July 13, 2021
Among the disruption and uncertainty of COVID-19, staff in K-12 schools found themselves in roles they had never anticipated as they worked to support their learners – academically, physically, emotionally and remotely.
Using funding support from the Centers for Disease Control and Prevention, the North Carolina Department of Public Instruction (NC DPI) partnered with the North Carolina Institute for Public Health (NCIPH) to create an accessible learning resource for staff in each of N.C.’s 100 counties to help address rapidly changing roles and responsibilities. The result is the North Carolina Healthy Schools Training website, a repository of short, online, educational courses to help school staff be responsive to needs that emerged during the pandemic.
The project was well-suited for NCIPH, a group at the UNC Gillings School of Global Public Health that works with state and local public health agencies to put the School’s research into practice. A previously established relationship with NC DPI and their Healthy Schools section made it a seamless process to identify gaps in training created by the pandemic and brainstorm the best solution. A team of students and educators led by Rachel Wilfert, MD, MPH, CPH, director of workforce training and education at NCIPH, developed educational content and the accompanying website in collaboration with state education and public health partners.
Critical areas to address included understanding how to mitigate disease outbreaks, establishing best practices for virtual school nurse visits, development and leadership of school nursing teams, helping schools care for the emotional well-being of students and staff in the context of virtual learning, and working to raise awareness of critical inequities in oral health and supporting connections to care.
“We talked to our expert partners, came up with a framework for training that met identified needs and then developed content to be delivered as online modules,” Wilfert explained. “In some instances, we were ahead of the curve, because often we were trying to fill needs that lacked official guidance. Sometimes we would develop content on a particular topic, and then, halfway through the process, a state policy would be issued, which meant we didn’t have to re-cover that topic and could focus on what still needed to be addressed. So many things were constantly changing during the pandemic, and it required our team to very nimble and responsive.”
The NCIPH project added surge capacity to develop and deliver high-quality training materials during a time when state public health and educational professionals were managing an overwhelming set of demands in response to the pandemic. The modules, which are accessible and designed using best practices for online training, were formulated to be of use even beyond the context of COVID-19.
Content such as the course on using nurse extenders – trained practitioners who are able to provide nursing services in support of a school nurse – are expected to have longevity because the pandemic has restructured many of the ways schools approach health services.
“Very few nurse extenders were employed in N.C. schools prior to the pandemic,” said Ann Nichols, MSN, RN, NCSN, a state school health nurse consultant from the North Carolina Department of Health and Human Services (NC DHHS) who provided subject matter expertise to the project team. “Prior to the pandemic, they were largely hired for students that needed high levels of regular engagement for care, like a one-on-one relationship. With the focus on increasing school nursing services, there is a need for nurse extenders in order to provide more health services to students.”
Nichols says the state is also encouraging nurses to develop skills related to virtual visits, both for situations like the pandemic and for more efficient use of school nurse resources when virtual visits are appropriate for a particular need.
Some of the site’s other modules teach management skills that are useful both for school nurses and those in leadership positions, while courses on social-emotional learning and oral health are relevant to all school staff.
Although tooth decay continues to decrease among children as a whole, the prevalence of tooth decay remains higher among minority children and children living in poverty. School-based oral health programs provide access to dental care for some of these most vulnerable children.
“As pandemic restrictions were implemented in schools, many school-based oral health programs were suspended. This limited our ability to enter schools to provide preventive services,” says Jessica Scott DHSc, RDH, school oral health coordinator in the NC DHHS Oral Health Section. “We thought it would be valuable to partner with NCIPH to develop oral health modules designed to equip school staff with basic oral health knowledge, including the impact of oral health on student learning and the importance of a dental home. We also provided resources that the schools can use to connect children to dental care in their communities.”
The North Carolina Healthy Schools Training Website officially launched in June and has been positively received by school staff and leadership across the state. Nichols says the NC DHHS plans to add official nursing credit hours to the modules over the course of the year. NCIPH is in the process of developing plans to collaborate with NC DPI over the upcoming year, particularly in support of the social-emotional and mental health needs of school staff who will be coming back to in-person instruction in the fall.
Contact the UNC Gillings School of Global Public Health communications team at firstname.lastname@example.org