May 292012
 

These days, the buzz in nursing education is technology. USA Today  recently asked whether technology has changed the content in our nation’s nursing schools. The answer is two-fold: technology provides new opportunities for nursing students and technology creates additional questions that must be answered.

East Carolina University’s College of Nursing is located in a modern, tech savvy building that has eight clinical laboratories for student practice. Each lab contains life-like manikins that can be programmed to replicate just about any condition from childbirth to heart attack. Students have the opportunity to practice new skills in a controlled, safe environment.

Today, most nursing students do not remember a time when computers were not part of their lives. The equipment in these labs mirrors the equipment in hospitals where new graduates will work. Even the software in the bedside computers is similar to the charting software in hospitals and medical offices around the country. Learning on the real thing gives today’s nursing students a leg up when they enter the workforce. As expected, millennial students excel using advanced technology, but does this make them better nurses?

Dr. Frances Eason, a longtime ECU Nursing professor, keeps her students grounded by teaching them how to care for their patients without depending on technology. Calculators are not allowed in her tests—she reasons that a patient can die in the amount of time it takes a nurse to find a calculator to figure a drug calculation or IV dosage. But, what about accuracy? She believes technology should be used only after students learn how to solve problems by clinical reasoning. Often, we rely on calculators but really do not know how to set up the calculations in the first place!

Many providers now use handheld computers to input patient data and to research diagnoses and medication. While students learn how to use these devices, we stress the importance of the credibility of the information they can access. Handhelds provide instant access to information, but students must learn how to distinguish between good and bad information.

Technology is certainly exciting and a huge asset in nursing education, but this advantage comes with strings. Students must be taught traditional nursing skills to be able to interpret and use the technology. And, they must learn to question the credibility and validity of the technology. For this, students will continue rely on a blend of critical thinking and technology.

–Dr. Sylvia T. Brown, Dean
College of Nursing

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May 252012
 

Once considered healthy and a way to ensure vitamin D synthesis, sun exposure and tanning carry serious consequences. Acute sunburn is painful, but chronic sun exposure in those with outdoor occupations like farming, fishing, and roofing can have significant detrimental effects. Basal cell carcinomas are the most common skin cancer associated with sun exposure, and while cosmetically objectionable, do not carry the serious effects of squamous cell carcinoma or the more rare melanoma. Basal cell carcinomas appear as nodules with dilated capillary vessels, depressed skin lesions with rolled borders, or frank ulcerations, and can be found on persons who tan outdoors or in tanning beds.

Squamous cell carcinomas appear as non-healing scales, crusts, ulcers, or masses. Melanomas appear as areas of altered pigment (red, white, brown, black, and blue) with irregular outlines, diameters greater than 6mm, and occasional ulceration.

Appropriate clothing should be worn to protect the skin from damaging UV radiation. Sun-blocking lotions and lip balms of SPF 35 or greater must be included on areas not covered by clothing. The lips are covered by oral mucosa that extends to and merges with perioral facial skin. Sun exposure is evidenced by the loss of a distinct vermillion border on the lip. Dryness, fissuring, scaling, erosion, and ulceration can also be noted. Anyone with persistent chapping, fissuring, scaling, and bleeding of the lips requires a biopsy to assess the extent of the UV damage and whether malignant transformation has occurred. This is often noted in the dental office, particularly when the lips are stretched during an oral exam, and scaling, crusting, and ulceration are more evident. When actinic cheilitis is diagnosed, the lips should be protected by large brimmed hats and lip balms of SPF 35 or greater. Blue-eyed, blondes, redheads and fair-skinned persons of Irish ancestry are particularly prone to damaging sun effects, but everyone needs to be aware of the effects of sun damage, e.g., loss of skin elasticity and wrinkling. So cover up, wear your sunscreen, and “be careful out there”.

–Bobby M. Collins, DDS, MS
Section Chief, Oral and Maxillofacial Pathology
ECU School of Dental Medicine

May 222012
 

Four family medical clinics administered by ECU will now offer patients instant online access to reliable medical resources and information thanks to a new partnership between the Laupus Library, Family Medical Clinic and ECU Physicians. From diabetes to heart disease to shingles, patients will now be able to access information about diseases, conditions and wellness issues using a computer kiosk in their doctor’s office.

In late May, selected family medicine clinics will receive a kiosk housing a computer, printer and wireless internet to connect patients to a comprehensive database maintained by the National Library of Medicine’s Medline Plus service. This technology can help patients stay informed and take better care.

Patients can use the information when talking to their physician or print resources to take home. Jeff Coghill, project leader and the head of outreach at Laupus Library, noted, “We are excited to bring these kiosks to the clinics so that patients can help manage their own care and learn more about their own health while they have an appointment in the doctor’s office.”

The National Networks of the Libraries of Medicine (NNLM) at the University of Maryland, Baltimore, awarded Laupus Library nearly $30,000 to install the kiosks and train medical office staff to use them.  Kiosks will be located at the Family Medicine Clinic, the Monk Geriatric Center, the Firetower Road Office and the Bethel Family Medical Clinic. 

Other project leaders from Laupus Library include Katherine Rickett and Roger Russell. Clinical Assistant Professor Jaime Messenger served as the project leader for Family Medicine.

–Dr. Dorothy A. Spencer, Director of Laupus Library

May 182012
 

Earlier this month, AAMC (Association of American Medical Colleges) announced a bit of good news concerning the nation’s looming physician shortage, a result of increased demand for care from a growing and aging population. According to their projections, the nation’s medical school enrollment is on target to achieve the 30 percent growth needed in the supply of physicians by 2016.

Most of this growth (58%) results from the expansion of existing medical schools like ECU’s Brody School of Medicine (BSoM). The rest has come about from the creation of new physician programs. Despite the heartening trend, more than half of institutions surveyed indicated concern with their ability to maintain or increase enrollment due to the current economic environment.

At Brody, we have increased enrollment by 11 percent since 2006. Eighty new medical students will start this fall, marking the largest incoming class in the school’s 35-year history (which started with 28 students in the inaugural 1977 class).

For now, this will likely be the largest class Brody can sustain. A 2006 BSoM task force set a student cap at 80, given the current number of faculty, classroom and lab facilities, and clinical sites. Like many North Carolina institutions, the BSoM at ECU has lost roughly a third of its state funding over the last three years, making further expansion impossible without a substantial increase in state revenue.

Regardless, the BSoM remains steadfastly committed to its mission: educating primary care physicians to serve the people of our state. In our students we instill a love of learning, commitment to service and concern for people. In fact, we rank in the top 10 percent of all US medical schools for graduates who go into Family Medicine, practice in rural areas, and practice in underserved areas.

– James G. Peden, Jr. MD,  Associate Dean of Admissions

 

May 152012
 

The ECU Department of Health Services and Information Management received approval to establish the Master of Science in Health Informatics and Information Management program.   The MS degree will begin in Fall 2013, replacing the current BS degree in Health Information Management.

Why is it important for health information managers to be trained at the graduate level?

Since 1970, the BS in Health Information Management has been successfully training administrators.  For decades, these HIM professionals focused on paper-based medical records and processes, later transitioning to electronic health records (EHRs). These personnel usually managed records for one organization.

Today, the health care system is moving towards digitization and interconnectivity, with universal EHRs and reliable health information exchanges across the US as the goal.  A wealth of data will be collected, stored, distributed, used and analyzed.  Health care operations will be structured and automated electronically.   New specialists trained in the field of health informatics and health information management will be needed to lead such systematic changes.   

A workforce study by Hersh and Wright forecasts that approximately 40,000 informatics professionals are needed by 2016 in order to meet the predicted growth in the adoption of electronic health care information systems in the US.

Now it is time to train these new professionals.  We expect the ECU MS, Health Informatics and Information Management students will become leaders and experts in the field.

–Dr. Xiaoming Zeng, Chair
Department of Health Services and Information Management