SPL Description and Vision Statement

SYSTEMS, POPULATION AND LEADERSHIP

The Department of Systems, Population and Leadership (SPL) is dedicated to leading ground-breaking interdisciplinary research, teaching, executive leadership, and clinical practice centered on systems and population-level phenomena that shape the health of diverse groups and communities both locally and globally. In order to critically engage in developing new knowledge, SPL’s interdisciplinary faculty represent nursing science and a wide range of disciplines including epidemiology, economics, health informatics, data analytics, and demography. In addition to representing multiple disciplines, SPL Faculty bring a depth of experience in health care and health system leadership. Grounded in multiple research approaches, theoretical perspectives, and clinical practices, SPL faculty seek to discover, evaluate, apply, and teach innovative solutions to improve health and shape the systems and structural factors that influence health and impact policy in Michigan and around the world.

SPL Faculty conduct research, scholarship and practice centered in three key domains:

Systems: SPL faculty are engaged in research, scholarship, and practice that informs health care delivery and management and promotes economic and environmental sustainability of health care systems, with the goal of improving the experience and outcomes of care and promoting equitable access to care. Our faculty’s work informs contemporary health care delivery systems and policy environments and includes evidence-based quality and safety science, team structure, communication, and performance, occupational exposure and safety, implementation of evidence-based practices, and healthcare markets and value.

Population: SPL faculty have wide reaching and deep expertise in population health – across local and global contexts. We conduct research, teaching, and practice that centers on developing and testing approaches that promote healthy lifestyles and quality of life among populations ranging from children and adolescents to older adults. Our emphasis is on identifying the determinants of health outcomes across multiple levels (i.e. families, communities and systems) and reducing health disparities. Population and health research within SPL focuses on issues ranging from sexual and reproductive health, substance use, violence, hearing health, chronic disease, aging, and cancer and pain management.

Leadership: SPL faculty prepare future healthcare leaders through clinical practice, mentoring, scholarship, learning through formal education (both in person and digitally) and engaged research for executive leadership roles. We provide training in information systems, health services research, implementation science, and opportunities to collaborate with clinical and community partners. SPL faculty conduct innovative research to understand and improve the functioning of clinical teams.  SPL faculty are routinely represented in leadership roles in national and international nursing and health sciences organizations (e.g. AACN and WHO).

As a diverse, inter-disciplinary faculty, the work of SPL is grounded in core values of diversity, equity and inclusion, and respectful and productive engagement with diverse communities.


Time Out Podcast with Michigan Nursing

Hosted by University of Michigan School of Nursing Clinical Professor Michelle Aebersold, Time Out with Michigan Nursing takes deep dive into the latest nursing research news, new practice implementation and important topics related to patient care and safety. Professor Aebersold will be joined each episode by U-M School of Nursing faculty researchers, clinicians and newsmakers to have a unscripted discussion about the subjects that matter most to nurses working on the frontlines of healthcare systems across the country. Stay on the cutting-edge of nursing practice and research that will help increase your knowledge of the most important advancements in nursing care by listening to Time Out with Michigan Nursing bi-weekly. Listen to "Time Out with Michigan Nursing" on Spreaker.

Michelle Aebersold:

Hi, welcome to Time Out with Michigan Nursing. I will be your host, Dr. Michelle Aebersold. Time Out with Michigan Nursing takes a deep dive into the latest nursing research, news, practice implementation and important topics related to patient care and safety. Each episode I will be joined by University of Michigan School of Nursing faculty, researchers, clinicians, and news makers to have an unscripted discussion about the subjects that matter most to nurses working on the front lines of the healthcare systems across our country. Stay on the cutting edge of nursing practice of research that will help increase your knowledge of the most important advancements in nursing care by listening to Time Out with Michigan Nursing. Hello, and welcome to Time Out with Michigan Nursing. Today we are so fortunate to have Dr. Rob Ploutz-Snyder with us to talk a little bit about one of his exciting studies. but before we get there, let's let Rob introduce himself.

Robert Ploutz-Snyder:

Thanks Dr. Aebersold. My name is Rob Ploutz-Snyder and I'm a research professor here in the school of nursing. I'm an applied biostatistician and I also lead the applied biostatistics lab and the data management core at the school of nursing. So the ABL, as we call it, is a collaborative team of faculty and staff that work with other faculty and contribute experimental design expertise, statistics, and statistical modeling. We do a lot of grant proposal work and related scholarship. Now the faculty in my group also have our own areas of scholarship. And I was asked today for this interview to talk a little bit about some of the work that gets me excited when I come into work in the day. I've been here at the University of Michigan for almost five years. Prior to coming here, I was a senior research scientist at NASA, working at the Johnson Space Center in their human research program.

Robert Ploutz-Snyder:

Prior to that, I was faculty in a school of medicine elsewhere, but while I was at NASA, I was collaborating with Ph.D. scientists from multiple labs. NASA's Johnson Space Center is like a small campus. They have a bone lab and a muscle lab, exercise physio lab, immunology, radiation, cardiovascular, pharmacy, environmental physiology. They've got some engineering teams. It's really interesting. It's like a small university and I collaborated with members from all of those labs. It was really pretty exciting stuff. So I thought maybe I'd talk about one of those studies today.

Michelle Aebersold:

Wow. That's really exciting. And how timely, because just this past week, NASA put another little rover up on Mars. I was reading about that. I know that you've done some really cool stuff with NASA and, of course, I'm a huge fan of flying and all that kind of stuff. So it would be really cool if you could share with us a little bit about one of your NASA projects.

Robert Ploutz-Snyder:

Yeah, you're right. Thank you. I mean, it is cool. We did just land a rover on Mars and that's not an accident. NASA plans these missions multiple years in advance. And so that rover is on the planet now, taking pictures and sending them back so that NASA can prepare to send humans to Mars. That's really on their horizon as the next big thing for deep space exploration. And so they're taking those steps now. But most of my work at NASA had to do with humans, not the robots. And so I wanted to talk a little bit about how that research got conducted there. In one study in particular, we recently got a manuscript published from this work that I'll describe today. If you're a space person, you probably have seen videos and you know that people are currently, even right now, floating around in space on the International Space Station in what we call microgravity.

Robert Ploutz-Snyder:

I think the lay person talks about this as zero gravity, but the technical term is microgravity. So they're floating around waitlists on the International Space Station. And the research I'm talking about today is dealing with that. So as our astronauts float around in microgravity, their muscles that are normally resisting the gravitational pool of earth, they're no longer doing that. And so as a result, particularly their lower muscles, they tend to lose muscle size, it is called atrophy. They also lose bone, interestingly, but that's another topic. They lose muscle size and muscle strength just from floating around in microgravity. And it's not trivial, particularly the longer they're staying in microgravity, the worst this gets. And so for the last couple of decades, NASA has been flying astronauts in this microgravity environment on the International Space Station. And they had them on there for short and also long duration missions.

Robert Ploutz-Snyder:

Most of these long duration missions were about six months in total, but we've actually had astronauts now for the last few years, staying on the space station for up to a year. And this is in preparation for those really long missions to Mars, where we think it's going to take about a year just to get there. Then they're going to spend some time on planet doing science and then another year to get back home. So currently the reference mission is almost three years, if you can believe it.

Michelle Aebersold:

That's amazing.

Robert Ploutz-Snyder:

Yes, it's really important for us to understand what that impact is going to be on the human person so that once they land, let's say, on Mars, they can actually get up and walk and get around and do stuff. But most of our data is based on these six month long missions. And in six months time, even though our astronauts currently have a two hour per day prescribed exercise intervention to offset these effects, they still lose as much as 25% of their muscle mass in their lower extremities.

Robert Ploutz-Snyder:

And that's just in six months time. And so as NASA is planning for these deep space missions that lasts a lot longer. It's really important to know if the muscle mass loss that we've seen in just six months is going to continue to decline in that same pattern, or is it going to plane off a bit so that we can plan what kind of shape they're going to be when they land. So we have a manuscript that has just recently been accepted for publication, and it was along this lines. It was a fun one for me because it involved, in statistical terms, a doubly nested experimental design. All of our astronauts, so far at least, have both the right and left legs. So you have two legs nested within the same human being. And this experimental design that I'm talking about today also had nested observations over time.

Robert Ploutz-Snyder:

Now we only have so many astronauts that are flying around in space at any given time. And so this study involved what's called an analog. NASA uses several analogs that try to represent some of the dangers or the odd effects of this reduced microgravity environment. And the one I'm talking about today is a bedrest study. So in the bedrest study, we had research participants lie down in bed with their head tilted downward, that emulates the fluid shift that astronauts experience when there's no gravity pulling blood and other fluids downward, the fluids tends to shift upwards towards their chest and their head. And they're in this bed rest posture for 70 days. They're not allowed to get up to go to the bathroom. They're not allowed to get up at all. All of their food is brought to them. They have a television and a computer to keep them entertained, but this goes on for 70 days, pretty long period of time to just be sitting in bed.

Robert Ploutz-Snyder:

And on this study that I'm talking about, we took MRI images of their muscle groups in their lower legs before bedrest, and then also several time points during bed rest, and then also a few time periods afterwards when we return them to a vertical posture and gave them training to get back into shape. So a bed rest is a really common analog for space flight because it does simulate the changes that we see in muscle and the cardiovascular systems. And so this study was using that, and it was an interesting study because the main purpose was to look at an intervention to try to offset those negative effects, an exercise intervention. But the data I'm talking about today were with our control subjects. So, they went into this bedrest environment and they did nothing to try to mitigate the muscle strength declines that we would normally see.

Robert Ploutz-Snyder:

So, literally these people were lying in bed, head down tilt for 70 days and nights without getting up and no exercise intervention whatsoever. They were wheeled into the shower facility on a gurney for hygiene purposes. They had a bed pan that they would use to go to the bathroom. They ate a very structured diet and they're even monitored if they turned on their sides and that was restricted. So this is a very highly tightly controlled study. I will say that it was completely conducted in a hospital in Galveston, Texas. They were monitored very closely by a team of doctors and nurses. So, their health was definitely looked after very carefully. So my job then was to determine if the muscle changes in size and strength over the 70 day period, was that primarily a linear decline, and we might expect it to just keep on going down if we had them in bed rest for longer than 70 days, or was there some noticeable non-linear pattern that might've fit the data better.

Robert Ploutz-Snyder:

So I worked at several different models on different muscle groups, including a linear decay model, but also a three parameter non-linear exponential decay model that mimics other decay patterns that we see in nature. It turns out that exponential decay models are pretty common in nature, so we wanted to try some of that. And then as well, some less supervised, what are called, fractional polynomial decay models that evaluated fractional powers of time ranging from a negative two to a positive three. So this could be a pretty complicated non-linear decline pattern. And so I was comparing the fit of this linear decay model to an exponential decay model, and then also to unsupervised or computer determined fractional polynomial models. Now, for the most part, given a small sample size and the time involved, this was only a 70 day bedrest study, it turns out that the linear model fit the data just about as well as any of those more complicated nonlinear models.

Robert Ploutz-Snyder:

The exponential decay model never seemed to fit better across all the different muscle groups that we looked at, although I will say that for some of the muscle groups, the fit indexes that we used to compare models favored the unsupervised fractional polynomial model a little bit, very slight favorability for that, but ultimately just out of scientific parsimony, the ability for us to explain decay and the probability that that unsupervised non-linear poly model would fit other data sets. We concluded that the linear decay model really did fit just about as good as we might get from any of these more complicated models.

Michelle Aebersold:

Rob, that's really interesting, just listening to all the work that you did to try to figure out what model fit best and then at the end, something that was a little bit simpler seemed to do the trick. Where are things at now? First, I just have to say, I can't imagine being on bed rest for 70 days. I mean, that's crazy, but gosh, what dedication they had to the science. But could you tell us, has there been any followup to that, where are things at now?

Robert Ploutz-Snyder:

Yeah, sure. Well, with this particular study, there's another aspect of it too. Remember when I first described it, I said that we collected measurements pre bedrest, and then several time points during the 70 days of bedrest, but we also had several time points after bedrest. So all of these experimental subjects, when the study is completed, of course, they have to stand up and regain their normal activities in life. And so there's a very well-planned out rehab program that they go through. And so we wanted to see how do the muscles regain in their size. And so for that, since we knew that the decline was essentially linear and we only had a few post bedrest time periods, I fit something that's commonly referred to as a hockey stick model that shows the decline as one sloped model and then the increase back to normal muscle size and strength as a second slope going back up again.

Robert Ploutz-Snyder:

And so that was a interesting model to fit the data well, too. And at least for the number of data points that we have, that seemed to fit really well. So it was a fun project for me because I got to do a lot of interesting statistical modeling, but I'll also say that it really was impactful for NASA because it helped inform the chief scientists teams at NASA that at least within the 70 day time period, this muscle decline is essentially linear. And it's going to continue to go downward for longer periods of time. There was some speculation that even within 70 days, muscle mass declines would peter off in an exponential model and then not really get worse from there. But our data was quite contrary to that and at least in the 70 day time period, it didn't look like there was any slowing down.

Robert Ploutz-Snyder:

So, this is not necessarily good news for NASA, but it's informative, because now they're trying to plan for much longer missions and what they know, at least from these data, are that they're going to have to extend the studies to a longer period of time before we know if it ever really does peter off. I mean, if you think about a person who lives life in a wheelchair, because they're paralyzed from the legs down, their legs get very small, but at some point they stop shrinking and we expect that something like that similar will happen for astronauts, but we just don't know where that point's going to be yet. And this was a motivator for NASA to extend their current six month missions for astronauts on the International Space Station out to a year. And we've got now several astronauts that have done that, but it's still the sample size is so small, it's going to take several more missions, many more years before we can really model that data well to understand what's likely to happen after that.

Robert Ploutz-Snyder:

Now the good news is current missions are to go to a planet like Mars so once they get there, they will be in a gravitational field. It's not exactly the same on Mars as it is on earth, but we know they'll have gravity at least. So if we can keep our astronauts healthy for that long duration flight to get there, we're pretty confident that we know how to rehab them and get them in good shape so that once they're walking around on the planet, that negative microgravity environments been relieved and so they should be able to be successful at the mission. At NASA it's really all about the astronauts health and the mission, in that order, I'll say. So it was pretty fulfilling research for me. I continue to work with NASA on this type of study and a few others that I'm working on. I still managed to maintain some of those collaborative work arrangements with NASA scientists and it's quite fulfilling. I love it.

Michelle Aebersold:

Wow. Thank you so much for sharing with us. That's really interesting. And it's amazing, myself, having been a nurse practicing in the intensive care unit and knowing how debilitated our patients get from being in bed sometimes because they just medically can't get out of bed and then seeing how long it takes for them to recover, this work is just really fascinating. And perhaps, although the work was done really for the astronauts and NASA and lengthy flights, maybe there's some things that we can learn from that as we think about particularly now with many of our patients who've had COVID that have had very lengthy stays. Maybe there's some things that people can extract from that and put to use in other areas as well.

Robert Ploutz-Snyder:

Yeah, that's such a great point. NASA, it's so hard to get real astronaut data, it takes years to get them up there. And then when they're on the space station, they've got a mission to accomplish. And by the way, we can't fly, for instance, an MRI machine. So we're really limited in the data that we can collect from astronauts. So it's cool because our scientists try to extract relevant terrestrial analogs, real conditions here on earth that might relate to astronauts in space, but you're absolutely right. The relationship's the other way too. We can learn things from astronauts in space that can apply to terrestrial populations here on earth. So it goes both ways and that's part of the fun.

Michelle Aebersold:

Great.

Robert Ploutz-Snyder:

Thank you for having me.

Michelle Aebersold:

Thank you. And thank you for joining us on Time Out with Michigan Nursing.

Speaker 3:

Time Out with Michigan Nursing is produced by faculty and staff at the University of Michigan School of Nursing in Ann Arbor.

 

Listen to "The Nursing Executive Fellow Academy with Dr. Rhonda Schoville" on Spreaker.

Dr. Michelle Aebersold:

Hi, welcome to Timeout with Michigan Nursing. I will be your host, Dr. Michelle Aebersold. Timeout with Michigan Nursing takes a deep dive into the latest nursing research, news, practice implementation, and important topics related to patient care and safety.

Dr. Michelle Aebersold:

Each episode I will be joined by University of Michigan School of Nursing faculty, researchers, clinicians, and newsmakers, to have an unscripted discussion about the subjects that matter most to nurses working on the frontlines of the healthcare systems across our country. Stay on the cutting edge of nursing practice of research that will help increase your knowledge of the most important advancements in nursing care by listening to Timeout with Michigan Nursing.

Dr. Michelle Aebersold:

Hi, and welcome to Timeout with Michigan Nursing. This is a podcast that really focuses in on the new and exciting things that our faculty are doing here at the School of Nursing. Today. We are very fortunate to have Dr. Rhonda Schoville here to talk a little bit about a new program that she's just launched. But first, Rhonda, why don't you tell us a little bit about yourself and what you do at the School of Nursing?

Dr. Rhonda Schoville:

Well, sure. Well, let me tell you about my journey in nursing. I actually have been in healthcare for 45 years. I started as a unit clerk for 11 years, and then I went on and got an ADM, and never thought I'd leave the small little community I grew up in Wisconsin. But shortly after graduating, I transferred out here to Michigan and worked in the Critical Care Medicine unit.

Dr. Rhonda Schoville:

Quickly realized I needed a bachelor's degree and went to U of M. Yay, go blue, and got my bachelor's. And then I started moving in from the clinical world to leadership roles, and realized I needed to get an MBA so that I could be really informed about finances and strategic planning. So I did get an MBA with a leadership component with it, and then continued my career and finished my Ph.D. at the University of Michigan.

Dr. Rhonda Schoville:

So where have I practiced in these 45 years? I've been on orthopedics, endocrine, trauma, critical care medicine. I was a manager of opeads ICU. And so my leadership has been in all of these areas. I was supervisor, nurse manager, head nurse. And after a while I realized that I wanted to do more, and I went into nursing administration. And my focus ended up being technology and also business processes.

Dr. Rhonda Schoville:

So my business side of my role, I really looked at acuity systems, data analytics, payroll, scheduling. So anything that nursing needed to analyze or needed a system, that reported through me. My other side of my job was all technology. So it was call lights, pagers, telephones, cardiac monitors, IVACs. I also worked on bringing up our new Children's Hospital, which isn't so new anymore. I worked at a bringing up the Brighton Health Center, and really I was a nurse informaticist way before it was cool. Nobody had really heard that and they didn't have nurses representing that kind of work.

Dr. Michelle Aebersold:

Wow.

Dr. Rhonda Schoville:

That was kind of cool. And I did that for 20 years, and I decided to retire because benefits were changing. And then that took me over to another large health system in the country, and I worked with 96 different hospitals in very similar capacity. We were bringing up the Cerner Electronic Health Record and we were developing the standard for the country. So we had a lot of work that we did in Kansas, but also a lot of work at the 96 hospitals.

Dr. Rhonda Schoville:

And I also did very similar work where I had payroll and QD systems, and a lot of the technology that also reported to me. I was a Director of Nursing Informatics, and then our Chief Nursing Informatics Officer Vice-President left so I stepped in and did a lot of her work. And another director went out to Washington, DC to work in a government role and I took on her work, which was really a lot of the implementation of big projects.

Dr. Rhonda Schoville:

And then I had a very sick family member, it was my dad, and knew that I needed to move closer to home and be home, not halfway across the country when he's being hospitalized. So that's how I started my second career, which is being a Clinical Assistant Professor at the University of Michigan School of Nursing, and I've never regretted it. It's been lots of fun. I teach in the leadership program, which focuses on leadership and analytics and innovation, and also the electronic health record and nursing informatics.

Dr. Rhonda Schoville:

My research, I really love technology and informatics. And so it's really, I look at new things that are being brought up. How do we implement them? What are the strategies that help us lead that user to adopt the product? So that's a little bit about me from academia, where I practice, and now here as a faculty member what I teach, along with my research interest.

Dr. Michelle Aebersold:

Wow.

Dr. Rhonda Schoville:

So that's the Schoville.

Dr. Michelle Aebersold:

That is a pretty amazing career trajectory. So I know that you've had a lot of different leadership roles, as you mentioned both here at the University of Michigan, as well as outside of the University of Michigan. And I think that's really great, and it makes me think that's probably one of the reasons why you were tapped to lead our new Nursing Executive Fellow Academy at the School of Nursing.

Dr. Michelle Aebersold:

And I wondered if you might talk a little bit about the Academy. How did you get started with this? What happened that put this in your lap, so to speak, to get this up and running?

Dr. Rhonda Schoville:

So this program is really an innovative program that we're focusing on high-level nurse executive competencies. And how I got involved is I still practice one day a week. And I had lots of conversations with the CNIO that I was working with around, "These are the needs that I need. I need financials." And out of the blue, I was asked to start thinking about a nurse executive fellow academy. The health system that we're affiliated with had a need to have their executives not improve, but enhance their skills that they already had.

Dr. Rhonda Schoville:

So we had met with that Chief Nurse Executive and she had lots of ideas about interconnectedness and working across lines. And your decision in one area may affect another area. So we got a lot of feedback with her. Then our Dean put together a team of nurse executives throughout the state, and we interviewed them, and we talked about what are the needs of nurse executives.

Dr. Rhonda Schoville:

And so we took that information, it was about a two hour session. And then we developed a team. And this was not all what I put together, there is a really strong leadership team at our school. And we sat down and we looked at the literature, and we looked at our professional practice groups, and what are the competency they are suggesting that executives have. And so that took us about a year to map all of that and come up with a curriculum.

Dr. Rhonda Schoville:

And so what this is, it's really to advance excellence in nursing and promote advanced executive leadership development in nursing. At our facility, the health system that we're affiliated with, and also the University of Michigan, developed this Nurse Executive Team Fellow Academy. And the Academy is specifically focused to enhance the executive leadership skills and career trajectory to those who have focused on executive nursing opportunities.

Dr. Rhonda Schoville:

We all know that there's a need for succession planning. And so we originally were really looking at that top executive level, but COVID hit. And so we had to step back a little bit. People decided to retire, people got sick and didn't come back to work. And so succession planning took the forefront. And so we're not at the very high executive level that we're working at, but the next lower level, so that people can move into these really important roles. So through the Academy, what we do is that the participants are given the tools and resources to develop these advanced leadership skills and refine the fellows' current skills.

Dr. Rhonda Schoville:

So this program is over about a six month period. We have six didactic days that are put together, and we focus on the core competencies around what is executive leadership? What is executive presence? How do you communicate differently at an executive level? We look at change, focusing on high-performance systems and complexity, really looking at how do you implement some big changes. And also quality improvement we really focus on. We took a day and just talked about strategic planning. We looked at business intelligence and analytics, and then healthcare and nursing financials. So them were the areas we focused on after looking at the literature, the professional practice competencies, and also talking with what were the needs out there.

Dr. Rhonda Schoville:

So what the goal of our Academy is really to be sure that our leaders understand the interconnectedness when you work across the healthcare system and within a healthcare system. We focus on working in diverse teams, utilization of business analytics for data-driven decisions. Advanced techniques around implementation science and adoption of innovation. We look at strategies to lead clinical digital transformation to improve the quality and safety and effectiveness in patient outcomes. Again, like I said, effective communication. In collaborative efforts, we're looking at the institutional philosophy, the mission, vision and objectives of nursing.

Dr. Rhonda Schoville:

Also these leaders need to be culturally sensitive. Do they have integrity, and do they value diversity? And then are they accountable? So these were the things that we were trying to teach in them different didactic courses.

Dr. Michelle Aebersold:

That sounds pretty comprehensive. Couple of times you talked a little bit about this being based on competencies. Could you maybe tell us a little bit about where the fellowship draws on competencies? So what organizations did you look at to try to identify what kind of competencies should we have in our nurse executives and nurse leaders?

Dr. Rhonda Schoville:

So we looked at the American Nurse Executive Leadership Professional Practice group, they have a bunch of competencies. So we mapped them. So what the chief nurses told us and what we were seeing in the literature, we mapped them to them competencies.

Dr. Rhonda Schoville:

I also looked at AACN, because I'm faculty. And so what are we teaching our individuals that come into our Master's program? So I did look at them and really felt like we were on track, because it was meeting the needs of our professional practice or our professional organizations. Competencies, we were meeting the competencies we're teaching our Master's students and above. And so that's where we really drew the competencies from.

Dr. Michelle Aebersold:

Great. And so I think you mentioned that you have our first cohort of fellows that started last fall. And so how's that going? Where are they at in the process, and what kind of feedback have you had so far?

Dr. Rhonda Schoville:

Well, we're really proud of that. Maybe, just to back up a little bit, not only do we do the didactic course, they come with a project, the fellows. And so one day a month, so eight hours, they give to the didactic day, and the fellows also one day a month have to work on their project. And their project is affiliated with what needs to be accomplished at the health system. So projects may be like resiliency during COVID of the nursing staff and the leaders. Is diversity an inclusion? We have somebody really focusing on making sure that care is transparent across the continuum of care. Them are just a few.

Dr. Rhonda Schoville:

And so they have to work on their project, and we have a group of people that help them. So you've got the fellow at the unit level. Then we have individuals that are called partners and they work with the fellow. They've got a 20% effort with them, so eight hours a week that they work with them to really focus on the project, getting it up and going and having a sustainability. And then we have coaches. Our coaches really have a big role with the program, and they move on and they choose a didactic day to focus on. They may teach that day or they'll arrange speakers to come in to meet the objectives of the day.

Dr. Rhonda Schoville:

And then they have two or three different partners and fellows that they work with. So they're really our advanced leaders at the School of Nursing. They've got lots of leadership. They've been in nurse manager roles or other administrative type of roles, so they know the ins and outs of how operations work. They know the resources, so they can guide these teams. So they have a pretty big role with us. So that's the core team that works on the project.

Dr. Rhonda Schoville:

And to be very honest, we give an evaluation after each class, and our results have been 94% and above, more about 97, 98. And I actually have a quote from one of the fellows that said, "All presenters were knowledgeable. Everyone was excited to be there and support this new program. This excitement makes a program even more of a positive experience. All objectives were met, and I really appreciated how we were given the opportunity to engage in conversation as the presenters shared the information."

Dr. Rhonda Schoville:

So them are the kinds of things that we're getting in the formal evaluation. So I think the team, and certainly I am very proud of what we've done. We were actually not going to launch until this January, but given everything with COVID, we were asked to really up it to October and it's like, "Whoa, we have to figure out how we're going to get it there." And we have done a spectacular job, to the point that other people are hearing about us. The Veterans Administration is entrusted and we're actually working with the World Health Organization around the needs of other countries.

Dr. Michelle Aebersold:

Wow.

Dr. Rhonda Schoville:

So lots of excitement, and we're all very proud of the program.

Dr. Michelle Aebersold:

That's really great. It sounds like a awesome program and I'm very honored to be a part of that as well. And thank you so much for sharing a little bit about that. So when will the first group of fellows finish up, and are there any plans for when the next group is going to get started?

Dr. Rhonda Schoville:

So we actually, in March, will be their last day. And then we're planning a celebration, including the health system, because this will be a way to further advertise it to people that are interested. Our next cohort will start again in the fall. And the reason being we've got so much time between it is we just want to do a good evaluation.

Dr. Rhonda Schoville:

So we've got some sessions set up to do interviews and ask questions from the fellows' perspective to the team, and then make any little changes that we need to, which I don't foresee having a lot, but certainly we'll learn. And we'll start again in October next year. And then the plan is to open this up to the public down the road. We're hoping maybe in the next year here, and offer it more than once a year.

Dr. Michelle Aebersold:

Great. Well, that sounds really exciting. So maybe we'll have you back again next year when you kick off in the fall, and you can let us know a little bit about how things are going and where things are at with the program.

Dr. Rhonda Schoville:

Perfect.

Dr. Michelle Aebersold:

So thank you again, Rhonda, for being with us and we look forward to talking to you again.

Dr. Rhonda Schoville:

Thank you.

Dr. Michelle Aebersold:

And thank you for joining us on Timeout with Michigan Nursing.

Speaker 3:

Timeout with Michigan Nursing is produced by faculty and staff at the University of Michigan School of Nursing in Ann Arbor.

 

 Listen to "The Future of Digital Learning with Dr. Barbara Medvec" on Spreaker.

Dr. Michelle L. Aebersold:

Hi, welcome to Time Out with Michigan Nursing. I will be your host, Dr. Michelle L. Aebersold. Time Out with Michigan Nursing takes a deep dive into the latest nursing research, news, practice implementation and important topics related to patient care and safety. Each episode, I will be joined by University of Michigan School of Nursing faculty, researchers, clinicians, and newsmakers, to have an unscripted discussion about the subjects that matter most to nurses working on the front lines of the healthcare systems across our country. Stay on the cutting edge of nursing practice and research that will help increase your knowledge of the most important advancements in nursing care by listening to Time Out with Michigan Nursing.

Dr. Michelle L. Aebersold:

Welcome to Time Out with Michigan Nursing. Today, we're here with Dr. Barbara Medvec, who is the program director for our digital education program and also a clinical track faculty. Welcome, Barb.

Dr. Barbara Medvec:

Thanks, Michelle for having me. I appreciate joining you.

Dr. Michelle L. Aebersold:

Thank you. We so much appreciate you taking time out to chat with us today. So, I thought maybe you could give us a little bit of background on what you do at the school of nursing, and then maybe talk a little bit about your past work. I know you haven't always been a faculty member.

Dr. Barbara Medvec:

Well, that's true. Thanks for letting me share a little bit. I've been at the school of nursing for the last four years. I am a clinical assistant professor in the Department of Systems, Population and Leadership. And previous to that, I have been in a variety of executive leadership roles as a system-wide chief nursing officer for eight hospitals, for four hospitals, as a leader of hospital organizations and health systems. I've been able to do not only nursing leadership, but I've led post-acute care divisions, care management, and have been able to really use my leadership and executive skills to further a lot of progression of good nursing work using evidence-based practice. So, I like to say I'm a recovering chief nursing officer because coming to academics has been a real highlight for my career and I've enjoyed that.

Dr. Michelle L. Aebersold:

That's great. And we are so fortunate to have you, you have such a wide and diverse background that you really, I know, bring a lot to the students in our program and really a lot of great wisdom and collaboration with many of the faculty. So, today I thought we would start with a little bit about our new digital education program. Of course, in the past, our master's program has been a hybrid, where students would come on campus one day a month and then they would do online stuff in-between. But over the past two years, you have really led the effort for SPL in moving us into a completely digital platform, a whole digital course offerings for our LAI program. So maybe just share with our audience a little bit about what that's been like and some of the high points of that?

Dr. Barbara Medvec:

I'd love to. It's been an interesting two years of work because we took the approach of really revamping the master's degree program to meet with what the demand was happening out in our community. So, talking to CEOs and chief nursing officers from around the country, as well as our school of nursing alumni and our students, what we found out was really that leadership isn't going away. Some people think, there aren't roles in leadership, but in fact, we found from chief nursing officers and CEOs that they were having tremendous difficulty finding data-driven action-oriented nursing leaders and that in fact, they were struggling to fill many of their positions, both in traditional healthcare as well as outside of kind of the traditional mode in industry, as well as in post-acute care or the continuum of care.

Dr. Barbara Medvec:

We spent time deep-diving our curriculum and really eliminating redundancy and looking specifically to build on core leadership skills, build on analytics and how nurses can and are involved in the analytic and critical decisions that go on in healthcare. And then we've also taken to developing the innovation focus for our master's program, because as we all know, and the COVID pandemic is a great example, nurses are not only resilient, but they are also key to the innovations that are needed to continually provide healthcare. So, we've had a good time doing that.

Dr. Michelle L. Aebersold:

Wow, that's a big job. I know that just having been a part of some of that really, it was not just a move to the digital world, but it started with a whole curriculum revision before you move those courses to a digital platform.

Dr. Barbara Medvec:

And that's a really good point. We did. So we consolidated restructured organized and a key group of faculty yourself included really spent time thinking very thoughtfully about building a program of learning in the curriculum that will really develop the tools and the kit of tools that current leaders need going into the future. And we've had a good time doing that as well. A lot of learning for all of us.

Dr. Michelle L. Aebersold:

Yeah. It has definitely been a journey. I know you talked a little bit about the need for development of leaders in healthcare. And one of the cool aspects that I think our LAI digital education program has, is this whole concept of revision health. And I wondered if you could share with our listeners a little bit more about revision health, what it is, how do faculty use it?

Dr. Barbara Medvec:

Thanks. Revision health was really a concept that the implementation team came up with and latched on to because we found as faculty, we spend a lot of time hunting and seeking for good cases and good studies. We're looking in text, we're looking in published articles. And what we really found through our discussion is that the depth of case study learnings really many of us have those experiences to bring to the table. And when students say they're enjoying our classes the most is when we're really talking from that experience base and drawing parallels with theory or drawing parallels with content in our courses.

Dr. Barbara Medvec:

So we created revision health to allow the faculty to build their own case studies, to build their own stories into the context of courses. So the students don't have to waste any time learning about an organization and then getting to the concept that we want to teach them. But more students all the way along their curriculum know about revision health and as faculty, we're building and growing our content for class within a revision health concept. I think right now, Michelle, we're up to three hospitals in three communities, and we have developed human resources departments and nursing organizations. We have done some mergers already. We have done some improvements in oncology centers and emergency rooms. And so, through our stories as faculty, we're really building revision health as that practice where students go to learn about the tools that we're teaching.

Dr. Michelle L. Aebersold:

Wow. I think that is just so cool and such a really innovative idea, but also I think the faculty have really risen to the challenge and have developed some really neat case studies. And I look forward to seeing how we build out revision health.

Dr. Barbara Medvec:

Well, it's going to keep growing. And the good news is we don't have to get any approvals to continue to build it. So we're going to keep doing lots of good things with it.

Dr. Michelle L. Aebersold:

There you go. No building permits to pull, none of those things to worry about.

Dr. Barbara Medvec:

Right, right. Absolutely.

Dr. Michelle L. Aebersold:

Great. So, I thought we would sort of wrap up by talking a little bit about some of your new adventures. I understand that you recently got a grant from the Extended Reality or XR Initiative through the Center for Academic Innovation. And I was hoping you could share a little bit about what your plans are with that.

Dr. Barbara Medvec:

We're really excited about the grant from Academic Innovation, because one of the things we've continued to experience through the pandemic is this reality that when our students are starting to learn how to be leaders, how to lead teams of people, how to be mentors and coaches, one of the things that they do is a traditional kind of learning at the elbow of another leader. And in COVID we have found that leadership access is very focused towards the work at hand, but also we have not been able to have a lot of learning at the elbow because so much is virtual. And what we're proposing with our XR grant is building innovative scenarios where students can privately through using the virtual reality tools, really be able to experience what it's like to pitch their business plan to an executive board of leaders or what it's like to be in a conflict situation with a colleague or to negotiate with a CFO around funding.

Dr. Barbara Medvec:

So we're building a host of scenarios that will allow students to get that at the elbow learning, if you will, that they would by kind of seeing one and working with a mentor or a coach, but instead do that in a reality and a video situation where they can continue to replay their learning and learn different branches of how their decisions will affect the trajectory of a conversation or a plan. So, we're new into this. I know, Michelle that your experience is great in this, and we've appreciated that you're one of our coaches, but we think that working in this kind of traditional area of soft skills, if you will, that are very difficult to train to, unless you're in the actual situation, building those situations for our students is really going to give them the opportunity to practice and to learn and to reflect on how they've approached different experiences in a unique way.

Dr. Michelle L. Aebersold:

Wow. I think that's really exciting. And yeah, this is definitely right in my area of interest and yeah, some amount of expertise, but I think the whole idea of simulation-based learning is so powerful and to be able to leverage some of these virtual tools, particularly some of the new virtual tools that are out there to allow our students, our faculty, our friends and colleagues over at Michigan Medicine to have access to this is just such a neat, neat thing to do. So, I'm really looking forward to seeing how this turns out and I'll be excited to watch progress and provide some assistance along the way.

Dr. Barbara Medvec:

Yeah, I think we're excited about it from the perspective that this also gives our master's students who may not have as much experience in their practice as some of their more seasoned colleagues. It really gives them an even platform to learn and to develop their skills. So, we're really excited and happy to be working with you as well.

Dr. Michelle L. Aebersold:

Great. Well, we will invite you back later to tell us a little more about it and knowing the folks over at Academic Innovation, I am sure Jeremy Nelson will be chatting with you and probably doing a similar podcast to have you share all the cool things you're going to be doing. Thank you, Barb so much for spending some time with us. Is there anything else you'd like to share with our audience before we wrap up today?

Dr. Barbara Medvec:

No, I hope everyone's safe and well, and I thank you for letting me join you today. Really appreciate the time.

Dr. Michelle L. Aebersold:

Great. And thank you for joining us Time Out with Michigan Nursing. We'll look forward to seeing you in the future.

Speaker 3:

Time Out with Michigan Nursing is produced by faculty and staff at the University of Michigan School of Nursing in Ann Arbor.