/ spring 2019 issue / THE STATE OF SIMULATION / the objective structured clinical examination lab, the school’s fourth simulation lab, is a space for nurse practitioner students to improve their clinical skills.

The George PHOTOGRAPHY ERIN JULIUS Washington University REESE RACKETS PRESIDENT FEATURE WRITERS THOMAS LEBLANC ERIN JULIUS MEREDITH LIDARD KLEEMAN School of Nursing WRITERS DEAN AND PROFESSOR RUTH ADAMS PAMELA JEFFRIES JON EICHBERGER REESE RACKETS GWNursing CRYSTAL SCHELLE EDITOR-IN-CHIEF EDITING DAVID BIGLARI Division of External Relations KEITH HARRISTON MANAGING EDITOR RACHEL MUIR ERIN JULIUS DESIGN Cover Artwork KATE CONNOLLY

Marketing and Creative Services HEATHER OESTERLING (Design and Illustration) JOSH SCHIMMERLING (Project Management) spring 2019

DEPARTMENTS FEATURES 02 FROM PENNSYLVANIA AVE. 04 HEALTH POLICY & MEDIA ENGAGEMENT

8SIMULATION IS THE FOUNDATION

/ spring 2019 issueProponents / of health care simulation 16 education have said for years that it improves RESEARCH & SCHOLARSHIP clinician performance and reduces patient safety errors. In the past decade, it has THE STATEadvanced OF rapidly due in large part to the efforts of nurse educators. It’s time to reflect SIMULATIONon where simulation education has been and 23 where it’s going. AGING, HEALTH & HUMANITIES 24 COMMUNITY & GLOBAL INITIATIVES

GWNursing is published biannually by:

GEORGE WASHINGTON UNIVERSITY SCHOOL OF NURSING 28 1919 Pennsylvania Ave., NW RAISING HIGH AT GW Suite 500 Washington, DC 20006-5818 EXPLORING NEW AVENUES IN Telephone: 202–994–7901 ADVANCED PRACTICE Email: [email protected] 12 Website: nursing.gwu.edu NURSING EDUCATION

Comments, letters, advertising and change of address A growing and aging population, large notices are welcome. numbers of students and competition for ©2019 The George Washington University clinical sites have created a “traffic jam” in

The George Washington University is an equal advanced practice nursing education. opportunity/affirmative action university. At the same time, with a growing provider shortage, it’s more important than ever that the profession efficiently produces well- prepared providers.

nursing.gwu.edu | 1 from pennsylvania ave

If you want things to change, start a conversation. Maybe we take that for granted here in the nation’s capital, surrounded by national organizations and agencies of health. When I walk out onto Pennsylvania Avenue, I often find myself tripping on one of the many soapboxes throughout the city. Every once in a while, however, you fall into an important conversation at the intersection of education At the and policy. This happened over the winter to me when my colleagues and I began a vital conversation Intersection of about the state of simulation in nursing education and its future. As educators, we know that incorporating simulation into the nursing curriculum instills confidence in students, allows immersion in their scope of practice, all in a safe, nonthreatening environment, and ultimately Education and produces high-quality providers. While the literature points to clear benefits and outcomes of simulation at the Policy undergraduate level, the body of evidence is lacking at the advanced practice nursing level. Given the scope of practice nurse practitioners have in each state, the use of simulation in instruction is as much a question of policy as it is education. In this issue of GWNursing, we offer an invitation to our colleagues to engage in a national dialogue in order to discuss the clinical education challenges and to call for a strong body of research through multisite studies that will lead to the evidence and establishment of best practices for simulation in graduate Pamela R. Jeffries, nursing education. PhD, RN, FAAN, ANEF, FSSH Like most great things, we can’t do it alone. Partnering with national nursing organizations Dean | School of Nursing is key to this discussion. We are fortunate to have several GW faculty on nursing boards, The George Washington University including Sigma Theta Tau International President-Elect Richard Ricciardi who writes on their importance to your career and the profession on page 6. If you are looking for more conversations, I encourage you to learn more about our Health Policy Leadership Lecture Series on page 4 to discover how you can get involved in health care policy. No matter what your daily journey entails, I encourage you to get out and occasionally trip on a soapbox. Sometimes the first step in creating change is to stumble into a conversation.

2 | / dr. pamela slaven-lee presents on simulation in graduate nursing education at the annual gw simulation conference in march 2019.

The Future of Graduate Simulation - Let’s Build It Together

Over my years of staffing, events and introducing best practices for share resources and establish best practices. organizing and refining instituting them. Too often, I still hear I now broaden that invitation to those of simulation being used for summative readers interested in helping develop the simulation-based learning events assessments rather than formative learning. use of simulation in advanced practice and how we use them in nurse Experience shows that simulation used in nursing education. practitioner education, I’ve seen high-stakes testing does not benefit our Join us and let’s build a future of graduate learning happen. I’ve watched the students and, in reality, can shake their simulation together. proverbial “light bulb come on,” as confidence. True learning occurs and students examine a standardized confidence is built through a formative use of  To get involved, visit simulation. today. patient, or receive feedback from go.gwu.edu/simconsortium Now is the time to establish these an instructor after an Objective best practices. Clinical Structured Exam exercise. During GW Nursing’s March simulation conference, I invited my graduate colleagues Pamela Slaven-Lee, DNP, FNP-C, CHSE Our undergraduate colleagues, to join us in a simulation consortium, where Sr. Associate Dean for Academic Affairs | however, are ahead of us in establishing a we can acknowledge challenges before us, School of Nursing body of literature to support simulation The George Washington University

nursing.gwu.edu | 3 health policy& media engagement

I served on the Senate’s Special Committee for Aging in the office of the chair, Sen. Susan Collins (R-Maine), during my Health and Aging Policy Fellowship in 2018. A large part of the work I did for the senator and Aging Committee focused on Alzheimer’s disease and working to get the BOLD Infrastructure for Alzheimer’s legislation passed in the 115th Congress. More than 5 million Americans over the age of 65 are living with Alzheimer’s and that number is expected to triple by 2050. Of the top 10 leading causes of death for Lecture Series Brings Health older adults, Alzheimer’s is the only one that cannot be prevented, slowed down or treated. The number of deaths from Alzheimer’s Care Leaders to Campus increased 145 percent between 2000 and 2019, while deaths from other diseases, such wide-ranging discussion on the burgeoning The Center for Health Policy as heart disease and cancer, decreased in innovation in health care. Despite a political and Media Engagement last that time frame. The cost of unpaid family climate in which research budgets have been fall launched the Health Policy caregiving is estimated at over $232 billion cut, health care is relatively safe because it is and more than 18 billion hours. Leadership Lecture Series, which so clearly critical, he said. While we wait for a cure, those with the brings to campus notable leaders This spring, Terry Fulmer, president of disease will need care. All types of dementia in the health care field. and chief strategist for the John A. Hartford are essentially “brain failure,” and providing Foundation, visited the campus as part of the care requires a unique set of skills. Our U.S. Surgeon General Vice Admiral Jerome series to discuss age-friendly health systems. M. Adams visited GW’s Foggy Bottom communities and families do not have these campus in October as the series’ first speaker. skills in today’s society, and the BOLD Dr. Adams discussed the nation’s opioid Infrastructure for Alzheimer’s Act seeks to epidemic and identified stigma as the number Helping address this. 1 killer. Headed by the Centers for Disease “As members of the most trusted Caregivers Give Control and Prevention (CDC), the BOLD profession, nurses can help alleviate that Infrastructure for Alzheimer’s Act will stigma and encourage patients to seek Care establish Centers of Excellence to implement recovery,” Dr. Adams said. “There is nothing the CDC’s Healthy Brain Initiative through more powerful than a nurse armed with the by melissa batchelor-murphy state and national partnerships. correct information.” Most caregivers are friends and family members, and their lives are negatively Mental health, opioid abuse and obesity On Dec. 31, 2018, the president are just a few of the stigmatized health issues. impacted by the financial, emotional and The stigma keeps people in the shadows signed into law Building Our physical cost of caring for someone with and prevents them from getting help, Largest Dementia (BOLD) dementia. The Centers of Excellence will Dr. Adams said. Infrastructure for Alzheimer’s promote public education on early detection Victor Dzau, president of the National Act, bringing much needed and diagnosis. By supporting early detection, Academy of Medicine, also spoke this past attention to the needs of over 5.7 the BOLD Infrastructure for Alzheimer’s Act allows persons living with the disease winter as part of the series. million Americans living with Currently, health and health care are and their caregivers more time to plan and the most prolific areas for technological Alzheimer’s disease and related prepare their health care and end-of-life advancement, Dr. Dzau said during a dementias. strategies.

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As the BOLD Infrastructure for illuminate health disparities at the state and get that information out to the public to Alzheimer’s Act moves into the national levels. minimize the impact Alzheimer’s has on our implementation phase, the work We know that Alzheimer’s disease families, communities and the nation. will be accomplished through cooperative is on track to be the costliest condition agreements among public, private and in our nation’s history and is the most nonprofit organizations. The CDC’s under-recognized threat to public health Melissa Batchelor-Murphy, PhD, RN-BC, FNP- proposed action plan has one goal to monitor in modern times. The BOLD Act is among BC, FGSA, FAAN, is an associate professor at prevalence rates across the country. Data the first to draw attention to the enormous George Washington University School of Nursing grants will improve the analysis of data burden this disease brings. There are things and director of GW’s Center for Aging, Health and collected on Alzheimer’s caregivers, and will we know to do that help, and we need to Humanities. She is profiled on page 23.

Blurb from Politico

In the Media “Medicaid, low-income and rural populations don’t use live The New York Times telecommunication with providers as much as other groups do, + y. tony yang highlighted researchers in another study found. Older Americans Are Flocking to That remained true even in states Medical Marijuana with less restrictive telehealth Oils, tinctures and salves — and sometimes policies, according to a study old-fashioned buds — are increasingly authored by Jeongyoung Park common in seniors’ homes. Doctors warn that popularity has outstripped scientific and other George Washington University scholars. The authors evidence. (a) suggested that making state policy December 7, 2018 less restrictive isn’t enough to encourage adoption, and that U.S. News & World Report patients may need better incentives + pamela jeffries highlighted for using telemedicine.” a 4 Tips for Mapping Out Online Program Courses For prospective online students, it’s b important to choose an online degree program that meets their professional and personal needs, and how different programs are structured plays a huge part. (b) November 29, 2018

Nursing Times + diana mason highlighted Let’s Give Thanks to Nurses When most people think of a nurse, they likely envision someone in a hospital with a stethoscope around her neck, wearing scrubs.

November 22, 2018 health policy & media engagement

national conferences, journals and other and challenges and evolve our careers through Why Should resources to ensure continuous learning and meaningful opportunities. support licensure or specialty certification. Nurses represent the largest segment You Join a Participation in conferences and other of the health care workforce. As such, programming, whether in person or nursing organizations play an important Professional virtually, provides the added benefit of an role in representing and strengthening the opportunity to interact with scientists and capabilities and value that nurses bring to Organization and subject-matter experts to share ideas about improving health for individuals, families how to implement new evidence to improve and communities. Ensure your unique voice Get Involved? practice and care delivery. Some professional is included through active participation organizations also partner to offer reduced as we move our profession forward. fees for malpractice insurance and continuing education credits. Exposure to fresh ideas and innovations Richard Ricciardi, PhD, CRNP, FAAN, is a in care delivery stimulates our creativity and professor at George Washington University School provides an opportunity to tackle complex of Nursing, president-elect of Sigma Theta Tau issues in practice, education, research and International and past-president of the National policy. Professional organizations offer a rich Association of Pediatric Nurse Practitioners. and unparalleled venue to engage with and by richard ricciardi learn from talented and successful leaders. The opportunity to network with a diverse Faculty on Boards group of colleagues, to strengthen your Participation in professional leadership, writing and public speaking skills, The nationwide “Nurses on organizations has substantially and to develop a broader understanding Boards Coalition” is implementing shaped my career and has provided of organizational systems are key benefits. recommendations from the 2010 Institute of Medicine report, The Future me with opportunities to not Participating in organizational initiatives of Nursing: Leading Change, Advancing only become a more productive, such as guideline development, conference planning or policy statement preparation, or Health, and aims to have 10,000 nurses informed and engaged nurse, but serving on a journal editorial board stretches serving on boards by 2020. also a more thoughtful and globally your skills, confidence and scholarship. At GW Nursing, several faculty members connected individual. I encourage In my own career, the opportunity to serve on national boards where they everyone, both those who are new work alongside a diverse group of colleagues influence the future of the profession and steer health policy: to the profession and those who on committees or work groups has nudged me to take on new roles and progressively are already established, to engage Associate Professor Mercedes Echevarria greater responsibility while also providing deeply in the transformative and mentorship and support. Taking on active National Organization of Nurse Practitioner healing power of our nursing roles in professional organizations has also Faculties — board member at large profession through membership in allowed me to give back to the profession that Dean Pamela Jeffries a professional organization. has given much to me. We all stand on the shoulders of the giants that have come before American Academy of Nursing — board Active membership brings with it the us, and professional organizations provide of directors joy and privilege of helping others beyond a venue for us to pay that legacy forward, Global Network for Simulation in those in your immediate workplace and both individually and collectively. These Healthcare — board member provides access to limitless possibilities for organizations play a critical role in capacity Associate Professor Karen Kesten professional achievement and fulfillment, building, career development and succession AACN Certification Corporation — immediate both locally and globally. The nursing planning for the profession through past chair of the board of directors profession offers a number of valuable scholarships, academic awards, leadership organizations you might consider joining. development workshops, formal mentoring Associate Professor Mayri Leslie Some are nursing focused, whereas others are programs and research funding. International MotherBaby Childbirth interprofessional or specialty focused. Contemporary health care is demanding, Organization — board of directors Regardless of your professional experience fast-paced, complex and dynamic. Day-to-day or career phase, being an active member stressors can lead to a loss of purpose and Professor Angela McNelis in one or more professional organizations joy in our work. Professional organizations National League for Nursing — board has tangible benefits. Obvious benefits provide programming and networking of governors include access to local, regional and opportunities that allow us to share our joys

6 | health policy & media engagement

Assistant Professor Jeanne Murphy Network — collaborative community Professor David Keepnews American College of Nurse-Midwives committee member Hispanic Healthcare International — (representative for Region II) — board editorial board of directors Associate Professor Ashley American Journal of Nursing, Journal Darcy-Mahoney Oversight Committee — member Professor Richard Ricciardi Medical Legal Partnership Summit — Policy, Politics & Nursing Practice — Sigma Theta Tau International Honor Society planning committee member editor emeritus of Nursing — president-elect Beyond Flexner Alliance — research American Academy of Nursing, committee member Fellow selection committee — co-chair Research Faculty Edward Salsberg Bridging the Word Gap National Research American Academy of Nursing, bylaws National Resident Matching Program — Network — leadership team committee — chair board of directors Assistant Professor Maritza Dowling Associate Professor Kate Associate Professor Mary Jean Schumann Gerontology and Geriatrics: Research — Driscoll Malliarakis Nursing Alliance for Quality Care — chair of editorial board Washington, D.C. Board of Nursing, the advisory board Biometrics & Biostatistics Open Access Committee on Impaired Nurses — member ACT/ProExam — advisory board member Journal — editorial board Professor Angela McNelis Assistant Professor Majeda El-Banna State of Indiana, Mental Health Washington Regional Nursing Research & Addiction Services Development Program Consortium — co-chair — board member Faculty in SAGE Publishing — editorial advisory board member for nursing video collection Professor Joyce Pulcini Leadership National League of Nursing — award Policy, Politics and Nursing Practice — senior committee, home instead scholarship associate editor Advocacy is important at all levels and committee member, ambassador, District of Columbia Action Coalition — in all capacities. We have faculty Commission for Nursing Education board member members serving on committees for Accreditation — on-site reviewer national professional organizations, Eastern Nursing Research Society — Graduate Faculty Nancy Rudner editorial boards for health care and nomination committee member Journal of Lifestyle Medicine — research publications and boards of editorial board state organizations. Instructor Esther Emard Florida Action Coalition — steering board Sigma Theta Tau International — board of League of Women Voters of Florida, Health Associate Professor Melissa directors governance committee charter Care Committee — co-chair Batchelor-Murphy review task force member Nursing Open — editorial board URI Foundation — board of directors Associate Professor Mary Jean Schumann Journal of Nutrition in Gerontology and governance committee member Maryland Nurses Association — treasurer Geriatrics — editorial board State of Vermont — blueprint for health planning and evaluation committee member Clinical Assistant Professor Assistant Clinical Professor Linda Cassar Christine Seaton Association of Women’s Health, Obstetric Associate Professor Kathleen Griffith Virginia State Simulation Alliance — and Neonatal Nurses — research Oncology Nursing Forum — review board conference planning director advisory panel Associate Professor Joyce Hahn Research Professor Karen Wyche Associate Professor Catherine Virginia Board of Nursing American Psychological Association — board Wilson Cox Virginia Joint Boards of Nursing of educational affairs Virginia Nurses Association — commissioner and Medicine Women in Social Work Inc. — board member for nursing education Eastern Nursing Research Society — Assistant Professor Cameron Hogg Professor Y. Tony Yang membership committee Nurse Practitioner Association of the District BioMed Central Health Services Research — American Association of Colleges of of Columbia — president editorial board Nursing, Baccalaureate Education Conference Subcommittee — member Dean Pamela Jeffries American Association of Colleges Virginia Association of Colleges of Nursing of Nursing, Faculty Leadership — president-elect

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by meredith lidard kleeman

Proponents of health care simulation education have said for years that it improves clinician performance and reduces patient safety errors, but until recently they have lacked the data and evidence to share with academic leaders and policymakers.

Simulation education in health care has advanced rapidly in the past decade, due in large part to the efforts of nurse educators. The National Council of State Boards of Nursing (NCSBN) in 2014 released the results of a landmark simulation study, which was followed up in 2015 by the publication of the National League for Nursing (NLN) Jeffries Simulation Theory. GW Nursing Dean Pamela Jeffries’ work as one of the consultants of the NCSBN study and her eponymous theory helped legitimize simulation education in pre-licensure nursing education. The NCSBN National Simulation Study examined the role and outcomes of simulation in pre-licensure nursing education. The study provided substantial evidence that simulation can be effectively substituted for up to 50 percent of traditional clinical experience in all pre-licensure nursing courses, under conditions comparable to high-quality, high-fidelity situations described in the study. The study results reaffirmed simulation education advocates’ belief in this type of experiential learning strategy while providing concrete data to address concerns held by simulation skeptics. The research team had its own skeptics—they were unsure of how well simulation could supplement traditional clinical experiences in certain areas, including mental health, pediatrics and obstetrics, but the data showed no significant differences as long as the correct simulation technique was used. “For me personally, it was those areas that the simulation worked for that surprised me a little, as someone who likes traditional clinical experiences,” said Nancy Spector, the NCSBN director of regulatory innovations and a consultant on the study. ...continued

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(OSCE) center contains 12 patient exam Ms. Farina said. “We didn’t know how rooms and two acute care rooms, bringing important it was to the students’ self-esteem Study results influence the total simulation space available to both and to their socialization as a nurse if they state policy undergraduate and graduate students to didn’t catch the mistake,” she explains. The NCSBN study marked a shift in nearly 20,000 square feet. The NLN Jeffries Theory set forth how nursing schools and policymakers While the new OSCE space was designed guidelines that simulation should be viewed simulation education. Each state’s for nurse practitioner students to improve collaborative and transparent—the student, board of nursing makes its own decisions their clinical skills, GW Nursing also recently simulated patient (if one is used) and faculty regarding how much simulation can be used invested $400,000 in upgrades to make should know exactly what’s expected and to supplement traditional clinical experiences simulation as comparable to a hospital setting what the objectives are. in pre-licensure programs. After the NCSBN as possible for undergraduate students, “There’s no way students can meet the study was published, many states amended said Crystel Farina, the school’s director of objective if they get caught up in how to their policies and increased the amount of simulation and experiential learning. Those program the IV pump,” Ms. Farina said. allowable simulation. “The study has had upgrades include eight new moderate-fidelity Schools that implement high-quality a really positive impact on what boards simulators (manikins that breathe and have and high-fidelity simulation have seen of nursing are allowing,” Dr. Spector said. a pulse to practice certain skills, but with improvements in student performance and There was no evidence before the study, so fewer features than high-fidelity manikins), clinical confidence. “Anecdotally, we’re seeing boards made arbitrary decisions regarding new beds, IV pumps, medication dispensing much better outcomes from simulation simulation, and some states didn’t allow machines and workstations on wheels. The now that we have the NLN Jeffries Theory,” any amount of simulation to be used to school launched another renovation this Ms. Farina said. “Their ability to talk with supplement clinical experiences. spring that will add additional simulation and each other and other care providers is One year after the study was published, debriefing space, new technology, a virtual definitely enhanced. Their teamwork is also the NCSBN convened an expert panel reality space and a simulated operating room. much better—they’re able to work as a team, to develop national simulation guidelines As simulation director, Ms. Farina ensures and they don’t see things as individual tasks.” for pre-licensure nursing programs. These that all of the school’s many simulation Dr. Jeffries’ groundbreaking work has guidelines included evidence to support the events run smoothly. Simulation is influenced nurse educators for years, even use of simulation and information for faculty integrated throughout GW Nursing’s entire before the publication of the NCSBN study and program directors on how to incorporate curriculum—every course has some sort of and her eponymous theory. Jeffries’ 2007 high-quality, high-fidelity simulation in their simulation experience in it, Ms. Farina said. book, “Simulation in Nursing Education”, was programs. “My role is to ensure that not only does the Kellie Bryant’s go-to resource when she was Since the NCSBN released these simulation continue, but that it’s high quality hired as the director of simulation learning at guidelines in 2015, more than half of all and meets the standards of best practice,” New York University College of Nursing in pre-licensure programs in the country she said. 2008. have adopted them, according to a survey Those standards, which are set by the “From my experience, her book was conducted by the NCSBN evaluating the International Nursing Association for how a lot of us got started in simulation,” simulation landscape. That survey also Clinical Simulation and Learning (INACSL), Dr. Bryant said. “I’m talking over 10 years revealed that high-fidelity simulation use were developed based on the NLN Jeffries ago when there weren’t conferences or has substantially increased for almost all Theory and the NCSBN guidelines. Nursing other books or journals—that book was our undergraduate courses since 2010. schools now have a solid framework and template for simulation.” explicit standards to guide the development In her current role as executive director of high-quality simulation experiences. of simulation at Columbia School of Nursing, While the virtues of simulation as a teaching Dr. Bryant is using Dr. Jeffries’ evidence- High-quality simulation fosters strategy are well established, Ms. Farina and based approach to developing high-quality better student outcomes other dedicated simulation educators are simulations, with a focus on creating GW Nursing is committed to providing quick to point out that it’s crucial that simulation experiences that address proper students with high-quality, high-fidelity students engage in high-quality, high-fidelity medication administration. “We know that experiences and has made significant simulations. When simulations are conducted medical errors are a leading cause of mortality investments in simulation under the direction improperly, or not in accordance with the and death, and a component of that is giving of Dr. Jeffries, an innovator in promoting and guidelines and standards set forth by NCSBN the wrong medication or the wrong dose,” she advancing the field of simulation education. and INACSL, simulation can actually be explained. Recent renovations at Innovation Hall harmful to students. Dr. Bryant and her colleagues began with on GW’s Virginia Science and Technology In the early days of simulation use, manikin-based simulations, then moved Campus nearly doubled the simulation instructors would purposefully introduce on to using standardized patients (actors space available to nursing students. The new mistakes into a simulation in the hopes portraying patients) for students to practice Objective Structured Clinical Examination that students would catch the mistake, the proper protocols, such as reading a

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patient’s chart correctly, conducting safety Nursing schools with CHSE-certified colleagues developed simulation experiences checks, scanning a patient’s identification educators ensure that their simulation is for nursing and medical students that band and more. “The clinical instructors high quality and high fidelity, which is key to included specific competencies developed in the hospital are reporting that students following the standards and best practices set by the Interprofessional Educational have stronger skills than in the past, and forth by the NCSBN simulation study and Collaborative with intentional objectives seem more comfortable with medication the subsequent guidelines. related to the Team Strategies & Tools to administration,” Dr. Bryant said. “That’s “If you have a CHSE-certified person in Enhance Performance & Patient Safety because of simulation, because of deliberate your simulation center, you have high quality (TeamSTEPPS) teamwork system for health practice. Students understand the rationale, and high fidelity,” Ms. Farina said. “It really care professionals designed by the Agency and realize for each step why it’s important to does support what the study was requiring. A for Healthcare Research and Quality. Studies follow protocol.” lot of schools out there are doing simulations have shown that hospitals that implement but are completely missing that high-quality, TeamSTEPPS have improved patient high-fidelity piece because they don’t know outcomes, and Dr. Epps wanted the medical the pedagogy.” and nursing students to become familiar with Best practices and certifications that model of communication. for simulation educators “At first, students thought [the Although Dr. Bryant relied heavily on Dr. interprofessional simulation] felt very Interprofessional simulation Jeffries’ early books for guidance due to the strange,” he said. “But it got to the point lack of available training opportunities, she While nurse educators have advanced where if we did a simulation with just medical cautioned novice educators against jumping the field of simulation and set the standards students and the nursing students weren’t into simulation. for assessing clinical skills, other health care there, they’d look around and say, ‘Where are “All schools are realizing that if they don’t professions have also been using simulation the nursing students, something’s wrong.’” have a simulation program or a simulation- technology for years. In addition to increasing interprofessional based curriculum, then they’re behind the Chad Epps, executive director at the experiences among health care students, curve,” she said. “Everyone knows they have Center for Healthcare Improvement and Dr. Epps said he expects to see simulation to use simulation, but people aren’t really Patient Simulation at the University of used more widely among health care prepared to utilize it the best way. You have to Tennessee Health Science Center, recalls providers to improve patient safety. “We be trained, you have to have that theoretical using a simulation-based model for practicing shouldn’t just use simulation for students, background and you need to know what anesthesia during his medical residency we should use simulation for practicing you’re doing.” program in 2001. “I learned how to use professionals,” he said. “The airline industry For aspiring simulation educators, that anesthesia on a simulator before I ever has done this—if you’re a commercial pilot, begins with securing support from their did it on a patient,” he said. “That left an you have to go through simulation every six school’s leadership as well as procuring funds impression on me in terms of its potential as months or you risk losing your license. We to attend a training program or conference. an educational modality.” don’t have that in health care yet, although we “Education is the key—before you can start Dr. Epps pursued his interest in education probably need it.” using it with students and teaching other and simulation as he embarked on a career faculty, you have to know what you’re doing as an anesthesiologist. He became the and have that expertise first to utilize it and director of simulation at the University of Where does simulation go to teach others,” Dr. Bryant said. Alabama at Birmingham (UAB), where he from here? Without simulation training and started a program for nurse anesthetists and instruction on what qualifies as high developed the curriculum, which included Simulation-based curricula and the use of quality and high fidelity, schools will be interprofessional simulation experiences. simulation have been adopted by the majority out of compliance with the NCSBN and In his various simulation educator of pre-licensure nursing programs. Our work INACSL standards. positions, Dr. Epps has pushed for more continues in conducting the research to Educators who are committed to interprofessional experiences that mimic design best practices and to learn more about advancing their simulation knowledge and real-world clinical environments. how simulation-based experiences affect skills can become professionally certified. “We graduate these professional health student learning and, ultimately, patient The Society for Simulation in Healthcare students, and they go into clinics and outcomes and quality, safe care. developed its Certified Healthcare the clinical world, and they’re suddenly Simulation Educator (CHSE) certificate exposed to all of these other professions,” he in 2012 to recognize educators for their explained. “In the past, [these students] never expertise in simulation. The certification learned anything about those professions so demonstrates that an individual is committed they didn’t know what their role was, or what to simulation and has specialized skills the other professions’ role was.” and knowledge. During his time at UAB, Dr. Epps and his

nursing.gwu.edu | 11 feature 2 Exploring New Avenues in

By Erin Julius

A growing and aging population, Health care simulation experts from value because it evaluates those higher-level large numbers of students and professional organizations, schools and skills,” Dr. Bigley said. competition for clinical sites technology companies gathered in January of Carla Nye, clinical associate professor this year in Washington, D.C., to discuss how at the Virginia Commonwealth University have created a “traffic jam” in best to evaluate health care simulation in NP School of Nursing, and Suzanne Campbell, advanced practice nursing (APN) programs. associate professor at The University education. At the same time, with Hosted by the National Organization for of British Columbia School of Nursing, a growing provider shortage, it’s Nurse Practitioner Faculties (NONPF) and previously surveyed the research related more important than ever that the GW Nursing, the Thought Leaders’ Summit to simulation in NP education. Their profession efficiently produces on Simulation in NP Education examined examination of literature produced between existing evidence, discussed the challenges of 2010 and April 2015 found that a minimal well-prepared providers. evaluation and began formulating next steps. number of research studies had been Then in March, more than 100 nursing completed, the quality of studies was low, the GW Nursing Dean Pamela Jeffries educators attended GW Nursing’s second studies used small sample sizes, the use of describes the state of nurse practitioner annual simulation conference, which this year existing International Nursing Association (NP) education as a “traffic jam” due to the focused on simulation in NP education. for Clinical Simulation and Learning lack of available clinical sites and the larger (INACSL) standards wasn’t known and number of NP students compared to medical there was a lack of standardized scenarios. students. Many nursing leaders across the State of the science An update of their work looking at research nation this year have taken steps to clear the published between 2015 and 2019 did not roads, turning to simulation to supplement While a framework for the effective use of show much improvement in the state of the clinical education hours as another avenue simulation is established at the pre-licensure science, Drs. Nye and Campbell said. to provide the clinical practice hours and nursing level, little evidence exists regarding Despite its flaws, the existing body of competency testing for NP students. While simulation’s use in APN programs. research does offer promising outcomes, accrediting organizations require that NP NP education is fundamentally different according to Drs. Nye and Campbell: students undertake a minimum of 500 direct from pre-licensure education and requires Students like simulation and see its value; patient care clinical hours to prepare for their an entirely different approach from the students self-report more confidence; future role, many programs require hundreds established framework at the undergraduate simulation learning can be transferred to more clinical hours. Simulation offers a way level, said Mary Beth Bigley, CEO of clinical settings; and simulation can improve to clear congestion at clinical sites while NONPF. communication skills. ensuring students are prepared to deliver “When we get to this level of education, Drs. Nye and Campbell also conducted high-quality care. standardized patient encounters have more

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When we get to this level of education, standardized patient encounters have more value because it evaluates those higher-level skills.”

– Mary Beth Bigley, CEO of the National Organization for Nurse Practitioner Faculties

their own inquiry to describe the current Barriers use of simulation in advanced practice registered nurse (APRN) programs. The The survey study conducted by Drs. study was born of the research arm of a Nye and Campbell found that faculty skill Simulation in Advanced Practice Nursing and staff support were the most reported Task Force organized after discussions about barriers to simulation use. Programs reported APN simulation at the 2016 INACSL annual additional barriers to simulation use in APN conference. programs, such as an inconsistent course-by- Results of a descriptive survey sent to course approach to simulation, an increase in all APN programs in the United States and student fees to pay for resources, competition Canada show that a majority of the programs with undergraduate simulation resources and employed simulation up to 20 hours, with distance education. participants reporting a wide range of In small working groups, summit zero to more than 100 hours. Simulation is attendees identified forces that inhibit the most frequently implemented in physical adoption of simulation in achieving NP assessment courses, their survey showed, but competencies. Lack of resources and equity it was also used in many other courses. of resources between programs led the list, Schools most frequently reported using with limited faculty knowledge and skills standardized patients (SPs), but the use of and a dearth of peer-reviewed literature also manikins, computer and virtual simulation, emerging as major areas of concern. task trainers, interprofessional simulation, Educators evaluate an NP student’s ability video recording and distance/telehealth was to obtain a patient health history, conduct a also reported. physical exam, work through a diagnosis and This survey also showed that 98 percent create a management plan. All of these skills of respondents reported using simulation are based on critical thinking rather than in their APN programs, and 77 percent of manual skills, Dr. Bigley said. respondents supported the replacement Standardized patients are considered the of some percentage of clinical hours with highest-fidelity level of simulation, but the simulation. Drs. Nye and Campbell stressed resources required to both train and pay SPs survey participants who chose to complete were repeatedly cited as a barrier. the survey may have a pro-simulation bias. NP education is already undergoing a major shift, with programs working toward

nursing.gwu.edu | 13 feature 2 WE’RE LOOKING FOR EXPERIENCED NURSES to join our GW Hospital team

DEFINING MEDICINE

The George Washington University Hospital (GW Hospital) is a 385-bed, tertiary care, academic medical center located in downtown Washington, DC.

As an academic medical center, our employees and providers are Defining Medicine through their capacity to think, study, research, discover, evaluate, teach, learn, refine and innovate.

The mission of The George Washington compliance with the goal of a Doctor of development in simulation scenarios, Dr. Practitioner Education.” A white paper with University Hospital Nursing Practice (DNP) as the entry to McNelis said. a call to action regarding the need for more is to provide the practice by 2025. Faculty members who work closely with evidence to use simulations in NP clinical highest quality “NONPF is committed to the DNP as students know that simulation works, said education is expected to be published later the entry degree by 2025. NP practice should Pamela Slaven-Lee, senior associate dean this year and should set the stage for a healthcare, advanced be at the DNP level,” said Lorna Finnegan, for academic affairs at GW Nursing. “We’re rigorous study. technology and executive associate dean at the University of in the rooms with the students, and we see Evidence is needed through conducting world-class service Illinois at Chicago and NONPF president. the light bulb come on. We see the learning, multisite studies on NP clinical education to to our patients in an we know it’s happening, and we need the obtain evidence for new models of education. academic medical research so we can move forward. Our In the current environment, significant center dedicated Need for adoption undergraduate colleagues are ahead of us,” Dr. shortages of clinical sites, clinical preceptors to education and Despite the challenges and complications, Slaven-Lee said. and financial resources pose barriers to research. NP educators agree that simulation will only Current students are digital natives, NP education. These barriers create an grow in its value to the field. Christine Pintz, professor at GW Nursing, opportunity for educators to develop new Emerging evidence shows that learning said during the panel presentation at the models capitalizing on the strong tradition does occur during simulation experiences, March conference. “These are individuals of preceptor-based clinical experiences and said Angela McNelis, associate dean for who understand the simulation process and leveraging innovative and evidence-based scholarship, innovation and clinical science, also want this process,” she said. simulations that meet national competencies Join the hospital that is DEFINING MEDICINE at GW Nursing. Anecdotal evidence also reinforces the and continue to prepare graduates for To learn more, contact: Reliance on the current precepted clinical openness to including simulation in NP practice. As noted by Dr. Jeffries, the future • Reimbursement for certifications and model is a challenge to sustain or expand, programs, with one attendee sharing that her can be accomplished if there is a concerted annual certification bonus Lauren Graves colleagues call simulation “on-campus clinical effort to generate evidence through robust [email protected] • 202-715-5087 so educators must focus on maximizing • Eligibility to apply for the GW Signature student time in clinical settings and exploring hours.” and rigorous research on simulation in Scholarship to obtain a degree from GWU alternative models, she said. NP education. The current clinical model Roy Ector • A monthly travel stipend The demands and technology savviness faces ongoing challenges and requires new [email protected] • 202-715-5671 of this generation of learners dominated Moving forward thinking. It is time to be bold and institute • Annual tuition reimbursement the summit’s discussions about the need for To address the need for a standardized, new models that include evidence-based adoption of simulation. efficient, sustainable model for NP clinical simulation. Current evidence shows that students education, a team led by Drs. Bigley and report increased confidence, decreased Jeffries presented their proposed study on anxiety and communication skills “The Use of Simulation in Family Nurse

14 | The George Washington University Hospital is an equal opportunity employer. Physicians are independent practitioners who are not employees or agents of the George Washington University Hospital. The hospital shall not be liable for actions or treatments provided by physicians. 170349 1/17 WE’RE LOOKING FOR EXPERIENCED NURSES to join our GW Hospital team

DEFINING MEDICINE

The George Washington University Hospital (GW Hospital) is a 385-bed, tertiary care, academic medical center located in downtown Washington, DC.

As an academic medical center, our employees and providers are Defining Medicine through their capacity to think, study, research, discover, evaluate, teach, learn, refine and innovate.

The mission of The George Washington University Hospital is to provide the highest quality healthcare, advanced technology and world-class service to our patients in an academic medical center dedicated to education and research.

Join the hospital that is DEFINING MEDICINE

• Reimbursement for certifications and To learn more, contact: annual certification bonus Lauren Graves [email protected] • 202-715-5087 • Eligibility to apply for the GW Signature Scholarship to obtain a degree from GWU Roy Ector • A monthly travel stipend [email protected] • 202-715-5671 • Annual tuition reimbursement

The George Washington University Hospital is an equal opportunity employer. Physicians are independent practitioners who are not employees or agents of the George Washington University Hospital. The hospital shall not be liable for actions or treatments provided by physicians. 170349 1/17 research&scholarship

GW Nursing’s Dale Lupu is co-principal implement them, she said. investigator on a $2.4 million grant aimed at “It’s about the nitty-gritty details of improving the quality of care for seriously ill making new models of care and of figuring patients who have kidney disease. out what actually works to deliver more “This project will find ways they can have patient-centered care,” Dr. Lupu said. better support and care through the entire “We are working with the leading dialysis course of illness. It’s not only about dying; it’s centers and teams in their communities,” said about making the care more patient-centered Dr. Lupu. “These are centers that are willing from the moment of diagnosis,” said Dr. to innovate, to risk trying something new.” Creating Lupu, an associate research professor. Findings from the Pathways Project will Kidney patients in the U.S. face a deficit in also be relevant for other specialties, such as supportive care, also known as palliative care. cardiology, that seek to include more primary Care Protocol They are rarely offered alternatives to dialysis, palliative care into their care models. which may not extend life for patients already The Pathways Project is the first attempt for Kidney frail from other conditions. Instead, they to implement supportive care at multiple often face obstacles if they say that they value sites in the United States. Other countries Patients quality of life or wish for a peaceful death including Canada, Australia and Great Britain rather than multiple trips to the hospital and are implementing supportive care. by erin julius ICU at the end of life. Families of dialysis patients rate the quality of their loved ones’ end-of-life care worse than families of those “ We are so pleased that the A study titled the Pathways with cancer and other chronic conditions. Pathways Project has found Project may ultimately impact as The Pathways Project seeks to change that. many as 100,000 kidney patients While other countries offer disease a home here at GW Nursing. in the United States. management for end-of-life renal patients This important research without dialysis, treatment in the U.S. has will make a positive impact typically been more aggressive. on kidney patients and their The second phase of the Pathways Project, families.” based at GW Nursing in collaboration with – dean pamela jeffries West Virginia University, began in November 2018 and focuses on the implementation of best practices. This phase will address the In the first phase, the Pathways Project project’s central research question of whether developed 14 evidence-based best practice a quality improvement approach to spreading recommendations designed to improve supportive care best practices at dialysis supportive care delivery for patients with centers and affiliated clinics will measurably kidney disease. A technical expert panel increase the provision of supportive care defined the ideal care system for seriously ill best practices. patients with kidney disease. “We are so pleased that the Pathways In this ideal patient-centered system, Project has found a home here at GW patient preferences, goals and values are Nursing. This important research will make a discussed and respected, patients receive positive impact on kidney patients and their treatment in keeping with their goals, families,” said Dean Pamela Jeffries. and patients and families receive support, Experts have put out a number of resources and assistance to help them prepare guidelines and articles calling for more for end-of-life care. supportive kidney care, Dr. Lupu said. Now The Pathways Project is funded by the health care providers will figure out how to Gordon and Betty Moore Foundation.

16 |

Robert Wood Johnson Foundation Funds Study on State Laws Discouraging Tobacco Control Measures

by erin julius tobacco products, licensing tobacco, whether the United States, according to the Centers young people have access to tobacco products for Disease Control and Prevention (CDC), and where smoking is allowed. Preemptive making youths’ access to tobacco products a Some state laws that preemptively laws block local governments from taking key public health issue. prohibit tobacco control measures these steps to protect public health. Dr. Yang’s team will also examine may be at odds with common “Although a consensus exists among whether majority-minority counties are public health efforts. A new tobacco control practitioners that disproportionately impacted by state study, awarded $149,600 by the preemption adversely impacts tobacco preemption laws, potentially exacerbating control efforts, there is limited empirical health disparities between racial and Robert Wood Johnson Foundation evidence to quantify its effects on adolescent ethnic groups. Policies for Action program and health and health disparities,” said Dr. Yang, Although African Americans usually led by GW Nursing’s Dr. Y. Tony professor and health services and policy smoke fewer cigarettes and start smoking Yang, will examine the impact researcher at GW Nursing. cigarettes at an older age, they are more these state laws have had on Tobacco kills more than 480,000 likely to die from smoking-related diseases public health in the United States. people annually—more than AIDS, alcohol, than white Americans, according to the car accidents, illegal drugs, murders and CDC. Cigarette smoking among lesbian, gay, Specifically, the study will examine suicides combined. Tobacco costs the U.S. bisexual, transgender or queer (LGBTQ) laws enacted or repealed between approximately $170 billion in health care individuals in the U.S. is higher than among 1997 and 2017. expenditures and more than $150 billion in heterosexual individuals, with about 1 in 5 lost productivity each year. LGBTQ adults smoking cigarettes compared Effective tobacco control efforts include Each day, more than 3,200 people under 18 with about 1 in 6 heterosexual/straight adults, restrictions on marketing and promoting years old become daily cigarette smokers in according to the CDC.

nursing.gwu.edu | 17 research & scholarship B M CAROL BRAUNGART, A. Watson, R. Rubin. ANGELA MCNELIS, K. Dreifuerst, “The effects of interprofessional collaboration RHONDA SCHWINDT. “Educating nurses on nurse managed warfarin program.” Journal for the faculty role.” Nurse Educator, 2018. of Interprofessional Education & Practice, 2018. P F JEONGYOUNG PARK, C. Erikson, X. Han, D. Coppa, T. Schneidereith, CRYSTEL P. Iyer. (2018). “Are state telehealth policies FARINA. “Simulated home-based health care associated with the use of telehealth services Faculty scenarios for nurse practitioner students.” among underserved populations?” Health Clinical Simulation in Nursing, January 2018. Affairs, 2018. Publications November 2018 - April 2019 G R K. Sagherian, S. Zhu, C. Storr, P.S. Hinds, L. Schirlel, A. Norful, NANCY RUDNER, L. D. Derickson, JEANNE GEIGER-BROWN Poghosyan. “Organizational facilitators and (2018). “Bio-mathematical fatigue models barriers for optimal advance practice nurse predict sickness absence in hospital nurses: practice environments: An integrative review.” An 18-month retrospective cohort study.” Health Care Management Review, October- Applied Ergonomics November 15; 73: 42,47. December 2018.

ADRIANA GLENN, F. Claman. “Using a NANCY RUDNER. “Population health as a low-fidelity simulation to enhance cultural primary care priority.” American Journal of awareness and emotional intelligence Managed Care, 2018. in nursing students.” Nursing Education Perspectives, 2018. NANCY RUDNER. “Mending the patchwork of nurse practitioner regulations in policy and politics for nurses and other health professionals.” Advocacy and Action, Third H Edition, 2018. JOYCE HAHN. “The perceptions and experiences of national regulatory nurse leaders in advancing the advanced practice registered nurse compact policy agenda.” S Journal of the American Association of Nurse R.P. Newhouse, M. Janney, A. Gilbert, J. Agley, Practitioners, 2018. G. Bakoyannis, M. Ferren, C. Mullins, C. Daniel, M. Johantgen, RHONDA SCHWINDT, K. Thoele. “Study protocol testing toolkit versus usual care for implementation of L screening, brief intervention, referral to E. Anderson, A. Aldous, DALE LUPU. “Make treatment in hospitals: A phased cluster your wishes about you (MY WAY): Using randomized approach.” Addiction Science & motivational interviewing to foster advance Clinical Practice, 2018. care planning for patients with chronic kidney disease.” Nephrology Nursing Journal, RHONDA SCHWINDT, K.S. Kudmon, M. 2018. Knisely, L. Davis, C. Pike. “Impact of tobacco quitlines on smoking cessation in persons with mental illness: A systematic review.” Journal of Drug Education Substance Abuse Research and Prevention, 2018.

18 | research & scholarship

Y. TONY YANG, P. Zettler. “Food and Drug Administration’s regulatory shift on direct T to consumer genetic tests for cancer risk.” J. Maring, M. Vail, K.A. Wright, BILLINDA American Cancer Society, November 2018. TEBBENHOFF, K. Canova, E. Costello. Grants “Attitudes toward academic dishonesty.” Y. TONY YANG, J. Ortendahl. “How Journal of Allied Health, Winter 2018. does the Cox maze procedure compare? and Funding Cost-effectiveness analysis of alternative treatments of atrial fibrillation.” Journal of Associate Professor MELISSA , 2018. Medical Research and Opinion BATCHELOR-MURPHY received funding

W from the I-Corps: Innovation Corps for A. Maradiegue, D. Seibert, KAREN WHITT. Y. TONY YANG, J. Szaflarski. “The U.S. Food “Exploring Handfeeding in Dementia as a “Genomic assessment: Interpreting findings and Drug Administration’s authorization of Scalable Training Program for Long-Term and formulating differential diagnoses.” the first cannabis-derived pharmaceutical: Care Settings.” Advanced assessment: Interpreting findings and Are We Out of the Haze?” JAMA Neurology. formulating differential diagnoses, Fourth November, 2018. Assistant Professor MARITZA DOWLING Edition, 2019. received a subaward from the University Y. TONY YANG, J. Colgrove. “New York City of Wisconsin Madison for “Prevention of childcare influenza vaccine mandate.” JAMA Alzheimer’s Disease in Women: Risks and , 2018. Y Pediatrics Benefits of Hormone Therapy.” K. E. Baumann, J. Paynter, H. Petousis- R. Silverman, Y. TONY YANG. “Lessons from Associate Research Professor DALE LUPU Harris, R. Prymula, Y. TONY YANG, J. Shaw. California’s discipline of a popular physician received funding for “Pathways Project “Comparison of vaccination coverage of four for vaccination exemptions without medical 1 Closeout” from Quality Insights and childhood vaccines in New Zealand and New cause.” , 2018. JAMA Pediatrics funding for “Pathways Project II” from York State.” Journal of Paediatrics and Child the Gordon and Betty Moore Foundation. , 2018. P. L. Delamater, E.J. Street, T.F. Leslie, Y. Health Dr. Lupu also received a subaward from TONY YANG, K.H. Jacobsen. “Complexity Milken Institute of Public Health for B. K. Chen, Y. TONY YANG, C.L. Bennett. of the basic reproduction number.” Emerging “Evaluating Impact of Recent Federal Policy “Why biologics and biosimilars remain so , 2019. Infectious Diseases Changes on Hospice Utilization Among expensive: Despite two wins for biosimilars, Patients with Alzheimer’s Disease and the Supreme Court’s recent rulings do not Related Dementia.” Read more about Dr. solve fundamental barriers to competition.” Lupu’s work on page 16. Drugs, 2018.

Assistant Professor RHONDA SCHWINDT B.K. Chen, Y. TONY YANG, R. Gajadhar. received a subaward from University of “Early evidence from South Carolina’s Indiana for “Phased Multisite Cluster Medicare-Medicaid dual-eligible financial Randomized Trial Testing Screening, Brief alignment initiative: an observational study Intervention, Referral to Treatment for to understand who enrolled, and whether People that Use Tobacco, Alcohol, and the program improved health.” BMC Health Non-prescription Drugs.” Services Research, 2018.

Professor Y. TONY YANG received funding T.F. Leslie, P.L. Delamater, Y. TONY YANG. through the Robert Wood Johnson “It could have been much worse: The Foundation (RWJF) Policy for Action Minnesota Measles Outbreak of 2017.” Science for “The Effects of State Preemption of , 2018. Direct Local Smoking Restrictions on Health Disparities.” Policies for Action is a Y. TONY YANG, S. Glantz. “San Francisco signature research program of RWJF voters and the sale of flavored tobacco administered through the national products despite strong industry opposition.” coordinating center at the Urban Institute. , 2018. Annals of Internal Medicine Read more about Dr. Yang’s work on page 17.

nursing.gwu.edu | 19 research & scholarship

Anaheim, California Dowagiac, Michigan Dean PAMELA JEFFRIES gave the Dean PAMELA JEFFRIES gave keynote “Changing the Way We the keynote address during the Educate: Workforce Expectations simulation center grand opening and Evolving Health Care Systems” at Southwest Michigan College in and “APRN Summit: Developing January 2019. a Simulation Staff Educator Development Plan & Evaluation Strategies” during the National Association of Neonatal Nurse  Las Vegas Practitioners annual Conference Associate Professor MELISSA in October 2018. BATCHELOR-MURPHY presented “Professional Use of Social Media” during the American Association for Respiratory Care annual Conference Atlanta in December 2018. Local and Global Associate Professor ASHLEY DARCY-MAHONEY presented Presentations “Language Proficiency and Executive Function: An fNIRS Study” during New York August 2018 - January 2019 the Biomedical Engineering Society Dean PAMELA JEFFRIES served as Conference in October 2018. invited moderator at the inaugural Columbia University Innovations in Simulation Summit in October 2018.

Boston Associate Professor MELISSA BATCHELOR-MURPHY presented Orlando “Key Trends and Issues in Aging Associate Professor KAREN WHITT Policy as Seen by the Health and presented “The Usability of Family Aging Policy Fellows” and “Eating Health History Tools in Primary Care” Performance in Relation to Food during the International Society of and Fluid Intake in Nursing Home Nurses in Genetics World Congress Residents with Dementia” during on Genetics and Genomics in the Annual Scientific Meeting of the October 2018. Gerontological Society of America in November 2018. Professor JOYCE PULCINI presented “The REACH Project: Palm Springs, California Reducing Childhood Anemia in Assistant Dean SANDRA DAVIS Caracol, Haiti: A Mixed-Method, and Associate Professor KAREN Community-Based Action Study for KESTEN presented “Building the Sustainable Improvement - Phase Infrastructure: Collaborations for I” and “Listening to the Voices of Health Equity and Community Our Global South Nursing Partners” Engagement” and DR. KESTEN during the Global Nursing Caucus in also presented “Influence and October 2018. Impact: The Broad Reach of the DNP” during the National Doctor of Nursing Practice Conference in September 2018.

20 | research & scholarship

 Rockville, Maryland San Diego, California Dean PAMELA JEFFRIES moderated Professor RHONDA SCHWINDT Associate Professor ASHLEY “The Role of Evidence in Health Policy presented “Creating an Inclusive and DARCY-MAHONEY gave a poster Communications” during the AAN Affirmative Healthcare Environment presentation “Language Proficiency Transforming Health, Driving Policy for Transgender and Non-Binary and Executive Function: An Conference in November 2018. Persons” for the Forensic Unit Staff fNIRS Study” at the Society for Professor JOYCE PULCINI at Shady Grove Medical Center in Neuroscience in November 2018. presented “Developing a Student/ December 2018. DR. DARCY-MAHONEY also Family-Centered School Health presented “Using FDA Risk Collaborative” and “Political Communication to Reduce Adverse Efficacy and Participation of Nurse Drug Events for Cancer Patients” Practitioners” at the AAN Tranforming Richmond, Virginia and “Associations between Physician Health, Driving Policy Conference in Associate Professor CATHERINE Supply Levels and Amenable November 2018. WILSON COX presented Mortality Rates: An Analysis of Taiwan Associate Professor KAREN “A Veterans’ Bachelor of Science in over Nearly Four Decades” at the WHITT presented “The Effect of Nursing Program: The Experience American Public Health Association Family Health History Interviews on of Three Virginia Institutions” during Annual Research Meeting in Perceived Risk for Disease among the Virginia Nurses Association November 2018. College Students” at the Council for Conference in September 2018. Dean PAMELA JEFFRIES, Advancement of Nursing Science Professor JEANNE GEIGER- State of the Science Congress on BROWN, Associate Professor Nursing Research - Precision Health KATHLEEN GRIFFITH, Professor Y. in September 2018. Rotterdam, The Netherlands TONY YANG and Assistant Professor Associate Professor KAREN KESTEN SHERRIE WALLINGTON presented presented “Convening a Consensus on the panel “Building Capacity in Based Work Group to Identify Transdisciplinary Research” during On the Web Common Competencies across the American Association of Colleges Four APRN Roles” and “Partnership of Nursing Doctoral Education Strategies to Ensure a Quality Conference in January 2019. Associate Research Professor DALE Advanced Practice Nursing LUPU gave the webinar presentation Workforce” during the International “Providing Supportive Care: Tools Council of Nurses Advanced Practice & Resources for the Journey” in Nursing (ICN NP/APN) Conference in Washington, D.C. November 2018. August 2018. Associate Professor MELISSA Professor Y. TONY YANG Professor JOYCE PULCINI BATCHELOR-MURPHY presented presented “Will I be liable? presented “The REACH Project: “Media Savvy in the Modern Age: Understanding the risks of using Reducing Childhood Anemia How to Up Your Game” at the and adopting digital health solutions in Caracol, Haiti: A Mixed-Method, American Academy of Nursing (AAN) in practice” during the American Community-Based Action Study Institute for Nursing Leadership in Medical Association Physician for Sustainable Improvement - Phase November 2018. Innovation Network in September I,” “Examining the Relationship Associate Professor ASHLEY 2018. between Elevated Blood Pressure, DARCY-MAHONEY gave a podium Elevated Blood Glucose and BMI in presentation “Testing a Theory of a Population of Adults in Haiti” and Sensory Hypersensitivities in Young “A Coordinated Strategy in Chile to Children with Autism to Facilitate Implement APN in Primary Health Early Diagnosis and Develop Care Using the PEPPA Framework” Novel Interventions” at the George during ICN NP/APN Conference in Washington University School of August 2018. Nursing Research Colloquium in November 2018. Senior Policy Service Professor DIANA MASON presented and

nursing.gwu.edu | 21 research & scholarship

“Early detection and management of “The rollout of the NLN’s latest New Tools of socioeconomic barriers is an important and Advancing Care Excellence for Pediatrics emerging component of pediatric scope program was an excellent place for this the Trade of practice,” said Dr. Darcy-Mahoney, an toolkit to be housed,” she said, describing associate professor at GW Nursing and the program that identified education about by reese rackets director of infant research at GW’s Autism social determinants of health as a critical gap and Neurodevelopmental Disorders in nursing curricula. Institute. Expanding pediatric care providers’ This toolkit is aimed at “meeting the A growing body of literature scope of practice to include identifying and growing demand for quality care of children supports the connection between addressing the social determinants of health at greatest risk, living in circumstances poverty and related social will require additions to existing nursing beset by poverty, neglect and abuse,” Dr. determinants of health in shaping curricula to cover these new topics. Darcy-Mahoney said. The toolkit is divided health outcomes, especially in In the new toolkit, Pediatric Adversity into four modules that can be incorporated early brain and child development. and Early Brain Development, Dr. Darcy- into a nursing curriculum to “educate future GW Nursing’s Ashley Darcy- Mahoney offers a concise way for faculty in pediatric clinicians in understanding the Mahoney, in partnership with schools of nursing to explore the literature drivers of inequity and equipping them about pediatric adversity and consider ways with the knowledge, skills and courage to the National League for Nursing to integrate the social determinants of health build more equitable health systems and (NLN), developed an online into existing curricula. organizations.” toolkit aimed at helping nursing By partnering with NLN, Dr. Darcy- schools better educate students Mahoney hopes to leverage the organization’s on how to identify and address considerable reach as a leader in nursing  The toolkit is free factors not previously considered education in disseminating the toolkit, she and available for download at when providing pediatric care. said. go.gwu.edu/NLNtoolkit.

THOUGHT LEADERSHIP COUNCILS The O’Neil Center is the industry’s first central resource combining guidance from prominent health care thought leaders,

EVIDENCE-BASED RESEARCH evidence-based research and proven translational tools to move patient and family engagement from theory to practice.

Learn more at getwellnetwork.com TRANSLATIONAL RESOURCES aging,health& humanities

patients may not even recognize the food on their plate. “There is a huge need for education An New and training [for Alzheimer’s caregivers], especially around mealtimes,” said Dr. Batchelor-Murphy, an associate professor of Advocate for nursing and geriatric nursing researcher. She specializes in feeding patients with Geriatric dementia and has advised for and appeared in AARP’s new video series, “Home Alone Nursing at GW Alliance,” which teaches family members basic caregiving skills. Dr. Batchelor-Murphy now brings her advocacy for gerontological Aging Center patients to her new role as director of GW’s interprofessional Center for Aging, Health by ruth adams and Humanities. In the classroom, Dr. Batchelor-Murphy “I like to eat” may be an unusual counsels students that “health care is not all entry point for a discussion in about acute care.” “I think it’s still a pervasive thought for gerontological health care, but students to not want to work in long-term for Melissa Batchelor-Murphy care, but it’s an exciting and viable career it makes perfect sense. Patients path,” she said. with Alzheimer’s or dementia The center is known for its education are often robbed of this simple programs and innovations in clinical process, pleasure; swallowing problems can and Dr. Batchelor-Murphy plans to create a group of other researchers and clinicians in lead to weight loss and choking in aging to build the center’s research capacity. patients with middle- and late- “I want to put GW on the map for excellence stage Alzheimer’s. Sometimes in aging education and policy,” she said. Dr. Batchelor-Murphy brings the expertise

nursing.gwu.edu | 23 community&global initiatives

A Week in Uganda

Below is an excerpt from the blog “Rhonda’s GW Adventure,” written by Rhonda Krigbaum, BSN ’18, about a recent GW Nursing international clinical trip.

Uganda has five levels of health care, and we were fortunate to see a level-four health center in the Mukono District. Level one starts out with the Village Health Teams (VHTs) that we worked with throughout the week. I will never forget walking up to the health clinic and seeing so many moms and children waiting for immunizations. I don’t think I have ever seen so many people waiting for vaccinations in the United States, because typically immunizations are part of regular doctor appointments, but this health center is full on Tuesdays, immunization day. It was encouraging to see so many people eager to get vaccinated, and they seemed to understand the importance We were also educated on sleeping with the screenings I provided, I think only two of immunizations. mosquito nets, maintaining immunizations, people had “normal” blood pressure. About At the clinic they had a laboratory, general boiling all water even if from a clean water two-thirds of all the villagers I screened had appointment rooms, a mental health room, source, prenatal care, family planning and never had their blood pressure taken before a dentist, a maternity ward, an AIDS ward, AIDS/STD prevention, newborn care, and all needed lifestyle education on ways to a tuberculosis (TB) ward and an OR. They vaccinations and healthy foods to eat. lower their BP. We made a BP education sheet require everyone to take off their shoes in the My favorite part of this trip was the blood that was translated into the local language, OR waiting room because wearing shoes is pressure (BP) screenings we did in several Luganda, and provided to every person who thought to bring in more contamination than different villages. The average life expectancy was screened. a bare foot. in Uganda is 58 years, and the most common We really got to spread our nursing During the trip, we also learned a lot about cause of death from a chronic condition education and work with the VHTs to train how common health issues are addressed, is cardiovascular disease. Hypertension them how to take an accurate BP reading so for example, how cookstoves are made out (elevated blood pressure for those not they can continue to screen and educate their of a combination of ant hill mud, grass, water familiar with medical lingo) is known as a community long after we leave. and banana stalks. Cookstoves filter the silent killer because you can have high BP for I am so proud of this nurse-driven trip and smoke out of the room to reduce chronic years and not have any symptoms. Ugandans can’t believe how lucky I am to have shared obstructive pulmonary disease (COPD) and tend to have very high blood pressure (high- my knowledge and experience on a global asthma exacerbation. salt diet, stress, genetics, etc.). Out of all of scale.

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Dr. El-Bayoumi went on to say the model of community partnerships needs to change Forging Lasting Partnerships from one of top-down leadership with one group at the top—be it physicians, nurses Through Community Engagement or other stakeholders—to a wheel model with rotating leadership. GW Nursing by reese rackets share their ideas and success stories for practice and community partners in relationship-building initiatives at an event attendance said the event provided invaluable themed “It Takes a Community!” learning opportunities. Diversity in the health care Hosted by GW Nursing, the event “One of the things that really struck workforce, continuing education aimed “to align the goals of our community me was the piece about diversity in the for care providers and building partners and faculty to better serve the health workforce,” said Charles Birdie, executive partnerships with community and well-being of the Washington, D.C., director of the Loudoun Free Clinic. “I’d like community,” organizers said. to see more minority physicians and health stakeholders are the pillars Dr. El-Bayoumi’s keynote address, care personnel start to volunteer at the clinic, on which healthy, resilient “Working Together to Improve the Health because I think it’s going to be better for communities are built, according and Well-Being of the DMV (District of everyone all around. I think the School of to Jehan El-Bayoumi, executive Columbia, Maryland, Virginia),” focused on Nursing can help us with that.” director of GW’s Rodham the broad disparities between different parts GW Nursing sends Bachelor of Science in Institute. Dr. El-Bayoumi gave the of the city as well as some exemplars that have Nursing students to the Loudoun Free Clinic made strides in closing those gaps. for clinical assignments, and some students keynote address this winter at the “We at the Rodham Institute like to also volunteer there. The partnership has first annual community partners present not just a problem but a solution,” been beneficial for both the clinic and the engagement event. said Dr. El-Bayoumi before introducing school, he said. the institute’s three priorities in building “I’m really glad GW Nursing put this Community partners from across the health equity: community collaboration, together, and I’m glad to see it’s the first Washington, D.C., metro area, and GW education for health care providers and annual event,” Mr. Birdie said. “I will certainly and local care providers came together to workforce diversity. be back next year.” community & global initiatives

down the amount of liquor they consume. The picture on the right is an example of how to improve the community. For every one liquor store you have there should be one organic store too.” this project Through this project, area middle funded by the NPHF/ schoolers learned not only how to take care Astellas Foundation. of themselves, but also how to advocate for This project made such an and in their communities. GW Nursing impact on its community that BSN students guided the middle school it was on display in an exhibit students under instruction by Dr. Davis and at the Smithsonian’s National her co-principal investigators, Assistant Museum of African American Professors Karen Dawn and Adriana Glenn, History and Culture through as part of the BSN program’s community May 2019. health portion. Teaching The middle schoolers learned by Social and environmental factors—such completing a PhotoVoice project in as education, housing, places to exercise which they explored and documented and healthy places to eat—all matter when Healthy Living their surroundings by taking photos, writing it comes to heart disease and risk factors commentary on what was unhealthy and for heart disease. Underrepresented groups, to Middle noting how their environment could be especially African Americans, suffer a made healthier. disproportionate risk factor burden for Schoolers “Children get used to what they see at heart disease. In addition to being one of the home,” said Iris Fountain, a parent who poorest cities in the United States, D.C. has attended the Saturday Institute PhotoVoice one of the highest avoidable death rates from by erin julius Exhibit held at Thurgood Marshall heart disease of all major U.S. cities. Academy Public Charter High School in Earlier this month, Ms. Fountain’s Delivering high-quality health December. Ms. Fountain pointed out that son wrote Maryland Gov. Larry Hogan care requires knowing more than neighborhoods in the D.C. area can have as encouraging him to create more community a patient’s blood pressure, heart many as three liquor stores on one block that gardens in public areas. This was the Fountains’ first activity with GW Nursing rate and weight. Patients are more open as early as 6 a.m. “If I notice, children notice it,” she said. and the AnBryce Foundation, but it will not than these numbers; where they Indeed, one student wrote about the be the son’s last as he hopes to attend Camp live, what they eat, whether they prevalence of alcohol. Dogwood, where BSN students provide first exercise also play a role in their “The picture on the left shows people aid to campers, later this summer. health. GW Nursing’s Bachelor drinking liquor and throwing it away in the of Science in Nursing (BSN) streets. This shows that there are drunk students are learning this crucial people who hang out in the community, and that it is full of bottles of liquor,” one student lesson through a participatory wrote. “The photo can educate people in my action research project conducted community by showing what most people in partnership with the AnBryce are hooked on, and telling Foundation. them to cut

“During this project, our nursing students, along with the middle school students whom they taught, learned the importance of social determinants of health and how they can facilitate or impede the making of a heart- healthy community,” said Sandra Davis, the school’s assistant dean for diversity, equity and inclusion, and principal investigator on

26 | MedStar Health Nursing is proudour academic practice partner,to support George Washington School of Nursing.

We applaud your vision to drive innovation and improvements in health care through the education of compassionate nurses, esteemed educators and researchers, entrepreneurial leaders, and influential policy experts.

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Expanded simulation lab space can practice patient care and learn from will enable George Washington their mistakes in a safe and controlled University School of Nursing environment. With an “unwavering commitment” to nursing education, students at all levels to engage in GW Celebrates GW President Thomas LeBlanc said the health care simulations and better university is committed to building a physical serve patients. infrastructure that is conducive to fostering ‘Unwavering student learning and community. Students, faculty and staff from GW Simulation offers the ability to create Commitment’ Nursing gathered in November to celebrate real-life scenarios through which students the opening of the new simulation lab develop, refine and apply knowledge and space and Student Success Center at skills without the risk of harming patients. to Nursing Innovation Hall on the Virginia Science and The newest simulation space was developed Technology Campus. for nurse practitioner students who visit Education With the opening of the simulation campus for skills training and test outs, lab, the school nearly doubled the amount formative assessments of how students are of space where GW Nursing students progressing through the program.

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From Test-Taking Tactics to Tissues: How Professional Advisers Support Students

To address non-nursing challenges students face while in school, GW Nursing has added two professional advisers to its Office of Student Affairs.

Chloe Harner works with students from the Bachelor of Science in Nursing program, and Hannah Hahn is the adviser for graduate students. “Professional advisers offer students Interested in Policy? There’s a support and have a clear understanding of program, school and university policies and procedures,” said Jennifer Hayes-Klosteridis, DNP for That. assistant dean for student affairs. Both Ms. Harner and Ms. Hahn are GW Nursing this fall will launch cost, access and quality, and nurses need to trained by the National Academic Advising a new Doctor of Nursing Practice bring their knowledge of population needs Association and assist students with and effective interventions into the policy (DNP) degree in the field of health completing necessary paperwork, discussion to improve our health system and registering for courses and navigating policy. provide safer, higher-quality care,” she said. degree requirements. Opportunities for graduates include The 42-credit program, led by Program “Our job is to make sure students are in consulting firms, educational foundations, Director David Keepnews, is for nursing good shape and have the right information health departments, nonprofit groups, professionals interested in acquiring in-depth when they need it,” Ms. Hahn said. academic institutions and governmental knowledge of the health policy process and In addition to ensuring all degree organizations. how to influence policy to improve quality of requirements are met, Ms. Hahn said Mercedes Echevarria, an associate care, increase access and control costs. professional advisers help students take professor and assistant dean for the DNP Located in the heart of Washington, D.C., “a holistic view of academic life.” Advisers program, said one of the motivations behind GW is strongly associated with policy. Only can offer suggestions and resources to the DNP in Health Policy, which is offered blocks from the White House, Capitol Hill help students successfully complete their in an online format, is a need to prepare a and dozens of government and professional degrees no matter what challenges they may new generation of nurses who can advocate organizations, the university will offer encounter, she said. for patients and the nursing profession as a students pursuing the DNP the unique “I’m good at helping people adjust to whole. opportunity to engage with policymakers at an accelerated program and be a successful “We have a faculty well prepared to teach the national level. student. I’m not a nurse, so I haven’t been this material. Some have expertise in research Jean Johnson, dean emerita and executive through everything students are going that supports health policy, while others are director of GW Nursing’s Center for Health through. For that, they have a faculty experienced in advocacy and policy analysis,” Policy and Media Engagement, said a greater mentor,” Ms. Harner said. she said. number of nurses are needed who understand With offices at the school’s Virginia the important role policy plays in the nation’s Science and Technology Campus location, health care. both advisers are readily available to students. “There are many very serious health For more information, visit care issues facing our country in terms of go.gwu.edu/policyDNP.

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in nursing that benefits the geriatric community. She was also inducted as a fellow during the Gerontological Society of America’s 2018 annual meeting.

Dean Pamela Jeffries was elected to the American Academy of Nursing’s board of directors.

Instructor Esther Emard was named a peer reviewer for the Journal for Healthcare Quality, a national journal for professionals in the field and those that are certified in health care quality through the National Celebrating Diversity Efforts, Association for Healthcare Quality. Clinical Assistant Professor Christine Seaton HEED Award has been promoted to assistant director of simulation. She will work alongside Crystel Farina, director of simulation. Institute, Drs. Sandra Davis and Arlene Members of the GW Nursing Dr. Seaton is an active member of the Pericak created The Health and Community community, university leaders and Virginia State Simulation Alliance, for which Engaged Passport — an interprofessional local leaders gathered in February she serves on the board of directors as approach to teaching nurse practitioner conference planning director. in Innovation Hall on the Virginia students about the social determinants Science and Technology Campus of health. Associate Professor Karen Kesten was to formally recognize the school’s Innovative Diversity Education named director for doctor of nursing Health Professions Higher Macy Faculty Scholar Dr. Ashley Darcy- practice projects. Dr. Kesten brings a wealth Education Excellence in Diversity Mahoney developed and launched “Pediatric of experience to the role, having most (HEED) award from INSIGHT Adversity and Early Childhood Development recently served as the director of faculty Into Diversity magazine. Dean and Health,” a course for nursing and medical initiatives at the American Association of Colleges of Nursing and as the liaison Pamela Jeffries unveiled the students to learn about social factors that shape health. for the work of the APRN Clinical Training school’s message of diversity Task Force, the American Association of Health and Wellness and inclusion, and BSN students Critical-Care Nurses Competency-based Through the school’s Well-Being presented posters about the social Education for Doctoral Prepared APRN Work Experience, a series of eight sessions, Group, the Implementation of the DNP Task determinants of health. students develop the knowledge and skills Force and the Task Force on Defining the to cope with stress and adversity in healthy, As a recipient of the annual Health Scholarship of Academic Nursing. proactive ways. GW Nursing aims to educate Professions HEED Award — given to health a generation of nurses who can manage the schools and centers that demonstrate an Assistant Professor Gretchen Wiersma stress and challenges of an ever changing outstanding commitment to diversity and has been appointed to the newly created health care environment. inclusion — GW Nursing was featured in role of veterans and military faculty liaison. the December 2018 issue of INSIGHT Into Dr. Wiersma will provide academic support Diversity magazine. and supervision and promote internal and “Diversity plays an important role in the external communication and relationships classroom, health workforce and society,” said for GW Nursing as they relate to veterans Dean Jeffries. “It is an honor to be recognized Accomplishments and the military. with the HEED award as diversity initiatives are a strategic priority for GW Nursing.” Associate Professor Melissa Batchelor- Professor David Keepnews is the director INSIGHT Into Diversity magazine Murphy was awarded the 2018 Excellence for the new DNP in the field of health policy. selected GW Nursing for a number of factors, in Research Award by the Gerontological Dr. Keepnews has held policy-related staff including: Advanced Practice Nurses Association. leadership positions at the American Nurses Community Outreach This award is given to an individual who Association, California Nurses Association and the New York Academy of Medicine. In collaboration with the Rodham demonstrates a commitment to research

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An alumnus of the Robert Wood Johnson low-income and underserved populations community-based participatory research Foundation Executive Nurse Fellows using mobile health technology. strategies that particularly focus on cancer program, Dr. Keepnews also served as prevention, cancer health disparities editor-in-chief of Policy, Politics and Nursing Richard Ricciardi, PhD, CRNP, FAANP, and clinical trials. Her health disparities Practice, a scholarly journal, for a decade. FAAN, is a professor and health policy and cancer research is supported by the faculty member from the Agency for American Cancer Society, the Robert Wood Associate Professor Laurie Posey is one Healthcare Research and Quality (AHRQ), Johnson Foundation, the National Institutes of the winners of this year’s Bender Teaching where he served as the director of the of Health and the National Cancer Institute. Award, which recognizes undergraduate, Division of Practice Improvement. He is graduate and professional teaching at GW. also president-elect of Sigma Theta Tau Staff International. His scholarly interests include Sabrina Beroz, DNP, RN, CHSE-A, is the Assistant Professor Carol Lang now implementation science, preventing and associate program director of professional serves as the director of community and mitigating adverse body composition and programs and initiatives. global initiatives. sedentary behavior, and the role of nursing in the delivery of primary care. Prior to Gloria Bognin is a research project Assistant Professor Maggie Venzke joining AHRQ in 2010, Dr. Ricciardi served assistant supporting the Pathways Project led now serves as the director of the Adult- as active duty military in the Army for 30 by Associate Research Professor Dale Lupu. Gerontology Primary Care Nurse Practitioner years, holding numerous clinical, research program options. and senior leadership positions within Denise Bridges is an administrative the Department of Defense, including assistant for the Office of Student Affairs. pediatric and family nurse practitioner, GW Welcomes research scientist and educator. Paul Collins is simulation technology Dr. Ricciardi maintains a part-time clinical administrator. Faculty practice and is a fellow of the American Helen Brown, MS, ACNP-BC, FNP-BC, Academy of Nursing and the American Hannah Hahn is an academic adviser. FAANP, is an adjunct clinical instructor Association of Nurse Practitioners. and an acute care nurse practitioner with Matthew Hess is a program assistant for Mark Tanner, DNP, RN, is assistant dean 20 years of experience in the Emergency community and global initiatives. of the Bachelor of Science in Nursing Department at Anne Arundel Medical program and a clinical associate professor. Center in Annapolis, Maryland. She has been Tanisha Judkins is the program associate Dr. Tanner previously served as director of teaching graduate students for 13 years for clinical placement for undergraduate the BSN program at University of Arkansas and has been recognized by her colleagues students. for Medical Sciences (UAMS), where he for excellence in education regionally also earned his DNP. He worked at UAMS and nationally. She is the recipient of the Cyndi Kelley is a coordinator for the acute Hospital in the Progressive Care and Critical American Association of Critical Care Nurses and chronic care community. Care units where he specialized in medical Circle of Excellence Award and Georgetown and neurological/neurosurgical patients. University’s Excellence in Education Award. Nichole Robertson is a program associate He has taught in the Pathophysiology, Adult for clinical placement, graduate studies. Daisy Le, PhD, MPH/MA, is a visiting Med-Surg, Fundamentals and Critical Care assistant research professor and a social courses. Dr. Tanner was named to Arkansas Alexander Schlichting is a technical scientist in behavioral and community Great 100 Nurses in 2018 and to Arkansas support associate. health specializing in community-engaged Action Coalition 40 Under 40 Nurse Leaders Shari Sliwa cancer prevention and health disparities in 2017.  is the project manager for the research. She received her doctorate from Pathways Project led by Associate Research Sherrie Wallington, PhD, is a tenure-track the University of Maryland and recently Professor Dale Lupu. assistant professor and health disparities completed her postdoctoral fellowship with researcher specializing in oncology. She Haley Stepp the Department of Epidemiology at the  is the senior communications joins the policy, populations and systems Johns Hopkins Bloomberg School of Public associate for the Center for Health Policy and faculty community from the Georgetown Health. Dr. Le teaches and conducts research Media Engagement. University Medical Center and the Lombardi in the general areas of multicultural studies Comprehensive Cancer Center, where Narah Thomas and health promotion and communication.  is a records and registration she served as an assistant professor of Her specific focuses are on sociocultural specialist. oncology. Dr. Wallington teaches and determinants of health and community- conducts research on the role of health Wenxia “Joy” Wu is a senior based and -engaged approaches across communication, health promotion and instructional designer. the cancer continuum that target minority,

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Originally, Dr. Bryant said the paper was Alumna Helps Organizations meant for GW’s doctorate repository. Barely a month after graduation, she contacted The Achieve Nursing Excellence Journal of Continuing Education in Nursing to inquire about the possibility of submitting it. Knowing she would need help and by crystal schelle guidance, she reached out to Laurie Posey, an associate professor at GW Nursing and Tiffany Bryant has had a lifelong passion for nursing, which she now director of the graduate certificate in nursing employs as a senior magnet program analyst for American Nurses education, who had been her mentor and Credentialing Center in Aldie, Virginia. academic adviser at GW, to assist her with preparing the paper for submission. “My work is different but equally as her job at the time as an education program Dr. Bryant praised Dr. Posey on her help important in the nursing profession,” she specialist at the American Nurses Association throughout the process.“I just can’t say said. “It’s really pushing organizations (ANA) in Silver Spring, Maryland. enough about her. She was instrumental and through innovation and nursing excellence.” “The coursework and projects all helpful to me,” she said. The Loudon County, Virginia, resident were aligned and enhanced my work with Dr. Posey said that Dr. Bryant approached had for years looked upon the profession as continuing education for the association. It the work as a collaborative effort. something noble. led into my research,” she said. “Nursing allowed me to be a part of an honorable profession,” said Dr. Bryant. When she started her first nursing “ Once I went to nursing school, I felt good about program, Dr. Bryant knew she had found the work. From when I was still working as a clinical nurse her path. “Once I went to nursing school, I felt and particularly when I went into education.” – tiffany bryant good about the work. From when I was still working as a clinical nurse and particularly when I went into education,” she said. For her DNP capstone project, Dr. Bryant graduated from GW Nursing Dr. Bryant analyzed nurses’ intent to change with a Doctor of Nursing Practice (DNP) in their practice and actual practice change May 2018. after participating in ANA continuing Throughout the DNP program, education courses. The result was “Evaluating Dr. Bryant said, she was able to apply many Transfer of Continuing Education to Nursing of the principles she was learning about in Practice.”

Members of the Advisory Council

CHAIR Ellen Dawson Robin Kaplan Angela Patterson Julie Settles PhD, RN MSN, RN DNP, RN RN, MSN, ACNP Mary-Michael Brown Professor Emeritus, GW Kushner Hebrew CVS MinuteClinic Lilly USA DNP, RN School of Nursing Academy MedStar Health JoAnne Reifsnyder, Beatrice Welters Patrick DeLeon Elizabeth (Betsy) K. PhD, MBA, MSN, FAAN Founder/Co-Chair MEMBERS PhD, JD Linsert Genesis Healthcare AnBryce Foundation Retired, Chief of Staff MS, FNP Diane Billings to U.S. Sen. Daniel GW Colonial Al Shimkus Stephanie Wright EdD, RN, FAAN Inouye (D-Hawaii) Health Center MSN, RN, Capt. USN PhD, FAANP Indiana University (Ret.) Professor Emeritus School of Nursing Karen N. Drenkard Lynn Mertz Naval War College GW Nursing PhD, RN, FAAN PhD Alan Schurman Cohn GetWell Network AARP Center to Janet R. Southby JD Champion Nursing PhD, RN AbsoluteCare Lucas Huang in America Interagency BEE, BAE Institute for Federal B-Line Medical HealthCare Executives

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Include GW in your estate plan and the university will match a portion of your future gift today – to the department, program, or area of your choice!

The 2019 GW Legacy Challenge provides an immediate cash match for donors who document new or increased planned gift commitments to the School of Nursing, such as gifts by will, trust, or IRA beneficiary designation. As a planned giving donor, you can direct matching funds to your area of interest (equal to 10% of the value of your planned gift, up to $10,000).

Participate in the 2019 GW Legacy Challenge and give 110% to GW!

+ = x

You document your 10% Legacy Challenge Immediate Future planned gift using the Match Funds impact to your impact Legacy Challenge Gift are directed where area of interest with your Confirmation Form you specify at GW planned gift

Visit go.gwu.edu/give110Nursing to learn more.

We are deeply grateful to the late Joan H. Colbert, CCAS BA ’61, and Douglas J. Mitchell, GWSB MA ’93, for bequeathing the matching funds being used in this program.

nursing.gwu.edu | 3 DAR3550 School of Nursing The George Washington University 1919 Pennsylvania Ave., NW Suite 500 Washington, DC 20006-5818

Lead the science of nursing Learn more about our PhD in Nursing PhDat go.gwu.edu/nursingphd

Take a seat at the table Learn more about our DNP in Health Policy at go.gwu.edu/policydnp

4 | The George Washington University does not unlawfully discriminate in its admissions programs against any person based on that person’s race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, or gender identityDNP or expression.