AMPHL Workshop Abstracts FRIDAY, May 15, 2015 Teamwork in a code blue: Managing roles and communication Code blues are uncommon, yet represent the acutely stressful situations for health care professionals. Such cases require excellent teamwork and communication, at times posing challenges for DHH health professionals and interpreters. While code blue training is easily available, less so is training specific to the challenges faced by DHH health care professionals and interpreters (if they work with interpreters). This workshop will include: 30 minutes: Interactively discussing a typical code blue and its requisite elements to develop a shared vision, followed by identifying and prioritizing specific challenges based on participants’ professions and roles. (Before each of the following situations, roles will be assigned to each participant, such as running the code, performing chest compressions, monitoring a pulse, interpreting, or administering medications.) 10 minutes: Conduct a relatively uncomplicated simulated code blue that resolves relatively quickly. 15 minutes: 10-minute simulated code blue with multiple repetitions, each with a different challenge identified beforehand to a team to focus on specific adaptations. Challenges will be identified as above; we anticipate including disruption in sightlines, difficulty hearing due to noise, overcrowding with difficulty finding optimal positioning, and uncertainty identifying roles. We will take 5 minutes after each simulation for reflection and debriefing. 20 minutes: Reflection, discussion, and debriefing of challenges and solutions, along with feedback/insights for and from facilitators. Presenters: Todd S. K. Agan, CI, CT, BEI Master, is the lead designated interpreter at the University of Texas Health Science Center in San Antonio. A member of the division of hospital medicine, Todd has spent the last 15 years interpreting for deaf medical professionals, from medical school to practice. Chris Moreland, M.D., MPH, is a deaf academic hospitalist at the University of Texas Health Science Center at San Antonio. After graduating from UT Houston Medical School and completing residency and fellowship at UC Davis, he and his wife, an emergency medicine physician, returned to Texas. As an internal medicine residency associate program director, he maintains a strong interest in interprofessional medical education and communication. Other academic interests include health disparities (particularly for the deaf and limited English proficient), healthcare interpretation services, and diversity among healthcare professionals. Co-existing conditions in Deaf & hard of hearing children Per the most recent (2009-2010) Gallaudet Research Institute Regional and National Summary, approximately 40% of children who are deaf or hard of hearing also have a coexisting condition(s). Often, the hearing status becomes the focal point for all concerns at hand, which can lead to incorrect diagnosis and failure to implement appropriate supports and services. This workshop will illustrate patient scenarios that initially presented as related to hearing status, but actually involved a previously undiagnosed etiology (including genetic, behavioral, and neurologic co-existing conditions). Presenter: Rachel St. John is a board-certified pediatrician, and a NIC-Advanced certified sign language interpreter through RID. She received her BS degree in psychology at George Mason University. She completed her MD degree at the University of Virginia School of Medicine, and then attended Georgetown University Hospital for her residency in pediatrics. She also holds an MA degree in counseling from Gallaudet University. Dr. St. John is also the director of the Family-Focused Center for Deaf and Hard of Hearing Children at Children’s Medical Center Dallas/UT Southwestern Medical Center. The FFC provides support for families to make informed decisions regarding their deaf/hard of hearing child, as well as provides education and collaborative support to providers caring for these patients in keeping with national standards. Additionally, she works as a Designated Interpreter with a deaf post-doctoral neuropsychiatry lab researcher. Technical Standards of American Medical Schools and the Americans With Disabilities Act Physicians with disabilities are more empathetic towards their patients, especially their patients with disabilities. Indeed, a AAMC principle states that physicians should resemble their patients. While 20% of the United States population has a disability, only 1% of medical students have a disability. Legislation like the American with Disabilities Act (ADA) requires that medical schools provide reasonable accommodation. In response to this, medical schools have issued technical standards to identify required physical attributes of applicants and students. This workshop will review the results of the study assessing the availability of technical standards of medical schools, and evaluating and determining specifics and factors associated with ADA compliance. Despite being the law of the land, many medical schools are in violation of the ADA, which is significant considering that they’ve had over 20 years to comply. While we see an increasing amount of people with disabilities in clinical, education, and research roles, they still face significant barriers. Presenter: Ben Case works for Global Brigades, a sustainable development and global health organization, in Estelí, Nicaragua. A 2014 University of Michigan graduate, Ben plans to begin working in the laboratory of Dr. Alan Cheng at Stanford University after his time with Global Brigades. He intends to apply to medical school, and is interested in hearing research, access to health care, and global health. Taboo Team Topics This workshop will explore a few of the taboo themes that are naturally exposed as you delve into the symbiotic relationships of DIs and DPs. We are all only human, but how can we make sure our super-human side is also unleashed at the bedside? How do you manage comments that created friction for the DI team? What happens if you have a mismatch of values? We will explore these themes, along with other challenges that result from working so intimately with a team. We will also attempt to create a practical guideline for the "Do's and Don'ts" for both veteran teams and newlyweds. Perhaps your relationship can be diversified and improved with some subtle guidance? All participants will be welcomed to share their experiences and take away practical tips. Presenters: Alicia Booth, NIC holds a BA in Journalism and a BS in Signed Language Interpretation from the University of New Mexico. She has served as Lead Designated Interpreter for several universities and has consulted for accommodations specialists across the country. Alicia's past workshops have focused on "Designing Designated Interpreters" and "Creating an Integrative Approach with CART and ASL." She has also participated on numerous panels and focus groups, addressing the unique role of non-traditional service providers. Alicia currently serves as the Lead Designated Interpreter at the University of Creighton Medical School in Omaha, NE. Michael Argenyi, MSW and M3, is a future physician, completing his third year at Creighton University School of Medicine in Omaha. He will apply this coming fall to residency. His interests include pediatrics and underserved urban health with a focus on STI/HIV wellness. Before medical school, Michael completed his Bachelors of Arts in History at Seattle University and became interested in medicine while working as a CNA at Seattle Children's Hospital. He has also co-authored research in clinical sensory physiology under Michael Gorga at Boys Town National Research Hospital and completed a Masters of Social Work at Boston University. Navigating the Pre-Med Experience / Getting Into Medical School This presentation’s theme is providing solutions to the existing communication barriers commonly experienced by students with hearing loss entering the medical field. Each of these students is idiosyncratic in their hearing loss and identities, thus the solutions will be unique to the individuals as well. The continuum of hearing loss and identity requires that solutions be creative and specific to the student, taking into account not only their hearing loss from an audiological standpoint, but their selfdetermined identity. No matter where on the continuum of deafness a student lies, they can be empowered and successful. Presenter: Will Fetzer is currently a premedical undergraduate student at the Indiana University – Purdue University of Indianapolis (IUPUI). He will take the MCAT this April 18, apply AMCAS and IUSM this June, and graduate this August with BS in psychology/neuroscience. Since birth, he has a profound bilateral hearing loss due to genetic (Cx26/GBJ2) congenital sensorineural deafness. ASL is his primary language and English is his second. He efficiently converses with non-ASL users by using ASL interpreters, typing screens (desktop, tablet, mobile), and of course, paper and pen. His workshop will focus on is providing solutions to the existing communication barriers commonly experienced by students with hearing loss entering the medical field. Each of these students is idiosyncratic in their hearing loss and identities, thus the solutions will be unique to the individuals as well. The continuum of hearing loss and identity requires that solutions be creative and specific to the student, taking into account not only their hearing loss from an audiological standpoint, but their selfdetermined identity. No matter where on the continuum of deafness a student lies, they can be empowered and successful. Best Practices In Mental Health Interpreting With recent expansions of insurance coverage and greater efforts in many states to ensure mental health parity, although there is a long way to go, members of the Deaf community find greater access to mental health services and psychotherapy than ever before. As such, interpreters may find greater demand to provide services in this setting along with therapists/clinicians who have little to no experience working with interpreters themselves. Through lecture and discussion, this workshop will focus on providing participants with information on working with the therapist in support of treatment objectives, developing a therapeutic alliance, common mental illnesses and the impact of such on language processing, the varied use of language to direct clinical treatment, recognizing language dysfluency, fostering intrapersonal awareness, managing boundaries, and ensuring proper self-care when trauma enters the therapeutic discussion. Presenter: Leslie Pertz, LMSW, NIC is a licensed social worker (MI) and nationally certified ASL/English interpreter who has been working in mental health settings for over 10 years as an interpreter, and for three years as a therapist in a medical setting. Leslie has worked with many spoken language interpreters as the therapist, and as the interpreter for Deaf patients in psychotherapy and recovery settings. Leslie’s workshop will focus on best practice approaches to working in a triadic therapy relationship. SATURDAY, May 16, 2016 Legal Rights of Deaf and Hard of Hearing Individuals Overview of the Americans with Disabilities Act and section 504 of the Rehabilitation Act Overview of the rights in the workplace that deaf and hard of hearing professionals have as individuals with a disability – discuss legal issues and provide general advice for the job search process Overview how the ADA/section 504 apply to educational and training programs in the health care fields Overview how schools’ technical standards must comply with the ADA/section 504 Overview of recent cases involving deaf/hard of hearing professionals and students in health care fields Presenter: Michael Stein, JD, a deaf attorney, is committed to ensuring that all individuals with a disability are able to participate fully and equally in all facets of society. He has litigated Americans with Disabilities Act cases around the country on behalf of individuals with a disability, including individuals who are deaf or hard of hearing. Mr. Stein has also litigated numerous cases against hospitals and other health care providers for failing to ensure effective communication with deaf patients and their companions. Prior to joining Stein & Vargas, LLP, Mr. Stein was a Skadden Fellow with the National Association of the Deaf. He also clerked for the Honorable William G. Young in the United States District Court for the District of Massachusetts. Mr. Stein obtained an A.B. degree from Princeton University and a J.D. from Harvard Law School, where he was Notes Editor of the Harvard Law Review. Mr. Stein is a member of the bars in Massachusetts, New York and the District of Columbia. He is also admitted to the Seventh Circuit. Mr. Stein associates with local counsel around the country in bringing cases of special importance to individuals with disabilities. Accommodations in Health Professional Schools: Personal Experiences A panel of health care professionals and students will share their experiences with the audience by discussing the following questions. How and when did you reveal your hearing loss to your program and how did they respond? What resources worked best for you in the classroom and with patients? Do you have a bad/not so good experience that you can share? Do you have a positive/surprising experience that you can share? Is there anything you would have done differently to make your experience go smoother? Presenters: Sarah Hein, BS, MS Tiffany Panko, MBA Marcie Johnson, MPA, PA-C Megan Jack, MD Kimi Ross, BA, MA Early Hearing Detection and Intervention - Great Lakes and Great Partners Michigan currently is focused on monitoring loss to follow-up at all three stages in the EHDI process: 1) initial hearing screening 2) final newborn hearing screen to audiologic diagnosis and 2) audiologic diagnosis to early intervention. Given the diverse population of Michigan from very rural, small to large urban population centers, change strategies identified to improve loss to follow-up are not expected to be successful in all locations. This presentation will focus on the ongoing efforts identified to address significant loss to follow up rates in Southeast Michigan. Loss to follow up rates in Southeast Michigan has slowly declined from 77% in 2009 and 2010, 64% in 2011 and 42% in 2012. To continue to facilitate and expedite improvement, new strategic methodologies have been instituted. Using transformational initiatives and focusing on measurable processes, Michigan EHDI has implemented program strategies to improve loss to follow-up rates in Southeast Michigan. Community partners and stakeholders are engaged through distinct and unique projects to identify variables impacting loss to follow up rates. Using specific, measurable, attainable, realistic and timely (SMART) benchmarks, projects are assessed monthly and quarterly for measurable progress and strategic refinement. Presenter: Nan Asher, MLS was diagnosed with a hearing loss at age 4 during kindergarten screenings, where she immediately started school in the Monroe County Program for Hearing Impaired Children. She was fully mainstreamed at age 9 when the family moved to Washtenaw County. She started her working life as a veterinary technician in high school. She graduated college with a bachelor's of science in Health Administration. She received her Master's in Interdisciplinary Technology, specializing in Assistive Hearing Technologies. She has been actively involved in many local & statewide organizations related to Deaf and hard of hearing. She has long advocated educating the public about hearing loss & helping adults with newly diagnosed with hearing loss with coping strategies. She also has a profoundly deaf brother who wears bilateral Cochlear Implants who performs as a Deaf Magician on occasion. She currently works at EHDI as a program consultant and as treasurer of the Michigan Coalition for Deaf, Hard of Hearing & DeafBlind People and is one of the many volunteers that make Camp Chris available for Deaf/hard of hearing youth. Amplified Device Use in Acute Health Care Settings The patient population is aging rapidly and becoming sicker, now more than ever, it is important to ensure proper communication and patients understanding of their plan of care. One way that this could be improved is by utilizing amplified devices that are provided by the institution, such as voice amplification systems for patients who are severely hard of hearing whom have left their hearing aids at home or have not been consulted by an audiologist. Hearing aids are expensive, so many patients may opt out on bringing them to the hospital in fear of them possibly being lost, broken or stolen. Hearing aids also require batteries and if patients are brought into the hospital settings emergently, they may not have the extra batteries for them to work for their entire hospital stay. This is a major barrier for patients understanding of their plan of care and their discharge teaching. The ability for patients to consolidate information regarding to their disease processes and medication regimens increase tremendously if they have the appropriate access to information and are included in their plan of care, beginning at admission. Repetitive education and teach back is significantly important when it comes to increasing patient compliance and awareness. Amplified devices that are owned by institutions and utilized with patients who have extreme hearing loss would greatly increase patient satisfaction, compliance and decrease time spent in the patient’s room. Presenter: Amber Kimball, RN is a Registered Nurse at Moses Cone Memorial Hospital in Greensboro, North Carolina. She currently works full-time on a busy inpatient orthopedic and medical/surgical floor. Amber Kimball was born in Kansas City, Kansas, with 80% hearing. She developed further losses and was in need of hearing aids by the time she was 18 months old. She lost the rest of her hearing by four years of age. Tammy, Amber’s mother, learned about a Cued Speech and cochlear implant program for deaf children in North Carolina. Amber had a successful unilateral cochlear implant procedure at UNC Chapel Hill at the age of five. Amber used Cued Speech and disability services throughout her elementary and middle school years. Amber is currently enrolled in Winston Salem State University’s RN to BSN program. Once completed, she plans to apply to doctoral programs for either her doctorate in nursing practice or PhD in nursing research. At Your Fingertips 24/7: Free Resources and Professional Development Opportunities In today’s fast paced world, individuals need access to critical information at all hours of the day. Join the staff of pepnet 2 for a tour of the free resources available 24/7 that are designed to provide professionals the resources and professional development opportunities they need to provide quality services for individuals who are deaf or hard of hearing. This session will feature an interactive tour of resources available on the pepnet 2 website. Disclosure 101 One of the key components for consideration during the job seeking process is how, when, and why to disclose a disability to an employer. Such a seemingly simple act can significantly impact one’s ability to effectively obtain and maintain employment. During this session the following aspects to disclosure will be examined and discussed: legislation, pre-employment, interviewing, and on the job. Presenter: Kathy Schwabeland, MA is a staff member with pepent2. She has worked in the field of deafness for over 20 years in a variety of settings including vocational rehabilitation, community mental health, secondary education, and post-secondary education. She holds a Master’s degree in Rehabilitation Counseling from Gallaudet University. Breaking the Silence: Overcoming Obstacles and Facilitating the Education of Pre-professional Students With Hearing Loss Julie received her BSN from Bowling Green State University, and her MSN, from Lourdes University. Her Capstone focus was on The Impact of Protein on Cognitive Functioning of School Age Children. Currently, Julie is employed as a Certified School Nurse (CSN) for an urban public school district since 1997. Prior to becoming a CSN, Julie was employed as a staff nurse and charge nurse at a University Medical Center in a variety of settings. She has been employed as a RN for over 30 years. Julie is a member of several professional organizations including Sigma Theta Tau and National Association of School Nurses. Julie enjoys mentoring nursing students, teaching American Sign Language and volunteering for canine rescue. When weather permits, Julie enjoys hiking the State and National Parks and kayaking. Born and raised in Cincinnati, Julie has two adult sons and resides in Perrysburg, Ohio. Audiology Assistive Technology: Clinical Simulation Lab with (H)AT & Amplified Stethoscope Demos Assistive technology for individuals who are deaf, hard of hearing or deaf-blind is constantly evolving and changing. For some, this assistive technology can involve maximizing their residual hearing and for some, assistive technology is in the form of supplemental visual information. For many of us who work in the medical field, we may use a combination of the two. We use this technology in our everyday lives as well as our work lives. In addition to (hearing) assistive technology changing, hearing aids, osseointegrated implants and cochlear implants are also improving in leaps and bounds. It is important to know what features and options to ask for at your next audiology appointment.The explosion of apps on Smartphones has also had a positive and significant impact for those of us with hearing loss. Not only does it give us more equal access to telecommunication, we can also utilize special apps to aid us in our everyday and work lives. Presenters: Sam Atcherson has post-lingual hearing loss from early childhood and is currently a bilateral cochlear implant user after many years of hearing aid use. Throughout his life, he has used a variety of different assistive technologies at home and in his education. He is currently associate professor and interim director of audiology at the University of Arkansas at Little Rock/University of Arkansas for Medical Sciences. Sam is lead co-author of two textbooks, Auditory Electrophysiology: A Clinical Guide (2012; Thieme) and Hearing Assistive and Access Technology (2015; Plural). He has been actively involved with AMPHL since 2001 having served in a variety of positions including President, provided assistive technology updates at every AMPHL conference, and received an AMPHL Recognition Award in 2011. Sam is also fluent in ASL, and brews his own beer in his spare time. Tina Childress is a former hearing audiologist who became a late-deafened adult and bilateral cochlear implant recipient. She has always loved technology and is well-known for her various presentations, workshops and articles on assistive technology, apps and leveraging social media to connect and share information. In addition to working as an educational audiologist and freelance speaker, she has worked for a cochlear implant manufacturer and is active on various boards and committees where she advocates for access. Tina is also fluent in ASL. Audism in the Academic Environment & Workplace Audism is defined as the notion that one is superior based on one's ability to hear. Although audism may be manifest openly, practices of unintentional audism are most common. Recognizing when audism occurs in the academic or workplace setting can lend tangibility to this type of discrimination and allow one to better deal with its repercussions. Practical and legal tools for handling audism will also be discussed. Presenter: Dr. Jaime A.B. Wilson, Ph.D. is a licensed psychologist in private practice. Wilson Clinical Services, PLLC. provides an array of psychological health care services to deaf, hard of hearing, deaf-blind, and blind individuals. Dr. Wilson received his Ph.D. in clinical psychology from Brigham Young University, Provo, UT and completed a predoctoral internship at the University of Miami Miller School of Medicine, Miami, FL. He also completed a postdoctoral fellowship residency at Madigan Army Medical Center in Tacoma, WA. He resides in Olympia, WA with his wife, two kids, and all of the kids' imaginary friends. SUNDAY, MAY 17, 2015 Veterinary Medicine: “Horns, Claws, and Teeth! Oh My!” Animals provide a wealth of visual information through body language and posture that can help the astute practitioner gauge the health and mental state of the animal. Being able to “read” an animal is important not only in assessing health status, but also in order to avoid injury (bites, kicks, head butts) from a painful, threatened, or nervous animal. Kimi Ross will complete her DVM at Washington State University in 2016. She is a late-comer to veterinary medicine, with a background in education and a passion for rural veterinary medicine developing from her experiences teaching in remote locations with no access to veterinary care for her own critters. A large animal veterinarian at the college recently said to her, “Auscultation is overrated.” We agree! The purpose of this presentation is to provide an overview of the various visual communication signals animals provide that help us assess a patient’s mental state when we may not detect a hiss, growl, or snort. Dogs, cats, horses, ruminants and camelids will be discussed. “We will not be ignored! Engaging the Deaf Community in Healthcare and Public Health Research For decades, health promotion and disease prevention for Deaf Americans who communicate primarily in ASL were largely elusive. Deaf ASL users comprise a linguistic minority who experienced exclusion in public health research projects and outreaches. However, in the past few years, health-related research with Deaf people has become a growing field. The Centers for Disease Control and Prevention (CDC) is one of the key funding contributors to Deaf Health research. One of the requirements for these funding applications is evident of sustainable and enduring academic-community partnerships such as CBPR. More and more academic health research centers throughout the country are realizing the enormous benefits of collaborating with minority members of racial, ethnical or linguistic backgrounds. By working together in CBPR, researchers and community members develop effective culturally and linguistically appropriate public health research designs and to improve access to quality health care. Presenters: Michael M. McKee, M.D., M.P.H. is an Assistant Professor at the Department of Family Medicine at the University of Michigan, and board-certified in Family Medicine. Dr. McKee’s research focuses on health literacy and health care access among disadvantaged populations, including linguistic minority and disabled populations. Dr. McKee has personal (has a hearing loss himself), clinical, and research expertise with a variety of individuals with hearing loss, including Deaf American Sign Language users. Due to existing health disparities in the Deaf and hard of hearing populations, he has conducted research and published on health care access, health literacy, health communication and health disparities in the Deaf community. He is also very active in medical and community health education involving Deaf and hard of hearing populations, including the ongoing Deaf Health Talks. Dr. McKee is currently on a K01 Career Development Award (2010-2015) through the National Heart, Lung and Blood Institute to study the effects of health literacy on cardiovascular risk factors for Deaf American Sign Language users. Matthew Starr, MPH is a public health practitioner in Rochester, New York. He previously worked at the National Center for Deaf Health Research, a federally funded Prevention Research Center at the University of Rochester Medical Center. Its mission is to promote health and prevent disease in Deaf and hard-of-hearing populations through community-based participatory research. He also served as the community liaison between NCDHR and its community members from the Deaf community. Currently he is a board member of Partners in Deaf Health, Inc., whose mission is to foster partnerships between Deaf communities, public health researchers and healthcare professionals to better understand the health needs of culturally Deaf people. Starr is now a member of a national FEMA Incident Management Assistance Team and as part of the Command Staff at the Joint Field Office advising Federal Coordinating Officers in ensuring full accessibility for survivors with disabilities and other access and functional needs. Evolution of a Designated Interpreter’s Role from Medical School to Practice The concept of the designated interpreter is still relatively new and not well understood. Todd and Alicia will share their experiences working as DIs to further explore how to successfully navigate the challenges of establishing a DI team. Some of the many topics that we will explore include the evolution of the DI role, understanding roles within the team, ethical considerations, and developing best practices within our niche. Participants are encouraged to bring questions and prepare for a frank discussion of the challenges and rewards that DIs may potentially experience. Presenters: Todd S. K. Agan, CI, CT, BEI Master, is the lead designated interpreter at the University of Texas Health Science Center in San Antonio. A member of the division of hospital medicine, Todd has spent the last 15 years interpreting for deaf medical professionals, from medical school to practice. Alicia Booth, NIC, holds a BA in Journalism and a BS in Signed Language Interpretation from the University of New Mexico. She has served as Lead Designated Interpreter for several medical schools and has consulted for accommodations specialists across the country. Alicia's past workshops have focused on "Designing Designated Interpreters" and "Creating an Integrative Approach with CART and ASL.” Alicia currently serves as the Lead Designated Interpreter at the University of Creighton Medical School in Omaha, NE. Wendy Eastman, MD is the current president of AMPHL. Her talk will be entitled: “The Biannual President’s State of AMPHL Address” Presenter: Wendy Eastman was born deaf, wore bilateral hearing aids and grew up in the Boston suburbs. She graduated from Dartmouth College, served two years in the Peace Corps in Ecuador, South America speaking and lipreading Spanish, worked at Harvard Medical School Channing Laboratory as a microbiology lab technician, then went back to Dartmouth for Medical School. While doing a Family Medicine rotation on the Navajo Indian Reservation in Tuba City, AZ, she fell in love with the Southwest and went west for her training. She completed her Pediatric Residency and Child Neurology Fellowship at Primary Children’s Medical Center at the University of Utah in Salt Lake City. She used CART and interpreters through medical school and training. She is now a Child Neurologist at Providence Sacred Heart Children’s Hospital in Spokane, Washington. * Remaining Presenter Bios and Workshop Descriptions Coming Soon