Dallas Conference Abstracts
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Physician Assistant Practice Patterns: A Review of Texas-Mexico Border Counties
- Karen Mulitalo,
MPAS
,
PA
-C,
The
University
of
Texas
Southwestern
Medical
Center
Southwestern Allied
Health
Sciences
School
; Eugene Jones, PhD, PA-C, The
University
of
Texas
Southwestern
Medical
Center
Southwestern Allied
Health Sciences School
, Department of Physician Assistant Studies
The
Hispanic population is the fastest growing population in our nation, and 27% of
the population in
Texas
over age 5 speak Spanish as their primary language (U.S. Census 2000). As language
and lack of cultural competency among providers remain barriers to adequate medical
care for this growing population (Starfield, 2000), a review of physician assistant
(PA) practice patterns in Texas can provide valuable insight for future curriculum
development and admissions policies for PA programs located in states with high
percentages of Hispanic populations.
The
Census 2000 County Worksite Data web site was queried using the EEO Data Tool to
examine PA and physician workplace data for the 14
Texas
counties along the
Mexico
border. Parameters included ‘Sex’, ‘Occupation Census/SOC code’ and ‘Ethnicity’.
The results were then compared with the Percent of Population 2000 Hispanic or Latino
Origin U.S. Census 2000 data for the same 14
Texas
counties.
The average Hispanic population for the 14
Texas
counties queried was 73.96% as compared with the
US
average of 12.0%. According to the U.S. Census 2000 data, there were 224 PA’s in
the 14 border counties queried. Of the 224 PA’s, 192 are reported as Hispanic (85.7%).
The female distribution was 112; 94 (84%) of which are Hispanic. The male PA distribution
was 112; 98 (87.5%) of which are Hispanic. According to the AAPA Masterfile 2003,
Hispanics represent 3.6% of US PA’s (n=668). For physicians, the total number practicing
in the 14 border counties is 2987. Of this number, 2409 are male with 1121 reporting
as Hispanic (46.5%), and 578 are female with 215 (35.4%) reporting as Hispanic.
Total Hispanic physicians in the 23 counties totaled 1326 (44.4%).
An
analysis of Physician Assistant practice patterns within the border counties of
Texas show a greater percentage of PA’s in these counties are Hispanic when compared
with physicians. The percentage of Hispanic PA’s practicing in these regions is
also significantly higher than the percentage of PA’s practicing nationally. As
the Hispanic population continues to increase, these data support the continuing
need to develop curriculum that increases cultural competency and proficiency in
the Spanish language among PA graduates as well as demonstrating that the practice
patterns of underrepresented minority PA graduates can benefit underserved populations.
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Ethnic Lunch and Learn Series to Recognize Cultural Competence in Clinical Dietetics
Students and Faculty - Bernadette Latson, MS, RD, LD, CDE, The University of Texas Southwestern
Medical Center Southwestern Allied Health Sciences School, Department of Clinical
Nutrition; Cindy Cunningham, MS, RD, LD, The University of Texas Southwestern
Medical Center Southwestern Allied Health Sciences School, Department of Clinical
Nutrition
The
first step in becoming a culturally competent healthcare provider is developing
an awareness and value of one’s own culture. Cultural competency continues to develop
though the exploration of intersections between cultures. For nutrition professionals,
demonstrating knowledge and respect for an individual’s food practices and customs
can help facilitate trust and promote desirable health and behavior change. This
sensitivity to cultural differences in food practices can be a bridge to overall
cultural competency.
Clinical
dietetics students divided into small groups led by students of different cultures
to research information on the food and related health and hospitality practices
of 4 different world regions. Students were asked to describe typical food practices,
belief systems or economic constraints that led to inclusion and exclusion of specific
foods, the use of food symbolically and in rituals and the health implications of
food practices. Each group planned a “Lunch and Learn” event that included a slide
presentation with information, resources and recipes for the regional cuisine as
well as the preparation and serving of representative foods. A survey of students’
knowledge and attitudes indicated their knowledge and appreciation of other cultures
was increased but more important, students indicated increased self-knowledge of
their own cultural values.
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Implementing a Spanish Objective Structured Clinical Examination (OSCE) in Physician
Assistant Education - Meredith Repka, BS, The University of Texas Southwestern
Medical Center Southwestern Allied Health Sciences School, Department of Physician
Assistant Students; Cristina Gonzales, MA, The University of Texas Southwestern
Medical Center Southwestern Allied Health Sciences School, Department of Physician
Assistant Studies
Objective:
Many new
US
immigrants experience barriers to healthcare due to language and cultural barriers.
The number of medical personnel who speak Spanish is woefully inadequate, often
resulting in the use of interpreters and translators, many of whom inhibit communication
between clinician and patient. In direct response to this need, our program has
implemented a longitudinal medical Spanish curriculum. The curriculum spans three
semesters, ending just before the physician assistant students begin clinical rotations.
To evaluate the effectiveness of the Spanish curriculum, we created an Objective
Structured Clinical Examination (OSCE) to test the students' knowledge of Spanish
at the end of the didactic curriculum
Method:
The students were given fifteen minutes to examine the standardized patients (SPs),
during which time they were to perform a review of systems and physical exam. Standardized
patients met with our medical Spanish professor to be taught how to evaluate the
students. The evaluation methodology used was a twenty-five point questionnaire
scored by answering "yes", "no" or "maybe". Training included guidelines to ensure
consistent scoring by the SPs. The OSCE Training included guidelines to ensure consistent
scoring by the SPs. The OSCE was videotaped and the students were provided a copy
for future use.
Results:
Students found the experience of interviewing a Spanish only speaking patient to
be beneficial. The medical Spanish curriculum was proven to be effective in preparing
the physician assistant students to serve the Spanish speaking population. A secondary
outcome of the medical Spanish OSCE was the improvement of the existing medical
Spanish curriculum due to student performance and feedback.
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Closing the Gap: Ethnic/Racial Diversity in Nursing - Mary Jane Ashe, RN, MA, CNS-Pedi, The
University of Texas at Arlington, School of Nursing
STARS for Nursing, a project funded through the Department of Health and Human Services,
Health Resources and Services Administration, aims to increase nursing education
opportunities for individuals from disadvantaged backgrounds underrepresented among
registered nurses. It will also increase the number of new nurses who enter the
workforce by recruiting, retaining, and graduating students who are ethnically and
racially diverse and able to deliver culturally competent care to a diverse patient
population.
Pre-entry
activities for students interested in nursing from six adopted high schools have
been implemented to increase the number of students from disadvantaged backgrounds
enrolling as freshmen at our institution. Recruitment strategies include interactive
nursing school tours; activities related to nursing, college preparation, and cultural
diversity; and nursing camp with hospital sponsorship. Two elective nursing courses
help pre-nursing students transition to college life and clinical activities. In
the RN Mentor program, nursing students are matched with RNs from community healthcare
institutions or professional nursing organizations to provide interaction with and
support from nurses. A Student Success Coordinator acts as a resource for test-taking
skills, study skills, and time management. The
Learning Center
provides additional course resources and computers for student use.
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Cross-Cultural Perspectives of Disability Views among Culturally and Linguistically
Diverse Populations - Katandria Love Johnson, The University of North Texas
Health Science Center
An increasing number of people from various cultures live in the United States as
the latest U.S. census reports that one in every three Americans belongs to a racial/ethnic
minority group (Tomoeda & Bayles,2002). Provision of speech-language pathology
and other public health disciplines are becoming increasingly challenging from a
cultural and linguistic competency perspective. It is hopeful that data collected
from interviews conducted in twelve countries will shed some light on these cultural
issues, which have a profound impact on the practice of speech-language pathology
and other public health disciplines when working with Brazilian, French, Latino
and Italian families in the
U.S.
This research was designed to examine social, economic and environmental influences
of communication disorders among culturally and linguistically diverse (CLD) populations.
Data revealed distinct similarities and differences regarding these three variables.
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The Texas Top 10% Law: Separating Fact From Fiction - Gary Lavergne, Director
of Admissions Research and Policy Analysis for the
University
of
Texas
at
Austin
The Texas Uniform Automatic Admissions Law (The Top 10% Law) was implemented in
1998 and is a hotly debated higher education issue. This program will give an historical
review of the law, how it has impacted diversity, and how successful students admitted
under the law have been.
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New Kind of Diversity Beyond
Ethnicity: Exploring Developmental World Views - Nan Richards, MA, LPC, Medical
Center of Plano
Scientific research and field-tested evidence reveals that beyond issues of race,
gender, sexual orientation and/or ethnicity are differing value codes or worldviews
that mark humanity's cultural evolution. When recruiting students in the health
care arena, we encounter at least 4 or 5 of these value codes. Learning how to communicate
with these diverse worldviews is a starting point for successfully interesting young
adults in the healthcare field. These codes can range from the "street smarts" of
inner city youths to the "on true way" of young believers to the "show me the evidence"
of many science majors or the "together, we can heal the world," attitude of the
young idealists. The way these different worldviews will approach every aspect of
their life will vary. We will need all these worldviews in a challenging and evolving
healthcare environment. Understanding these codes is important. It starts with understanding
not only what people think, but how they think about things, why they make decisions
in different ways, and why different people respond to different motivators. It
is recognizing value codes and applying appropriate interventions based on an identified
world view to achieve results. This workshop, using slides, music and movie clips,
will take the participant on a journey of both self-discovery and collective understanding,
leading to an expanded view of how to interest a broad range of students operating
under different value codes in the potentialities of healthcare in the 21st century.
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Increasing Diversity in the Nursing Profession -
Graciela Reyes-Salinas, BSN, International Bilingual Nurses
Alliance
Well known to many is the fact that the
United States
is in the midst of a national nursing shortage crisis that is expected to worsen
as the current generation of nurses continue to retire, shift to other fields, and
as the need for health care grows. Compounding the problem, reported by the American
Association of College of Nursing, is the fact that nursing colleges and universities
across the country are struggling to expand enrollment levels to meet the rising
demand for nursing care.
Insult is added to injury as Latino nurses account for less than 2 percent of the
total nursing workforce while the Latinos at large represent greater than 13 percent
of the population, according to the National Sample Survey on Registered Nurses.
Many recommendations resulting from reports across the nation are that healthcare
and educational institutions expand the pool of racial and ethnic minorities of
healthcare workers to represent the diverse demographic population that it serves.
Undoubtedly, the need for bilingual and bicultural nurses is a necessity to meet
the needs of Latino residents of all descents finding themselves medically underserved.
In addressing this issue several nursing communities identified a substantial pool
of experienced nurses trained outside of the
United States
capable of addressing this nursing shortage. However, instead due to difficulties
navigating the system foreign educated nurses are underutilized finding themselves
working as housekeepers, laborers, factory workers, garage attendants and other
nonprofessional positions. The International Bilingual Nurses Alliance (IBNA), a
nationwide collaborative of nursing organizations, to develop and implement programs.
These programs focused on identifying and addressing national barriers in credentialing
and licensure processing for nurses, developing standardized curricula to assist
foreign nurses transition into nursing practice in the U.S., identifying hospital
sponsors and funding sources to support programs designed to prepare nurses for
success on the national exam and transition into the nursing workforce, as well
as developing an enhanced mutual relationship with the Mexican government responsible
for credentialing.
IBNA's programs continue to pave the way for foreign educated nurses with the collaborative
relationships and on going dialogue with the Mexican government. The path is long
and difficult for foreign educated nurses and nursing organizations, however these
programs have reached an 85% success rate and have help improve the pool of Latino
nurses, by adding more than 300 nurses nationwide, thus meeting the needs of our
Latino communities across the nation.
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In Their Own Words: Increasing Hispanics in the Health Professions - Jennifer Gray;
Mary Lou Bond
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The National Health Service Corps - 3 decades of
Preparing and Training America’s Diverse Health Care Team - Albert Perrine, Commander,
U.S. Public Health Service; Harvey Browning, MPA, Texas Primary Care
Office
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Strategies for Addressing the Challenges to improving the Diversity of the Health
Workforce
- Yolanda Brooks, MS, SPHR, Texas Health Resources, Mina Kini, MS, MSW, AHA
Fellow, Texas Health Resources
This session focuses on Texas Health Resources’ proactive innovative approach
in the creation of a new nursing talent pool from existing untapped employees and
recent high school graduates. The program is based on innovative organizational
practices and support structures and strategies for creating career opportunities,
advancement and growth for individuals from diverse backgrounds with the aptitude,
drive and ability to be successful in the healthcare profession are used. This session
will describe, identify and share critical success factors and lessons learned,
in the areas of
Creating
a collaborative in house ADN program to address barriers for entrance in to traditional
nursing programs along with addressing the current work force shortages
Creating
a Language Institute to address the language and cultural barriers that exist in
our multicultural health care work force.
Creating
a high school youth work training program for entry level healthcare jobs that feeds
that the nursing recruitment pipeline.
The
session will also describe how successes are achieved through internal and external
community collaborations such as community colleges, universities, high schools
and community organizations. Our learners represent 10 countries, a blend of minority
groups, age, gender and ethnicity.
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HISPA - Today & Tomorrow - Gilbert Marez, PhD, Hispanic Healthcare Professionals
Association
The
Hispanic Healthcare Professionals Association, “HISPA,” is a non-profit, social
organization dedicated to promoting the health, education and well-being of the
Latino Community. HISPA is dedicated to promoting the delivery of culturally-proficient
and compassionate health care to all individuals. HISPA members spend many months
planning and providing their time and expertise in events like city wide health
fairs, advocacy, health education, cultural competency seminars, and are dedicated
to promoting the educational scholarship and the professional development of aspiring
and practicing health care providers and practitioners. HISPA has risen over $250,000
to help with efforts such as mentioned above over the last 15 years. HISPA started
a scholarship fund four years and has awarded over $30,000 in scholarships and has
no plans to slow down.
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Increasing the Confidence in Commitment to, and a
Sense of Belongingness in a Health Career among
Disadvantaged
Texas
High School
Students -
Manuel Angel Oscos-Sanches, MD, The
University
of
Texas
Health Science Center at
San Antonio
; L. Dolores Oscos-Florez, BSEd, The
University
of
Texas
Health Science Center at
San Antonio
This workshop will begin with participants identifying key program element that
are likely to increase confidence in, commitment to, and a sense of belongingness
in a health career among disadvantaged
Texas
high school students. The presenters will then share their experience with developing,
implementing, and conducting a randomized controlled evaluation of the
Teen Medical Academy
with both urban and rural youth. The
Teen Medical Academy
is a collaborative effort involving local school districts, medical school faculty,
residents, students and premedical students. During the workshop participants will
work cooperatively to design an intervention that integrates past successes and
new ideas with the goal of maximizing the effectiveness of interventions within
their local setting. The workshop will end with an open forum to address potential
barriers to project development, implementation, and evaluation.
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Windows of Opportunity -
Lydia
Gil-Hartman, LM, The
Prairie Area Health Education Center
Because
Texas
is already a minority state, there is a critical shortage of bilingual professionals
in the workforce, particularly the healthcare workforce.
North
Central
Texas
College
in
Gainesville
, NCTC, in collaboration with Prairie AHEC, has taken a big step to combat this
issue. They were awarded the WINDOWS grant: Workforce Initiatives Meeting the Nursing
Demand with Winning Solutions to address the high demand shortage of skilled and
qualified workers. In addition the project focuses on recruiting, preparing, and
training Hispanics to enter healthcare fields and provide career ladder options
for advancement. The overall goal of WINDOWS is to develop and implement a seamless
transition model to move individuals from K-12 to the community college, to the
university and into workforce with multi entry and exit points.
The
objectives will be achieved by explaining the population shift in
Texas
and the numbers of bilingual healthcare workers currently working in the state.
The presenter will address the importance of language and cultural competency in
the workforce and explain what the WINDOWS grant entails and how Prairie AHEC and
NCTC can address this shortage.
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Teaching Cultural Sensitivity for Health Professionals - Jacobo Kupersztoch, PhD,
The Centro Comunitario Mexicano -DFW
The
distinctions between documented, legal and undocumentedmigrants will be explained
as well as the effect of legislation onthe entry of migrants to the
USA
. Basic traditional diseases such as aire (wind) evil eye, accepted as such in México
and not in the
USA
will be discussed.
The increasing number of Mexican migrants in the state of
Texas
projects that by 2040 80% of the population of
Dallas County
is going to be of Mexican origin. Therefore health professionals and students should
be taught about the health care treatment that migrants are accustomed too in their
country of origin and how to relate to these patients in a culturally sensitive
way. The main provider of health care in
Mexico
is the Mexican Social Security System (IMSS) that cover near 40,000,000 workers
and their families. Additionally federal and state employees as well as workers
for the Mexican oil monopoly Pemex have access to their own health insurance. The
premium is covered by the employer, the government, and the worker. The system has
primary care offices and clinics, secondary and tertiary hospitals and centers.
The care starts at the primary care centers and is referred to the next levels if
required.
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Pioneering Nursing’s Future: An Approach to Diversify the Nursing Profession -
Elizabeth Fuentes, MS, RN, NP-C, Texas Woman’s University, College of Nursing;
Miriam Frias, BA, The DFW Area Health Education Center; Sonia Redwine, MPH,
The DFW Area Health Education Center; Caryl Mobley, PhD, RN, CPNP, Texas
Woman’s University, College of Nursing; Lori Millner, PhD, The DFW Area Health
Education Center
A
significant under-representation of Latinos in the nursing profession exists today.
The project Pioneering Nursing’s Future: Excellence through Diversity is a joint
effort between the Dallas/Ft. Worth Area Health Education Center and Texas Woman’s
University at Dallas aimed at serving disadvantaged Latino students interested in
nursing in the Dallas area. The program provides an increased awareness of the nursing
profession among Latino students, teachers and consolers in
Dallas
and Tarrant counties, support for TWU pre-nursing students, and scholarships and
mentorship for Latino nursing students in the
College of Nursing
at TWU. The goal of the presentation will be to assist attendees in gaining a better
understanding of the disparities that exist in the nursing profession and describing
strategies this type of program offers to Latino nursing students.
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Healthcare Disparities among Culturally and Linguistically Diverse Immigrants in
the
U.S.
- Katandria Love Johnson, The University of
North Texas Health Science Center
One
of the greatest challenges faced by the United States (U.S.) healthcare system is
how to provide cost-efficient, culturally and linguistically competent healthcare
services to racially and ethnically diverse populations. This challenge is due to
several issues ranging from disparity of healthcare services among such populations,
to language barriers, and to the dearth of bilingual and bicultural healthcare professionals
who can provide these services. Mullan (2005) reported that an estimated 1.5 million
legal and illegal immigrants arrive in the United States (U.S.) each year. As the
number of immigrants increase residencies in the
U.S.
, innovative measures must be implemented to address healthcare standards and assurances.
In response to these issues, degree programs and professionals are seeking ways
to improve healthcare access and services.
This
research project discusses the causes and suggested solutions to health disparities
among racially and ethnically diverse immigrant communities. The scope of this project
will specifically address issues related to the Texas Mexican immigrant population,
currently the largest minority population within this state.
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The Joint Admission Medical Program (JAMP) - Alan Podawiltz, DO,
The University of North Texas Health Science Center, Department of Psychiatry, Behavioral
Heath and Neuroscience