The Dynamics and Challenges of Different Forms of Relationship in Therapy

by Herman Bailey | Jun 21, 2023 | Essays

Introduction

The relationship between the client and the counsellor is an elusive and mystical sometimes, debated frequently and is always a psychotherapy enterprise aspect that is interesting. Gelso & Carter (1985, p. 155-194) indicated that the global definition of relationship as all the behaviours, attitudes and feelings, conscious and unconscious that occur between two people, where one between them is a help-giver who has been sanctioned professionally, and the other is a patient or a client. However, given that the definition is broad, Gelso & Carter (1985, p. 155-194) proposed a narrower definition of relationship as the attitudes and feelings that counselling participants have toward each other and the manner in which these get expressed. In this narrower definition, the procedures and techniques applied by the therapist that are wedded to the theory from which he or she is operating may reflect the issues of relationship, but do not provide relationship definition. There exists six forms or modalities of relationship in a therapeutic setting, and they include; (1) working alliance, (2) transference-countertransference, (3) reparative/ developmentally deeded, (4) person-person, and (5) transpersonal modalities (Clarkson, 2014, p.113). In this essay, I am going to discuss the forms of relationship in the therapeutic encounter and the challenges of identifying and working with these relationship processes. Lastly, I will reflect on how I have experienced two of these forms/modalities in therapy drawn on my own experiences in illuminating these issues.

1) The Working Alliance

Gelso & Carter (1985, p. 155-194) suggested that working alliance is the alignment that takes place between the client and the counsellor, and more precisely, between the counsellor’s therapizing or working side and the client’s reasonable side (the reasonable or the observing ego). It is helpful at this point to think of two disparate ingredients or qualities of personality. One of these allows for objectivity and reason in observing situations and more so on the individuals. The second is the one which does not observe but instead experiences and feels unreflectively. This is referred to as a split in the ego by the psychoanalysts, and for expressive therapy or for successful analysis to occur, the client must have the ability for oscillating between these two sides. He or she must have the ability of rationally experiencing the feelings and observing those feelings.

In the working alliance, the reasonable side of the client aligns with the working side of the counsellor (which is also his or her reasonable side). This allows the client to experience negative feelings towards the counsellor without work disruption. Therefore, the reasonable side of the client, which gets aligned with the counsellor, permits the client to look at these negative feelings and try grasping their source. Also, it is the working alliance, and more importantly, that creates the sense that the counselling relationship participants are joined together in a shared enterprise, with each contributing to the work (Gelso & Carter, 1985, p. 155-194).

Bordin (1975, p. 252-260) conceptualized the working alliances as comprising of three parts: emotional bond existing between the participants, agreement on the task of the work, and an agreement about the goals. Therefore, there exists a positive attachment between the participants and an explicit or implicit view that the explicitly or implicitly desired goas of the work are very much appropriate for both the client and the counsellor. Moreover, again either explicitly or implicitly, the participants agree on what extra and in-therapy behaviour (tasks) will be helpful in achieving the goals agreed upon.

Extending the Bordin’s formulation, Gelso & Carter (1985, p. 155-194) suggests that the working alliance is an emotional alliance that is both fed and fostered by the emotional bond, agreement on tasks and agreement on goals. This contrasts the definition Bordin proposed for the alliance as agreements and bonds. Despite the disagreement on the definition, Gelso & Carter (1985, p. 155-194) shared the hypothesis by Bordin that the working alliance strength is a primary contributor to the helping relationship’s outcome.

The side of the counsellor in the relationship, it is suggested that the professional compassion and concern and the abiding willingness of helping the client in facing his or her problems, contribute to the alliance between the participants. The well-understood client-centred conditions of respect, genuineness and empathy are possibly central in developing the alliance, and it may be that these conditions do have their key effect through the alliance they establish. Just like the working alliance necessitates the client to be making use of his or her observing, reasonable side, the therapist, also must utilize this part of herself or himself in facilitating a sound alliance. In most instances, therapists experience very strong reactions towards their clients. In these instances, the job of the therapists is to understand these feelings, and then make appropriate responses to the client with the aim of fostering an understanding and change of behaviour. Therefore, there must be constancy and consistency in the stance of the counsellor toward the client. The relationship is for the client’s therapeutic benefit, and the observing side of the counsellor is dominant in getting to understand his or her feelings, and disallowing these feelings to be used in ways that are antitherapeutic.

From the side of the client, he or she needs to be having some trust capacity for the healthy bonding to take place. Relatedly, it also follows that the client must have the ability to form attachments to people, to invest caring and energy in relationships. Moreover, probably the client needs to be having a similar worldview to the theoretical stance of the therapist that the task and goals of the counselling make sense to him or her. For all people, probably, their worldviews would be incompatible simply with the operations of particular counselling forms. This aspect addresses an issue of fit more than just the factor of the client. If the client cannot appreciate or understand what is to be offered by the therapist, one cannot expect working alliance that is sound to develop (Gelso & Carter, 1985, p. 155-194).

2) The Real Relationship

Historically, the notion of real relationship has been rooted in humanistic conceptions of therapy and counselling. Additionally, the increasing emphasis in the therapies of learning on issues of relationship appears, in part, to be representing a focus on the real relationship. It appears that the humanistic therapies tend to equate the real relationship with the therapist’s authenticity, genuineness, opened and congruence. A real relationship, in effect, exists to the extent that the therapist is able and willing to be genuine and open about her or his feelings in the relationship. This seems to be particularly clear from recent presentations of what is today known as a person-centred approach (Gilbert & Orlans, 2011, p.36). Also, it seems true of the gestalt therapy which is considered essentially humanistic though to a lesser extent as elaborated by Simkin and Yontef (1984, pp. 279-319). The approaches to learning, to the degree, that they are describing these phenomena, seems to be equating a real relationship with the openness of the counsellor, despite the fact that they do not view the real relationship as vital to positive outcomes almost to the extent that is done by the humanistic approaches.

Gelso & Carter (1985, p. 155-194) suggested that equating the genuineness and openness of the counsellor with a real relationship is misleading and incomplete for two reasons. First, by doing so it leaves out the client from the equation, or it gives the client a minor role. The impression that will be gotten by an individual from the humanistic literature, for instance, is that the therapist is offering a set of behaviours prescribed, such as the behaviours that reflect openness, and this facilitates the movement of the client in certain directions, including increased openness. On the other hand, real relationship implies at least a two-party interchange, whereby each is involved with the others in a developing a process. A real relationship according to Gelso & Carter (1985, p. 155-194) is something that develops and exists between a client and the counsellor as a result of the actions, attitudes, perceptions and feelings of each towards and with the other.

It may well appear that the major focus is on the counsellor, and that essentially the contribution of the client to the real relationship has been ignored partly, at least because of the role expectations of the counsellor are in a way contradictory and confusing, whereas the role expectations of the client are clearer. Therefore, it is an expectation from the client to try to be genuine and open at all times, despite the fact that at times it is not expected of them to succeed. On the other hand, the expectation to the counsellor is to be genuine and open and at the same time be working. By working means observing an individual’s communications and behaviours, and keeping them under some form of rational control. In many ways, this appears to be contradicting the dictates that state that the counsellor should be genuine and open. Such kind of contradictory expectations are evident and can see, for instance, in the prescription for experiential therapy by Mahrer (1983, p.45). These complexities, in effect, have created the need for more discussion of the contribution of the counsellor to the real relationship than the contribution of the client. Be it like that, the inattention of the contribution of the client and to the reciprocal influence of the counsellor and the client in fostering real relationship here is seen as a serious deficit.

There exists a second and perhaps even more serious problem in the tendency of equating a real relationship with the genuineness and openness of the counsellor. Greenson (1971, pp. 213-232) underscored that a real relationship comprises of the realistic and genuine reactions and perceptions of the participants to each other. Realistic reactions and perceptions are reality oriented, undistorted and appropriate. They have not been contaminated by the distortions of the transference. On the other hand, genuine reactions and perceptions reflect truthfulness, authenticity and honesty, as opposed to synthenticness and artificiality. While the component of transference of the relationship is genuine, by definition, it is never genuine. In other words, when enacting transference and when involved in, honestly the client does experience these feelings., and in most instanced they are intensely experienced. However, they are the therapist’s distortions, misperceptions based on relationships and experiences from another place and time. A differentiation between interpretations and attributions on the one hand, and on the other and are the feeling reactions may help in clarifying how a person may be genuine within the unreal relationship. This implies that any interaction may be seen as comprising of four steps that are sequential. That is, (1) an individual perceives a behaviour (2) an individual makes interpretations or attributions about that behaviour (3) one reacts internally, that is having feelings about the behaviour (4) an individual emits some response.

In their article, Gelso & Carter (1985, p. 155-194) proposed a position that the real relationship exists in all therapies, and it does so intermingled and also alongside the transference or unreal relationship. Gelso & Carter (1985, p. 155-194) indicated that in a real relationship, an individual’s interpretations and perceptions of another’s behaviour are realistic and appropriate, the behaviour is congruent and the feelings are genuine. The real relationship may possess two parts, that is the nonintimate or impersonal, and more personal and intimate. Both of these parts are significant and should be attended to and appropriately used. The more non-intimate real relationship part would entail chatty interactions, which may paradoxically convey a very human form of respect. On the other hand, the more intimate interactions entail feelingful and personalized messages. Therefore, the real relationship has a significant effect on the outcome and processes of every form of counselling (Culley & Bond, 2011, p.25).

3) Developmentally needed/reparative relationship.

This is the intentional provision by the corrective/reparative psychotherapist or parental relationship replenishing where the original parenting was deficient, overprotective or abusive. This relationship mode refers to the relationship aspects which may have been traumatic or absent for the client at certain periods of his or her childhood and which the psychotherapist repairs or supplies, normally in a contracted form during the psychotherapy. That is on request from the patient with an agreement. Ferenczi Sandor, one of the early followers of Freud attempted this by departing from impassivity and neutrality in favour of offering nursing care, management of regression or friendly hugs to very sick patients, day or night, including those he saw anytime as well as taking them on holidays. According to Ferenczi, thee needed to be a contrast between original infancy trauma and the analytical situation so that it can be facilitative in remembering rather than patient’s renewed trauma remembering (Gilbert & Orlans, 2011, p.62).

A reflection on how I have experienced two of these forms/modalities in therapy

In this section, I am going to offer a reflection on how I have experienced two of these modalities of relationship in therapy. Specifically, I will focus on working alliance and Reparative / Developmentally Needed modality.

To begin, during my therapy session, I often had a rupture with my therapist who was always showing up late for our appointments. Based on the working alliance modal, we were able to establish a relationship and work together. We were able to apply the principles of working alliance mode to repair the rupture and regain the trust again. In working alliance, the first stage is all about building a shared foundation and an understanding. Therefore, if the relation falters on the first stage, both parties can go back to the contract and repair the therapeutic alliance (Wallin, 2015, p. 49). The working alliance is the basis of the therapist-client relationship that enables both the therapist and the client to work together and would include things like presenting issues. Therefore, we were able to sit down with my therapist, discuss the lateness to appointment issue and came to an agreement that she will always try to send an apology if she will be late or engaged somewhere.

One of the problems why I had therapy sessions for counselling the trauma that I had when I was a child. When I was a child, my mother was an alcoholic, and this was traumatic for me when I was growing up. Attachment theory according to Fonagy (2018, p.1) is all about the nature of children’s early experiences and the impact of the experiences on the characteristics of later functioning of specific relevance to disorder of personality. The theory address how deprivation, particularly early trauma, will come to affect a person’s propensity to personality disorder. Moreover, it also concerns with how these adverse consequences can be avoided. The key assumption in this theory is that the social behavior of an individual may be understood in terms of social relationships generic mental models constructed by an individual (Fonagy, 2018, p.1).

Based on the Reparative / Developmentally Needed modality, we were able to see improvement in my counselling sessions. As a client to my therapist, I came to see her as the better alternative at some level, I emotionally took on my therapist as a parent figure to support me in my personal growth which takes place when I am with her during her sessions. Given that my mother was an alcoholic during my childhood and was traumatic for me, my therapist asked me to imagine that my daughter was experiencing what I did as a teenager. Would I have more compassion and understanding for myself when I could mentalize that trauma happening to my daughter? With those thoughts and mentalizing my daughter growing up with an alcoholic parent, I began having compassion and trusting my judgement. I also began using the therapist as emotional support, and this helped in relieving off the emotional burden that I have been carrying since childhood.

Conclusion

In conclusion, the paper Critically reflected on forms of relationship in the therapeutic encounter and the challenges of identifying and working with these relationship processes. It also drew on my own experiences in illuminating these issues. Going forward, I will work with the three relationship modalities; Working Alliance, Real Relationship (Humanistic person-centred) and Developmentally needed/reparative perspectives in various ways. I will apply working alliance modality by aligning the reasonable side of the client with my working side as a therapist. This will create the sense for us (client and therapist) in the counselling relationship get joined together in a shared enterprise with each of us contributing to the work. I will also apply Developmentally needed/reparative perspectives modality on clients which had overprotective, abusive or deficient original parenting to replenish relationship. Lastly, will use Real Relationship modality in creating some genuineness and opened with my clients.

References

Bordin, E.S. (1975). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research And Practice, 16, 252-260

Clarkson, P. (2014). The therapeutic relationship. London: Whurr.

Culley, S., & Bond, T. (2011). Integrative counselling skills in action. Los Angeles: SAGE.

Fonagy, P. (2018). � PSYCHOMEDIA – Peter Fonagy, ‘Attachment, the development of the self, and its pathology in personality disorders’. Psychomedia.it. Retrieved 26 February 2018, from http://www.psychomedia.it/pm/modther/probpsiter/fonagy-2.htm

Gelso, C. J., & Carter, J. A. (April 01, 1985). The Relationship in Counseling and Psychotherapy: Components, Consequences, and Theoretical Antecedents. Counseling Psychologist, 13, 2, 155-94.

Gilbert, M., & Orlans, V. (2011). Integrative therapy: 100 key points & techniques. Hove, East Sussex: Routledge.

Greenson, R.R (1971). The “real” relationship between the patient and the psychoanalyst. In M. Kanzer (Ed.), The unconscious today: essays in honor of Max Schur (pp. 213-232). New York: International Universities Press

Mahrer, A.R (1983). Experiential psychotherapy: Basic Practices. New York: Brunner/Mazel

Simkin, J. S., & Yontef, G.M (1984) Gestalt therapy. In R.J Corsini (Ed), Current psychotherapies (3^rd Ed.,pp. 279-319). Itasca, IL: Peacock

Wallin, D. J. (2015). Attachment in psychotherapy.

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Herman Bailey

With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.

Improving Communication for SEVIS Compliance: Effective Strategies for International Students

by Herman Bailey | Jun 21, 2023 | Essays | 0 comments

“Background Information About SEVIS Regulations and its impact on students and International Educational Effectiveness”

The capacity to track foreign visitors better within the United States is a continued priority of the Immigration and Naturalization Service (INS) (Calvillo, 2014). Manifestations of this are the Student and Exchange Visitor Information System (SEVIS) system’s improvements designed to enable efficient tracking of international students attending institutions in the United States. According to SEVP & USICE (2000), the efforts began on July 1^st, 2002, when the INS granted permission to colleges and universities to use the SEVIS database. This information system facilitates the data transmission on M-1 and F-1 students and exchange visitors of J-1 to and from the federal government. SEVIS was born based on a pilot program – the CIPRIS (Coordinated Interagency Partnership Regulating International Students (the United States, 2002).

According to Arnone (2002), colleges complained that the system permitted entering information only by hand and did not allow colleges to connect their databases to SEVIS. Additionally, Arnone mentioned that it was also incapable of processing J-1 visa applications, which most international professors and researchers have. Technical guidelines to help colleges connect their databases to the system became available in August 2002. Thus, SEVIS entered into production on that same date.

To put this into perspective, the most significant challenges encountered three years ago at one of the Minnesota State Colleges, and Universities (MNSCU) schools were student communication, as the only way the international office used to share federal information with the international students was via email (Siskin & Library of Congress, 2004). The email communication did not prove to be very reliable, as the students complained about not receiving the emails; some did not have a computer and did not have access to email. NAFSA et al. (2003) indicated that not every student entering the United States is aware of the F-1 visa rules and regulations, leading to severe problems. For instance, Homeland Security officers arrest many students who do not have proper work permits (Markel, 2013). Typically, those students are not aware of the regulations.

Understanding most of the rules is easy, but the problem is often miscommunication between students and international offices within the colleges. According to SEVIS, many students do not know they cannot work on campus for more than twenty hours a week and can work full time in summer as long as this is also on campus. When students work outside the campus and are caught by homeland Security, they are sent home and cannot return to the United States (SEVIS, 2013).

According to the United States Citizenship and Immigration Services (USCIS), another common problem is correctly applying for classes. The international students must register for each semester at least twelve credits. If a student chooses to withdraw from a class, he or she must also register for another class as the F-1 student visa still requires twelve credit hours (USCIS, 2013). Similarly, several students do not recognize that they must provide notice within ten days whenever their address changes.

There are many strategies that colleges may use for improving information flow to students. For example, 450,000 students enrolled in City University of New York (CUNY) in 2013; nearly 23,000 were international students from 165 countries around the globe (CUNNY, 2013). Generally, one out of every three students who enroll in CUNY was born outside the United States (CUNNY, 2013). As part of these students, there are many things the international students need to know about attending a CUNY college, obtaining and maintaining their immigration status, and seeking employment in the United States. Therefore by reviewing some of their students, they firmly believe that the workshops are helping them to understand the academic system, regulation by having experts to answer their questions, students from their own country for them to talk to and help them to choose the suitable classes, also CUNY communicates with their students through writing services. If a student has any problem, he or she can write to the International Office and receive a reply (CUNY, 2013).

Shiraev & Boyd (2014) pointed out that currently, for the 2014 fall semester, Winona State University hosts a population of nearly 390 international students from 40 countries around the world. All international students hold an I-20 form, which is the official document for non-immigrants and serves as the student’s key to enter and study in the United States. With their most recent SEVIS (visa) status, students need to be aware of the rules and regulations and keep their SEVIS record active at all times. SEVIS is a government database set with real-time parameters that do not allow for spontaneous change, much less negotiation of deadlines. Therefore, the most challenging aspect nowadays is the time-sensitivity of data entering.

Purpose of Statement:

The purpose of this study is to identify the most effective method of maintaining appropriate communication between WSU`s International Office and WSU`s international students. The study will get information from other universities, Winona State University staff, and a literature review.

Research question

What is the most effective method of maintaining appropriate communication between WSU`s International Office and WSU`s international students to ensure compliance with the SEVIS regulations?”

Definition:

SEVIS– exchange visitor information system; this is the database user to collect international student information between universities and immigration centers.

CPT– Curricular Practical Training is an authorization for work that permits F1 students to take part in practicum or internship courses as they continue working towards the achievement of their degrees in different fields of study

Optional Practical Training (OPT) – this is temporary employment related directly to a significant area of study of an F-1 student. Under the previous rules, authorization was granted to an F-1 student to receive practical training of up to a total of 12 months either before and after completion of studies.

DSO– Designated School Official

INS– Immigration and Naturalization Service

MNSCU– Minnesota State Colleges and Universities

CUNY- City University of New York

WSU– Winona State University

NAFSA– National Association for Foreign Student Advisers

ELC– English Language Center

BSU– Bemidji State University

CBP- United States Customs and Border Protection

Limitations

The essay identified some limitations to the study, which include time, costs, and distance. The limitation of time deals with how the SEVIS is updated. The data reporting in the SEVIS system is time-consuming and also needs maximum accuracy. This will be a significant limitation identified by the essay since many processes are involved, and much accuracy is required, which consumes a lot of time. I am the Designated School Official (DSO) at WSU; federal law and regulations require me to update and maintain the SEVIS records of non-immigrant students holding an F-1 visa. I have to work cheerfully with international students and update their requests in SEVIS at specific times. Automatic functions of SEVIS take place after the passing of the legal time limits for an individual to be allowed to update the student’s records. They do not prolong the legal limits of time and are not intended to make replacements of the timely action by a DSO to conform to reporting responsibilities (Danley, 2010).

Distance is another limitation to the study because we have students attending classes on three campuses: Winona, Rochester, and the English Language Center at Bemidji University. These campuses need information in a timely fashion. From my experience, I see WSU faculty are ill-informed about SEVIS recommendations as the current system of communication between emails and websites are currently being used; I need to improve how can face encounters with students, as we need to schedule more face to face opportunities and workshops to present the information to all students and might be a good idea to invite some faculty either through monthly orientation or through assigned workshops. However, this might be a challenge because of the distance limitation (Janet, 2009).

The cost was another limitation of this project. To begin, there is a significant initial budget for the system that outlays the actual budget for SEVIS interface software installation and the business practices changes. Moreover, other involved costs include expenses and maintenance fees. This study covers a wide range of subject matters that need to be addressed in different universities. It encompasses collaboration between Winona, Rochester, English Language Center in Bemidji University, the international students.

Moreover, other activities require a large number of funds for them to be executed. They include the organization of educational conferences with the international students, production of educational materials and information for the international students, and funds for intensive orientation of the international students when they arrive at the campuses. Similarly, there is a cost involved in the facilitation of meetings and collaborations of the institutions involved. All these may be costly to the project and may pose a challenge (Calvillo, 2014).

Assumptions

The first assumption the study made was that most of the international students from different countries have language barriers and therefore face difficulties understanding the rules and regulations of SAVIS. This assumption has been adopted because international students do not use the English language as their first language. Therefore, they may not be able to understand the rules.

Another assumption of the essay was that different countries have different technologies. Therefore the country of origin of an international student determines the way of communication he or she is well versed with. One form of communication by SEVIS may not be enough because different students from different countries may prefer emails. In contrast, others may prefer Facebook, phone calls, and others’ use of websites.

Another assumption is that the faculties in WSU are ill-informed about the recommendations of SEVIS. Therefore, there is a need for building strong relationships with the faculties so that all international students from different faculties will be informed of the proper SEVIS rules and regulations.

Literature Review

Current school:

Federal law and regulations require DSO to maintain and update the non-immigrant students’ SEVIS records holding an F-1 visa. Working with international students and update their requests in SEVIS at specific times. Automatic functions of SEVIS take place after the passing of the legal time limits for an individual to be allowed to update the student’s records. They do not prolong the legal limits of time and are not intended to make replacements of the timely action by a DSO to conform to reporting responsibilities. With all the reporting that needs to be done in SEVIS, the penalty for giving false or misleading information to the SEVIS database is significant. Winona State University could lose its ability to sponsor international students and scholars on F-1 visas. SEVIS is very unforgiving when it comes to errors. Therefore, only the authorized WSU Designated School Officials and Responsible Officers have access to SEVIS.

Washington State University (2014) is a public research university, per NAFSA conference (2013). WSU has a growing community of 1,900 international students and around 600 scholars.

According to Hansen(2014) (phone call interview), the director of Washington State University, the most effective method to communicate with international students is using iCoug Tutorial, pre-arrival online orientation with a module on “Visa and Immigration, Maintaining student status,” Hansen provided me with the login to their system to test it.

One of the seven MNSCU (Minnesota State Colleges and Universities) uses the Batching process from ISRS to SEVIS. For example, all the information entered in ISRS by any registrar staff or any administrator can cause a problem for international students because it is batched with SEVIS overnight. I am working with Bemidji State University, The English Language Center (ELC) situated at Bemidji, and offered by WSU, provides training in the English language to international students who wish to satisfy the requirements of English language for admission to BSU, Winona State University, or other US colleges and universities.

The third resource comes from Bobson College, Nicosia, N. International Student, and Scholar Advisor for the last few years; I have built a good relationship with other schools, especially Bobson College adviser since we met at an immigration workshop.

And the fourth recourse with the administrator of WSU, and see how they communicate with domestic students and which database they are using.

This regulation affects three campuses that need this information in a timely fashion.

Winona state university:

WSU faculties are ill-informed about SEVIS recommendations.

As the current communication system between emails and websites is currently being used, we need to improve how we can face encounters with students, as we need to schedule more face-to-face opportunities and workshops to present the information to all students. It might be a good idea to invite some faculty either through monthly orientation or through assigned workshops, also how WSU technology assists in establishing better communications with our international students using blog hang out and other technologies for sharing information online.

Student’s responsibility and WSU

International students, while studying in the United States, have an independent responsibility in maintaining lawful status. This includes becoming knowledgeable on reporting updates and requirements and the international center of reportable events’ timely notifications and maintaining the current contact information with the registrar. The penalties for scholars and international students are also significant. According to SEVP & USICE (2000), failure by international students to provide up-to-date information may lead to the student being deported or becoming out-of-status, which may negatively impact future applications for visas to the United States.

For the international students to maintain their immigration status each semester, they must enroll for full-time studies and meet with the DSO at, beginning and end of each semester. Any change in the duration of studies must be completed in not less than 60 days before their study program ends- based on the date stipulated on their I-20. Students may not become employed on or off-campus until they have received authorization and approval in their I-20. Address changes also need to be reported within ten days of the move. The researcher must submit every student’s request for changes in their I-20 by a specific time to the DSO, and the DSO must complete the student’s requests promptly to capture all students’ status in the SEVIS database (the United States 2002).

The U.S. government takes individuals working illegally very seriously. CPT is a work authorization that allows an F-1 student to engage in an employment opportunity that is an essential part of a curriculum established. At Winona State University, this language is inferred to mean that the student either engages in an internship that is a mandatory part of their degree program or the international student is engaging in an optional practice for which they are registered in a practicum or internship course before they graduate. By regulation, students need to complete one academic year before requesting CPT unless required immediately for the student’s major (Bray & Falstrom, 2007).

Registering for the class is not enough reason for them to start working on CPT. They must first register for the required class and then submit these documents to the International Services Office; a letter from their employer that indicates the title of the job, employment start and end dates, wage or salary, number of hours per week, and location of employment (NAFSA et al., 2013). Once a student has obtained and submitted these documents, if approved, the DSO will authorize CPT and make the fitting notation on the current I-20 of the student. Another type of employment that will allow international students to work after they have earned their degree is OPT (Optional Practical Training), an opportunity for an F-1 student to gain work experience to complement their academic program.

Time constraints when applying for OPT are based on the completion of the student’s degree. An application for OPT can be submitted as early as their program end date by 90 days (For instance, if the graduation of a student is on May 15, the student can apply for their OPT as early as the 15^th of February). Also, United States Citizenship and Immigration Services (USCIS) must receive the student application not later than 60 days after the day the student completes his or her program or the program end date indicated on the student’s I-20, whichever occurs first. However, students cannot start working in the U.S. until they have received the Employment Authorization Document (EAD) from USCIS. Working without an EAD can negatively affect a student’s immigration status now and in the future (Siskin & Library of Congress, 2004).

Differed Culture:

Therefore many international students experience culture shock upon arriving in the United States. These students must understand the cultural differences and how to we should deal with them. The article by Araujo (2011) reviewed the concerns of the adjustment issues experienced by international students enrolled in American universities and colleges. The three issues were English fluency, social support, and length of study in the U.S.

According to Hansen, the Washington State University director, the most effective method to communicate with international students is using iCoug Tutorial, pre-arrival online orientation with a module on “Visa and Immigration, Maintaining student status.”

Stanford University uses Facebook office hours. So far, they said the experiment has been successful, which is apparent by the number of questions being asked by the faculty members – and by the number of positive reviews, the practice has received thus far.

Media is an easy way to communicate with students all around the world. They can be shown all involved with the F-1 visa, utilize it properly, and ensure the regulations are not violated. The researcher can share articles, news, and photos quickly and without delay.

In a statement made by Nicosia (2014), the International Student and Scholar adviser at the University of Babson, “The most effective tool we use is setting up automatic emails reminding students to do specific things at particular times of the year. More specifically, we remind them about travel signatures, full-time registration, and employment authorization deadlines”.

However, she points out that the best thing they have done is to clear away the barriers between students and academic advisors. They have been building good relationships with their academic advisors to minimize problems on that side of the house.

Workshops provide a means for the International Office to explain the F-1 visa rules.

Given the large body of my research on the workshops, I offer a way to create training and include the dean and academic advisor. These workshops will build a good relationship between WSU administrative and international students.

NAFSA (2014) conference, NAFSA conference is supporting scholars and International Students, there are a lot of new regulations that need to be addressed to our students, one of NAFSA meeting were disused Ebola virus disease …and how we should deal with our students who are coming from West Africa, Larry Minner is one of the CBP United States Customs. Border Protection spoke about serious issues that they are dealing with; travelers are transporting food into the United States for personal use. The international office must inform the international student’s travelers who must declare all their food products. Failure to make a declaration of their food products can result in up to $10,000 in penalties and fines.

Communication with international students

According to the United States (2004), there have been many changes in the policy and legal landscape surrounding the education of international students. The international students that wish to study in the United States continually face several hurdles in the SEVIS, especially in communication between them and the international office. Shiraev & Boyd (2014) asserted that contradictory information and lack of communication from the Department of State (DOS) and DHS regarding changing requirements and restrictions of SEVIS, mainly when they affect the status of the students, has continued to frustrate many international students in different campuses.

In trying to find out the most effective method of maintaining appropriate communication between the international office and the international student, to ensure compliance with the SEVIS regulations, the essay will discuss the experiences and methods that different schools have adopted in trying to communicate appropriately with the international students to comply with the SEVIS regulations.

Washington State University (WSU)

WSU first successfully integrated the SEVIS data requirements into the business processes of the institution’s departments that are responsible for SEVIS compliance. Bray & Falstrom (2007) pointed out that even though the SEVIS compliance responsibility is under the International Students Office, other offices such as the undergraduate Admissions, the Intensive America Language Center, the Graduate School, and the other three campus branches all have Designated School Officials (DSOs) currently. Danley (2010) stated that these DSOs assist internal students’ offices with SEVIS processes, especially in communicating with international students.

Additionally, WSU created the SEVIS coordinator position to ensure that reporting of data is done in a timely fashion and accurately. This has eased implementation, compliance with SEVIS regulations, and communication with the international students.

Jane (2009) noted that international students, through assistance with the efficient and established method of communication between the international office and the relevant DSOs in different departments and campuses, are now well aware of their responsibilities for frequent contact maintenance with the International Student Office to protect their status. Moreover, Calvillo (2014) indicated that the intensive orientation is given to the international students on arrival to any of the campuses of WSU assists the international students to understand the requirements of SEVIS.

University of Idaho (U of I)

To ensure efficient communication between the international student’s office and e international students for compliance with the SEVIS regulations, the U of I’s International programs office has adapted to SEVIS, including staffing changes. To improve communication and get in touch with the international students, I added more staff and trained more for their 17 campuses, such as the DSOs.

According to SEVP & USICE (2000), the international students at U of I are aware of the SEVIS requirements. Moreover, the International Programs Office sends to the international students repeated and frequent updates and reminders fortnightly, and this is helpful to the students in compliance with the SEVIS regulations.

Lewis-Clark State College (LCSC)

In LCSC, the International Programs Office is concerned with supporting international students and constantly communicate with them, especially on the regulations of SEVIS. According to United States (2002), to effectively communicate with international students, the international programs’ office of LCSC created a chain of command with a detailed process for communicating notifications and solving issues and problems that may arise, especially on SEVIS regulations.

However, NAFSA et al. (2003) noted that the changes faced by staff in LCSC in a bid to stay abreast with the latest changes in SEVIS regulations and data requirements for a small school are taxing. With much work and minimal staff, it is hard to relay some information to international students. However, international students tend to comply with the requirements of SEVIS status. Moreover, Siskin & Library of Congress (2004) noted that the international students from Africa and Asia exhibit significant stress and fear of failing the SEVIS status that their data reporting is always on time and correct.

Walla Walla Community College (WWCC)

United States (2004) noted that the communication between the international students and the college has been efficient because the process of admission and preparation of 1-20s is much smoother. The college uses email alerts for faster and efficient communication with international students, especially n alerting them to any changes to the SEVIS requirements. The staff and the WWCC faculty assist new international students in understanding the regulations and rules of SEVIS. Therefore, generally, international students at WWCC appear to comply and understand the requirements of SEVIS without complaints.

References

“5 Facts for International Students on F1 Visas in the U.S..” peerTransfer Blog. N.p., n.d. Web. 31 Oct. 2013. Retrieved from http://blog.peertransfer.com/2013/02/27/what-can-international-students-do-with-a-f1-visa-in-the-u-s/

“CUNY’s International Student Guide.” CUNY’s International Student Guide. N.p., n.d. Web. 1 Nov. 2013. <http://www1.cuny.edu/international/sec1-4.html>.

“Students and Employment.” Homepage. N.p., n.d. Web. 31 Oct. 2013. Retrieved from http://www.uscis.gov/working-united-states/students-and-exchange-visitors/students-and-employment.

“Working in the USA.” International Student. N.p., n.d. Web. 31 Oct. 2013. Retrieved from http://www.internationalstudent.com/study_usa/way-of-life/working-in-the-usa/

Araujo (2011). Adjustment Issues on International Students Enrolled in American Colleges and Universities. Retrieved from http://dus.psu.edu/mentor/old/articles/051212mi.htm>.

Arnone, M. (2001). U. of Maryland will help Uzbekistan create a virtual university. Chronicle of Higher Education, 29 August.

Bray, I. M., & Falstrom, C. (2007). U.S. immigration made easy. Berkeley, CA: Nolo.Danley, J. V. (September 06, 2010). SEVIS: The Impact of Homeland Security on American Colleges and Universities. New Directions for Institutional Research, 146, 146, 63-73.

Calvillo, I. (2014). Naturalization, immigration, and citizenship: Select U.S. policies.

Hopkins, K. “3 Surprises for International Students at U.S. Universities – US News and World Report.” US News & World Report | News & Rankings | Best Colleges, Best Hospitals, and more. N.p., n.d. Web. 8 Oct. 2013. Retrieved from http://www.usnews.com/education/best-colleges/articles/2012/04/18/3-surprises-for-international-students-at-us-universities?page=2.

Janet, V. D, (July 2009). Walla Walla Community College The Impact on American Colleges and Universities,

Markel, J. (8 Oct. 2013). “The Mentor: An Academic Advising Journal.” Division of Undergraduate Studies (DUS) – Pennsylvania State University. N.p., n.d. Web.

NAFSA Convention, NAFSA: Association of International Educators (Washington, D.C.), & United States. (2003). SEVIS in Salt Lake at the NAFSA Convention: Student and Exchange Visitor Information System: Salt Lake City, UT, May 25-30, 2003. Washington, D.C.?: Dept. of Homeland Security, Bureau of Immigration and Customs Enforcement.

Shiraev, E., & Boyd, G. L. (2014). The accent of success: A practical guide for international students in U.S. colleges. Ann Arbor, MI: University of Michigan Press.

Siskin, A., & Library of Congress. (2004). Monitoring international students in the United States: The Student Exchange Visitor Information System (SEVIS). Washington, D.C.: Congressional Research Service, Library of Congress.

Student and Exchange Visitor Program (U.S.), & U.S. Immigration and Customs Enforcement, (2000). Student and Exchange Visitor Information System: General summary quarterly review.

The United States. (2002). Student and Exchange Visitor Information System (SEVIS): Final rule implementing SEVIS: tightening and improving procedures for international students visiting the United States. Washington, DC: U.S. Dept. of Justice, Immigration and Naturalization Service.

The United States. (2004). Homeland security: The performance of the information system to monitor international students and exchange visitors has improved, but issues remain: report to congressional committees. Washington, D.C.: U.S. General Accounting Office.

5/5 - (6 votes)

Herman Bailey

A Comprehensive Evaluation of “Juno” and Critical Assessment of “Caroline”

by Herman Bailey | Jun 20, 2023 | Essays | 0 comments

Introduction

Initially, we have got an evaluation of a teen movie that revolves around two teenagers Breaker (Michael Cera) and Juno (Ellen Page). The two has unprotected sex, but weeks later Juno becomes pregnant, she finds it hard to tell her parents, but she decides to give birth to the child without consulting Breaker. In this text, I am going to evaluate the author’s assessment of the movie and then give my evaluation of the Caroline film by Logan George and Celine Held.

Assessment of the film

The author of this assessment of the movie has said both the positive and negative facts about the movie. The author gives accredit where it deserves as well criticizes it in the same way. For example from the film according to the author Juno is filled with comedy despite the situation that she is in, she has stoicism and sarcasm character as well which is the different expectation of her. Therefore the movie does not portray her pregnancy in the expected way however the film is heart-touching. The dialogues in most of the episodes in most of the events are unrealistic the movie carries people’s emotions, and its ostentation carries it across even though it has a lot of comic scripts. “Hi baby, it’s me. It’s Vanessa,” and then continues, “I can’t wait to meet you.”

Therefore I give credit to the author’s assessment of the movie for balancing both the positive side and negative side of the film and finally bringing the truth about it.

Assessment of Caroline film

Caroline’s violence in films is utterly harmful. He insists that exposure to such images and film revolves around Caroline a kind who is six years old her mother and her Siblings. It is a film directed by Charles Henry Selick and can be accessed through the link https://www.shortoftheweek.com/ from the film’s summary Caroline’s mother is seen to be less responsible for how she is caring for her children, we see her leaving then anywhere despite their young age, she leaves them in a car and goes into a restaurant she left Caroline with the car keys. This is not expected of a mother of such a young kind she is seen to be protective of them when she had an opportunity to leave, and the kids start to cry she stops and tries to understand them ‘’hey are you okay”.

The movie is full of unrealistic episodes, Caroline is a six-year-old sibling but she can understand instructions on how to use the car key, she bites the woman who was fighting her mother instead of other kids of her age instead could cry. The movies are so exciting and moving mostly considering Caroline’s acting traits.

Conclusion

In conclusion, the evaluation of “Juno” and the assessment of “Caroline” shed light on the diverse aspects of these films and their impact on audiences. “Juno” captivates with its blend of comedy and heart-touching moments, challenging the conventional portrayal of teenage pregnancy. The author’s balanced assessment acknowledges both the positive and negative aspects, offering a truthful perspective on the film. On the other hand, “Caroline” raises concerns about the portrayal of violence and unrealistic scenarios, questioning the responsibility of the characters. By critically examining these films, we gain a deeper understanding of their storytelling techniques and the emotions they evoke. Evaluating and assessing movies allows us to appreciate the complexities of filmmaking and the varied responses they elicit from viewers. Ultimately, these analyses contribute to the ongoing dialogue surrounding the art of cinema and its impact on society.

References

Tobias, Scott. Rev. of Juno, dir. Jason Reitman. The A. V. Club. The Onion, 6 Dec. 2007. Web. 13 Apr. 2008.

Celle, C., Mayousse, C., Moreau, E., Basti, H., Carella, A., & Simonato, J. P. (2012). Highly flexible transparent film heaters based on random networks of silver nanowires. Nano Research, 5(6), 427-433.

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Herman Bailey

Exploring Generational Perspectives on Menopause: Shifting Perceptions and Definitions

by Herman Bailey | Jun 20, 2023 | Essays | 0 comments

The article the change: Women, aging, and the menopause by Greer talk about the description of menopause that has shifted from a normal, progressive change to a progressively more medicalized view that accentuates organic discrepancies of the aging feminine figure. Although menopause could be simply defined as the time when one’s menstrual periods stop permanently and one can no longer get pregnant. Notably, Greer talks deeply about menopause as being a topic that people no longer shy about to analyze. Also, it clearly brings the difference in the definition for the mothers and their daughters. Mothers knew that menopause is a developmental transition and they would consider it a time of self-evaluation and prior setting whereby they would sit down and do a personal reflection of their life keeping away from their husbands and kids. While their daughters thought it was a physiological process of the aging body. Additionally, it was a health problem that could be cured.

Reference

Greer, G. (2018). The change: Women, aging, and menopause. Bloomsbury Publishing.

Utian, W. H., & Schiff, I. (2018). NAMS-Gallup survey on women’s knowledge, information sources, and attitudes to menopause and hormone replacement therapy. Menopause, 25(11), 1172-1179.

Utz, R. L. (2011). Like mother, (not) like daughter: The social construction of menopause and aging. Journal of Aging Studies, 25(2), 143-154.

5/5 - (7 votes)

Herman Bailey

The Power of Health Information Technology in Improving Healthcare Collaboration

by Herman Bailey | Jun 19, 2023 | Essays | 0 comments

Abstract

Interdisciplinary collaboration can be improved by using Health Information Technology (HIT) to assist the patients better. The key motivations for using a smartphone in healthcare settings to enhance interdisciplinary collaboration has been the need for information resources and better communication at the point of care. The importance of smartphone and apps for healthcare professionals in interdisciplinary collaboration include; convenience, better clinical decisions, improved accuracy, increased efficiency and enhanced productivity.

Introduction

In today’s workplace, many activities involve working in a group or team 1. Virtually all economic and societal sectors are increasingly emphasizing on teamwork. This reflects the growing evidence that when people with differing training, knowledge, attitudes and experience find new of working in a team, the result is increased synergy, productivity, and innovation. The need for defining teamwork and encouraging its application in healthcare is not new. However, Talley & Travis2 indicated that the series of primary healthcare field developments have demonstrated how significant it is to coordinate working practice. These include; (1) unprecedented flow of technical and scientific information that show the important roles different healthcare providers play; (2) High levels of knowledge and awareness among clients/patients with a concomitant demand for better and more services; (3) a growing focus on the population and prevention health; (4) shift to the client-centred approach; (5)patients with some complex needs being treated at the community, basically because of early discharge from the hospital; and (6) the need for 24/7 healthcare for timely access to health care providers for the citizens, no matter where they reside.
Interdisciplinary collaboration

Interdisciplinary refers to a deeper collaboration degree among the team members. It implies expertise and knowledge integration of many disciplines to come up with solutions to complex problems in an open-minded ad flexible way4. This type of team is characterized by common goals ownership and shared process of decision-making. According to Freshman, Rubino & Chassiakos, 3interdisciplinary teams members must open territorial boundaries to give more flexibility in their professional responsibilities for them to meet the needs of the clients.

Collaboration according to Freshman, Rubino & Chassiakos, 3is a dynamic process focusing on sharing, partnership, interdependence, and power. Sharing includes shared values, healthcare philosophy, responsibilities, planning, and interventions. Partnership implies that more people come together in a productive, authentic and collegial relationship, characterized by honest and open communication, respect and mutual trust. Every partner must value the perspective and work of the other professionals and strive towards specific outcomes and common goals. Interdependence implies that the professionals are not autonomous but interdependent, because of their common desire for fulfilling the needs of the patients/clients. Lastly, power is shared among the members of the team, with all participants accorded empowerment. It should be based on experience and knowledge, rather than on titles or functions.4

Petri4 described the collaborative practice as centred on the patient and refers to it as a “new professional practice direction where the professionals of healthcare work together with the patients.” collaborative practice involves continuous interaction with many disciplines or professionals into a common effort to solving or exploring common issues, with the patient’s best possible participation. It is designed to promote each discipline of active participation in inpatient care. Moreover, collaborative practice enhances family and patient-centred goals and values, optimizes participation of staff in clinical decision making across and within disciplines, provides mechanisms to caregivers for continuous communication, and fosters respect for all professionals for disciplinary contributions.5

Health information technology

The concept of Health Information Technology (HIT) is based on the definition of the world health organization of health. The information technology on health indicates that digital technology facilitates the achievement of accessible, equal and high-quality healthcare for all members of society. WHO6 defined HIT as the uses of digital technology to treat patients, educate students, conduct research, monitor public health and track diseases among others.

The healthcare service according to Lyhne7 is strongly dependent on information and knowledge. Digital technology in the form of information and technology, constitutes an integrated and vital part of healthcare. Black et al8 stated that the use of digital technology will increase in the future in interdisciplinary collaboration, communication and patient care between different organizations and stakeholders such as in quality improvement, coordination, administration, and research. Information communication and technology is mainly employed to; facilitate the handling, transfer and storage of data; to facilitate health care from a distance, and to support clinical decisions.9

The health care professionals are required to be updated and prepared in facing and taking part in the development of HIT based on a professional perspective. Information technology services development in society, such as social media, impacts the healthcare already. WHO9 pointed out that in 2010, the uses of wireless telecommunication were over five billion with a coverage of 85% of the global population. Patient’s access to information increases their opportunities of assuming responsibility for their health. For instance, patients suffering from high blood pressure and diabetes who performs self-tests combining with feedback and health information via Telemedical devices. Such developments make the healthcare professionals assume a guiding and supportive role about a more informed and knowledgeable patient.11
In the efforts of the healthcare professionals to provide person-centred care to the patients, they are faced with new demands and needs. The development of HIT implies patients benefit such as a possibility of influencing future and present health and social care provision, increased flexibility.

According to Lyhne, 7 HIT can support processes of healthcare to ensure patient safety, quality, continuity and person-centred approach in the process of care. The healthcare professionals have the function of coordinating in the organization that includes handling of the information that is related to health. This information should always be available to the right person, on the right occasion and in the right format in the process of care for the provision, decision-making, and healthcare evaluation. A prerequisite for HIT to develop in that direction and to meet care needs of the patients is that the health care professionals, contribute to their commitment and knowledge, irrespective of their roles through interdisciplinary collaboration.

Communication and interdisciplinary collaboration

HIT influences the patient-nurse encounter. Even though it can add value to the processes of care delivery based on the needs of the patients, there is also the risk of HIT causing alienation and frustration. Nilsson & Söderberg 12 asserted that in the encounter involving two individuals, the technology should not be dominating but rather supportive. A key objective of such kind of interaction is to support the involvement, continuity and integrity of the patients and the significant others by considering their perspectives. Involvement and continuity can be strengthened by digital technology means, but health care professionals must take care and ensure that the integrity of the patients perseveres. Digital technology communication differs depending on the technical and form of solution employed. For instance. For instance, communication in real-time during home care video conference allows dialogue and two-way communication, while SMS, email, written texts or discussion forums in electronic patient records can instead be described as one-way communication methods. However, home video conference allows for greater flexibility in terms of space and time.

CeHis13 gave an example of an e-Health service in Sweden created by Center for e-Health in Sweden called “. Similarly, within European Union, epSOS, an ongoing development project aims to create possibilities for exchanging record information of the patient between the member states of EU.14 Additionally, other HIT services such as “1177.se Healthcare Online” and “My Healthcare Contacts” are directed to the patients and the significant others to facilitate handling of prescriptions, bookings appointments, counselling among others. Moreover, “My Healthcare Services” will allow the patients to access and also enter information in their personal medical records.

According to Nilsson et al, 12 distance care to patients provided via Telenursing and telemedicine enables more efficient use of resources and specialists competence. Additionally, it can facilitate independent living and increase the sense of safety for the patients, as it becomes easier having contact with the allocated nurse on duty, hence enhancing accessibility.

HIT services can facilitate communication of the nurses with the patients and significant others. However, it is important to minimize threats and risks to dignity, integrity and confidentiality by respecting individual preferences and preconditions of the patient for communication. Wakefield10 indicated that the power balance between the healthcare professional and nurse shifts when the patient has access to information online about ill health and health. Furthermore, it places greater demand on the healthcare professionals to act as guides and advisors about the individual efforts of the patients in attaining and maintaining health. The online information that is not objective and is misleading can cause worry or confusion among the patients and the significant others. The educational function of the healthcare professional becomes more important and comes along with the need for developing evidence-based educational material to apply in ICT solutions for the patients. Lymberis11 asserted that such material can be used in a face-to-face meeting between the health care professional and patient or via the internet, according to the needs of the patient and situation.

Smartphone usage in healthcare settings to enhance interdisciplinary collaboration

The smartphone is becoming an important device that assists physicians with clinical tasks, medical decision-making, and other computing functions. A smartphone according to PC Magazine Encyclopedia 15 is a device combining mobile communication, accessibility of internet and word processing. In this section of this practice-focused research paper, it examines the software applications related to health care that is available across most smartphone platforms. PC Magazine Encyclopedia15 indicated that software applications of smartphones are increasingly becoming popular for both healthcare providers and consumers. Furthermore, the paper will discuss the importance of using smartphones as a HIT to improve interdisciplinary collaboration among healthcare professionals.

The use of smartphones by the health care professionals according to Wallace, Clark and White16 has transformed many clinical practice aspects. Smartphones have become common in healthcare settings, and this has led to the rapid developmental growth of medical software applications for these platforms. 16, 17 Aungst 17 pointed out that numerous applications are available to help the health care professionals with many important tasks such as health record access and maintenance, time and information management, consulting and communication, patient monitoring and management, reference and information gathering, medical training and education, and clinical decision-making. 16-26
Smartphones combine both communications and computing features in a single mobile device that can be stored in a pocket and held in hand, permitting easy access and to be used at the point of care.18 Additionally, apart from text and voice, smartphones offer more advanced features such as global positioning service (GPS), web searching, sound recorders, and high-quality cameras.19 With all these features combined with operating systems, powerful processor, high-resolution screens, large memories, smartphones have become handheld computers.19

Need for smartphones at the point of care for interdisciplinary collaboration
One of the key motivations that drive the widespread adoption of smartphones by healthcare providers has been the need for information resources and better communication for interdisciplinary collaboration at the point of care. 18, 20 Ideally, healthcare professionals require access to different types of resources in a healthcare setting, which includes:

Communication capabilities with the team embers such as email, text, video conferencing and voice ¹⁸
Hospital information systems which include electrical medical records, electronic health records, picture archiving and communication systems, clinical decision support systems, andlaboratoryinformation18
Informational resources such as drug references, medical literature, guidelines and ¹⁸
Clinical software applications such as medical calculators, and diseases diagnosis ¹⁸

Before the development of mobile devices such as the smartphones these resources were mainly available and provide by immobile computers, which hindered mobility in the healthcare settings.¹⁸ However, with the availability of mobile devices such as smartphones, the health care professionals now have the access to large information sources at their fingertips
In a study conducted by Manhattan Research in 2012, the results identified the purpose for which the health care professionals rely on mobile devices such as smartphones.²¹ The most popular activity was searching among health care professionals with 56% using smartphones.²¹ Among the physicians using smartphones alone, searching was also the most common activity taking 48% of their phone time. Additionally, professional applications in the smartphones consumed an additional of 38%.moreover, physicians averagely spent three hours weekly watching online videos for professional purposes on smartphones by 13%, tablets 29% and laptops or desktop computers 67%.²¹
Smartphone Apps for healthcare professionals

The rapid integration of smartphones into clinical practice has been driven in part by rising quality and availability of medical software applications also referred to as “Apps”²⁰. Apps according to Wallace, Clark, White, ¹⁶ are software programs developed to run on mobile devices or computers to accomplish a specific purpose. Improved memory, faster processors, open-source operating systems that are highly efficient and perform complex functions, and smaller batteries have paved the way for the development of many medical apps for mobile devices for both personal and professional use. ²²

How healthcare professionals use smartphones and Apps to enhance interdisciplinary collaboration

Health care professionals our smartphones and apps for interdisciplinary collaboration purposes which can are grouped into five broad categories: health record access and maintenance, administrations, reference and information gathering, communication and gathering, and medical education. Table 2 below shows the many uses for a smartphone, and Table 2 shows types of medicals apps falling under the broad category purposes as illustrated by Ventola^.23
Table 1: Uses for smartphone and apps by healthcare professional

purpose	Uses
Information management	v Dictate notes v Write notes v Record audio v Organize information and images v Take photographs v Access cloud service v Use e-book reader
Time management	v Record call schedule v Schedule meetings v Schedule appointments
Health record access and maintenance	v Access images and scans v Access EMRs and EHRs v Electronic prescribing v Coding and billing
Communication and consulting	v Video calling v Voice calling v Email v Texting v Video conferencing v Multimedia messaging v Social networking
Reference and information gathering	v Medical journals v Medical textbooks v Literature search portals v Medical literature v Medial news v Drug reference guides
Clinical decisions making	v Clinical treatment guidelines v Clinical decision support systems v Differential diagnosis aids v Disease diagnosis aids v Laboratory test ordering v Medical calculators v Medical exams v Laboratory test interpretations
Patient monitoring	v Monitor location of the patient v Monitor patient health v Collect clinical data v Monitor patient rehabilitation v Monitor heart function
Medical training and education	v Knowledge assessment tests v Continuing medical education v Case studies v Board exam preparation v Surgical simulations v E-learning and teaching v Skill assessment tests

Table 2: Uses of Medical Apps by healthcare professionals

purpose	Apps	Uses
Information management	ü Notability ü Evernote ü GoodReader ü iAnnotate ü Dropbox ü Box ü Google Drive	ü Note taking and organization ü Note taking and organization ü PDF Viewer ü PDF viewer ü file sharing and cloud storage ü file sharing and cloud storage ü file sharing and cloud storage
Communication and consulting	ü Doximity	ü Social networking site for the MDs
Reference and information gathering	ü Dynamed ü Epocrates ü Micromedex ü Skyscape/Omnio ü UpToDate ü Dynamed ü John Hopkins Antibiotic Guide ü Medscape ü Medpage Today ü Sanford Guide to Antimicrobial Therapy	ü Drug and medical reference ü Drug and medical reference ü Drug reference ü Drug and medical reference ü Medical reference ü Medical reference ü Medical reference ü Medical reference ü Medical news ü Medical reference
Patient management and monitoring	ü Pocket lab values ü Diagnosaurus ü Archimedes ü Lab Pro Values ü Mediquations ü MedCalc ü AHRQ ePSS ü Calcu;ate	ü Laboratory reference ü Differential diagnosis ü Medical calculator ü Laboratory reference ü Medical calculator ü Medical calculator ü Screening and prevention tool ü Medical calculator
Medical training and education	ü QuantiaMD ü MedPage Today	ü Continuing medical education ü Continuing medical education

Importance of smartphone and apps for healthcare professionals in interdisciplinary collaboration

Convenience

Clinicians collaborating in a team associate numerous conveniences with using smartphone in their clinical practice such as rapid access to multimedia resources and information, portability, choice of different powerful apps to complete many purposes ^{16, 19}. Healthcare professionals in a team can access information simultaneously with many conveniences, keeping current by accessing updates about new reviews, guidelines, new books and medical literature conveniently

Better clinical decision-making

Several medical apps in smartphone support clinical decision making by clinicians in a team at the care point. ^{18, 25 This is essential in evidence-based medicine since healthcare professionals nay not seek answers always to the clinical questions after completing their clinical encounter. ^{20, 18, 25}The most useful smartphone tools that support clinical decision-making and evidence-based medicine as cited by practising clinicians practising interdisciplinary collaboration include medical textbook, drug reference, medical calculator apps and diseases diagnosis.¹⁸}

Improved accuracy

According to Divali,¹⁹ mobile devices including smartphones have repeatedly been found to improve the accuracy and completeness of patient documentation, and this has been attributed to their ease of use. Moreover, increased medication safety, more frequent side effects documentation and more accurate diagnostic coding through reduced medical errors among the clinicians have been reported.²⁵ Furthermore, timely communication amongst clinicians collaborating as a team within a hospital has also been found to reduce medical errors, particularly in critical care

Increased efficiency

Kiser ²² indicated that interdisciplinary collaborating healthcare workers using smart phones are efficient in their work areas. Other increased efficiency to interdisciplinary collaborating healthcare workers through the use of smartphones include rapid access to information, increased patient documentation quality through complete records and fewer errors, and improved patterns of the workflow.²⁵ Use of smartphones to retrieve information from the drug database has efficiently made decision-making and care for the patients easy to the physicians. Moreover, Mickan 26 asserted that physicians also reported more efficient and quicker access to the clinical support resources and improved care coordination by the collaborating physicians

Enhanced productivity

Aungst ¹⁷ demonstrated that use of smartphones inpatient care has helped in streamlining workflow and increasing productivity of the healthcare professionals. Moreover, it causes a significant increase in the electronic prescribing average rate to 64% from 53%. ²⁶ Productivity of the pharmacists can also be increased by allowing important information on drugs, such as interactions and contraindications, to be quickly checked, hence more rapid prescription processing.²⁶

Conclusion

Interdisciplinary collaboration approach is gradually being used more in primary HealthCare. Patients or clients must also be involved in interdisciplinary collaboration for them to be included in their own care. The health system also needs to have channels by which the patients and their families can get involved in the planning, assessment and delivery of healthcare.
HIT should provide person-centred and equal care. Moreover, HIT is an important tool for increasing patient involvement and accessibility in healthcare. Therefore, it should form part of all the levels of professional practice and medical education.
Mobile medical devices especially smartphones and apps are already invaluable medical tools for the healthcare professionals, and as their uses and features expand, they are becoming widely incorporated into almost every aspect of the clinical practice and in interdisciplinary collaboration. Despite the fact smartphones, apps, and other mobile medical devices provide the physicians with many advantages, they are being used currently without an in-depth understanding of their associated benefits and risks.

References

Klarare, Anna, Hagelin, Carina Lundh, Fürst, Carl Johan, & Fossum, Bjoorn. Team Interactions in Specialized Palliative Care Teams: A Qualitative Study. Mary Ann Liebert, Inc. 2013.
Talley, R. C., & Travis, S. S. Multidisciplinary Coordinated Caregiving: Research Practice Policy. Dordrecht: Springer. 2013.
Freshman, B., Rubino, L., & Chassiakos, Y. R. Collaboration across the disciplines in health care. Sudbury, Mass: Jones and Bartlett Publishers. 2010.
Petri, L. Concept Analysis of Interdisciplinary Collaboration. Nursing Forum. 2010: 45, 2, 73-82.
Forman, H. Nursing Leadership for Patient-Centered Care: Authenticity Presence Intuition Expertise. Springer Pub. Co.2010
Health topic – eHealth. 2011a. http://www.who.int/topics/ehealth/en/. Accessed February 1, 2015.
Lyhne S, Georgiou A, Marks A, Tariq A & Westbrook J.I. Towards an understanding of the information dynamics of the handover process in aged care settings – a prerequisite for the safe and effective use of ICT. International Journal of Medical Informatics.2012: 8(7):452–460.
Black A.D, Car J, Pagliari C, Anandan C, Cresswell K et al. The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Medicine 2011: 8(1): e1000387. doi:10.1371/journal.pmed.1000387. Accessed February 1, 2015
mHealth: New horizons for health through mobile technologies: Global observatory for eHealth series – Volume 3.2011b http://www.who.int/goe/publications/ehealth_series_vol3/en/index.html. Accessed February 1, 2015.
Wakefield B.J, Ray A, Adams M.R & Hills S.L. Outcomes of a home telehealth intervention for patients with diabetes and hypertension. Telemedicine and eHealth. 2012: 18(8): 575-579.
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Introduction

People Also Read

1) The Working Alliance

2) The Real Relationship

3) Developmentally needed/reparative relationship.

A reflection on how I have experienced two of these forms/modalities in therapy

Conclusion

References

Purpose of Statement:

Research question

Definition:

Limitations

Assumptions

Literature Review

Current school:

Winona state university:

Student’s responsibility and WSU

Communication with international students

Washington State University (WSU)

University of Idaho (U of I)

Lewis-Clark State College (LCSC)

Walla Walla Community College (WWCC)

References

Introduction

People Also Read

Assessment of the film

Assessment of Caroline film

Conclusion

References

People Also Read

Reference

Abstract

People Also Read

Introduction

Health information technology

Communication and interdisciplinary collaboration

Smartphone usage in healthcare settings to enhance interdisciplinary collaboration

How healthcare professionals use smartphones and Apps to enhance interdisciplinary collaboration

Convenience

Better clinical decision-making

Improved accuracy

Increased efficiency

Enhanced productivity

Conclusion

References