Practicum Final Paper - Concordia University-Nebraskawp.cune.org/.../files/2015/06/PracticumFinalPaper.docx · Web viewPracticum Final Paper. Aaron Sweazy. ... (NCP) was implemented

Running head: PRACTICUM FINAL PAPER 1

Practicum Final Paper

Aaron Sweazy

Concordia University of Nebraska

Practicum

MPH599

Dr. Jen Janousek-Instructor/ Ms. Margarita Allen, R.N. - Supervisor

June 28, 2015

PRACTICUM FINAL PAPER

Table of Contents

Abstract............................................................................................................................................5

Introduction......................................................................................................................................6

Discussion........................................................................................................................................8

Quizzes.........................................................................................................................................9

CHW Project Grading................................................................................................................11

Creating a Teaching Manual......................................................................................................12

Personal Assessment......................................................................................................................13

Epidemiology.............................................................................................................................13

Health Policy..............................................................................................................................14

Conclusions and Recommendations..............................................................................................15

References......................................................................................................................................17

APPENDICES...............................................................................................................................18

Appendix 1: Introduction to Community Health Worker Course- Student Manual.....................18

Appendix 2: Assignments-Student Manual...................................................................................22

APPENDIX 3: Quizzes/Surveys-Student Manual.........................................................................24

Appendix 4: Documentation Skills Quiz:......................................................................................28

Appendix 5: Organizational Skills Quiz:..........................................................................28

Appendix 6: Cardiovascular Health Quiz:.....................................................................................29

Appendix 7: Assessment Skills Quiz:............................................................................................30

Appendix 9: Colorectal Health Quiz:............................................................................................32

Appendix 10: Breast Health Quiz:.................................................................................................33

Appendix 11: Cervical Health Quiz:.............................................................................................34

PRACTICUM FINAL PAPER 3

Appendix 12: Introduction to CHW Course -TEACHING ASSISTANT.....................................35

APPENDIX 13: Announcements..................................................................................................40

APPENDIX 14: Assignments........................................................................................................42

APPENDIX 15: FORUMS............................................................................................................50

APPENDIX 16: Gradebook...........................................................................................................54

APPENDIX 17: Tests and Surveys...............................................................................................63

APPENDIX 17: EVALUATION FORM Page 1 (SUPERVISOR).............................................74

Appendix 18: EVALUATION FORM Page 2 (SUPERVISOR)................................................75

PRACTICUM FINAL PAPER

Abstract

This report is about the experience in which I had working for the Department of Health

and Human Services of Nebraska (DHHS) for the Women and Men’s Health Program along with

the Every Woman Matters (EWM) campaign. I carried out this project to help with the

reconstruction of the Community Health Worker (CHW) course work, which had been neglected

in some aspects due to lack of staffing and time to focus solely on improving the course. From

the start of my practicum I went to work with vigor overhauling quizzes to test for knowledge

base as well as creating and implementing step-by-step instructions for both students and

teaching assistants alike so they could easily navigate the CHW website. Previously there had

been no creation of a Teaching Assistant Manual, thus it was new ground for everyone involved.

Besides the creation of documents I was also involved with the grading of and making

suggestions for the CHW course work participants to help them be better prepared if they were to

go and present their information to the general public. In conclusions I was able to help with a

myriad of things pertaining to public health, mainly from a person suggesting changes or giving

criticism to presented materials. I believe in moving forward though anybody that takes on a

similar position should do so by coming in at the start week of the CHW course.


Introduction

In the beginning finding a practicum for myself was a battle and I was in the middle of a

tug-o-war with two organizations; Four Corners Health in York, Nebraska and The Department

of Health and Human Service (DHHS) in Lincoln, Nebraska in the division of Men and

Women’s Health. After a week of high anxiety and uncertainty if I would land a practicum

experience at all, the call came in from DHHS and I was Lincoln bound. I initially met with

Margarita Allen who would wind up being my supervisor (and in many cases like a surrogate

mother). Margarita made me feel welcome from the get go and made it a priority to introduce

me to everyone in the Men and Women’s Health section. I could tell I was in a good place with

passionate people and the humor wasn’t lost either when Margarita introduced me first to the

Epidemiologist of the Department; Champagne. So five minutes into a morning I have met

Margarita and Champagne, a combination usually only found back in my non sober days. I come

to learn from Margarita that the Men and Women’s Health is a more “politically correct” way of

talking about the program I would be involved in called Every Woman Matters (EWM). There

are funds set aside to help with colon, breast, and cervical cancers screenings within the Men and

Women’s Health Program. For women to qualify for services (Cervical and Breast) according to

DHHS (2015); "women must be between 40-74 years of age, fall within the income guidelines,

be citizens or legal residents and do not have insurance that pays for preventive services,"

However when it comes to colon screenings, The Nebraska Colon Cancer Screening Program (a

division of DHHS) suggests (2015) that a person "be 50-74 years of age, fall within income

guidelines, be citizens or legal residents and don't have insurance that pays for preventive

services." (DHHS, 2015). In 1995, the State Legislature approved EWM to increase funds to

help women pay for treatment services.


The Breast and Cervical Cancer Advisory Committee (BCCAC) and the EWM

Foundation were formed to assist with this undertaking(The Nebraska Department of Health and

Human Services (DHHS) & Every Woman Matters (EWM), 2011, p. 2) . In 2001, Nebraska’s

Medicaid Treatment Bill (LB677) was approved in the Legislature. Women identified with

breast cancer, cervical pre-cancer or cervical aggressive cancer through the EWM Program, after

September 1, 2001, were deemed eligible for treatment through Nebraska Medicaid (Nebraska

DHHS & EWM, 2011, p2).

Nebraska also has one of the greatest prevalence rates of colon cancer. In 2006, the

Nebraska Colon Cancer Screening Program (NCP) was implemented in order to deliver colon

cancer screening tests for Nebraska men and women who are sandwiched between 50 and 74

years of age(Nebraska DHHS & EWM, 2011, p2).. Nebraska was one of only five such

programs in the country. In 2009, the program received an additional five years of subsidy to

offer fecal occult blood test and colonoscopies to those qualified based on family and individual

health history (Nebraska DHHS & EWM, 2011, p2).

Within Nebraska DHHS happens to be trainings to educate individuals state wide (of

various ethnic backgrounds) in a Community Health Worker (CHW) course. The CHW course

is eight weeks in length and incorporates information about Cervical, Breast, and Colon health

issues as well as other health topics such as Blood Pressure and Body Mass Indexes (BMI).

During those eight weeks, the trainees learn about hypothetical situations in which a patient may

be of a certain age, gender, income, or nationality and then tries to figure out what is the best

solution in helping the patient to overcome barriers to health care. The trainees also must gather

information for a CHW manual (a portfolio basically) and turn it in at the end of the eight weeks


in which there is also a two day seminar where they all come together at a central site (Grand

Island) and present CAPSTONE Projects on health topics they have chosen.

Discussion

When I finally was able to get into the doors of the DHHS, Margarita Allen took me

under her guidance and informed me my tasks initially would include scanning the CHW Course

assignments into the computer, making copies, and then one of the bigger things was creating

quizzes that showed merit it terms of testing knowledge for the CHW class. One of the main

issues in this coming aboard with the CHW course was a lot of the information (such as the

quizzes) were not very congruent to a learning experience. There were instances where

someone would submit a treatment plan for a hypothetical client based on barriers, but they

couldn’t even identify what potential barriers were. I got started in reviewing the entire course

of eight weeks in a period of about three to four days. I sat down and had a blank notepad in one

hand and began chipping away at the CHW Coursework like it was an archaic document lost in

the ruins of a buried public health civilization. There was contradiction in the verbiage with one

sentence saying something along the lines of; “Fecal Occult Blood testing is not effective,” and

the next saying “A good way to test for colon abnormalities is through a Fecal Occult Blood

test.” I cringed the deeper I delved into the catacombs of the CHW course and it wasn’t just the

readings that left a lot to be desired, but the quizzes had me wincing in pain as well. One quiz

was a Likert Scale model and it asked something along the lines of; “Public Health awareness is

good for the health of the public.” It then gave five options ranging from Strongly Disagree to

Strongly Agree, and you had to select a radial in which you though correctly answered that

statement! I realized several grammatical errors too, which were minor compared to the errors of

correct forms of verbiage in the documentation itself, which sometimes lead to confusion among


the students and the assignments and quizzes. This resulted in lackluster results among all whom

were in the class (so it wasn’t a fluke in other words).

Quizzes

One of the proposed goals when taking on this practicum as mentioned previously, was to

help revamp the quizzes (which you will be able to see attached in the appendices later on). As

mentioned before, the Likert Quiz formula wasn’t that great in terms of testing knowledge as it

was based on the premise of someone’s opinion on a particular subject, which depending on the

upbringing of an individual could be extremely different than a peer. Based on this, I went ahead

and started to revamp the quizzes and implemented questions that made you think based off the

readings of that section such as the question below (which I formulated for the Service

Coordination section Quiz):

Figure 1. Sweazy, A (2015) Question 2: Service Coordination Quiz Draft/CHW Course.


While I thought Question 2 of the Service Coordination Quiz (as shown by Figure 1

above) was a great proposed change in testing knowledge, I found myself up against the wall and

facing some barriers when it came to what I perceived to be a pretty flawless example of a quiz

and set of questions that would test knowledge base. One of the things in reviewing my

“revamping” of the quizzes was that Margarita mentioned I needed to realize not many of these

students have the Master’s level of thinking. It was at this juncture the I realized I simply needed

to challenge them still, but on a more rudimentary scale to including simplification of verbiage

used within the quizzes. The aforementioned was needed in order to still get the emphasis

across to the students of the CHW instructors wanting to see what knowledge they had actually

ascertained. So of course being a student myself (in terms of learning on the job), I began

looking at other methods of quizzing the students. Margarita said in moving forward (due to time

crunch and needing to get to other projects), the current instructors would take my questions and

formulate them into more of a multiple choice selection. The purpose of this would to still be

allowed to challenge the minds of the participants but also permit them to accommodate for

major barriers such as English not being their native language and having trouble with reading

the questions and being able to also formulate an answer.

I believe we did address the proposal of making the quizzes knowledge base and in turn

we were able to the collectively come up with the understanding in moving on (for future edits

by interns or other faculty) more option based, simplistic language quizzes would be the best

way of testing for understanding of the materials which had been presented to the student during

each particular week in the CHW course. We also determined for future references we need to

keep the number of questions to a to ensure we are not “running-off” students due to the course

being overly aggressive in nature and possibly intimidating again to the non-English pupils.


CHW Project Grading

After taking some time to try to fix the issues at hand with the quizzes I began grading

student’s submissions for what their Community Health Worker project would be. This was a

task in itself. Many times there were areas not addressed, to which the panel I was a part of

(along with Margarita and another nurse named Andrea), recognized. In each project an

individual had to identify what the public health issue was to be addressed, along with a brief

synopsis of what the prevalence is of the health issue, how to combat it, and financially how

much money would be needed in setting up a campaign to fight it. For the most part all of those

sections were pretty flawless, but it was coming up with a time-table which gave the class fits to

the point that only 1 out of 20 individuals was even in the ballpark of correctly putting together a

time-table in the correct manner. This was a red flag (in my opinion) indicating the needs of the

instructions to be stated clearer in the syllabus on what exactly the expectations are in creating a

time-table. So apparently the lack of information on how to correctly put together a time-table

was a huge issue (not just among the English as a second language individuals either). In

addressing this situation we came together and realized the expectations were broad and with no

real explanation of how to do a time-table it was left up to interpretation by the pupils in the

class. Margarita, Andrea, and I determined the issue needs to be fixed and maybe include a

draft of what a time-table should look like that way if someone needs a proverbial road map, it

will be present in front of them to look back on for reference. It was further resolved that

precision needs to happen when mentioning a time-table such as exact dates of implementation

for services, time frames of follow ups, and number of times to follow up. Within these dates

the specific day of the week was also discussed in order to have the most comprehensive and

accurate statistical evidence when it came to seeing if there was any flaws in the program.


Creating a Teaching Manual

When it came down to the most elaborate work I had to do, it was hands down the

creation of a Teaching Assistant’s Manual. Previously I went in and was able to help with a

student’s manual for the CHW course, but that was more of an editing fix in taking a document

previously created and then inch by inch going through and dissecting for flaws in grammar and

verbosity which may have been too complex for the CHW participants. While I did not think

the language I was using was intimidating, I had to be reminded by Margarita (whom was not

born in the United States herself although grew up in a household that spoke English), that many

of the individuals in the class did not have English as a first language so keeping things

rudimentary would be essential in their learning process so they would not be “lost in

translation” if you will.

In creating the Teaching Assistant’s Manual there was no previous guide so I was forced

to use my own thoughts and then dictate them into the manual. The purpose of creating the

manual for teaching assistants is to ensure all of those helping with the instruction of the class in

the future, to know step-by-step basics on how to navigate the website and interact with the

students. The manual was a rather large undertaking to say the least. Trying to assume each

individual doesn’t even know how to navigate basics on the computer made for the instructions

at time to be very elementary and some of the steps were redundant. However, I soon realized I

myself as a teaching assistant was going through the learning process at the same time when I

was introduced to the Snipping tool. The Snipping Tool allows you to highlight an area on your

screen and basically cut it out so you can paste elsewhere. This came in handy in making the

manuals as it provided pictures with highlights and even arrows to insure individuals would be

directed to the right places within the CHW Course navigation.


Personal Assessment

When glancing back at the practicum with DHHS, I am still in disbelief as to how fast

time flew by. Margarita along with the staffers within Men & Women’s Health were

phenomenal to say the least and if I had a flaw in my work, they were caring and constructive

which allowed me to be productive and not feel overwhelmed with stress. In the 75 plus hours I

was a part of for the practicum, Epidemiology, Health Policy and Management, along with

Social and Behavioral Sciences came into play the most for the discipline specific competencies.

Epidemiology

When I was evaluating the CHW Course there were several modules in the course which

asked you hypotheticals on how you would answer questions (kind of like a risk assessment).

Within these modules things such as diabetes and cardiovascular disease were mentioned. In one

of the hypothetical situations you had a young female that didn’t speak English very well, was

not a citizen, had no vehicle and was unemployed. After recognizing the barriers for care of the

young female (which also included finding a babysitter so she could get screened for a

mammogram), I realized this was an issue to be remedied. When the CHW Course Students

came together for the seminar and presented on various aspects of public health issues, the

Epidemiology of disease was always the first piece of information many shared in pinpointing

how diabetes, HPV, or breast cancer starts. It was from their reports in the CHW course when I

was afforded an opportunity to evaluate and grade each individual on their strengths and

weaknesses of presenting their topic. The grading was based on things such as eye content,

visual aids, and proficient knowledge of topic. In my opinion, the CHW class could be

considered a program that promotes healthy lives just because CHWs work to reduce health

disparities and improve access to care.


Health Policy

The grading aspect was not a sole responsibility of just one individual, although the four

of us grading all did grade independently before coming together to discuss presentations

through the use of a rubric. In the review of the portfolios which were turned in by students

along with grading their CAPSTONE projects and presentations, I realized three aspects of

health policy competency in which I applied as a teaching assistant which were collected from

the PDF file on Engage which included Graphic Model, Discipline Specific Definitions,

Interdisciplinary/Cross Cutting Definitions, and Discipline-Specific Competencies (Unknown

taken from Engage, n.d.). Upon listening to the presentations I had to identify the main

components and issues being presented. The individuals also had to show how they would

budget and deliver health services to those in need in the community through newly formed ideas

or existing organizations. Based on their presentations of budget proposals I had to indicate

whether or not it was adequate for the Capstone project they had proposed. The staff

encouraged students to have conversation in regards to the policy process on how to improve the

health status of a population by doing things like pre and posttest surveys on knowledge of risk

factors for developing HPV among teenage girls ages 13-17 (for example). It was encouraged

to find ways to incorporate the community to come together as one to fight the battle of whatever

the health issue was prevalent to the community. Basically you are applying a systematic

approach to thinking by having several different minds unifying together to promote health. It

was with a better understanding of their project goals we helped guide them in a direction to

potentially have those goals met through partnerships with influential cohorts who might be able

to help them in various phases of the project to include publicity, financing and tracking and

organization of current and future trends in the related health issue being addressed.


Conclusions and Recommendations

From the onset the practicum with DHHS was one of great enthusiasm stemming from

the hosting group from Every Woman Matters. I believe it was this enthusiasm that made it an

easy transition to working and suggesting changes without feeling negative recourse.

Everything which I completed was responded too with constructive criticism in a calm voice and

met with positives. If for some reason a negative came up, it wasn’t that bluntly stated, but it

was veered in the direction to lift you up and make you realize you did a good job, however you

could have done something a smidge different and have a near perfect product. This nurturing

attitude was a welcome change from the do something and get yelled at because you made

horizontal rows as opposed to vertical rows mentality. I was able to help with a myriad of

things pertaining to public health, mainly from a person suggesting changes or giving criticism to

presented materials. I believe in moving forward though anybody that takes on a similar position

should do so by coming in at the start week of the CHW course. While the previous statement

may not be feasible, it would allow for the student to get to know the program better and also be

able to understand the interaction functions of the forums and weekly assignments (although our

MPH program through Engage would have any Concordia-Nebraska Alumnus very well

prepared for the mission at hand. Something else which really needs to be considered is the

implementation of other forms of communication to the CHW candidates when they come to the

training seminar. I came to realize in a class of approximately 20-25 individuals there were at

least half of the students who learned English as a second language. By addressing the issues of

language barriers it could in the long run help educate more people through the CHWs in exactly

in the way they need to be taught, so health ideas are not lost in translation and misinterpreted

among the masses.


One issue not addressed in the paper but needs to be changed is educating those that are

grading to know what specifically they are looking for. In one instance Margarita marked a

presenting group very low on a presentation based on the fact they didn’t present their project but

merely presented the prevalence of diseases and the barriers to care. For the three of us that

joined here we didn’t see a significant difference and thus there was a large variance of grades

from Excellent to Poor. One enjoyable thing with the CHW training was the fact that everyone

attending was reimbursed mileage and hotels which allowed for a high participation rate at the

training. Feeding the participants and instructors four of six meals in those 48 hours was an

added bonus which lead to a lot of happy and productive individuals as well. Although two

days was pretty fun and educational I would like to see day one be longer to allow for day two to

be shorter (like half a day) so individuals can be on the road at a decent time and not drowsy

drivers. Overall the experience of DHHS was awesome although I would like to see places that

offer internships or practicums to do something to encourage more applicants to give their

organization an opportunity. It would be awesome to have something in place like validation for

your parking because I believe if a “broke college kid” has to pay upwards of $15- $25 per week

plus put $40 or so in gas in your tank you could be spending close to $200 or more a month that

might be taking food off your table. The fear of taking better opportunities for practicums with

places like DHHS might be lost because of barriers such as gas money or parking. I believe if

there were ways to take care of parking or even assist with gas, places like the DHHS which

have tons of job openings might find individuals more willing to apply. By open the door to

these individuals with a subtle gesture, positions within their organization may not stay vacant as

long. Additionally it would benefit a person partaking in a practicum if they were involved in

more group dynamics to learn the ways to interact in a professional setting with peers.


References

The Nebraska Department of Health and Human Services, & Every Woman Matters (EWM)

(2011). Every Woman Matters Program & the Nebraska Colon Cancer Screening

Program. . Retrieved from http://dhhs.ne.gov/publichealth/Fact%20Sheets/Every

%20Woman%20Matters%20and%20Colon%20Program.pdf

Unknown (taken from Engage) (n.d.). Domains of Public Health (PDF). . Engage.cune.edu

Course Resources folder.

APPENDICES


Appendix 1: Introduction to Community Health Worker Course- Student Manual

Welcome to the Nebraska Department of Health and Human Services (DHHS) Community Health Worker/Health Navigator Certificate online course. The workshop is highly interactive, involving online case studies, resources and participant discussion. It has been devised to be used in weekly sessions that students can fit around their own schedule. Expect to spend approximately 90 minutes per week during the course of the workshop online, working with your supervisor (if applicable) and completing assignments. Participants will attain confidence and credibility in the communities that they serve along with general knowledge on health topics, communication and organizational skills.

There will be a pre-training webinar the week before the start of the course. It includes review of the syllabus, orientation to staff, and an opportunity to introduce yourself to your fellow participants and ask questions.

The complete course begins with the pre-training webinar, includes a 1-day in-person session, 10 weeks of the online portion which includes two webinars with some time allowed at the end of the first and second half of the online course to catch up on any late assignments, and a final, 2-day, in-person session. Students will have 2 months after the coursework to complete their Capstone Project and Capstone Final Report.

o In this course you will be helping to facilitate a learning experience for those desiring to contribute to their communities in pursuit of a Community Health Worker license. This program is sponsored by The Women’s and Men’s Health Program (WMHP), through the Department of Health and Human Services (DHHS).

o A little bit about the Women’s and Men’s Health; it is a part of Nebraska Health and Human Services and under the Division of Public Health. There are several programs in our area. These programs are: the Every Woman Matters Program which houses the Breast and Cervical cancer screening program and Wise Woman program (inclusive of cardiovascular disease and diabetes screening and community linkages, & Nebraska’s Colorectal Cancer Screening Program. All three of these programs have activities around patient or health navigation, which includes the Community Health Worker Course. This course has been offered three times and is now getting ready to register its fifth class.



The Objective

The purpose of this training is to provide a baseline understanding of the role of patient navigation for community health workers. The course content is intended to clarify your understanding of the material and concept presented in person an online during the period of the course.

Course Website:

http://www.training.nehealthnavigation.com/login.php

Instructions for Website:Login Page

Once you have gone to the course website, you will notice there is an area to log in by putting in your username and password. Your Password should have been emailed to you. In the event you do not recall your password, there is a button you can press that will send you information on a new password. Below is a screenshot of what to expect when going to the website.

My Courses

Congratulations, you are now logged in! If you did things correctly you should be able to select: Health Navigator-CHW Course by clicking on it, or by using the drop down tab at the top middle of the screen. This will take you into the course and allow you to look at things from the start of the course, however as the semester goes on you may wish to not start at the beginning, that is when you should hit he RESUME button, which will then take you back to the last point in time you were on the website. A screenshot of the My Start Page > My Courses page is located on page 4 for your convenience.



Home Page

Now that you are on the Home Page, you should be able to see several tabs at the top as well as a listing of modules on the left hand side for each week. Click to start at the beginning if a new user. If you are a returning user you can go ahead and head to the module you were last on by simply clicking on the course tab number in that left hand column. If you are unsure where you were last time you happened to be logged in, you can simply click on the RESUME button located in the upper right corner. A screenshot of the Home Page has been included below for your convenience.


Community Health Worker Course

Appendix 2: Assignments-Student Manual

Assignments are essential in seeing that you understand what you have learned and then applying it through these various modules. In many regards this course is going to be like going back to school for many of you. One main element to remind yourself of though is all assignments will need to be printed and put in your Resource Manual, as well as turned into the Assignment Drop Box for review. In order to print, most the time you can hit CTRL and “P” at the same time and it will open a printing function, you may also (if the document allows you), go to File and then find the Print option to print your document.

Assignment Drop Box

All assignments will need to be turned into the drop box. It is imperative that you turn assignments in before the due date/time, as they are electronically time stamped and the instructors will know if you are late in getting your information in. When you are on the Home page of the CHW website you will notice there are tabs at the top. The 6th tab over (including the Home tab) is the Assignment Drop Box which I have highlighted below:

Click on the Assignment Dropbox and the following screen should appear:


Assuming we are in Week 2. I have clicked on 2-Case Stud Assignment: Filipa and Fatima which then produces this screen listed under the File Storage tab:

I have clicked on the first name at the top of the screen to show you what it should look like in your dropbox for having an assignment. You will need to save your document first to the computer and then download it into the dropbox by pressing the download button on the bottom of the screen. Make sure you know what you saved the file as, and more important, where you saved it! If you have downloaded everything correctly, you should be able to see your documents listed in the File Storage


Community Health Worker CourseAppendix 3: Quizzes/Surveys-Student Manual

QuizzesYou can find the quizzes toward the end of each week’s module. For sake of explaining I will use the Week 2 module for Organizational Skills (section 2.9). When you get to the quiz page, it should appear like so (you will want to click on the underlined link which in this case is the Organizational Skills Quiz:

After clicking on the link you will be directed to a list of quizzes (to bypass the previous instructions you can also click on the 5th tab over in the middle labeled Tests & Surveys). A quiz in one module may be slightly different than a quiz in another module, so make sure you read all directions. Make sure you click on the correct quiz for the week you are on. In this case I will click on Organizational Skills Quiz which I have highlighted below:

Notice on most of the quizzes all the way to the right you have up to 2 attempts, use both attempts if you need them. Also be careful and make sure all work is in before the end date, in the figure above Pre-Assessment is EXPIRED! Once you have clicked on the Quiz of your choice you should then be taken to a screen like so:


Read the instructions!!! Then when you are ready proceed to Begin Test, which will take you to quiz itself. Not all quizzes are alike. In some you may have to match a word with its meaning, in others (like this one you have to simply choose an answer based off of multiple choice as shown below:

When completed with the quiz you will submit. Now sometimes, you may not get everything right, don’t fret…the test will let you know (remember you get 2 attempts on most quizzes so you have a great opportunity of getting a great score in each module on you quizzes). If for some reason you don’t do well you will see a screen like this:


When you go back to the menu to select the quiz, you will see that 1 of 2 attempts has been made (which I have highlighted):

If you happen to not pass the quiz, go to the Test & Surveys page and at the bottom of the screen you will see Your Submissions. In the Your Submissions area you will be able to click on View Results and “study up” so you can pass the next attempt of the quiz should you need it. I have highlighted Your Submissions and View Results below so you know where to look for them:


Let’s go back and take the quiz a second time (or if this is your first time let’s see what it looks like to ace the quiz).

After you complete the quiz you can hit back and go to the Tests & Surveys screen and see both quizzes are listed below. Notice there is a time spent section which calculates how much time it took to take the quiz. In the attempt I failed it took me 192 hours and 21 minutes, in the quiz I passed it took 10 seconds. Now don’t just click answers super-fast like I did in the 2nd attempt, however don’t overanalyze either and take 8 whole days to answer! Narrow down to the best answers and eliminate ones that don’t fit. That should help in being successful.


Appendix 4: Documentation Skills Quiz:

Q1: Three critical parts of effective documentation are: Consistency, Accuracy, and Clarity. Documentation often can either be subjective (opinion) or objective (factual). Using the examples below, take the subjective statement and rewrite it so it is objective.

1. Subjective: The client says she feels cold and complains of numbness in her fingers.

Objective: __________________________________________________________

2. Subjective: The client is lazy and smells bad which is why they probably can’t keep a job.

Objective: __________________________________________________________

Appendix 5: Organizational Skills Quiz:

Q1: Having good fundamental skills in your role as a patient navigator is a must! Select all the answers below that are False in regards to the role of a patient navigator.

o Organizational skills are essential so you know where you are supposed to be and what you are supposed to do, but never how to find the information that you need.

o Organizational skills are the same for everyone, having a clean space which is free of clutter helps everyone equally in working efficiently.

o Organizational skills are essential so you don't forget important tasks.

o Organizational skills are essential so you can multitask.

Q2: Feeling confident using the organizational tools and procedures required by your organization is key in being successful as a patient navigator. One of the main issues we face is Time Management issues. Based on the readings from Section 2.5; Name at least 4 of 7 Time Management Tips (as it is listed) in the course:

1. ________________________

2. ________________________

3. ________________________

4. ________________________


Appendix 6: Cardiovascular Health Quiz:

(The one on the Website is not bad…these may add to it!!!)

Q1: True or False

1. ______________ Heart disease is the leading cause of death among men, while it is a close second (only behind breast cancer) for women.

2. ______________ Approximately 12.8 Americans have cardiovascular disease.

3. ______________ Nearly 500,000 Americans die from heart attacks caused by Cardiovascular Disease each year.

4. ______________ Strokes kill more individuals than heart attacks actually do.

Q2: What is the difference in a heart attack and a stroke in terms of affected organs?

1. Heart Attack affects ______________________

2. Stroke Affects___________________________

Q3: In Section 9.3 (Cardiovascular Disease (CVD)) some warning signs are given on heart attack symptoms. Name two:

1. ______________________

2. _______________________

Q4: In Section 9.3 (Cardiovascular Disease (CVD)) the issue of Stroke Warning Signs is mentioned with the “FAST” symptoms. What does FAST stand for? Fill in the blanks below:

F________________________

A________________________

S________________________

T________________________

Q5: In Section 9.5 (Controllable Risk Factors), we talk about how systolic (upper number), and diastolic (lower number) measures blood pressure. However, what does each specifically measure? Please answer on blanks provided by both systolic and diastolic.


Systolic measures: _____________________________________

Diastolic Measures: ______________________________________

Q6: In Section9.6 (Reducing CVD) Use the BMI Table you printed out, identify what category a client falls under:

1. 71 inches & 193 lbs. _______________________________

2. 66 inches & 220 lbs.________________________________

3. 59 inches & 110lbs_________________________________

Q7: In Section 9.10 (The 5 A’s of Self-Management), we learn about how to facilitate individuals in self-management and behavioral change. Using the definitions below, identify what “A” word best fits from the 5 A’s:

1. _____________ Identify personal barriers, strategies, problem-solving techniques and social/environmental support.

2. _____________ Beliefs, Behavior & Knowledge

3. _____________ Provide specific Information about health risks and benefits of change

4. _____________Collaboratively set goals based on patient’s interest and confidence in their ability to change the behavior

5. _____________ Specify plan for follow-up (e.g., visits, phone calls, mailed reminders)

Appendix 7: Assessment Skills Quiz:

Q1: Effectively assessing patient needs in an important part of being a navigator. In Section 4.5 (Assessment Skills), it was determined that assessments are effective in determining: physical status, psychological issues, decision-making, communication/sharing of information, social issues, spiritual issues and practical issues. These determinants are listed below. In the blank next to the determinant please give an example of what may be associated with that determining factor.

1. Physical Status ____________________________________________________________

2. Psychological Issues ____________________________________________________________


3. Decision-Making ____________________________________________________________

4. Communication/Sharing of Information ____________________________________________

5. Social Issues ____________________________________________________________

6. Spiritual Issues ____________________________________________________________

7. Practical Issues ___________________________________________________________

Q2: In Section 4.7 (Assessment and the Role of the Community Health Worker/Health Navigator) you are encouraged to seek assistance when you are concerned for the client’s safety because of what reasons? (Please give 3 of the 4 mentioned in the reading).

1. ___________________________

2. ___________________________

3. ___________________________

Appendix 8: Service Coordination Quiz:

Q1: Keep the current question one the same!

Q2: In section 5.3 (Resource Activity), you reviewed Maslow’s Hierarchy of Needs it was identified that there were five levels of need. On the Pyramid below, please correctly place the needs to where they fit in the hierarchy.


Q3: In Section 5.4 (Service Coordination and the Healthcare Team), there are 3 explanations given in which you are encouraged to make a referral. Please provide 2 of these reasons for a referral below:

1. ___________________________________________

2. ___________________________________________

Appendix 9: Colorectal Health Quiz:

Q1: In Section 6.2 (Colon Anatomy and Function), the term polyp is mentioned. Using the blank below, please define what a polyp is:

Polyp: ______________________________________________________________________

Q2: In Section 6.3 (Risk Factors for Colorectal Cancer), it is mentioned that there are several signs of colorectal problems. Using the blanks below, please identify at least 3 signs of colorectal problems as mentioned in section 6.3.

1. ________________________________________

2. ________________________________________

3. ________________________________________


Q3: How often should the following screenings be conducted assuming they are normal? Place your answer in the blank provided next to each.

1. High-Sensitivity FOBT (Stool Test) ______________________________________

2. Flexible Sigmoidoscopy ______________________________________________

3. Colonoscopy _______________________________________________________

4. Double Contrast Barium Enema ________________________________________

Q4: Based on the readings in Section 6.6 (Screening Preparation) label each TRUE or FALSE:

__________ A diet that incorporates high amount of fruits is a risk factor for colorectal cancer.

__________ Everyone should begin being screened for colorectal cancer at the age of 38.

__________ Screening is the only way to detect colorectal cancer.

Appendix 10: Breast Health Quiz:


Q1: Based on the information provided in Section 7.3 (Benign Breast Conditions), please match the correct term with its proper definition.

1.___________ Fibrocystic breast 2.___________ Nipple Discharge

3.___________ Fibro adenomas 4.___________ Lobular carcinoma in situ

A. Benign breast tumors that are usually too small to feel, and occur in women 20 to 30 years old. They have rounded edges and when discernible, feel hard, like a marble.

B. Fluid-filled pockets that form in the tissue of the breast. These are most common in women who are between 30 and 50 years old.

C. Fluid coming from the nipples, usually resulting from hormone changes.

D. A benign pre-cancerous condition that increases the risk of cancer in the breast. It stays in the breast

Q2: Identify whether the following are MYTHS or FACTS based off of the reading in Section 7.4 (Breast Cancer).


1. _______________ Trauma to the breast can cause cancer

2. _______________ A majority of women that wind up with breast cancer have a family history

3. _______________ A lump in the breast doesn’t necessarily mean you have cancer.

4. _______________ Breast Cancer is the most commonly diagnosed cancer in women in the USA

5. _______________ Breast Cancer is the leading cause of cancer death among women in the USA

Q3: In Section 7.5 (Risk Factors for Breast Cancer) there were 7 items listed as risk factors or Breast Cancer. Please name 3 of them:

1.___________________ 2._____________________ 3.___________________

Q4: In Section 7.6 (Screening Methods) it is mentioned that Breast Cancer Screening is a 3-Pronged Approach. What are the 3 prongs?

1.___________________ 2._____________________ 3.___________________

Appendix 11: Cervical Health Quiz:


Q1: In Section 8.4 (Risk Factors for HPV and Cervical Cancer), there are 2 risk factors listed for HPV, list one:

1._____________________________________

Q2: In Section 8.4 (Risk Factors for HPV and Cervical Cancer), there are 3 risk factors listed for Cervical Cancer, list two:

1._____________________________________

2._____________________________________

Q3: In Section 8.5 (Reducing the Risk of HPV Infection and Cervical Cancer) it is mentioned that there are several was a woman can lower their risk of getting HPV and Cervical Cancer. Name 3 of them:

1._____________________________________

2._____________________________________

3. _____________________________________


Q4: Fill in the blanks:

1. Women should have their first Pap test at the age of _____________.

2. According to the 2012 US Preventive Services Task Force Guidelines, if a woman has a Pap test and it is negative, she will not need another Pap test for ____________ years.

3. If the Pap test was done with HPV co-testing, a Pap test is not needed for ___________ years.

Q5: True or False

1. ___________ A positive result on an HPV test means that a client has a form of cancer.

2. ____________ Cervical Cancer is 100% Preventable

3. ____________ Cervical Cancer cannot be treated, unless it is caught early.

Appendix 12: Introduction to CHW Course -TEACHING ASSISTANT

Welcome to the Nebraska Department of Health and Human Services (DHHS) Community Health Worker/Health Navigator Certificate online course. The workshop is highly interactive, involving online case studies, resources and participant discussion. It has been devised to be used in weekly sessions that students can fit around their own schedule. Students should expect to spend approximately 90 minutes per week during the course of the workshop online, working with your supervisor (if applicable) and completing assignments. Participants will attain confidence and credibility in the communities that they serve along with general knowledge on health topics, communication and organizational skills.

The Objective

The purpose of this training is to provide a baseline understanding of the role of patient navigation for community health workers. The course content is intended to clarify your understanding of the material and concept presented in person an online during the period of the course.

Course Website:




Instructions for Website:Login Page

Once you have gone to the course website, you will notice there is an area to log in by putting in your username and password. Your Password should have been emailed to you. In the event you do not recall your password, there is a button you can press that will send you information on a new password. Below is a screenshot of what to expect when going to the website.

Profile

Congratulations, you are now logged in! If you did things correctly you should find yourself on the MyCourses main page and be able to select: Profile by clicking on the 2nd tab at the top of the screen (which has been highlighted for you in these instructions).


After you have clicked on Profile you will find yourself on the Profile page. You need to go ahead and enter information so you are identifiable in the course. Note: The only things required are your First and Last Name, however you may choose to include more information if you wish (who knows someone in the class may wind up with a great job and be able to network with you)! The profile page is shown below. You may also select whether or not you wish to have your email private. When finished click Save at the bottom right of the screen.

Changing You Password

In the event you would like to change your password from something generic to something you are more likely to remember, you may do so by clicking on Change Password (located under the Profile Tab. Once there you will be prompted to give the old password (the one you don’t want anymore) and then supplying a new password with the confirmation (retyping) of the new password:

Changing Your Email


This step is similar to changing your password except it just asks for your current password (so if you changed it use that) and then a spot to type in the email desired. You may find the Change Email by clicking on Change Email (located under the Profile Tab):

Adding a PictureBeing in an online course can be frustrating to many, however seeing a “friendly face” shows us that there

are others out there taking the class and working just as hard as we are. There are two key sections on how to add a picture. Section A will inform you how to save, Section B will inform you how to upload. In order to upload a photo you will first need to save one to the computer so you can retrieve it, you can do that by:

A:1. Right clicking on a photo of yourself (maybe from your Facebook or Twitter page) 2. Clicking Save Picture As… 3. The photo should try to save under Pictures, if It does not go ahead and Save it there4. Naming the file (choose something simple so you will remember it)

You will find the Picture section by clicking on Picture (located under the Profile Tab):

B:1. Click Browse to upload your photo2. Go to Pictures3. Find your picture and double click


4. You will now notice there is a document pending in the Browse area 5. Hit Save and you will be taken to a screen that indicates you have successfully added a

picture:

You can then go on to update your profile if you would like by going to the Networking tab (4th over on the top of screen) and then clicking into the Network Profile. You will notice in the middle of the screen is an image of a pencil…this is used to edit any information you would like to change (which I have highlighted below):


If you click on the pencil you will be taken to a screen that allows for changes your profile in a variety of ways. This screen is shown below:

Appendix 13: Announcements

Now that your profile is all created, we need to look at the My Courses page and select: Health Navigator-CHW Course by clicking on it, or by using the drop down tab at the top middle of the screen. This will take you into the course and allow you to look at things from the start of the course, however as the semester goes on you may wish to not start at the beginning, that is when you should hit he RESUME button, which will then take you back to the last point in time you were on the website. A screenshot of the My Start Page > My Courses page is located below:


ManageAs a teaching assistant you will become very familiar with the Manage tab. This tab the last tab one the

right, just above your Name…I have circled it in red to help you identify where to click:

Let’s first look at announcements as they are the first link on the top of the page. If you click on Announcements you will either come to a blank screen (as these are deleted at the end of each session) or you


will come to a screen like so:

In this screen you can go in and edit previous announcements to the class and let them know of any changes in the coursework. If you want to make a new announcement click on the Add Announcements link which will direct you to this page:

If you hit save in the lower right corner the Announcement will now post onto the course:


To Edit/Delete this post from the website simply click on the radial to the left, then click on either the Edit/Delete button at the bottom of the screen (based on which you were planning on):

If you choose to Delete you will see the following:

Click YES if that is your intention. Once you have done that you will be taken back to a screen that indicates your success in deleting:

Appendix 14: Assignments

Now that your profile is all created, we need to look at the My Courses page and select: Health Navigator-CHW Course by clicking on it, or by using the drop down tab at the top middle of the screen. This will take you into the course and allow you to look at things from the start of the course, however as the semester goes on you may wish to not start at the beginning, that is when you should hit he RESUME button, which will then take you back to the last point in time you were on the website. A screenshot of the My Start Page > My Courses page is located below:


ManageAs a teaching assistant you will become very familiar with the Manage tab. This tab the last tab on the

right, just above your Name…I have circled it in red to help you identify where to click:

Let’s look at assignments which are the second link on the top of the page. If you click on Assignments you will come to a screen like so:


In the above slide Week 1 Tab was clicked. I have hit submissions which now will bring you to a screen like so:

I have clicked on the top name which now will put us into that student’s file storage which is shown below (showing Week 1 which was clicked on earlier):

If you wish to look at a week other than week one click on the down arrow next to the word go to open up the Workspace folder:


Upon clicking you will come to a screen like the one below, click on another week and then press Go! This will send you to whatever week you desire to be on.

Editing AssignmentsLet’s now backtrack to the beginning screen and this time hit the Edit button, this is the screen you should

be on:

After you have clicked on the Edit button you will see that it is a little different than the other screens. In this screen you can change title, due date and whether or not accept late submissions. If you decide to make changes go ahead and click on the save button. If you decide not to make changes then click cancel.


Adding AssignmentsLet’s return to the following screen and click on Add Assignment

You will now find yourself at a screen where you can add a title, to whom specific information is going to and the due dates along with whether or not late submissions will be accepted.


Be careful how you enter. As an example I put 10-Woo Hoo, Finished! (with no specific date) When I clicked Save it put the document toward the top (it is based off the first character in the word/phrase, thus 10 comes after one but it is done alphabetically in recognition not numerically initially so it shows up before the number two as shown below), also In order to avoid the document being out of place you will need to consider if a document will be higher than the number nine for the assignment you are creating, that way it will find its way to the proper destination, so realizing this mark the document by clicking the radial to the left and then hitting delete to get the following two slides:


Then confirm by clicking Yes, you should see an indication in the middle part of the screen indicating the action has been completed successfully:

This time we will try by adding time:

You will now see that your finished entry is at the bottom in order of where it should be:

COURSE EMAIL


Let’s start back at the Manage Tab screen where this time we will work on looking at the function of Course Email:

You will next come to a screen that looks like the following:

Mark whom you would like to send information to, the subject and then enter your message in the body as shown below:

After you send your information you should be directed to a screen confirming the action:


Appendix 15: FORUMS

Let’s start back at the Manage Tab screen where this time we will work on looking at the function of FORUMS:

Notice there are 3 options in which you can click. I will click on Forums first to get the following screen:

I have went ahead and clicked 1-1 and then Edit (which can be found at the bottom of your screen). This will bring you to a page which allows you to make changes:


After you have made your edits hit the save button to see success!

CREATE FORUMSGoing back to the manage tab home screen click on the second option now of Create Forum:

You will then find yourself in a screen in which you can create a new forum to post:


Once you hit save you will get a confirmation of successful completion at the top of the page as so:

Meanwhile at the bottom of the page your newly created forum will appear like so:

Export ForumGoing back to the manage tab home screen click on the third option now of Export Forum:


You will now be on a screen like so (I will click Export Forum in the lower left hand corner to Export Physical Activity and Goals):

When you click on the Export Forum it will ask you if you want to Open or Save (select Open):

You will now see the forum has been downloaded to your computer. Double click on the exported_forum (highlighted in yellow on this sheet)

To get this screen:

I will now click on the blue underlined Physical Activity and Goals link which directs me to:

There is nothing showing when you click on the blue link. Check to see if there is a glitch.______________________________________________


Appendix 16: Gradebook

Let’s start back at the Manage Tab screen where this time we will work on looking at the function of Gradebook, in this section there are 6 options which include Gradebook, Add Tests/Assignments, Update ATutorMarks, External Marks, Edit Marks, and Grade Scale. We will explore the highlighted Gradebook

After clicking on Gradebook you will now see the screen below, please note 75-100% is Passing, 74% and below is failure (as it is set up now) you can click on a radial to the left of the Name of the document and Edit to change the grade scale to be something other than Pass-Fail (make sure you check with your supervisor first):

This is what the Edit screen will look like:


Saving any changes will then take you to a confirmation screen:

ADD TESTS/ASSIGNMENTS Let’s start back at the Manage Tab screen where this time we will work on looking at the highlighted Add Tests/Assignments:

After clicking on the Add Tests/Assignments option, you will find this link:


There will be drop down box (like below) which you can select)

When adding assignments, after you have made your selections in the Add ATutor Assignments/Test/Surveys hit ADD to get confirmation:

Now on the bottom I am going to Add External Assignments/Test:


Click ADD and you will now see your new assignment at the bottom of the page (note at the top Action Completed Successfully):

I will now highlight the radial to the left of “Made Up Assignment” and click REMOVE (as it was not needed for this class) you will be asked if you want to remove the document, say Yes:


You should see the familiar successful screen after hitting Yes:

UPDATE ATUTOR MARKS Let’s start back at the Manage Tab screen where this time we will work on looking at the option of ATutorMarks:

At the top of the screen you will see the following (I have marked Cardiovascular Health Quiz and Aaron Sweazy as the student) and will Update:


Notice I have highlighted the action indicating success in Updating, however, I have circled in red the message that indicates certain students cannot be updated because they have taken the test more than twice:

At the bottom of the screen is the Combine ATutor Test (you will not use this option, thus it has been covered by a Red X in this manual):


External Marks Click on External Marks (highlighted below) on the Manage Screen in the option of Gradebook:

At the top of the screen is the Export area. Select what you wish to Export and then click Export:

Do you want to Open? YES! Open the document!

This will bring you into an excel sheet with participants names and emails like so:


If you go back to the External Marks Screen you will see that there is an Import section, for the sake of this class we will not use that section thus the Red X:


Grade Scale Moving ahead we will not use Edit Marks, so let’s look at the Grade Scale:

This is where you will see the Grade Scale for the current class, under no circumstances should you change the grade scale unless you are given prior approval by a supervisor of this course!


Appendix 17: Tests and Surveys

Let’s start back at the Manage Tab screen where this time we will work on looking at the function of Tests & Surveys, in this section there are 4 options which include Test & Surveys, Create Test/Survey, Question Database, and Question Categories. We will explore the highlighted Test & Surveys:

You will now be on the Tests & Surveys screen. If you have a Test that has been created you would use the Import Test function by clicking Browse, then selecting your Test you saved on the computer, and then hitting Import. However, we are going to look at clicking on a radial to the left of a titled assignment and then hitting the Edit Button.

I selected Post-Assessment you will have the option of Edit, Preview, or Questions let’s look at EDIT first. If you wish to make changes do so on this page:


After making changes and submitting you should see the success screen:

Now let’s return to this page and check a radial on the left and do a preview:


A preview allows you simply to see the test as the student sees it:

If you would have clicked on Questions instead you would come to a screen like so (notice you can change points, order, question, type and Category. You can also choose to remove any questions…with approval of your supervisor):


At the very bottom of the screen you will find this screen (we are going to look at Submissions and Statistics for this section):

SubmissionsIn this screen you will be able to view the amount of time it took to complete the post-assessment per

students in the class, when they took the assessment, and how long they took on it.

To View and Mark the test select a name (in this case I will have already Marked the box next to A_lowedfuentes) and I will hit the View and Mark button at the bottom of the screen:


Notice there are green check marks by the questions with correct answers:

Create Test/Survey Create a Title and if you choose you can put a title description (click save when done):

You have success! Notice the Test is now on the top of the screen as well.

Let’s assume you didn’t get permission to add this Test and the supervisor isn’t happy about it and would like it removed, simply mark the radial to the left of the document created and then click Delete at the bottom of the page to come to the “Are you sure…” Click Yes!


The action has now been successfully completed!

StatisticsSelect any student’s name and then click statistics at the bottom of the page:

On this screen you will notice the breakdown of the class and how they did percentage wise. Notice the Green Check is supposedly to mark the Correct Answer, but in some of these questions, there will be no wrong answer as it is opinion based…so make sure things are accurate.


If you wish to delete an item from the original screen, mark the radial to the left and hit Delete and wait for the successful confirmation. The Export button we will not use in this class as of this time:

Create Tests/SurveyLet’s go back to the Manage main page an click on Create Tests/Survey this time.

Enter your information and then click submit to create the new test.


You have success! Except you realize that you misspelled a word in the previous screen, simply click the radial to the left of the Title and hit Edit or if you wish to Delete (realizing you had a lot of mistakes) do that.

You will be asked to confirm your decision, if you are sure click YES!

You have now successfully deleted the unwanted document!


Question DatabaseLet’s go back to the Manage main page an click on Question Database this time.

After clicking on the Question Database option you should be directed to the following screen:


There are 8 choices for Creating a New Question. I will go ahead and Create questions based off the Blue Highlighted Always-Never. Notice when you go into the Likert Scale, there are several fantastic options to choose from:

I have created a Likert Test and will hit Submit:


The Likert is now in the list of Tests:

Moving forward I decided to Preview the Test. Simply click the box to the left and click “Preview”:

Realizing a question about donuts isn’t relevant to the Community Health Worker Course as of now, let’s delete it by clicking Yes:

You have now successfully deleted the question.


Appendix 17: EVALUATION FORM Page 1 (SUPERVISOR)


Appendix 18: EVALUATION FORM Page 2 (SUPERVISOR)

Documents

Practicum Final Paper - Concordia University-Nebraskawp.cune.org/.../files/2015/06/PracticumFinalPaper.docx · Web viewPracticum Final Paper. Aaron Sweazy. ... (NCP) was implemented