leading the clinic for both their practicum experience and research," Gustin said.

Jonathan Taylor, the DNP student leader, has many responsibilities at the clinic: providing education to patients, physicians, nurses, and students of other programs about the clinic; attending and leading meetings with key leaders; developing and discovering resources for clients; building and maintaining relationships for local and state agencies; coordinating patient flow; and ensuring appointments and referrals are executed via follow-up. Taylor said his experience at the clinic has been more than inspirational.

"We are actually leading the change that we want to see in our nation's health care, all while setting the stage to influence global healthcare education," he said. "While most learners only come to our clinic for one or two visits, I have no doubt they take what they learn from our clinic and apply it to their practice. By providing care while working together, we are bringing the best options possible to patients while increasing our collective knowledge."

Taylor said the clinic's schedule allows for seven patients per clinic day (14 a month), and visits can take from 1½ to 4 hours. While transportation is often a problem for many patients, "if they show up, we see them," Taylor added.

Katie Harris, a senior in ODU's School of Nursing, said she heard about the clinic through her community health nursing class. The holistic approach to working with patients was of particular interest to her. Among her takeaways from the clinic experience was something as seemingly simple as the importance of keeping patients informed about their care, but also the sobering reality that "you cannot force someone to receive care, no matter how much you think they need it."

In the fall of 2016, Stull, an ODU dental hygiene lecturer, was invited by Rutledge to the IPC Clinic. One of the things that really impressed her, she said, was how the students handled the experience.

"When the student team is assigned to a patient, they were quiet, introspective, a little nervous and unsure of what value this experience would provide," she said. "After the direct, patient-centered interaction and engagement portion of the clinic, the student team came out of the room as one - centered, focused, caring and moved."

Kott said many students who have taken part in the clinic were surprised at how complicated the patients' needs were. Additionally, they learned the overlapping roles of health professionals and where certain professions play bigger roles depending on the issue.

Gustin, in citing one of her biggest takeaways, puts it succinctly: "It takes a village."

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