Simulation director Krista Anderson, RN, MSN, CHSE (center) acts as a patient for an interprofessional clinical simulation with student Ntshiashe "Kristine" Lee, MSN-EL'21 (left) and Hannah Zenisek OTD'22 (right).
During World War II, there was a great demand in the United States for educated women to enter the traditionally male-dominated workforce while men were fighting the war overseas. In response to this urgent need, the Sisters of St. Joseph of Carondelet at the College of St. Catherine, already known for their nursing programs, added additional professional degree programs in the health sciences and healthcare to support the war effort and provide new career avenues for women.
With its liberal arts core, St. Kate’s health science graduates had not only technical skills, but also broadness of mind, mental agility, and an ethical foundation. These traits allowed them to see the bigger picture and raise their voices to lead justly — invaluable traits in the middle of a seismic war.
Nearly 80 years later, we find ourselves facing another global crisis — the COVID-19 pandemic. Once again, we are in desperate need of well-educated healthcare professionals, and St. Kate’s is uniquely positioned to demonstrate the importance of a liberal arts education to America’s healthcare industry.
Foresight and Preparedness
St. Catherine University’s Henrietta Schmoll School of Health (HSSH) is one of the most comprehensive and reputable health sciences schools in Minnesota, with more than 35 programs across associate, bachelor’s, and graduate levels.
When the two deans of HSSH were appointed in 2019, Dean of Health Sciences Lisa Dutton, PT, PhD, and Dean of Nursing Laura Fero, PhD, MSN, RN, envisioned a forward-thinking and innovative education. They developed a plan that keeps liberal arts, women, and Catholic Social Teaching at the forefront with the flexibility to shift with the evolving healthcare industry and develop prepared, high-quality providers.
Dean of Health Sciences Lisa Dutton, PT, PhD, and Dean of Nursing Laura Fero, PhD, MSN, RN.
“Because Laura and I started our roles at the same time, it provided a great opportunity to create a future-forward strategy that leverages our school’s strengths and opportunities,” says Dutton.
Rooted in the University’s Academic Master Plan, their plan sets clear goals and initiatives to drive a culture of inclusive excellence, enhance external partnerships, and emphasize socially responsible leadership. With the support of University leadership and GHR Foundation grants, they set forth initiatives in career development, leadership skills, and cultural fluency for students with emphasis on clinical innovation, critical thinking, interprofessional education, relationship-centered care, and an inclusive, well-rounded curriculum.
“We want the School of Health to foster an environment of interprofessional and experiential learning to prepare students to deliver high-quality, safe, evidence-based professional care,” Fero says.
The Pandemic Pushes for Clinical Innovation
As the COVID-19 pandemic hit Minnesota in spring of 2020, its health and economic effects exacerbated the need to innovate and change the way healthcare is delivered. The deans saw how their plans for academic excellence in healthcare education were now even more crucial.
“The pandemic sped up our timelines and exposed the gaps in the healthcare system that our students need to tackle when they graduate,” says Fero. “The healthcare industry has to pivot with the quickly changing times — especially in a crisis. We are working to replicate that flexibility in higher education and present the most current information for our students.”
This strategy was of key importance as they worked to address some of the pandemic’s most dire effects on students’ educations. Most HSSH programs require hands-on clinical experiences (also known as preceptorships or fieldwork) for students to complete their degrees, and the School of Health has designated coordinators assisting students with placement in one of 1,300 affiliated partners. These clinical placements for many were interrupted — a stoppage that created an immediate need for new placements without falling short of accreditation requirements for graduation or students’ financial aid packages.
“We needed to pivot immediately to provide seamless education and care for our students by utilizing nontraditional clinical experiences,” Fero says.
Clinical education coordinators and HSSH faculty were committed to finding the best opportunities available for their students. HSSH’s Clinical Education Director Rebecca McGill, EdD, RN, says, “All the coordinators for the School of Health programs would meet and share ideas about how to get their students the hours that they needed.”
Telehealth and Virtual Healthcare
Alternative technologies, such as telehealth and virtual healthcare, are designed to work in conjunction with and support of clinical experiences. The pandemic has revealed an increased demand for practitioners with experience in virtual care, and telehealth use is on the rise as a means to provide safe and accessible care.
“Telehealth and virtual healthcare require a different set of skills than in-person care,” Dutton says. “We wanted to integrate this education into our liberal arts foundation so students are not only comfortable technically, but can provide excellent care to their patients when they need to use these technologies in their future careers.”
Faculty and clinical coordinators found opportunities for students to learn telehealth skills and think critically about what it means to interact remotely with patients while providing high-quality care.
Assistant Professor of Nursing and Pediatric Nurse Practitioner Gretchen Moen, APRN, MS, CPNP-PC, often precepts for nurse practitioner students at her clinic, Dakota Child and Family Clinic. When many clinical opportunities for students were shut down and her clinic was forced to go strictly into telehealth, Moen took on an unprecedented 12 students. She also encouraged colleagues in her community to follow her clinic’s model since many clinics didn’t have telehealth platforms to support students who were working from home.
Moen and her 12 students developed a system to have a safe and valuable clinical experience. Working with up to three students each day, Moen facilitated appointments with patients, and students joined virtually to either observe or interact directly with patients. Afterward, they would discuss the appointment and provide insights and feedback.
Moen instructed not just on nursing skills, but how to make the virtual visits easier for the patients. “We discussed improvements we could make between patient visits — the student’s representative image, the [sound of a] clicking keyboard, and general etiquette,” Moen recalls.
“Telehealth is here to stay,” she says. “Our students will have the skills and tools to be leaders in this arena, as they are with in-person patient care. This opportunity has presented a silver lining in an otherwise very dark cloud of COVID.”
Nontraditional and Emerging Practices
Another part of the deans’ clinical innovations was providing new care opportunities to communities that have traditionally been underserved due to access or insurance reimbursement regulations. These nontraditional or emerging practices provided a crucial opportunity for clinical experience during the pandemic.
“Allowing our students to learn in emerging or nontraditional practice settings gets them out of their comfort zones and encourages them to think differently to adjust the care-management cycle,” Fero says.
Assistant Professor of Nursing Jessica Miehe, DNP’21, MSN, RN, CCRN-K, secured funding from a GHR Foundation Legacy grant through St. Kate’s to start a free school-based health clinic in the White Bear Lake school district called Bear Care Health & Wellness Clinic.
“The clinic offers our White Bear Lake Area School District students an option to receive free, high quality healthcare that they may have struggled to find otherwise,” says Wayne Kazmierczak, PhD, superintendent of White Bear Lake school district.
Miehe is a clinical coordinator for the nursing department and she saw a valuable opportunity for St. Kate’s students at the Bear Care Clinic. Since the clinic opened in March 2020, 23 St. Kate’s students in nursing and social work programs have completed more than 600 hours of clinical experience providing care to White Bear Lake, Minn. children and families.
Katilyn Taylor, MSN-EL’22, administers flu vaccine to an elementary school student during her clinical work at the Bear Care Health and Wellness Clinic in the White Bear Lake School District.
St. Kate’s online occupational therapy assistant (OTA) program expanded its clinical placement opportunities for students eight years ago. Since the curriculum is offered online, students all over the country need local fieldwork placements. This existing structure was crucial when traditional OTA fieldwork settings, such as hospitals, clinics, and schools, shut down during the pandemic.
For example, OTA students in Texas are working in an emerging practice called SAFIRE (San Antonio Fitness, Independent and Recreational Environment), whose mission is “to provide people with intellectual disabilities an environment to physically, socially, and independently grow beyond expectations.” This partnership in a rec center environment is a stark contrast to the OTA’s traditional medical setting.
“The faculty did a great job of relating OTA to our work at SAFIRE, and the students were awesome. They did the job in a professional but personal way and took the time to get to know our clients,” said Teresa Sullivan, founder and executive director of SAFIRE.
OTA Online student and fieldwork coordinator Terri Grundy, OTR, virtually discusses OTA fieldwork and clinicals with students, the emerging practice site director, and fieldwork educator Melissa Benson, COTA.
Virtual Simulations
In addition to in-person clinical placements and telehealth, some HSSH programs’ accrediting bodies allowed students to use simulations for their clinical experiences. Students can learn and practice technical and cognitive skills in these controlled environments using virtual reality, mannequins, video, and scripted actors portraying patients.
The simulated experiences provide students the opportunity to deepen their understanding of the applicable skills both during the simulation and afterward while reviewing their performance with their instructor, classmates, and fellow participants.
HSSH’s first simulation director, Krista Anderson, RN, MSN, CHSE, was hired prior to the pandemic as part of the deans’ future-forward strategy. As COVID-19 closures increased the importance of simulations in students’ educations, Anderson was brimming with ideas. She pivoted to tackle the monumental task of providing increased clinical simulations while navigating the accrediting bodies’ rules and regulations.
The social work program, which formally joined HSSH in 2019, worked with Anderson to create simulated patient interactions for students when clinical placements weren’t available.
“By initiating consultation circles through scenario simulation, we could educate our students about direct-practice skills, such as engagement, intervention, and evaluation,” says Allison Scheel, MSW, assistant professor of social work.
Interprofessional Education
St. Catherine University has the most healthcare programs of any private college in Minnesota, allowing students to experience combinations of interprofessional practice and education that aren’t possible at other institutions.
“Interprofessional education is a hallmark of St. Kate’s, and we are expanding and building upon that history,” says Associate Dean of Health Sciences Sean Fitzpatrick, PhD, CMPC.
Teaching these principles in higher education helps St. Kate’s students learn to communicate efficiently with healthcare professionals in other fields, which paves the way for holistic and efficient care. For example, the nurse who first encounters a patient on admission must understand the patient’s ailment and be able to communicate important details with subsequent caregivers, such as physical and occupational therapists.
Healthcare program students participate in simulations to practice and fulfill practicum requirements.
“Interprofessional education allows students to collaborate across disciplines and to think critically about the broader picture of health so the care team can work together to provide a higher level of care for their patients,” Dean Fero says.
When finding clinical placements became difficult, HSSH simulation director Krista Anderson created interprofessional education simulations for OT, OTA, and nursing students to replace clinical and fieldwork hours. The OT and OTA clinical coordinators and faculty also worked together to provide their students with joint clinical experiences. “If we found a facility that would take an OT student for clinical placement, we would ask them to also take an OTA student, as it would be natural for those two programs to work together in their careers,” says Bonnie Riley, OTD, OTR/L, assistant professor of OTA.
Experiencing clinicals together helps students gain insight into one another’s roles and increases their confidence when partnering with colleagues in those roles in the future.
Moving Forward: Innovative Curriculum
Deans Fero and Dutton also hired HSSH’s first instructional designer, Ryann Sparrow, MA, JD, to build connections for faculty and students and explore new learning opportunities for students. Sparrow’s role quickly evolved during the pandemic to make distance learning successful.
“We needed to alter the curriculum to fit the technological vehicle and build an academic community online to support our students and one another,” Sparrow says. “We were triaging for a while, but the faculty is now confident in online learning, which allows the School of Health to be flexible and quickly incorporate new information into the curriculum.”
Sparrow and the instructors are not only expanding students’ technical skills and increasing student and faculty competency in remote communication. They’re also working together with Anderson to create consistency between the faculty’s curriculum and related simulations to guide students through complex situations they may face in the real world using critical thinking, cultural fluency, and advocacy skills of a liberal arts education.
Kara Koschmann, PhD, APRN, CPNP-PC, assistant professor of nursing and nurse practitioner co-program director, observes, “In addition to teaching our students to see the whole picture and combat injustices and systemic racism, we also need to provide them with the tools to connect through technology to serve justly.”
A Silver Lining Ahead
Throughout the myriad changes during these uncertain times, HSSH continues to prepare St. Kate’s graduates to be leaders in the healthcare industry.
“We are building a better, brighter future for healthcare education based on what we learned in these dark times,” Dean Dutton says.
MSW Field Education Director Allison Scheel, MSW, agrees. “The pandemic presented a unique opportunity for students to reframe their experiences and learn how to navigate in uncertainty, be flexible, and shift course on very short notice.” St. Kate’s students’ educational experience is paramount and central to all of the deans’ and faculty’s work, making theirs a crucial perspective. Nurse practitioner doctoral student Chinwe Obi-Walker ’22 reflects on her 2020 clinical experience with newfound wisdom. “Healthcare providers need to learn to adapt to ambiguous situations. I came into my program with an open mind, which helped me adjust to the changes presented. What should not come as a surprise is the amount of time and effort put into advocating for us students by faculty and staff. This support is exactly what I see, feel, and think about when I hear the name ‘St. Kate’s.’”
By Jessica Kruekeberg from 'The Future is Katie, St. Catherine University Magazine Spring 2021'