Project Description
A student-run clinic is defined as, “a health care delivery program in which medical students take primary responsibility for logistics and operational management and which is capable of prescribing disease-specific treatment to patients” (Simpson & Long, 2007, p. 352). A student-run clinic allows students to practice in a safe environment while developing interprofessional skills early during the didactic portion of their schooling. Specific skills obtained while volunteering at a student-run clinic include interprofessional collaboration, improved self-efficacy, conflict resolution, effective communication, and personal development (Haggarty & Daniel, 2014; Hu et al., 2018). There are over 152 student-run clinics nationwide, and the costs are free, commonly called “pro bono” (Society of Student-Run Free Clinics, 2023). However, there is a limited representation of occupational therapy in these clinics. In Indiana, there is one student-run clinic that provides occupational therapy services. This clinic is located in Bloomington, Indiana, and is known as the IU Student Outreach Clinic. The definition pro bono is a shortened Latin phrase and, when translated, is defined as "for the public good." The overlying purpose of pro bono, though, is the donation of services for free or at a low cost for those who are uninsured, underinsured, or underserved (Merriam-Webster, n.d.). A student-run clinic implemented by a school can allow experiential learning in students within a program to exhibit concern for others, promote good, and provide equitable services and opportunities to those uninsured or underinsured in a local community.
Needs Assessment
- As outlined in the 2020 Occupational Therapy Code of Ethics, there are distinct core values (altruism and justice) and principles (beneficence and justice) that guide the occupational therapy profession toward pro bono clinics (American Occupational Therapy Association, 2020).
- 82% of Huntington University OTD/OTA students surveyed were either interested or very interested in providing care under the direct supervision of an OT or other health care professionals at a pro bono clinic.
- 53% of Huntington University OTD/OTA students surveyed were either interested or very interested in participating in a student board that would aid in running the OT clinic.
- U.S Census Bureau (n.d.) reports approximately 15.5% of Fort Wayne’s population lives in poverty.
- U.S Census Bureau (n.d.) reports approximately 10.1% of Fort Wayne's population is under 65 years without health insurance.
- In 2020, 8% Allen county, 7.1% Dekalb, 6.6% Huntington, 10.8% Kosciusko, 42.6% LaGrange, 9.9% Noble, 8.2% Wabash, and 7.4% Whitely are without health insurance (Parkview Health, 2020).
- Parkview Health (2020) System’s top ten health service needs include mental health services, substance use disorder service, access to healthy food, access to primary care providers, senior services, access to recreational spaces, childcare, health insurance, gun safety, and access to birth control.
Literature Review
- According to Collins et al. (2020), 43.4% of adults aged 19 to 64 in the United States were inadequately insured in 2020.
- A study by Yue et al. (2021) sent a national survey to 190 accredited master's and doctorate programs to assess the current participation of OT students in a student-run clinic. Out of the 118 schools that responded, 103 schools reported either they did not have a student-run clinic or were not involved in a pre-existing clinic.
- There are 3 main impacts of a student-run clinic for the: (a) students, (b) patients, and (c) university.
- Students: Specific skills concerning interprofessional collaboration occur through student-run clinics, such as improved self-efficacy, conflict resolution, improved behaviors toward interprofessional interaction, effective communication, and personal development (Haggarty & Daniel, 2014; Hu et al., 2018).
- Patients: Smith et al. (2019) conducted interviews with patients who received treatment at a pro bono clinic. The study revealed that patients found the students to be helpful and kind, and patients were likely to recommend the pro bono clinic to people within the community.
- University: Froberg et al. (2018) found that supervisors in student-run clinics were able to spend time with students and build a rapport that allowed constructive feedback to identify additional skills needed.
area of focus
Program and Policy Development | Leadership | Administration
Target population
Uninsured adults in the Greater Fort Wayne Area and Huntington University OTD/OTA students
primary site
Huntington University
Huntington University supported participation in all educational endeavors.
Secondary site
Matthew 25 clinic
Matthew 25 Clinic provided the opportunity to observe the functionality of the clinic and to support the specialty clinic therapy nights to gain a deeper understanding of the community needs.
Mission and vision statement
Mission
To advance students in servant leadership by delivering scholarly excellence and client-centered care for all people, groups, and populations uninsured in the Northeast Indiana and Northwest Ohio area.
vision
To provide commitment through Christ, Scholarship, and Service to future OT practitioners by providing progressive interventions to improve local community health needs.
project team
Project manager - holly Weber, OTDS
Holly Weber holds a Bachelor of Science in Health Science with a concentration in rehabilitation science from Indiana University.
The project manager was responsible for all-encompassing factors related to the current project, including the planning, implementation, management, dissemination, and sustainability components, while simultaneously initiating communication with all key stakeholders.
Faculty mentor - dr. jill Linder, otr/l, DHSc, CBIS, CSRS
Dr. Linder served as the faculty mentor of the capstone project. She holds a Bachelor of Science in occupational therapy from Eastern Michigan University, Master of Health Science from the University of Indianapolis, and Doctor of Health Science from the University of Indianapolis. Dr. Linder is a professor at Huntington University.
Dr. Linder supported the clinical experience at a pro bono clinic setting while volunteering at Matthew 25. She oversaw productivity throughout the project and provided multiple networking avenues.
Expert mentor - Dr. sharon pape, OTR, OTD, MS, FNAP
Dr. Pape served as the expert mentor for the capstone project. She holds a Bachelor of Science in occupational therapy from the University of Wisconsin - Milwaukee, Master in Health Sciences Education from Indiana University, and Docotor of Occupational Therapy from Saint Louis University. Sharon Pape is the current program director of the Master of Science Occupational Therapy program at Indiana University South Bend.
Dr. Pape provided expertise in student-run clinics specific to uninsured populations and program policy and development and provided resources/connections for the proper installment of the capstone project.
Deliverables
The project consists of nine deliverables that are outlined below.
Outcome Measure #1: Student will demonstrate knowledge of program and policy development by designing a standard operating procedures manual for a student-run OT clinic.
Learning Objective #1.1: Student will identify and complete training in program management and leadership applicable to “student-run” and/or “pro bono” clinics as evidenced by continuing education opportunities extending knowledge.
Learning Objective #1.2: Through the completion of at least 30 hours of administrative observation of a successfully run “student-run” and/or “pro bono” clinics, the student will design a scope of work document outlining the roles and responsibilities of the administrative team.
Learning Objective #1.3: Student will interview at least 5 health care professionals to gain insight on the needs of the community members served for establishing a structured pro bono approach conducive to the instrumental daily living tasks needed.
Outcome Measure #2: Student will design an event plan for a launching event for the student-run clinic to introduce the stakeholders, future student leaders, and a sustainable action plan for the impact on the individual participant, community members, university, and metropolitan area.
Learning Objective 2.1: In order to establish a sustainable process for the student-run pro bono clinic, a student will initiate the structure of the pro bono OT student board with written roles and responsibilities to support the ongoing function of this service provided to the community from within the university.
Learning Objective #2.2: Student will gain perspective on the perceived academic benefits of the student-run clinic through an online engagement survey following a short presentation on the successes and future initiatives of the student-run pro bono clinic
Learning Objective #2.3: Student will develop a budget plan for the launching event of the student-run pro bono clinic.
Learning Objective #2.4: Student will develop materials for distribution to stakeholders in the community and on social media platforms.
Found below is each focus area explained in detail with visual depictions
clinical practice
- Provided consult services at the therapy clinic for diagnoses including shoulder pain, trigger finger, wrist pain, and hand weakness at the Matthew 25 therapy clinic.
- Completed occupational therapy evaluations for adults with orthopedic diagnoses under the direct supervision of an OTR/L at the Matthew 25 therapy clinic.
- Completed occupational therapy interventions for adults with orthopedic diagnoses under the direct supervision of an OTR/L at the Matthew 25 therapy clinic.
- Observed treatment sessions with OTR/Ls and PTs at Matthew 25 therapy clinic.
- Networked and collaborated interprofessionally with PTs and PTAs at the Matthew 25 therapy clinic.
- Discussed patient progression with interprofessional team.
- Documented under the direct supervision of an OTR/L through EPIC EMR system.
- Created individualized home programs for patients at the Matthew 25 therapy clinic under the direct supervision of an OTR/L.
- Recommended durable medical equipment for patients at the Matthew 25 therapy clinic under the direct supervision of an OTR/L.
program and policy development
- Created a Standard Operating Manual outlining an introduction, student-run occupational clinic, Huntington University Leadership Committee Board, clinic policies and procedures, and clinic functionality.
- Created policy and procedures highlighting code of conduct, disciplines, documentation and EMR, harassment, health and safety, threats, violence, weather, HIPAA, patient materials, technology.
- Sought out approval of the Huntington University Program Director and CEO of the Matthew 25 Clinic of the Standard Operating Manual
- Structured a student board outlining roles and responsibilities of the Huntington University Leadership Committee.
- Created a student leadership committee manual detailing statement, purpose, objectives, membership, meetings, compliance, committee board responsibilities, nomination, elections, pinning, special circumstance, mentoring, clinic day responsibilities, and addendums.
- Created a manual detailing clinic functionality including hours of functions, student information, leadership committee responsibilities, and supervisor information.
- Created a OneDrive folder containing policies and procedures in EPIC chart review, incident report forms, workplace violence report form, OT profile templates, SOAP note templates, drop boxes for completed notes, Huntington University inventory, material check in/out sheets, clinic manager schedule, reminder scripts, equipment logs, reminder cards, social media approved logos, photo release forms, patient photos, and welcome folder for supervisors.
- Developed an Event Plan entailing an outline of a budget plan, flyers, invitations, social media templates, sponsorship lists and contact information, follow up letters, volunteer job descriptions, event plan set up, event plan itinerary, and an event plan set up.
research
- Developed research questions to ascertain the healthcare professionals’ scope of practice, demographics of patients, practitioner burnout, clinic accessibility, payor sources, practitioner’s knowledge of occupational therapy, and to gain insight on the needs of patients served conducive to instrumental daily tasks.
- Developed research questions to investigate the sustainability of a student-run clinic, including Huntington University’s occupational therapy department entailing student demographics, OTD/OTA student involvement, inter/intraprofessional communication and skills development, level 1 fieldwork participation, and knowledge and interest level of a future pro bono clinic.
- Developed research questions to investigate determining the need for occupational therapy through a self-developed screening tool (compromised of 25 questions and reviewed to be at a 6th-grade reading level) to determine the eligibility of Matthew 25 patients for therapy services. The research also included developing a consent form, creating and receiving a letter of approval to conduct research at Matthew 25, and receiving a letter of approval to modify a current screening tool.
- Developed an occupational therapy screening tool in 4 languages (English, Spanish, Burmese, and French).
- Developed research questions to ascertain local occupational therapists' interest level at a pro bono clinic while serving as clinical instructors.
- Created 4 Exempt Status Applications for the Huntington University Institutional Review Board (IRB), including Healthcare Professionals Interview, Perceived Academic Benefits of a Pro Bono Clinic, Determining a Need for Occupational Therapy Services Through a Survey Screening Tool, and Occupational Therapy Volunteer Survey.
- Received 3 IRB approvals for Healthcare Professionals Interview, Perceived Academic Benefits of a Pro Bono Clinic, and Determining a Need for Occupational Therapy Services Through a Survey Screening Tool.
Administration
- Obtained over 30 hours of observation of administrative work at the Matthew 25 Clinic, IU Outreach Clinic, and Trine Carew Clinic
- Observed the Matthew 25 Clinic administrative team including the front desk manager, front desk, eligibility specialist, internal auditor, switchboards, resources specialist, and office associate to gain greater knowledge of patient intake and for proper clinic functionality dynamics
- Obtained administrative skills by observing occupational therapy team dynamics, including team members such as the chair, vice chair, operations chair, volunteer coordinator, and clinic manager.
- Obtained administrative skills by observing the Carew Clinic team dynamics, including the president, vice president, documentation specialist, and patient/student scheduler.
Leadership
- Obtained 5 certificates in leadership training.
- Completed 6.75 hour CEU courses related to leadership training from the American Occupational Therapy Association.
- Enhanced skills in leadership while listening to podcasts and engaging in education training modules.
- Attended several leadership events held by Lutheran Hospital.
reflection
The doctoral capstone experience provided personal and professional advancement in skills specific to adults with an emphasis on student-run occupational therapy clinics. For a more detailed personalized reflection, click the link below.
impact on occupational therapy
A manual detailing all functions of the clinic is available to future OTD/OTA students at Huntington University. The project manager will become the OT Lead at the Matthew 25 Clinic and will be readily available for networking opportunities with the HU fieldwork coordinator and to students.
future directions
- Obtain more OT/OTA volunteers.
- Continue research for eligibility for patients to receive occupational therapy services at the Matthew 25 Clinic.
- Launch the event plan in September of 2023.
contact information
weberjholly@gmail.com
dedication
for: kris martin
You left the world too early. I know how proud you would be of the marketing materials created for this capstone project.
references
American Occupational Therapy Association. (2020). AOTA 2020 occupational therapy code of ethics. American Journal of Occupational Therapy, 74(3), 1-13. https://doi.org/10.5014/ajot.2020.74S3006
Collins, S., Gunja, M., & Aboulafia G. (2020). U.S. health insurance coverage in 2020: A looming crisis in affordability. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2020/aug/looming-crisis-health-coverage-2020-biennial
Fröberg, M., Leanderson, C., Fläckman, B., Hedman-Lagerlöf, E., Björklund, K., Nilsson, G. H., & Stenfors, T. (2018). Experiences of a student-run clinic in primary care: A mixed-method study with students, patients and supervisors. Scandinavian Journal of Primary Health Care, 36(1), 36–46. https://doi-org/10.1080/02813432.2018.1426143
Haggarty, D., & Dalcin, D. (2014). Student-run clinics in Canada: An innovative method of delivering interprofessional education. Journal of Interprofessional Care, 28(6), 570–572. https://doi.org/10.3109/13561820.2014.916658
Hu, T., Cox, K. A., & Nyhof-Young, J. (2018). Investigating student perceptions at an interprofessional student-run free clinic serving marginalised populations. Journal of Interprofessional Care, 32(1), 75–79. https://doi.org/10.1080/13561820.2017.1363724
Merriam-Webster (n.d.). Pro Bono. https://www.merriam-webster.com/dictionary/pro%20bono
Parkview Health. (2019). Local health needs.Parkview Health. (2019). Local health needs. https://www.parkview.com/community/community-health-improvement/local-health-needs
Simpson, S. A., & Long, J. A. (2007). Medical student-run health clinics: Important contributors to patient care and medical education. Journal of general internal medicine, 22(3), 352–356. https://doi.org/10.1007/s11606-006-0073-4
Society of Student-Run Free Clinics (2023). Society of Student-Run Free Clinics. https://www.studentrunfreeclinics.org/
U.S. Census Bureau. (n.d.) QuickFacts: Fort Wayne city, Indiana. U. S. Department of Commerce. https://www.census.gov/quickfacts/fact/table/fortwaynecityindiana/PST045221
Yue, J. W., Delavar, M., Padini, B., Vanstrum, E., Milman, T., & Sideris, J. (2021). The value of occupational therapy student participation in university-based student-run free clinics in the United States. Journal of Occupational Therapy Education, 5(4), 1-22. https://doi.org/10.26681/jote.2021.050413