Why I Teach: With Dr. Sharon Bigger
This episode features Dr. Sharon Bigger, Assistant Professor in the College of Nursing. Dr. Bigger is a career hospice nurse and former medical interpreter who uses the lessons she has learned with her patients and her research to inspire our undergraduate and graduate students in the classroom and in their research endeavors.
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Dr. Sharon Bigger
I would say I take more of an empowerment approach in education. It's one thing to dispense information to the students, but it's another thing to present issues and problems to the students and say, "What do you think about this given the tools that you have, given the readings that you have done? What's meaningful here, and what's going to work?"
Provost Kimberly D. McCorkle
Hi, I'm Kimberly McCorkle, Provost and Senior Vice President for Academic Affairs at East Tennessee State University. From the moment I arrived on this campus, I have been inspired by our faculty, their passion for what they do, their belief in the power of higher education, and the way they are transforming the lives of their students. This podcast is dedicated to them, our incredible faculty at ETSU. Hear their stories as they tell us, "Why I Teach."
In this episode, we will talk with Sharon Bigger, Assistant Professor in the College of Nursing. Dr. Bigger is a career hospice nurse and former medical interpreter. She holds bachelor's degrees in nursing and sociology with a minor in Spanish, a master's degree in philosophy and religion with a concentration in women's studies, and a doctoral degree in nursing. She completed her Ph.D. in nursing at ETSU in May of 2021 and became a full-time faculty member in the ETSU College of Nursing in August 2021. She now serves as the research representative on the College of Nursing Council. Her program of research focuses on communication about goals of care with diverse populations with chronic illnesses, with specific focus on transitions between home health and hospice. She has presented her research findings at the local, regional, national, and international levels. Dr. Bigger is a member of the Hospice and Palliative Nurses Association's Research Advisory Council and is co-chair of the HPNA Emerging Scholars Special Interest Group. She serves on the editorial board of the American Journal of Hospice and Palliative Medicine. Enjoy the show.
Dr. Bigger, welcome to the show.
Dr. Sharon Bigger
Thank you for having me.
Provost Kimberly D. McCorkle
I like to start my podcast with the same question for every guest. Take me back to your first day of teaching at ETSU as a faculty member. And looking back on that day, what is one piece of advice that you would have given yourself?
Dr. Sharon Bigger
My first day of teaching at ETSU was in fall of 2021. And even though I teach primarily
in the graduate program online, they like to have us teach across programs. So about
one class per semester, I'm teaching to undergraduate students. And that is the memory
that's coming to mind. I got to come to campus; it was during COVID. We were all masked
in a pretty small room. There were about 18 students. So I had the chairs spaced out
as much as possible. And I was very excited and both, yeah, both excited and nervous
because I had taught first-generation students in Appalachia before, but never at
ETSU. I had been a student at ETSU, but never an undergraduate student. So there I
was. It was my first day teaching first-generation, primarily first-generation undergraduate
students at ETSU. I felt very nervous and excited. And the piece of advice that I
would have given myself would be to enjoy it. Enjoy the excitement. Enjoy it.
Provost Kimberly D. McCorkle
As I read your bio, you had a successful career as a hospice nurse before you arrived at ETSU. Can you tell us a bit more about your background and what inspired you to pursue a career in nursing?
Dr. Sharon Bigger
Well, as you can tell by my background, I have pursued many different courses of study. And what inspired me to pursue nursing was the one common thread in all of those things was that I've always been interested in where people find meaning. And nursing was a path that allowed me to be of service to people from all walks of life, particularly hospice nursing. It's the, it sounds a little morbid to say, but it's the one thing that we all have in common; it's the ultimate statistic. 10 out of 10 people will die. And it's just an honor to be invited into people's homes, to be of service to them in that time, and selfishly, it allows me to continue that exploration of where people find meaning while I get to be of service to them.
Provost Kimberly D. McCorkle
What made you decide to transition into nursing education? And now that you're at ETSU, what courses do you usually teach?
Dr. Sharon Bigger
So much of nursing is about education of the patient and the family through the avenue of health promotion. At any level of the life course and at any level of health, we could be involved in prevention; we can be involved in screening; we can be involved in helping people to maximize and optimize their quality of life. So I found myself doing a lot of teaching with patients and families. I then, after completing my master's degree, I then transitioned into the role of a clinical nurse educator for a hospice agency and wound up doing education with professionals. Found that very rewarding as well. It also turned me on to the academic side of things, the looking into the literature and finding best evidence. And I began to question where did this evidence come from? And that's what led me to pursue a Ph.D. in nursing. Because the Ph.D.s are ones who do the research and generate the new evidence that then gets put into practice. So the courses that I teach at ETSU, one is for Ph.D. students, the Philosophy of Nursing Science; it's exploring the philosophical underpinnings of the theories and the methods that we use in research. Again, it's an exploration of where people find meaning and how they find meaning. Another course that I teach is Health Policy Leadership. That's a very rewarding course as well, because it's for students at the master's level, as well as who are in the DNP program, doctorate of nursing practice, and the Ph.D. program. And they all come to the table and find that we have in common. There are things that we are passionate about that affect us and our patients and families, and here's how we can exercise our voice and have an influence to help shape those policies that affect us all. And then finally, at the undergraduate level this semester, I'm teaching Health Promotion and Research. It's really a combination of two main themes. About half the course modules focus on research, so teaching the undergraduate students, sort of the anatomy of a research article, as well as how to critically appraise; just because something appears online or just because something appears in a peer-reviewed journal doesn't make it high quality evidence. So empowering them and teaching them how to critically appraise and not just simply consume evidence. And then the other half of the course is how to use that evidence for the purposes of health promotion with patients and families.
Dr. Kimberly D. McCorkle
Those sound like really rewarding classes.
Dr. Sharon Bigger
They are.
Provost Kimberly D. McCorkle
So you're also quite involved in research, as I said in your introduction, both your
own, as well as the research representative for the College of Nursing Council. Could
you share some details about your current research interests and projects?
Dr. Sharon Bigger
Well, I'll say that from my dissertation, I wound up getting published five manuscripts because there were 10 hypotheses in the dissertation, and five of those results were significant.
Provost Kimberly D. McCorkle
That's fantastic.
Dr. Sharon Bigger
Yes. So five publications came out of that. And the topic of that research was advance care planning and hospitalization, rehospitalization and emergency department use among home health patients. So advance care planning involves talking ahead of time, having conversations ahead of time about values, goals, and beliefs, what's important to you in life, and then helping your health care decisions be guided by that. It can be very intimidating to people to say, "What kind of treatments would you want and not want?" Well, who knows ahead of time? And so what we're finding in the research is that it's more helpful to start that conversation with "What's important to you? What does a good day look like to you? And if you couldn't do those things, would you want to be kept alive and breathing, and perhaps maybe that's the only thing that you could do?" Some people say yes. Some people say no. Some people are somewhere in between. So I was looking at advance care planning a little bit more upstream than hospice because advance care planning truly happens in advance of a health care crisis and to see how a new policy from Medicare that mandated that home health agencies report, not the contents, but the fact that they were doing it to see what kind of effect that had on acute care services use. So that was, that was my dissertation. And that was really the launch of my research career. And since then I have broadened that to communication in general about goals of care among populations, diverse populations with chronic illnesses with specific focus on transitions between home health and hospice.
Provost Kimberly D. McCorkle
Yeah.
It's fascinating research.
Dr. Sharon Bigger
Thank you.
Provost Kimberly D. McCorkle
Can you tell us more about how your clinical experience has influenced your
approach to teaching and research? So in hospice, we are all about autonomy. What, what do you want your life to look like in the time that you have left to live and supporting and empowering people and their families to live the kind of quality of life that they want to given the circumstances that they are in. And so I've always held that passion for where people find meaning and then supporting them in their autonomy. And I have to say that has influenced my approach to education as well. I would say I take more of an empowerment approach in education. It's, it's one thing to dispense information to the students, but as another, it's another thing to present issues and problems to the students and say, "What do you think about this? Given the tools that you have, given the readings that you have done, what's meaningful here, and what's going to work?"
Provost Kimberly D. McCorkle
That's great. Can you share a memorable experience from your time working in a clinical setting that has shaped your perspective as an educator?
Dr. Sharon Bigger
Yes, I can. I was invited into the home of a hospice patient and family one time, and it was an adult, older adult father and two adult sons who were his care partners. And they were not parents themselves. They did not have jobs that involved any kind of caregiving. And so this was brand-new to them, and their father was becoming more and more debilitated, but he really wanted to live at home until he died. And his sons really wanted to support him in that. And as his father became, um, their father became more and more debilitated, he was losing mobility, and the sons were having a really hard time making sure that his personal needs were taken care of. So I was called into the home. My job as the hospice educator was really to educate the staff, but for this particular situation, I was called into the home to work with the patient and family. And I taught them some very simple transfer techniques that I myself had learned as a nurse from a physical therapist. Before I became a hospice nurse, I had worked in the hospital on the neurosciences unit. And so I was in close collaboration with many different disciplines, professions. So physical therapists, occupational therapists, speech therapists. I learned as much from them almost as I did in nursing school. And it was a physical therapist who taught me, you know, if you have a, if you have a, a gait belt, you can do anything. So I provided this patient and family with a gait belt. I taught them some safe transfer techniques, and this older gentleman was able to live at home until he died. You know, equally as important, his sons were able to feel successful in taking care of him.
Provost Kimberly D. McCorkle
So how do you think interprofessional collaboration benefits both nursing students
and professionals?
Dr. Sharon Bigger
Yes. So the patient is at the center of everything we say and do. I forgot to mention the other course that I teach in, which is the IPE simulation, interprofessional education. And I love that because it's all I've ever known. And I love bringing students to the table, students of medicine, of pharmacy, of public health, of nursing, of nutrition, of social work, audiology, so many different disciplines coming together. And, and if we truly honor that the patient is at the center, then we can acknowledge that each one of us brings a piece of the puzzle. And not only that, but the dynamic of our working together can only benefit the patient. I can give an example from my own life. And that is when my mother had a stroke and was in the ICU for about two weeks. And I was on the other side of things. I wasn't thinking like a nurse. I tried my hardest, but it was really hard because I was the daughter in that situation. But I witnessed all the many disciplines coming in, all the specialties of medicine, but all the many disciplines coming in. And they truly were multidisciplinary. They didn't seem to really be communicating with each other. And so I'm sorry to say, I, I, I saw what it should not be like. And it was ultimately when I requested that we get the palliative care team on board, that the palliative care team was the one who took the leadership and getting all the disciplines together and saying, "Here is the plan." And only when we had someone saying to the team, "Let's all get on the same page," did they really start to work as an interprofessional team. And my mother received better care.
Provost Kimberly D. McCorkle
That's a great example. And I'm sure one that helps demonstrate to students the power of interprofessional education. In your opinion, what are the most
significant challenges facing the nursing profession today? And what is the ETSU College of Nursing doing to help our students prepare for those challenges?
Dr. Sharon Bigger
Well, we're all aware of the nursing shortage, but I think equal on par to that is the ability for nurses to practice at their full scope of practice. That is sometimes limited by legislation, but sometimes it's limited by internal policy at an organization or even a nurse's own beliefs about what they are capable of. So I'm very proud that ETSU is the largest college of nursing in the state of Tennessee, and we have a very robust LPN to BSN program. So the baccalaureate level of nursing is a very powerful level of nursing because it involves leadership. It involves an awareness of research and using best evidence and practice. And it involves an awareness of population health and community health and how that impacts each individual. So what I see ETSU doing is, for lack of a better word, producing more baccalaureate-prepared nurses, as well as in part through the Health Policy Leadership course, but through other avenues as well, empowering the master's-prepared and doctorally-prepared nurses to advocate for policies that really allow them to practice at their full scope of practice.
Provost Kimberly D. McCorkle
Finally, what impact do you hope that you've made on your students?
Dr. Sharon Bigger
This actually comes from my background in the liberal arts. It's critical thinking. I really try to empower the students. As I mentioned before, it's not just a piece of knowledge or a fact for you to memorize and regurgitate and incorporate. It's a piece of information that you get to have thoughts and opinions about. And the structures and policies that exist, you also get to help shape them. So I try to role-model that receptivity as an instructor. I'm not just here as an authoritarian. I'm here because I have some experience. I have some expertise, but I also welcome your feedback, and I use it. So I try to give them that experience right away of that continuous process improvement that what they say matters, their experiences matter, and that they are empowered to help shape the future.
Provost Kimberly D. McCorkle
Thanks for listening to "Why I Teach." For more information about Dr. Bigger, the
College of Nursing, or this podcast series, visit the ETSU Provost website at etsu.edu/provost.
You can follow me on social media. And if you enjoyed this episode, please take a
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