“Pre-op Prep” Pre-Operative Preparation For The Virtual Healthcare Experience A Teaching and Learning Guide/Workbook Health Science Education West Virginia Department of Education ii TABLE OF CONTENTS Introduction To the Student To the Teacher Setting Your Goals Personal Goal Setting Pre and Post-Learning Activity Instructional Lessons Anatomy & Physiology: Skeletal System Infection Control: Medical and Surgical Asepsis WebQuest and Ethics Discussion Questions Procedures: Arthroscopy and Total Knee Replacement Recovery: Postoperative Care and Recovery Assessment Reflections Appendix Assessment Rubrics 21st Century Learning Skills and Technology Tools Acknowledgments iii Introduction To the Student I magine yourself as a healthcare professional. Your goal is to deliver quality, compassionate care resulting in successful outcomes for your patients. As a healthcare professional, you have many career options. Imagine that this week you will be working in the operating room, assisting the surgeon in performing a total knee replacement. You will use sophisticated surgical equipment and technology in an attempt to correct this patient’s physical condition. You will be a vital member of the surgical team. You will view the actual surgical field with the surgeon as he operates. Imagine! You could be a Patient Transporter, Registered Nurse, Circulating Nurse, Surgical Technologist, Central Supply Technician, Anesthesia Technician, Certified Registered Nurse Anesthetist, Anesthesiologist, Surgical 1st Assistant or a Surgeon. These are just some of the careers utilized in the hospital and found in today’s operating room or surgical suite. Imagine! When the day arrives, experience the real world inside the operating room – contemplate the patient’s concerns, feel the expert hands of the surgeon, see the knowledge and skills as they are demonstrated by the surgical team and celebrate in the knowledge that someone’s health and quality of life has been improved. Imagine! If working in surgery is not your area of interest, there are many careers necessary for the care of just one patient, along with his or her family. A patient scheduled for surgery or coming to a hospital might come in contact with the following: Registration or Admissions Clerk, Social Worker, Accounts Manager, Radiological Technologist, Cardiovascular Technologist, Phlebotomist, Physician Assistant, Licensed Practical Nurse, Nursing Assistant, Nurse Practitioner, Dietitian, Dietary Aide, Recovery Room Nurse, Surgical Intensive Care Unit (SICU) Nurse, Ward Clerk, Environmental Services Technician, Spiritual Care Team Member or Clergy. iv Imagine! Whatever career goals you are contemplating, you can do it within the healthcare industry. Unfortunately, there will always be people that are sick; and fortunately, there will always be people that want to stay healthy. Healthcare is for those who are sick and those who are well. As we move into the 21st century, wellness will play an increasingly important role in healthcare and will bring about additional careers that we have only begun to see. Today you do not have to Imagine! You have been given the opportunity to participate in the Imagine U experience. Rise to the challenge! Make the most of the experience by completing each of the following: Complete the Pre-Op Prep, the teaching/learning guide designed to help you better understand the experience. Review the Career Interviews (Imagine U website), provided for the purpose of introducing you to many of the healthcare careers and professionals that will be seen during the surgical broadcast. Review Brian Williams’ story, related resources on Baby Boomers and the increased incidence of replacement surgery and ethics discussion questions prior to surgical broadcast. View the live surgical broadcast. Participate in the Question & Answer opportunity, with the surgical health care provider/clinical specialist throughout the surgical broadcast. v Introduction To the Teacher The Virtual Healthcare Experience is an extraordinary teaching/learning opportunity. The partnership between education and the healthcare industry allows learning to move beyond the walls of the normal classroom. It transforms the classroom into a real world learning environment. The goals of this experience are to: introduce students to a variety of careers available within health care. generate student excitement and interest in the pursuit of careers within the health care industry. provide an authentic healthcare experience [this has become very difficult due to the Health Insurance Portability and Accountability Act of 1996 (HIPAA)]. demonstrate the necessity for integration of a strong academic and technical foundation. provide a student experience relevant to the elements of 21st Century teaching and learning. raise student achievement. As the classroom teacher, you are of vital importance in the accomplishment of these goals. You are being asked to engage your expertise to maximize student outcomes. The efforts put forth to provide this learning experience will be to no avail without your help. The components of the Virtual Healthcare Experience include the following: Pre-Op Prep, the teaching/learning guide designed to prepare students for the experience. Career Interviews, provided for the purpose of introducing many healthcare careers, specifically those which might be seen during surgery. Brian Williams’ story, related resources on Baby Boomers and the increased incidence of replacement surgery and ethics discussion questions. Surgery broadcast, which will include a live, interactive Question and Answer opportunity for the students. vi The Pre-Op Prep is both a teaching guide and a student workbook for the Imagine U: Virtual Healthcare Experience. In order to enhance learning and prepare students to view the surgery, five units of instruction have been created. Lessons of instruction include the following: Lesson 1: Lesson 2: Lesson 3: Lesson 4: Lesson 5: Arthroscopy and Total Knee Replacement Infection Control: Principles of Disease Transmission and Prevention in Medical and Surgical Asepsis Brian Williams’ story, related resources on Baby Boomers and the increased incidence of replacement surgery and ethics discussion questions Surgical Procedures: Arthroscopies and Total Knee Replacement Recovery: Postoperative Care and Recovery The learning guide is being provided as a resource for the Virtual Healthcare Experience and is to be used at the discretion of the teacher. It may be used in its entirety or the teacher may pick and choose desired activities within the units. There are numerous delivery methods for using the units of instruction including curriculum supplements to current content skill sets and objectives, independent study, homework assignments and collaborative projects. Also, the teacher should feel free to use any other materials necessary to raise student achievement. If you choose to incorporate additional activities, please provide an overview and feedback for future projects. However you choose to use the learning guide/workbook, do not distribute the guide without providing instruction to the students on its use. Units of instruction are standards-based and driven by instructional objectives. Each unit was correlated to the National Health Care Skills Standards in order to provide validity, thereby demonstrating the relationship of instruction to the National Skills Standards established for the Health Science Education Career Cluster. The Virtual Healthcare Experience’s instructional design is that of simple to complex, building on previous learning. It is designed to allow students to gain introductory knowledge of the human body, pathophysiological processes, medical/surgical interventions and recovery. As students’ progress through the learning workbook, questions might arise which are more appropriately addressed by a surgical health care professional/clinical specialist. It is recommended that the questions be recorded on the pages provided within the workbook and that the students bring the workbook, with the recorded questions, to the surgery broadcast. A surgical health care professional/clinical specialist will provide narration throughout the surgical procedure. During the broadcast, students may tweet or email questions to the surgical health care professional/clinical vii specialist. They will attempt to answer as many questions during the broadcast as possible. Consider contacting healthcare professionals from the local healthcare community to participate in the virtual surgery experience. They provide an excellent teaching resource and can address many of your students’ questions on site. On behalf of CAMC and the Health Science Education office of the West Virginia Department of Education, thank you for your participation in this educational opportunity. Throughout this experience, should you have questions that cannot be answered by your local administration, feel free to email Debra Catron, Coordinator of Health Science Education, at [email protected] or Cyndy Sundstrom, Coordinator of Health Science Education, at [email protected]. viii IMAGINE U: A VIRTUAL HEALTHCARE EXPERIENCE Setting Your Goals Goal setting is powerful! Writing your goals help you to make them become a reality. Developing a plan to meet your goals allows you to take control of where you want to go in life. Before beginning your Virtual Healthcare Experience think about your short and long term goals – for the VHE, education, career, and also your longrange goals. Where do you see yourself in 5, 10, 15, and 20 years? Select two goals for each of the areas below. Who Can Help Me Meet My Goals 1._________________________________ 2._________________________________ My Educational Goals 1._________________________________ 2._________________________________ Action Plan 1._________________________________ 2._________________________________ Start Date/End Date 1._________________________________ 2._________________________________ Who Can Help Me Meet My Goals 1._________________________________ 2._________________________________ Goals should be: Written in clear and specific statements. Realistic, achievable and challenging. Measureable, in order to know when you have met your goal. Leading you in the direction you desire. My Career Goals 1._________________________________ 2._________________________________ Action Plan 1._________________________________ 2. _________________________________ Start Date/End Date 1._________________________________ 2._________________________________ Who Can Help Me Meet My Goals 1._________________________________ 2. _________________________________ When setting your goals: Write your goals. Prioritize your goals. Develop an action plan. Decide on when you will take action. Decide on a date you hope to complete your goals. Check your progress regularly. Celebrate your success. My Long-Range Goals 1._________________________________ 2._________________________________ Action Plan 1._________________________________ 2._________________________________ Start Date/End Date My Virtual Healthcare Experience Goals 1. _________________________________ 2._________________________________ Action Plan 1. _________________________________ 2._________________________________ Start Date/End Date 1.______________________________ 2.______________________________ 1.______________________________ 2.______________________________ Who Can Help Me Meet My Goals 1._________________________________ 2._________________________________ You can do it! 1 IMAGINE U: A VIRTUAL HEALTHCARE EXPERIENCE Pre and Post-Learning Activity Know-Wonder-Learn Using the topics listed below and the chart provided, complete sections one and two, prior to beginning the instructional lessons and the last section after completion of the lessons. Arthroscopy and Total Knee Replacement Infection Control: Medical and Surgical Asepsis Case Review and Ethics Discussion Questions Operating Room Personnel and Processes Post-operative Recovery following Surgery *The chart may be completed individually, by each student or by the class as a whole. What do you know about the topics? What do you want to know about the topics? What did you learn about the topics and would still like to learn about the topics? 2 Surgical Procedures: Arthroscopy Total Knee Replacement Instructional Lessons 3 IMAGINE U: A VIRTUAL HEALTHCARE EXPERIENCE Lesson 1 Skeletal System Overview: The study of anatomy and physiology means the study of the structures and function of the human body. By reviewing the skeletal system, you will be more prepared for viewing the surgical procedure. Unit Standard: National Health Care Skill Standards: http://www.nchste.org Standard 1: Academic Foundation Accountability Criteria: 1.1 Human Structure and Function Lesson Objectives: Upon completion of this lesson, students will be able to identify the structure and function of the skeletal system. examine the changes in the skeletal system associated with aging. describe the treatment options for bone and joint disease/injury. Teaching/Learning Guide: Visit the following online site to meet lesson objectives: http://highered.mcgrawhill.com/sites/dl/free/0073378267/955183/see78267Chapter06.pdf Read the selection and outline the function of the skeletal system Examples of Assessments (to be used at the discretion of the teacher): Products*: Report – summary of knowledge gained on the urinary system. Essay – guest column for local newspaper on any topic within the lesson Poster – any topic within the lesson Performances*: Presentation – on any topic within the lesson Written and Oral Tests/Quizzes: Tests and Quizzes – on acquisition and comprehension of basic knowledge (i.e. vocabulary, structure, function, etc.) The following website has a variety of assessment tools and includes a rubric for each tool: http://www.hosa.org/node/117 See page 20-25 of this guide for sample rubrics. 4 IMAGINE U: A VIRTUAL HEALTHCARE EXPERIENCE Lesson 2 Infection Control: Principles of Disease Transmission and Prevention in Medical and Surgical Asepsis Overview: An essential component of a successful surgical procedure is infection control. The activities within this lesson are designed to familiarize the student with the principles of disease transmission and prevention and their role in medical/surgical asepsis. Unit Standards: National Health Care Skill Standards: http://www.nchste.org Standard 7: Safety Practices Accountability Criteria: 7.1 Infection Control 7.2 Personal Safety 7.3 Environmental Safety 7.4 Common Safety Hazards Lesson Objectives: Upon completion of this lesson, students will be able to describe Standard Precautions. define biohazard and recognize the symbol indicating the presence of biohazardous materials. compare and contrast medical and surgical asepsis. identify appropriate personal protective equipment required for surgery. define general terminology related to infection control. Teaching/Learning Guide: Objective 1 Using the following online site, define Standard Precautions. http://www.cdc.gov/ncidod/dhqp/gl_surgicalsite.html Optional Activities: http://www.cdc.gov/ncidod/dhqp/gl_surgicalsite.html Create a Power Point or Prezi presentation describing the Standard Precautions required for surgery. http://www.cdc.gov/handhygiene/ Create a poster on hand hygiene using the CDC’s Fact Sheet found at the website. 5 Objective 2 Use the online resources below to respond to the statement or question presented. http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=biohazard Define Biohazard. http://en.wikipedia.org/wiki/Biological_hazard Identify the Biohazard symbol. http://www.osha.gov/SLTC/etools/hospital/surgical/surgical.html Using the virtual reality tour on OSHA’s website, identify Biohazard symbols and create a Fact Sheet describing the Bloodborne Pathogens Standard. Objective 3 Create a table comparing/contrasting medical and surgical asepsis using the following online resources. http://en.wikipedia.org/wiki/Sterile_technique http://wiki.answers.com/Q/How_are_medical_asepsis_and_surgical_asepsis_different Objective 4 Using the online resources provided, list the personal protective equipment (PPE) used in surgery. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_i d=10051#1910.1030(d)(3)(i) (See Provision) http://www.reproline.jhu.edu/english/4morerh/4ip/IP_manual/05_PPE.pdf http://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact03.pdf Using the surgical suite on the Occupational Safety and Health Administration (OSHA) website, examine the set-up in a surgical suite. http://www.osha.gov/SLTC/etools/hospital/surgical/surgical.html After watching the video, AORN Hand Hygiene – Surgical Scrub for the OR, write a paragraph in which you describe the surgical scrub process. Objective 5 Use the web resources presented thus far in the curriculum and the additional websites listed below to define the following terminology: Asepsis Medical Asepsis Surgical Asepsis Sterile Field Pathogen Infection Control Disinfection Sterilization Antisepsis Sterile Technique Standard Precautions Personal Protective Equipment Biohazard Nosocomial infection 6 Medline Plus – http://www.nlm.nih.gov/medlineplus/mplusdictionary.html http://www.nlm.nih.gov/medlineplus/infectioncontrol.html Wikipedia – http://en.wikipedia.org/wiki/Infection_control Examples of Assessments (to be used at the discretion of the teacher): Products*: Report – summary of knowledge gained, such as Surgical Asepsis Essay – guest column for local newspaper on any topic within the lesson Pamphlet/Brochure – on any topic within the lesson Poster – any topic within the lesson, such as personal protective equipment Power Point – any topic within the lesson Performances*: Presentation – persuasive proposal on any topic within the lesson, such as the promotion and positive outcomes of proper handwashing Creative Performance – skit, such as healthcare professional teaching the surgical scrub Simulation – mock trial, using aspects medical and surgical asepsis as related to a healthcare professional that did not use proper procedures Interview – using elements within the lesson taking on human persona, such as the pathogen Written and Oral Tests/Quizzes: Tests and Quizzes – on acquisition and comprehension of basic knowledge (i.e. vocabulary, structure, function, etc.). The following website has a variety of assessment tools and includes a rubric for each tool: http://www.hosa.org/natorg/pub.html HOSA Handbook: Section B Competitive Events (use topics from the lesson). See page 20-25 of this guide for sample rubrics. 7 Lesson 3 Case Review/WebQuest Unit Standards: National Health Care Skill Standards: http://www.nchste.org Standard 6: Ethics Accountability Criteria: 6.1 Ethical Boundaries 6.2 Ethical Practice Lesson Objectives: Upon completion of this lesson, students will be able to: discuss the trend of increasing incidence of knee replacement surgery among Baby Boomers. discuss ethical issues surrounding replacement surgeries. Learning/Instructional Strategies: WebQuest Overview: NBC Nightly News Anchor, Brian Williams, underwent knee replacement surgery in August, 2013. He chose to have the surgery to relieve chronic pain. In his words, “This operation, my fourth surgery on the same knee, was 35 years in the making. It dates back to a hit I suffered in practice during high school football…” With this decision, he joined a growing number of Baby Boomers who have elected to undergo this procedure. His surgery has focused increasing attention on this trend. Go to the following websites to see Brian Williams’ story: http://www.nbcnews.com/video/nightly-news/52748856#52748856 http://dailynightly.nbcnews.com/_news/2013/08/16/20055492-brian-williams-on-kneereplacement-and-why-he-has-disappeared-from-tv-for-a-while?lite http://dailynightly.nbcnews.com/_news/2013/08/01/19820894-brian-williams-joins-risingnumbers-of-boomers-getting-new-knees?lite According to a government report released in the September 12 issue of the Journal of the American Medical Association, the number of knee replacement surgeries has risen dramatically. The report also found that people are getting knee surgery at younger and younger ages. See related articles: As Baby Boomers Age, Knee Replacement Surgery Numbers Soar Knee replacements on the increase among older adults 8 Research factors that have been suggested to account for 161.5% increase over the last two decades: genetics o “The best way to know how your knees are going to do is to look at your parents and grandparents,” says Dr. Richard McGough, an associate professor in the department of orthopedic surgery at the University of Pittsburgh Medical Center. “You can’t change your genes but there are some things you can modify, like maintaining a healthy weight, remaining flexible and getting exercise.” technology improvements (biomechanics) aging population obesity rates sedentary lifestyle less invasive techniques shortened recovery periods last resort for pain relief re-dos (replacing worn-out artificial joints) View online Chat with Dr. David Mayman from Hospital for Special Surgery (New York City) Dr. Mayman answers questions about knee replacement surgery Additional articles linking Baby Boomers and the growth of orthopedic surgeries Knee replacements – new rite of passage for boomers Baby boomers fueling boom in knee, hip surgeries Baby Boomers' demand, expectations for new knees soar Surge in Total Knee Replacements for Boomer Women See related video @ http://bonesmart.org/forum/threads/video-surge-intotal-knee-replacements-for-boomer-women.12691/ Knee surgeries double as hospital stays drop, readmissions rise Using the guidelines for HOSA’s Prepared Speaking competitive event (http://www.hosa.org/sites/default/files/PS13.pdf), have students write an informative speech on the relationship between an aging population and the increased incidence of total knee replacement surgery. 9 Ethics Questions (for discussion) Note: The surgeon, Dr. Rosenstein, will address these questions at the end of the broadcast. Do you believe that joint replacement surgery should be available to everyone? Do you believe that an individual “on Welfare” (receiving Medicaid – a U.S. federal health insurance program for families and individuals with low income and resources) should be eligible for replacement surgery? Do you believe that inactive, grossly overweight individuals should be eligible for a replacement procedure? Do you believe that an elderly individual, receiving Medicare (U.S. federal health insurance program available for persons over 65 years of age regardless of income level) should be eligible for replacement surgery? o What if the elderly individual, receiving Medicare, was your grandparent? Do you think patients should qualify for a second or third replacement procedure? 10 IMAGINE U: A VIRTUAL HEALTHCARE EXPERIENCE Lesson 4 Surgical Procedure: Arthroscopy and Total Knee Replacement Overview: The surgical procedures you will view, during the Imagine U: A Virtual Healthcare Experience broadcast, are Arthroscopy and Total Knee Replacement (performed at Charleston Area Medical Center). National Standards: National Health Care Skill Standards: http://www.nchste.org Standard 1: Academic Foundation Accountability Criteria: 1.1 Human Structures and Functions 1.2 Diseases and Disorders Standard 3: Systems Accountability Criteria: 3.1 Healthcare Delivery Systems Standard 8: Teamwork Accountability Criteria: 8.1 Healthcare Teams Lesson Objectives: Upon completion of this lesson, students will be able to describe the following: arthroscopy total knee replacement WebQuest Assignments For background information on these procedures see the following: American Academy of Orthopedic Surgeons’ discussion of Knee Arthroscopy Related resources on Arthroscopy and Total Knee Replacement: Arthroscopy Total Knee Replacement Knee Replacement 11 Examples of Assessments (to be used at the discretion of the teacher): Products*: Report – summary of knowledge gained on any topic within the lesson such as Patient Recovery Essay – guest column for local newspaper on any topic within the lesson Pamphlet/Brochure – on any topic within the lesson Poster – any topic within the lesson Power Point – any topic within the lesson Performances*: Creative Performance – skit, such as healthcare professional preparing a patient as to what to expect after surgery Interview – a patient regarding his/her preparation pre and post-surgery Written and Oral Tests/Quizzes: Tests and Quizzes – on acquisition and comprehension of basic knowledge (i.e. vocabulary, structure, function, etc.) The following website has a variety of assessment tools and includes a rubric for each tool: http://www.hosa.org/node/117 See page 20-25 of this guide for sample rubrics. 12 IMAGINE U: A VIRTUAL HEALTHCARE EXPERIENCE Lesson 5 Recovery: Postoperative Care and Recovery Overview: An essential component of a successful surgical procedure is appropriate postoperative care. That care often begins in an Intensive Care Unit (ICU). The following learning activities are designed to familiarize the student with the set up in an ICU and the patient’s recovery process. Unit Standards: National Health Care Skill Standards: http://www.nchste.org Standard 1: Academic Foundation Accountability Criteria: 1.1 Human Structures and Function 1.2 Diseases and Disorders Standard 5: Legal Responsibilities Accountability Criteria: 5.1 Legal Implications 5.2 Legal Practices Standard 6: Ethics Accountability Criteria: 6.1 Ethical Boundaries 6.2 Ethical Practice Standard 7: Safety Practices Accountability Criteria: 7.1 Infection Control Standard 9: Health Maintenance Practices Accountability Criteria: 9.1 Healthy Behaviors Lesson Objectives: Upon completion of this lesson, students will be able to: describe an Intensive Care Unit. describe the postoperative care and recovery process for a patient having a total knee replacement. Learning/Instructional Guide: Objectives 1 and 2 Go to the following web site: http://www.surgeryencyclopedia.com/Pa-St/Recovery-Room.html Scroll down the page and read the definition/description of a PACU. After reading the information presented, write a paragraph describing what a PACU is. 13 Go to the following web page: www.waiting.com/waitingicu.html Click on Equipment found in an ICU o Select each of the following to read the definitions of equipment commonly seen in an ICU: Arterial Line Central Venous Pressure (CVP) Line Electrocardiogram (ECG/EKG) Intravenous Monitor, Intensive Care Nasogastric Tube (NG Tube) Respirator/Ventilator Subarachnoid Screw Tracheostomy Tube Click on “A guide to the medical personnel and their roles in providing care for your loved one.” o Review the medical personnel a patient might encounter while in the Intensive Care Unit. Examples of Assessments (to be used at the discretion of the teacher): Products*: Report – summary of knowledge gained on any topic within the lesson such as Patient Recovery Essay – guest column for local newspaper on any topic within the lesson Pamphlet/Brochure – on any topic within the lesson Poster – any topic within the lesson Power Point – any topic within the lesson Performances*: Creative Performance – skit, such as healthcare professional preparing a patient as to what to expect after surgery Interview – a patient regarding his/her preparation pre and post surgery Written and Oral Tests/Quizzes: Tests and Quizzes – on acquisition and comprehension of basic knowledge (i.e. vocabulary, structure, function, etc.) The following website has a variety of assessment tools and includes a rubric for each tool: http://www.hosa.org/node/117 See page 20-25 of this guide for sample rubrics. 14 REFLECTIONS Prior to the Surgery Expectations: What do you expect to see and how do you expect to respond to seeing the surgery? _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Are you currently interested in a career in healthcare? If so, what are your career goals and where do you want to work? What do you think your job will be like? _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 15 REFLECTIONS During the Surgery Broadcast Using the space below, record your reactions to the surgery. _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Using the space below, record any questions you have for the surgeon. Question__________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Answer___________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Question__________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 16 Answer___________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Question__________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Answer___________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Question__________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Answer___________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 17 REFLECTIONS Post (after) Surgery Looking back at your expectations for the surgery, were they accurate? How different were your expectations from the actual surgical experience? _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ After viewing the surgery, has your interest in a healthcare career changed? Would you like to work in the operating room? _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ What are your impressions of the healthcare careers found within the operating room? _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ What are your thoughts on the Virtual Healthcare Experience you have just completed? _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 18 FOLLOW-UP Healthcare Professional Representative or Guest Speaker Name of speaker: ___________________________________________________ Place of employment: _______________________________________________ Topic (guest speaker): _______________________________________________ Five facts you learned from the healthcare professional or guest speaker: 1. _______________________________________________________________ 2. _______________________________________________________________ 3. _______________________________________________________________ 4. _______________________________________________________________ 5. _______________________________________________________________ Write a paragraph summarizing your thoughts and feelings after listening to the speaker. Use statements such as “I believe”, “I agree/disagree” or “This will help me.” __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ 19 ORAL PRESENTATION RUBRIC Teacher Name: ________________________________________________________________________ Student Name: ________________________________________________________________________ Date: ________________________________________________________________________ 4 Excellent 3 Good Enthusiasm Facial expressions and body language generate a strong audience interest and enthusiasm about the topic. Posture and Eye Contact Stands up straight; looks relaxed and confident. Establishes eye contact with everyone in the room during the presentation. Volume is loud enough to be heard by all audience members throughout the presentation. Student is completely prepared and has obviously rehearsed. Speaks clearly and distinctly all (100-95%) of the time and mispronounces no words. Uses vocabulary appropriate for the audience. Extends audience vocabulary by defining words that might be new to most of audience. Shows a full understanding of the topic. Facial expressions and body language sometimes generate a strong audience interest and enthusiasm about the topic. Stands up straight and establishes eye contact with everyone in the room during the presentation. CATEGORY Volume Preparedness Speaks Clearly Vocabulary Content Comprehension Listens to Other Presentations Time Limit 2 Needs Some Improvement Facial expressions and body language are used to try to generate enthusiasm, but seem somewhat faked. 1 Needs Much Improvement Very little use of facial expressions or body language. Does not generate much interest in topic being presented. Sometimes stands up straight and establishes eye contact. Slouches and/or does not look at people during the presentation. Volume is loud enough to be heard by all audience members at least 90% of the time. Student seems pretty prepared but might have needed more rehearsals. Speaks clearly and distinctly all (100-95%) of the time, but mispronounces one word. Uses vocabulary appropriate for the audience. Includes 1-2 words that might be new to most of the audience, but does not define them. Volume is loud enough to be heard by all audience members at least 80% of the time. The student is somewhat prepared, but it is clear that rehearsal is lacking. Speaks clearly and distinctly most (94-85%) of the time. Mispronounces no more than one word. Uses vocabulary appropriate for the audience. Does not include any vocabulary that might be new to the audience. Volume is often too soft to be heard by all audience members. Shows a good understanding of the topic. Does not seem to understand the topic very well. Student is unable to accurately answer questions posed by classmates about the topic. Sometimes does not appear to be listening and has distracting noises or movements. Presentation is less than 3 minutes OR more than 6 minutes. Student is able to accurately answer all questions posed by classmates about the topic. Listens intently. Does not make distracting noises or movements. Student is able to accurately answer most questions posed by classmates about the topic. Listens intently but has one distracting noise or movement. Shows a good understanding of parts of the topic. Student is able to accurately answer a few questions posed by classmates about the topic. Sometimes does not appear to be listening but is not distracting. Presentation is 5-6 minutes. Presentation is 4 minutes. Presentation is 3 minutes. Student does not seem at all prepared to present. Often mumbles or cannot be understood OR mispronounces more than one word. Uses several (5 or more) words or phrases that are not understood by the audience. Scale: 31-40 21-30 11-20 1-10 0 A – Excellent B – Good C – Needs Some Improvement D – Needs Much Improvement F Total = _______________________ Comments and/or bonus points: _____________________________________________________________________________________________ _____________________________________________________________________________________________ 20 ORAL PRESENTATION (Speech) RUBRIC Teacher Name: __________________________________________________________ Student Name: __________________________________________________________ Group: __________________________________________________________ Date: __________________________________________________________ Scoring Criteria 4 Excellent 3 Good 2 Needs Some Improvement 1 Needs Much Improvement N/A Clearly and effectively communicates the main idea or theme. Presenter is self-confident and clearly expresses ideas. Presenter answers questions with well thought out responses. Holds audience attention and maintains eye contact. Visual aids are clear and add to the presentation. NOTE: N/A represents a response to the performance which is “not appropriate.” Scale: 16-20 11-15 6-10 1-5 0 A – Excellent B – Good C – Needs Some Improvement D – Needs Much Improvement F Total = _______________________ Comments and/or bonus points: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ See Informative Speech Rubric: http://www.lausd.k12.ca.us/District_8/options/cd/speech-rubric.pdf 21 POWERPOINT RUBRIC Teacher Name: ______________________________________________________________________ Student Name: ______________________________________________________________________ Date: ______________________________________________________________________ CATEGORY Background Use of Graphics Text - Font Choice and Formatting Content -Accuracy Spelling and Grammar Sequencing of Information 4 Excellent 3 Good Background does not detract from text or other graphics. Choice of background is consistent from card to card and is appropriate for the topic. All graphics are attractive (size and colors) and support the theme/content of the presentation. Font formats (e.g., color, bold, italics) have been carefully planned to enhance readability and content. All content throughout the presentation is accurate. There are no factual errors. Background does not detract from text or other graphics. Choice of background is consistent from card to card. Presentation has no misspellings or grammatical errors. Information is organized in a clear, logical way. It is easy to anticipate the type of material that might be on the next card. A few graphics are not attractive, but all support the theme/content of the presentation. Font formats have been carefully planned to enhance readability. Most of the content is accurate, but there is one piece of information that might be inaccurate. Presentation has 1-2 misspellings but no grammatical errors. Most information is organized in a clear logical way. One card or item of information seems out of place. 2 Needs Some Improvement Background does not detract from text or other graphics. 1 Needs Much Improvement Background makes it difficult to see text or competes with other graphics on the page. All graphics are attractive, but a few do not seem to support the theme/content of the presentation. Font formatting has been carefully planned to complement the content. It may be a little hard to read. The content is generally accurate, but one piece of information is clearly flawed or inaccurate. Presentation has 1-2 grammatical errors but no misspellings. Some information is logically sequenced. An occasional card or item of information seems out of place. Several graphics are unattractive AND detract from content of the presentation. Font formatting makes it very difficult to read the material. Content is typically confusing or contains more than one factual error. Presentation has more than 2 grammatical and/or spelling errors. There is no clear plan for the organization of information. Scale: 19-24 13-18 7-12 1-6 0 A – Excellent B – Good C – Needs Some Improvement D – Needs Much Improvement F Total = _____________________ Comments and/or bonus points ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ 22 POWERPOINT RUBRIC Teacher Name: __________________________________________________________ Student Name: __________________________________________________________ Date: __________________________________________________________ 4 Excellent 3 Good Presentation Well-rehearsed with smooth delivery that holds audience attention. Requirements All requirements are met and exceeded. Rehearsed with fairly smooth delivery that holds audience attention most of the time. All requirements are met. Content Covers topic indepth with details and examples. Subject knowledge is excellent. Attractiveness Makes excellent use of font, color, graphics, effects, etc., to enhance the presentation. CATEGORY Includes essential knowledge about the topic. Subject knowledge appears to be good. Makes good use of font, color, graphics, effects, etc., to enhance the presentation. 2 Needs Some Improvement Delivery not smooth, but able to maintain interest of the audience most of the time. One requirement was not completely met. Includes essential information about the topic but there are 1-2 factual errors. Makes use of font, color, graphics, effects, etc., but occasionally these detract from the presentation content. 1 Needs Much Improvement Delivery not smooth and audience attention often lost. More than one requirement was not completely met. Content is minimal OR there are several factual errors. Use of font, color, graphics, effects. etc., but these often detract from the presentation content. Scale: 13-16 9-12 5-8 1-4 0 A – Excellent B – Good C – Needs Some Improvement D – Needs Much Improvement F Total = _____________________ Comments and/or bonus points _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 23 Student Name ______________________________________________ Date _____________ BROCHURE RUBRIC Circle the number that describes the best presentation or most pleasing to your point of view. ATTRACTIVENESS AND EYE APPEAL GRAPHICSPICTURES ORGANIZED AND NEAT CONTENTACCURATE SPELLING WRITING Scale: 19-24 13-18 7-12 1-6 0 4 3 2 1 Exceptionally attractive formatting. Attractive formatting. Average formatting. Confusing formatting. 4 3 2 1 Graphics go well with text and good mix of text and pictures. Graphics go well with text but so many that they distract. Graphics go well, but not enough. Brochure is text heavy. Graphics do not go with text or no graphics. 4 3 2 1 Well organized, typed or exceptional hand writing and neat. Well organized; hand written and neat. Organized. Messy and confusing. 4 3 2 1 All facts are accurate. 90-99% of the facts are accurate. 80-89% of the facts are accurate. Fewer than 80% of the facts are accurate. 4 3 2 1 No spelling errors. No more than one spelling error. No more than three spelling errors. Several spelling errors. 4 3 2 1 Each section is clear, defined, and well explained. Almost all sections are clear, defined, and well explained. Most sections have a clear explanation. Less than half the sections are clear. A – Excellent B – Good C – Needs some improvement D – Needs much improvement F Total = _______________ Comments and/or bonus points: ____________________________________________________________________________ ____________________________________________________________________________ 24 POSTER/TABLE/FACT SHEET RUBRIC Teacher Name: ______________________________________________________________________ Student Name: ______________________________________________________________________ Date: ______________________________________________________________________ CATEGORY Required Elements Attractiveness Content – Accuracy Graphics – Originality Graphics – Relevance Grammar 4 Excellent The poster includes all required elements as well as additional information. The poster is exceptionally attractive in terms of design, layout, and neatness. At least 7 accurate facts are displayed on the poster. Several of the graphics used on the poster reflect an exceptional degree of student creativity in their creation and/or display. All graphics are related to the topic and make it easier to understand. All borrowed graphics have a source citation. There are no grammatical mistakes on the poster. 3 Good All required elements are included on the poster. The poster is attractive in terms of design, layout, and neatness. 5-6 accurate facts are displayed on the poster. One or two of the graphics used on the poster reflect student creativity in their creation and/or display. All graphics are related to the topic and most make it easier to understand. All borrowed graphics have a source citation. There is 1 grammatical mistake on the poster. 2 Needs Some Improvement All but 1 of the required elements are included on the poster. 1 Needs Much Improvement Several required elements were missing. The poster is acceptably attractive though it may be a bit messy. 3-4 accurate facts are displayed on the poster. The graphics are made by the student but are based on the designs or ideas of others. The poster is distracting, messy, or very poorly designed. It is not attractive. Less than 3 accurate facts are displayed on the poster. No graphics made by the student are included. All graphics relate to the topic. Most borrowed graphics have a source citation. Graphics do not relate to the topic, OR several borrowed graphics do not have a source citation. There are 2 grammatical mistakes on the poster. There are more than 2 grammatical mistakes on the poster. Scale: 19-24 13-18 7-12 1-6 0 A – Excellent B – Good C – Needs Some Improvement D – Needs Much Improvement F Total = _____________________ Comments and/or bonus points – _______________________ 25 2013 Virtual Healthcare Experience 21st Century Learning Skills and Technology Tools are embedded within the Virtual Healthcare Experience Project Strategies and Culminating Activities Students’ Evidences of Success INFORMATION AND COMMUNICATION SKILLS 21st Century Skills Learning Skills INFORMATION AND MEDIA LITERACY The understanding of how words, images and sound influence the way meanings are created, shared and analyzed in a contemporary society so that a person can assign value, worth and meaning to information through a variety of media forms. VISUAL LITERACY The ability to interpret, use, appreciate, and create images and video using both conventional and 21st Century media in ways that advance thinking, decision-making, communication and learning. COMMUNICATION SKILLS The skills needed to generate and convey messages with meaning and understanding within and across various contexts, cultures and media. Learning Skills & Technology Tools Strategies and Culminating Evidence of Success Activities 21C.O.9-12.1.LS.1 Student recognizes information Career Interviews: needed for problem solving, can Students use a 21st Students will visit the efficiently browse, search and Century modality to gather CAMC website and navigate online to access relevant access/view the career and interpret information information, evaluates information interviews. on careers. based on credibility, social, Students analyze and economic, political and/or ethical interpret career information issues, and presents findings for personal problem clearly and persuasively using a solving and career decision range of technology tools and making. media. 21C.O.9-12.1.LS.2 Student analyzes and interprets visuals and recognizes the impact 26 Technology Tools 21C.O.9-12.1.TT.2 21C.O.9-12.1.TT.8 21C.O.912.1.TT.10 digital media influences (e.g. design, technique, and rate of speed) have on audiences. The student’s visual products reflect a sophisticated understanding of subject, digital media and design techniques. Student routinely applies keyboarding skills, keyboard shortcut techniques, and mouse skills with facility, speed and accuracy. Student uses advanced features and utilities of database software (e.g., to create tables, forms, perform table relationships, advanced queries, and simple reports) to test hypotheses or research questions and to report results. Student implements various internet search techniques (e.g., Boolean searches, meta-searches, web bots) to gather information; student evaluates the information for validity, appropriateness, content, bias, currency, and usefulness. Pre-Op Prep: Instructional Lessons: Student learning is independent and guided by lesson objectives. Students select from multiple learning activities, allowing an analysis and interpretation of media in the accomplishment of learning objectives. Students must browse, search, and navigate online to access information relevant to the objectives. Students are required to evaluate information based on multifaceted criteria (i.e. credibility, validity, bias, currency, usefulness, ethical issues, media) in order to draw conclusions regarding the care of the patient requiring a knee replacement. Accomplishment of lesson objectives requires students to use the Internet to research and gather information. Surgery Broadcast with Interactive Communication: Students recognize the impact of digital media as seen in the interactive presentation. 27 Students will complete each instructional lesson either independently or collaboratively with peers. Students will demonstrate active engagement in the use of technology to master learning objectives. Students will communicate learning to their teacher and peers. Students will view the surgery broadcast and have an opportunity to communicate with the surgical health care professional/clinical THINKING, REASONING AND INNOVATION SKILLS 21st Century Skills Learning Skills Students are digitally connected to the hospital and surgical environment. Students utilize technology to communicate and question the healthcare professional/clinical specialist who resides in their own community or region. Students visualize careers in action, within the world of work. specialist as a means for learning (if possible). *After surgical broadcast, the video will be archived and available for viewing for instructors who cannot participate on the scheduled date. CRITICAL THINKING The clear, precise and purposeful process of using specific cognitive skills and strategies to guide belief and action in accomplishing goals. SYSTEMS THINKING The ability to see and understand the whole, to recognize patterns and interrelationships of parts, and to determine how to structure those interrelationships in more effective, efficient ways. PROBLEM SOLVING The ability to apply appropriate process, including problem identification, information gathering, problem analysis, generating and testing alternated solutions, and evaluating results in order to generate resolutions to problems. CREATING AND INNOVATING The act of bringing an idea, product or performance into existence that is genuinely new, original and of value either personally and/or culturally. Learning Skills & Technology Tools Strategies and Culminating Evidence of Success Activities 21C.O.9-12.2.LS.1 Student engages in a critical Career Interviews: thinking process that supports Students will hear real-world Students will view the synthesis and conducts evaluation career interviews, as part applications of careers using complex criteria. of the Virtual Healthcare involved in the care of a Experience and patient having a knee communicate their 21C.O.9-12.2.LS.2 Student draws conclusions from a replacement. impressions of the surgical variety of data sources to analyze By seeing multiple careers process and team. and interpret systems. necessary in the care of one 28 21C.O.9-12.2.LS.3 Technology Tools 21C.O.9-12.2.TT.2 21C.O.9-12.2.TT.3 21C.O.9-12.2.TT.4 Student engages in a problem solving process by formulating questions and applying complex strategies in order to independently solve problems. patient, students are introduced to the interrelationship of parts to the whole/systems thinking. Pre-op Prep: In the accomplishment of the Student collaborates with peers, learning objectives, students experts and others to contribute to must engage in critical a content-related knowledge base thinking to synthesize and by using technology to compile, evaluate information synthesize, produce, and regarding all facets of care, disseminate information, models, for a patient undergoing a and other creative works. knee replacement. Student uses multiple electronic Students must use a variety sources of information and of digital media to draw multiple technology tools and conclusions regarding the resources tools (e.g., digital pathophysiology of joint cameras, graphing calculators, disease and surgical probes, MP3 players, handheld intervention via replacement. devices, other emerging Students will use technology technologies, simulations, models, to increase content-related browsers, word processing, knowledge, both authoring tools, spreadsheets, collaboratively with peers databases) to collaborate with and independently, as others, to formulate a hypothesis, directed by the teacher. to solve problems, make decisions, Students must use multiple and present and justify the electronic sources to satisfy solutions. learning objectives and Student uses technology tools and analyze and draw multiple media sources to analyze conclusions on patient care a real-world problem, design and (real-world) procedures and implement a process to assess the processes. information, and chart and evaluate progress toward the solution. 29 Students articulate systems thinking in relationship to the healthcare industry and patient care, as demonstrated in the accomplishment of learning objectives and activities. 30 Pre and Post-Learning Activity – KWL: Students will be guided in a selfassessment of learning. Students document selfassessment of learning using the KWL learning activity. Culminating Assessment: Students must utilize all knowledge and skills gained from participation in the Virtual Healthcare Experience by developing a comprehensive list of roles and responsibilities, as he/she assumes the role of one of the healthcare team members caring for the patient during the illness and surgical procedure. Students apply learning in a culminating assessment by assuming the role of one of the healthcare team members caring for the patient during the illness and surgical procedure. Live Surgery Broadcast with Interactive Communication: Students experience firsthand problem identification, information gathering, problem analysis, alternated solutions, and the evaluation of results in order to generate resolutions to problems as seen in patient care and the surgical procedure. Students view the results of 21st century medical technology as both creative and innovative to improve patient care. Being part of the surgical team by virtual means, Reflections: Students document the personal impact made by their participation in the Virtual Healthcare Experience by recording their expectations and post-experience reflections. students engage in critical thinking, systems thinking and problem solving as if they were actually part of the surgical team. PERSONAL AND WORKPLACE PRODUCTIVITY SKILLS 21st Century Skills Learning Skills INTERPERSONAL AND COLLABORATION SKILLS The ability to read and to manage the emotions, motivations and behaviors of oneself and others during social interactions or in a social-interactive context. Collaboration means cooperative interaction between two or more individuals working together to solve problems, create novel products, or learn and master content. INITIATIVE AND SELF-DIRECTION The ability to set goals, plan for achievement, initiate action, manage time and effort, and independently monitor and assess one’s own effort. FLEXIBILITY AND ADAPTABILITY The ability to modify one’s thinking, attitudes or behaviors to be better suited to current or future environments, as well as the ability to handle multiple goals, tasks and inputs with understanding and adhering to constraints of time, resources and systems. ETHICAL BEHAVIOR The ability to act with integrity according to the principles or right and/or moral conduct. SOCIAL/PERSONAL AND CROSS-CULTURAL SKILL The acceptance of responsibility for personal actions, including responsibility for learning, and to initiate or support actions that resolve issues in the interest of the common good. LEADERSHIP AND RESPONSIBILITY The process of influence or example by which an individual induces a group to pursue objectives held by the leader or shared by the leader and his or her followers. PROJECT PLANNING AND DEVELOPMENT The ability to organize and achieve the goals of a specific initiative or problem with efficiency and effectiveness. PRODUCTIVITY AND ACCOUNTABILITY The ability to set and meet high standards for delivery of quality work on time and to demonstrate diligence and a positive work ethic. Learning Skills & Technology Tools Strategies and Culminating Evidence of Success Activities 21C.O.9-12.3.LS.3 Student demonstrates ownership Students must demonstrate Career Interviews: of his/her learning by setting personal and workplace Students will see and hear goals, monitoring and adjusting productivity skills in order professionals within the performance, extending learning, to complete all learning healthcare industry as using what he/she has learned to expectations of the Virtual leaders in various careeradapt to new situations, and Healthcare Experience. 31 21C.O.9-12.3.LS.6 Technology Tools 21C.O.9-12.3.TT.2 21C.O.9-12.3.TT.3 displaying perseverance and commitment to continued learning. Student maintains a strong focus on the larger project goal and frames appropriate questions and planning processes around goal. Prior to beginning work, student reflects upon possible courses of action and their likely consequences; sets objectives related to the larger goal; and establishes benchmarks for monitoring progress. While working on the project, student adjusts time and resources to allow for completion of a quality product. Student works collaboratively to acquire information from electronic resources, conducts online research, and evaluates information as to validity, appropriateness, usefulness, comprehensiveness and bias. Student evaluates current trends in information technology, discusses the potential social, ethical, political, and economic impact of these technologies, and analyzes the advantages and disadvantages of widespread use and reliance on technology in the workplace and society. 32 related roles. Students will hear real-world references to working collaboratively on a healthcare team. Pre-op Prep: Students, engaging in the instructional lessons as independent learners, must demonstrate ownership of learning by monitoring and adapting until learning is achieved. Students use technology (i.e. electronic resources, online research) to achieve learning. Students are able to visualize and comprehend the use of technology in the healthcare industry. In the accomplishment of lesson objectives, students use technology to address the limits in their own knowledge in the area of medical technology and healthcare. Setting Your Goals: Students review the processes of writing and 21C.O.9-12.3.TT.6 21C.O.9-12.3.TT.8 Student evaluates and applies technology tools for research, information analysis, problem solving, content learning, decision making, and lifelong learning. Student uses technology to seek strategies and information to address limits in their own knowledge. setting goals. Students set goals in the areas of the VHE, education, careers and long-range goals. Students’ use of technology within the Virtual Healthcare Experience will positively impact future use of technology for decision making and lifelong learning. By goal setting, students engage in the role of planning for achievement, self-initiation of action, managing personal time and efforts, and independently monitoring and assessing their own path toward achievement of personal goals. Students apply personal and workplace productivity skills as they systematically document personal, educational and career goals using the worksheet provided in the Pre-op Prep Guide. Live Surgery Broadcast with Interactive Communication: Students will view interpersonal and collaboration skills of the surgical team, initiative and self-direction of team members to accomplish each task necessary for a successful surgery, ethical behavior, the transplantation process and procedures performed by each team member and productivity Students will view the live surgery broadcast and communicate with the surgical health care professional/clinical specialist, seeing professional and workplace productivity skills firsthand. 33 and accountability in action, as the surgical team orchestrates the surgical procedure and care of the patient. In viewing the live broadcast, students are choosing to use technology to increase their learning and the limits in their personal knowledge base. Students will participate in real-world learning as each component of the Virtual Healthcare Experience demonstrates the importance of 21st century Learning Skills. 21st Century Content Standards, Learning Skills and Technology Tools for WV Schools Standards and Objectives selected from the West Virginia Department of Education’s 21 st Century Learning Skills and Technology Tools – Teach 21 34 IMAGINE U: A VIRTUAL HEALTHCARE EXPERIENCE ACKNOWLEDGMENTS “Charleston Area Medical Center is pleased to work with the West Virginia Department of Education to plan the Imagine U Virtual Healthcare Experience and to provide the surgery footage, career interviews, patient education information and technology support for the program.” Charleston Area Medical Center “The Virtual Healthcare Experience is an extraordinary teaching/learning opportunity for the students within West Virginia’s schools. The partnership between the West Virginia Department of Education and Charleston Area Medical Center allows learning to move beyond the walls of the normal classroom. It transforms the classroom into a real world learning environment. Health Science Education, within the Office of Career and Technical Instruction, is extremely pleased to partner with Charleston Area Medical Center on this innovative project. Over 1,800 secondary and adult students participated in the Virtual Healthcare Experience last year.” West Virginia Department of Education 35 NOTES 36 NOTES 37
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