Taylor LottDr. Ron GimbelHealth 4200 April 20, 2016

During the spring semester of 2016, I had the opportunity to work at Clemson University International Center for Automotive Research (CU ICAR) for my Health Science Internship. While there, I was able to spend about 180 hours interacting with individuals from a variety of backgrounds and specialties from psychology to automotive technology. Because I spent my internship at a research center, the majority of my roles or duties revolved around research in relation to health and driving. The projects I was responsible for working on were collecting the baseline data from the driving simulations at both Christ Church Episcopal School and CU ICAR, compiling the data into Excel spreadsheets to use for presentations, and write a literature review for a non-profit organization that our research team partners with known as the Guard Your Life Challenge. The knowledge and lessons learned while at CU ICAR have given me a better understanding of research techniques and evaluations that I can apply to my future career.

1. Social Determinants in HealthModern public health has recognized a variety of social determinants of health. Pick one or more , from one of the 3 categories, of these social determinants of health and reflect on how it (they) may have influenced the type, variety, and/or need for the health or medical services delivered at your internship site:

Healthy Places

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Availability and safety of transportation (public or private)

According to the World Health Organization (WHO), social determinants in health are “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life” (2016). These systems can be categorized as economic, political, or social and are responsible for addressing health concerns throughout the world (World Health Organization [WHO], 2016). At Clemson University International Center for Automotive Research, all the research and studies performed during my time at my internship focused solely on the availability and safety of transportation. With the baseline studies, future studies will be able to use the data to make comparisons and interpretations on certain conditions and how it affects an individual’s operating of a motor vehicle. For my internship site at CU ICAR, I will discuss the importance of what my internship offers in relation to the safety and availability of transportation. The leading cause of death for teenagers in the United States is motor vehicle accidents (Center for Disease Control and Prevention [CDC], 2015). This statistic, along with many others, highlights the importance of research into defensive driving. During my internship at Clemson University International Center for Automotive Research, I was exposed to research involving the importance of education about driving safety. I was responsible for collecting data from simulations with scenarios that focused on different aspects of driving such as reaction timing, object detection, and change of steering direction. I was also able to aid in researching the effectiveness of the Guard Your Life Challenge, a non-profit organization that is partnered with the BMW Performance Center to host defensive driving courses. These projects allowed me to view the statistics associated with motor

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vehicle accidents and how important teaching emergency driving maneuvers are, most notably in teens. More and more people are obtaining driver’s licenses, meaning more individuals are cruising the roads. Every time an individual climbs into a vehicle they are putting themselves at risk. Although most states require some type of driver’s education course, these courses do not include defensive or emergency maneuvers. Also, first time drivers are not always able to get driving exposure before they receive a license. This could lead to novice drivers being placed into a somewhat dangerous environment where they are unprepared. This is why the research being done at CU ICAR is so necessary and imperative. The driving simulation participants consisted of graduate students from CU ICAR and high school students from Christ Church Episcopal School (CCES). The object of the driving simulations was to provide a baseline study for average drivers, both with little to no experience and with a great deal of experience. A future concussion study will use this data as a control. One future study that will be using this data as a control is a concussion study. For this concussion study, the research team is partnering with a Spartanburg Regional Healthcare System physician, Dr. John Lucas. The hopes of this study is to show how concussions affect driving, as well as offer a way for concussed individuals to integrate themselves back into driving in a safe, risk-free environment. The scenarios on the driving simulator were created to evaluate participants’ reactions under circumstances they would face while on the road. The reaction times within the scenarios are essential in determining how safe is an individual’s driving. Many times with concussions, individuals are unable to react as quickly as they would if they lacked a concussion. This suggests that these individuals would have a difficult time to react to a situation while in a motor

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vehicle. The driving simulations can track improvement of reaction times and act as a sort of therapy for concussed individuals. Since the data I collected at my internship site was baseline data, I was not able to see these types of interactions and improvements but I was able to listen to the discussion on why this study is going to be researched and performed. This type of research can lead to roads being safer for people under similar circumstances. Another instance in where driving safety was researched was with the Guard Your Life Challenge. The Humphries family, who are responsible for starting the non-profit organization, did so in the hopes that they could improve safety awareness in teen drivers. This family lost a young member in a car accident in 2012. They wanted to prevent this tragic loss in other families, hence why they started the organization. The Guard Your Life Challenge is partnered with the BMW Performance Center and hosts four-hour defensive driving courses at specified times throughout the year. The goal of both the Humphries family and the BMW Performance Center is to give teens the tools they need to respond in emergent situations while on the road. These driving courses include skid recovery, a distraction course, and emergency braking (Guard Your Life Challenge, n.d.). The idea is to subject novice drivers to controlled danger situations to teach them how to respond so that they can do the same if faced with a similar situation in an uncontrolled situation. Educating these teen drivers on defensive maneuvers for motor vehicles can increase their awareness and improve their safety while in a car. One of my roles at the internship was to survey the participants after completing the course. Later, follow-up questions would be asked to determine how effective the course was in increasing safety awareness in relation to transportation. A variety of driving experience can be seen since the ages that are allowed to participate in the course are 15 to 19. These ages span an experience level of

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learner’s permit, to restricted license, to unrestricted license. This gives a more detailed understanding of what level of experience is participating in the course. With the follow-ups, the different ages can also show how age may affect the number of car accidents in Guard Your Life Challenge participants as well. Because the social health determinants of transportation safety are so essential in a society that relies on motor vehicles, CU ICAR works diligently to make a risky environment safer for the population. The department I interned at saw the need for a safe, low-risk environment to evaluate driving procedures. These simulators are used to research driving in relation to a variety of syndromes, ailments, and situations. It is used in studies involving concussions and developmental disorders. Hospitals have taken advantage of these simulators as well, most notably occupational therapists in their practices. This plethora of uses for the simulators means that more people are being helped. The variety of individuals utilizing these tools is also producing results that aid in understanding not only more about the conditions of the participants, but also about safe driving as a whole. This type of service is so needed due to the majority of the population obtaining driver’s licenses. In the United States in 2010, roughly 210 million people were licensed drivers (Statista). This statistic shows just how salient it is for services to be offered that focus on improving the safety of transportation. Clemson University International Center for Automotive Technology realizes this importance and has reacted. 2. Organizational Behavior and Governance

Our health care system is an interface of multiple structures for the organization, financing, management, delivery and evaluation of a wide variety of health-related services. Based on classwork and your experience in your internship, (a) Identify a

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structure, role or function that you believe is crucial to the services (availability, quality, cost effectiveness etc.) provided at your internship site. (b) How is that structure, role or function facilitated by, (or impeded by) things like organizational culture, organizational functioning, policy or law? (c) If you could change the law, policy, or organizational practices to make the system more effective/efficient, what would you change? (d) Explain why.

My internship site at the automotive research center has different departments that have varying areas of interest. Each of them is set up differently and is the same is true for the area I interned in. For my site, I was involved in a research team that focused on collecting baseline data for future studies relating to driving in terms of reaction times and object detection. The research team was structured in a hierarchy, each tier being responsible for specific projects. This research team and its structure was crucial for the projects and research being produced at the internship site. Without this current setup, confusion could have occurred and less productivity could potentially result. The structure of the research team consisted of Dr. Johnell Brooks, the team leader, Casey Jenkins, a research assistant, Michael Anderson, another research assistant, and me as the intern. In order to execute the projects, Dr. Brooks would schedule a team meeting. At this team meeting, roles and assignments were delegated to the remaining team members. Casey’s job was mostly to keep up with scheduling demands and act as the lead member in charge when Dr. Brooks was not in the simulation lab. She would remain in constant contact with Dr. Brooks to keep her updated on the progress of the research projects. Michael mostly handled converting the data coding from the simulators into data that could be inputted into Excel spreadsheets. The majority of his tasks

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revolved around technology and computer functioning with relation to the research being conducted. My role in the team was to take the newly converted data from Michael and input it into Excel spreadsheets while also calculating the averages, standard deviations, maximums, and minimums. Many times I would also be responsible for creating graphs for a more visual understanding of the research progress and results. Without this type of hierarchical structure, the research conducted at CU ICAR would lack a group perspective of thinking and many valuable perspectives could be lost. Also, the organization of the system would not function properly, causing either confusion towards duties of the research team and ultimately lack sound research. Because the structure of the research team is so pertinent as to how research projects are conducted, it is important to mention its facilitation by organizational functioning. This idea of organizational functioning is one in which explains the hierarchy of the group and the relationships amongst the team members. Thus, it would serve as a reminder that without this organizational functioning, the structure and role of the research team in innovative studies on safe driving would be impeded. The definition of a team is “a group of people who work together” (Merriam-Webster, n.d.b). Without the combined efforts of each individual member, the group as a whole would no longer be able to produce the needed research. The relationships amongst the group allow for a work environment that involves dynamic conversation about the studies and provides an atmosphere that meshes unique perspectives. These relationships also provide an understanding about what each member’s responsibility to the studies is. If the individuals in the group were not part of a hierarchy, it would be unclear about the roles each member possessed. In other words, without a hierarchy or organization

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functioning, the research team would not be able to produce studies and research because no one person would be able to delegate roles to each member. This unclear role in the workplace can lead to the lack of production for needed research. With this group dynamic the research team possesses functions appropriately, alterations can be made to improve the functioning of the system as a whole. The change that would seem to work best in this system would be that the roles of each individual be delegated in a more definite manner. During my internship, my roles and the roles of the remaining team members would be established in informal meetings with Dr. Brooks. These informal meetings would include discussions on what the intentions were for future studies and an update on the progress of current studies. Many times while at my internship, I would be unsure of what I needed to be working on. Although this would usually be short-lived because someone would give me a job to do, I think it could be eliminated as an issue. This issue can be cleared up by Dr. Brooks and the team establishing clear, written roles of each team member. I think it would also help if at the beginning of a project, roles and assignments are written out for each team member and given due dates. This would make for a better flow and everyone would know his or her job and responsibilities. Previously, a general list would be discussed and no due dates established. It would also be somewhat difficult to keep up with who has what role and many times something would be forgotten. I think this occurred mostly because a timeline was not considered and the duties were not laid out in a manner that could be referred to in the future. Overall, I think the organizational functioning of the research team is appropriate for research and studies to be enabled. However, I think that making a more defined list of duties

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as well as consulting a calendar would improve the functioning of the current hierarchical system.

3. Concentration-Specific QuestionsPreprofessional Concentration: Professionalism is an important component of a health care worker’s contract with society. Not only do we need health professionals who participate in good evidence-based decision-making, but we need caregivers who apply those decisions in a way that is professional and ultimately supports patients/clients. Professionalism has many components. Among them are maturity, responsibility, communication skills, and respect for other persons, especially patients/clients. Describe a situation or individual that you encountered during you internship that exemplifies professionalism, and explain how/why this is true. What did you learn from your internship that can help you improve your own professionalism?

Professionalism is defined as “the conduct, aims, or qualities that characterize or mark a profession or a professional person” (Merriam-Webster, n.d.a). After interning at Clemson University International Center for Automotive Research, I discovered that professionalism takes on many identities and varies from person to person. To say someone is a professional or exudes professionalism is to say that they take their job seriously and treat all individuals with respect. Previous to my internship, I had notions that professionalism mostly meant that the individual would approach someone with a business-like demeanor, presenting a firm handshake and emotionless face. This is not to say that every professional presents themselves in a suit or works for a corporate office. It also does not mean that this stereotyped idea is true.

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While at CU ICAR, I was able to interact with an abundance of individuals, each unique in their identity. This is also true for their style of professionalism. What I learned while at the research facility was that professionalism is just as distinctive as a fingerprint. Some of the employees at CU ICAR were more like the businessman mentioned above while others were more like “everyday” people. Regardless, they all encompassed the qualities of being a professional. In particular was my preceptor, Dr. Johnell Brooks. Her professionalism and competence in a workplace modeled a new definition of what it means to be a professional. Instead of an uptight atmosphere with minions running around, she kept things very relaxed and wanted her workplace to take on a family style dynamic. One quality of professionalism that Dr. Brooks embodied was proficient communication skills. From the first day I began interning with her and her team, I realized how effective her methods of communication were. She kept in constant contact with everyone within and outside of the team. She made herself available by numerous modes of communication. If I emailed her a question or needed to discuss something by phone, she would make herself available to clear up any confusion. Also at my internship site would be in-person meetings or meetings via conference calls. During these exchanges, Dr. Brooks spoke in a manner that was easy to comprehend and was patient when there was a misunderstanding. Many conference calls consisted of speaking with occupational therapists about the manuals for the driving simulators. During these exchanges, Dr. Brooks made sure she walked the therapists through the manuals so that there would be no confusion. Her communication skills were critical for when she was discussing projects and assignments for the research team to complete, especially when she was working from home and not in the office. Many times Dr. Brooks would have a specific idea that the group needed to conceive.

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Without her communication expertise, we would lack the knowledge to produce the finished product she anticipated. Another professional quality Dr. Brooks conveyed in the workplace environment was responsibility to those who worked with her and the parties she was partnered with. Not only was Dr. Brooks and the research team responsible for working on numerous papers to be published, she was also contributing to projects for other companies across the United States, and even writing a book chapter. The never-ending list of projects was overwhelming, but this type of responsibility to others was what she thrived on. She diligently funneled her time and energy into projects that focused on promoting the use of driving simulators in transportation safety and its education. As stated earlier, many other professionals were looking to gain access to driving simulators in their practices, be that for endless treatments and studies. She would become responsible for traveling to those individuals who were interested in this type of equipment for therapies and research. Another instance where Dr. Brooks showed responsibility as a professional was in meetings with the family who began the Guard Your Life Challenge. The partnership between CU ICAR and the Guard Your Life Challenge program is fundamental in determining how well defensive driving courses are in curbing the high numbers of car accidents for teens. The responsibility of the research team to collect data on the performance of the program aids in the understanding and improvement of safe driving. Not only does this information affect the population in the upstate area of South Carolina, but the published information from this study can also act as a template for future research in other areas of the country and world. One thing I noticed with Dr. Brooks was that her responsibility never seemed like a burden, regardless of how overwhelming the amount of work she had on her plate. She always

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welcomed it and strived to provide her best self to all those she was accountable to. Although Dr. Brooks portrayed abundant qualities of a professional, the most important one I took note of was her respect to those she came in contact with. Dr. Brooks has a colorful personality and makes everyone comfortable in her presence. She is welcoming to all people, regardless of race, ethnicity, gender, or culture. This respect she emanates comes in the form of friendly jokes and praises. Although there are differences between her and many of the individuals she meets with, she remains respectful and treats them equally. Respect is vital in any sort of workplace environment. No person should feel disrespected and Dr. Brooks is consciously aware of her actions so that no person experiences this from her. Even within the research team, if someone does something wrong, she does not treat them with disdain or contempt. She explains their mistake and attempts to explain in a considerate manner how to alleviate the issue. This type of quality seems to be disappearing in many respects in this world, which is why it is ever-so pertinent for professionals to possess respect for others. My internship at Clemson University International Center for Automotive Research was an amazing opportunity that I was able to use as a valuable learning experience. The models of professionalism by Dr. Johnell Brooks and the rest of the research team gave me great insight into what it means to be a professional. Qualities such as responsibility, good communication skills, and respect are salient in all workplaces, especially the healthcare field. Because healthcare is my desired area of interest for a career, I was attuned to the interactions between participants and researchers, students and professors so that I observe professional interactions. I could then take what I learned at my internship and use it in my own profession. In my opinion, respect is the most important attribute of a

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professional that can be improved. While I strive to always be respectful, it can be difficult to remain unbiased in some situations. To respect someone is to treat everyone equally. In the field of medicine, physicians treat patients of all race, gender, and culture. It is of the utmost importance to treat all patients equally. While this may seem as if it is a rather simple task, situations arise that test a person’s professionalism. These are the moments when the physician must remember that their duty is to treat patients with respect. Physicians are to remain unbiased regardless of circumstances. However, emotions can cause a cloud in judgment. This can result in patients being unfairly treated and disrespected. After spending time with Dr. Brooks at CU ICAR, I was able to see how to eliminate this issue from occurring. Our job as professionals is to not pass judgment onto others and respect the people we are treating no matter the differences between our views. My internship experience further taught me how to deal with situations in which I would have a different view or opposing perspective than other people. I am a very respectful person, and because I know emotions affect judgment I can be better prepared when dealing with patients due to my time at CU ICAR. All the knowledge and experience gained while at my internship will help me to further my career in medicine. These experiences will also remind me to always treat everyone equally and with the highest respect.

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Works Cited

Centers for Disease Control and Prevention. (2015). Teen drivers. Retrieved

from http://www.cdc.gov/motorvehiclesafety/teen_drivers/

Guard Your Life Challenge. (n.d.) Driving experience. Retrieved from http://www.guardyourlifechallenge.com/driving-experience.html

Merriam-Webster. (n.d.a). Professionalism. Retrieved fromhttp://www.merriam-webster.com/dictionary/professionalism

Merriam-Webster. (n.d.b). Team. Retrieved fromhttp://www.merriam-webster.com/dictionary/team

Statista. (2010). Statistics and facts about car drivers. Retrieved from http://www.statista.com/topics/1197/car-drivers/

World Health Organization. (2016). Social determinants of health. Retrieved

from http://www.who.int/social_determinants/en/