Faculty Profile: Renee Shield, Ph.D. Brown

Renee Shield
Renee Shield, Ph.D. Brown
Clinical Professor
Health Services, Policy & Practice
Work: +1 401-863-9958
Dr. Shield has long been involved in the exploration of life and work in US nursing homes (NHs) and long term care using qualitative and mixed methods. Her NH research focuses on end-of-life care; the culture change movement; ethical decision-making; communication among staff, residents and families; and the roles of physicians. She also works on geriatrics in medical school education, electronic health records and health information exchange.

Biography

Dr. Shield is a cultural/medical anthropologist whose qualitative and mixed methods research has focused on health care for the elderly; work, retirement and well-being among elderly diamond traders; ethical decision-making; rites of passage and reciprocity in nursing homes; end-of-life care, culture change nursing homes; electronic health records; health information exchange; and medical school curriculum development and evaluation. Dr. Shield formerly served as the Director of Research and Education at the Jewish Home for the Aged in Rhode Island and the Director of Education at Aging 2000.

Research Description

Dr. Shield is a cultural anthropologist whose ethnographic research has focused on health care for the elderly; work, retirement, and well being among elderly diamond traders; physician-patient/family communication, ethical decision-making, rites of passage, and culture change in US nursing homes. Formerly the Director of Research and Education at the Jewish Home for the Aged in Rhode Island and the Director of Education at Aging 2000, Dr. Shield currently conducts research in end-of-life care and culture change practices in nursing homes in her work at the Center for Gerontology and Health Care Research, Brown University. Additional projects have focused on health information exchange and the implementation of electronic health records in physician's offices. Her work uses qualitative and mixed methods.

Grants and Awards

Watson Smith Prize in Anthropology, Brown University
Invited participant, Advanced Seminar, School of American Research, Santa Fe, NM
First Annual President's Award, The Jewish Home, Providence, RI
Community Service Award, The Alliance for Better Nursing Home Care, Providence, RI

Affiliations

American Anthropological Association
Society for Medical Anthropology
The Gerontological Society of America
Association for Gerontology and Anthropology
National Association for the Practice of Anthropology

Funded Research

GRANTS--CURRENT
Suicide Prevention Program, Brown University Program in Public Health and Rhode Island Department of Health, Substance Abuse and Mental Health Services Administration (SAMHSA) (T Wetle, PI), 1/1/10-9/30/11

PI, Evaluation Plan for the RI Health Information Exchange (subcontract with RIDOH, 11/1/09-6/31/10) (P Vivier, PI, AHRQ, 9/30/04-9/20/09)

Investigator, Schwartz Communication Sessions (R Besdine, PI), 1/1/09-12/31/10)

Director, Reynolds Foundation Mandatory Geriatrics Education for Brown Medical School: Comprehensive Curriculum Redesign. Resource Center for Geriatrics Education (R Besdine, PI), 7/1/06-6/31/10

Co-Investigator, Nursing Home Culture Change: Understanding Its Implementation and Impact, Retirement Research Foundation (S Miller, PI), 6/08-5/11)

Investigator, Shaping Long Term Care in America, NIA Program Grant, Core B (V Mor, PI) 9/07-6/12

GRANTS--COMPLETED
Investigator, Analysis of Planetree's Long-Term Care Resident and Direct Care Staff Focus Groups (S Miller, PI), Planetree, 6/09-12/09

Investigator, Ethnography of the Impact of Information Technology in a Family Medicine Clinical Practice, Dept. Health and Human Services (R Goldman, PI), HRSA Academic Administrative Units in Primary Care, 7/1/04-6/30/07

Investigator, The Role of State and Federal Policies in Shaping Accessible High-Quality Long-Term Care for Persons with Advanced, Chronic or Terminal Illness (S Miller, PI), JEHT Foundation, 10/1/06-3/31/07

Investigator, Improving Qualitative and Mixed Methods Research (T Wetle, PI), AAN, 11/1/05-6/30/06

Investigator, Building Relationships in Bioterrorism Preparedness and Response (T Wetle, PI), RIDH, 10/1/05-6/30/06

Principal Investigator, Exploration of Physician and Patient Attitudes Regarding Referral to Hospice, VistaCare Foundation, 4/1/04-3/31/05

Investigator, Improving Qualitative and Mixed Methods Research, John A. Hartford Foundation, National Institute on Aging (T Wetle, PI), Robert Wood Johnson Foundation, 8/1/04-10/31/05

Investigator, End-of-Life Issues in Nursing Homes (T Wetle, PI), AARP, 7/1/02-12/31/02

Principal investigator, Educational development in the nursing home, RI Foundation. The Jewish Home, Providence, RI. 1987, 1988

Principal Investigator, Educational development and the Nursing Home Teaching Conferences RI Department of Elderly Affairs, The Jewish Home, Providence, RI. 1988, 1989

Teaching Experience

UNIVERSITY TEACHING ROLES

Guest lecturer, SOC 1050-S01

Guest lecturer, PHP 2060

Guest lecturer in BC 244

Guest lecturer in PHP 1320/Soc 1320

BI 361 Doctoring, Brown Medical School. 2005-2006

BI 371 Medical Interviewing, Brown Medical School. 2003-2005

MD, Ph.D., MPH and senior thesis advisor and mentor, varied departments

Affinity Group co-leader, 1988-2003
"Alternative Medicine and Health Care," Program in Liberal Medical Education (PLME), Brown University, with Mark Brody, MD 1999-2003.

"Rethinking, Reorienting, and Reforming Medicine," Program in Liberal Medical Education (PLME), Brown University, with Barrie Weisman, MD, 1992 – 1996

"Issues of Identity and Culture in Aging," Program in Liberal Medical Education (PLME), Brown University, with James McCartney, MD, 1988-1992

Facilitator, Ethics Program, Brown University Program in Medicine. "Case Scenarios on Students' Professional Behavior." August 29, 1995.

University of Rhode Island, HDF 220. 1994. Department of Human Development and Family Studies. "Gerontology: Theory and Application."

University of Rhode Island, Spring semester, HDF 221, 1995. Department of Human Development and Family Studies. "Working With the Elderly."

Community Health Clerkship in the nursing home setting, Brown University Program in Medicine (with Henry Izeman, MD and James McCartney, MD). The Jewish Home, Providence, RI. 1987-1989.

Designed and taught Modes of Thought courses, "The Twilight Zone: Experiences of Aging in Cross-Cultural Perspective," Brown University, 1981-82, 1984.

Teaching Assistant, "Culture and Health," L. Newman, Brown University, 1978-1979

OTHER TEACHING ROLES
Preconference Workshop, Qualitative and Mixed Methods Research: Improving the Quality of Science and Addressing Health Issues of Diverse Populations. Gerontological Society of America, Annual Meeting. Co-organizer and leader. 2004, 2005.

Aging 2000, Providence, RI: developed and implemented research plan for Aging 2000 study; co-author of Aging 2000 report; created Strategy for Education; developed educational curriculum for consumer education on aging; organized and presented numerous conferences, workshops, discussions, and retreats. Talks, workshops, etc. for between 20 and 150+ people each time. 1989-1994.

Developed Interfaith Health Care Ministries annual conference, with IHCM board members and led workshop. 100-150 participants. Providence, RI, c.1992.

Developed and taught "Bioethics for Nurses in Nursing Homes," with Judith Mattea, RN, MSN and Alicebelle Rubotzky, RN. 40-50 students. The Jewish Home, Providence, RI, 1989.

Organized monthly Nursing Home Teaching Conferences; developed numerous workshops and panels for staff, nursing home residents, and community members on topics related to working and living in nursing homes, such as restraints, nursing home jargon, bereavement, transitions, culture and identity, professional support, and sexuality; Workshops held 8-20 participants each time. Conferences were approximately 30-100 each month. The Jewish Home, Providence, RI 1987-1989.

Organized and ran interdisciplinary ongoing seminar on design issues in nursing homes. Fifteen participants of varied fields from nursing homes, hospitals, RISD, Brown, and URI met monthly to discuss and design better environments for the elderly. Held at the Jewish Home, Providence, RI, 1988-1989.

Organized anniversary conference with Patricia Dwyer and Henry Izeman, MD, "Decisions at the End of Life: The Limitations of Treatment." 100-150 participants. The Jewish Home, Providence, RI May, 1988.

Courses Taught

  • Doctoring (BI0361)
  • Medical Interviewing (BI0371)

Selected Publications

  • Shield RR, Wetle T, Teno J, Miller SC, Welch LC. 2010. Vigilant at the end of life: Family advocacy in the nursing home, J Palliat Med. 13 (5):573-9. (2010)
  • Shield RR, Goldman RA, Anthony DA, Wang N, Doyle RJ, Borkan J. Gradual Electronic Health Record Implementation: New Insights on Physician and Patient Adaptation, Annals of Family Medicine. 2010; 8(4): 316‐326. (2010)
  • Tyler DA, Shield R, Rosenthal M, Miller S, Wetle T, Clark M. 2010. How valid are the responses to nursing home survey questions? Some issues and concerns. The Gerontologist. doi: 10.1093/geront/gnq095. (2010)
  • Lima JC, Miller SC, Shield RR. 2009. Palliative and hospice care in assisted living: Reality or wishful thinking? J of Housing for the Elderly 23 (1-2): 47-65. http://www.informaworld.com/smpp/section?content=a908657836&fulltext=713240928 (2009)
  • Shield R, Borkan J, Guest editors. ANTHROPOLOGICAL PERSPECTIVES ON MEDICINE. Medicine & Health / Rhode Island 91 (12). December, 2008. http://rimed.org/2008-12.asp (2008)
  • Shield R, Wetle T, Besdine R. 2008. Preparing for the silver tsunami: The integration of geriatrics into the new medical curriculum at the Warren Alpert Medical School of Brown University. Medicine & Health / Rhode Island: 91 (8): 247-249. (2008)
  • Farrell T, Campbell C, Nanda A, Shield R Wetle T. 2008. Evaluating geriatrics in the medical school curriculum: Using Student Journals. Medicine & Health / Rhode Island 91 (12): 378-381. (2008)
  • Shield R, Borkan J. 2008. Anthropological perspectives on medicine: Introduction. Medicine & Health / Rhode Island 91 (12): 360. http://rimed.org/2008-12.asp (2008)
  • Miller SC, Shield R. 2007. Palliative care/hospice for persons with terminal and/or chronic progress illness: The role of state and federal policies in shaping access and quality for persons receiving long-term care. Brown University: Center for Gerontology and Health Care Research. Available at: http://www.chcr.brown.edu/PDFS/JEHT_4_FINALREPORT07.PDF (2007)
  • Shield R. 2007. Physicians' perspectives on end of life care: A qualitative inquiry. Medicine & Health / Rhode Island. 90 (12): 391-392. (2007)
  • Curry L, Shield R, Wetle T., Eds. IMPROVING AGING AND PUBLIC HEALTH RESEARCH: QUALITATIVE AND MIXED METHODS. 2006. Washington, DC: Gerontological Society of America/American Public Health Association. (2006)
  • Shield RR, Wetle T, Teno J, Miller SC, Welch L. 2005. Physicians "missing in action": Family perspectives on physician and staffing problems in end-of-life care in the nursing home. J of the American Geriatrics Society 53 (10): 1651-1657. (2005)
  • Wetle T, Shield R, Teno J, Miller SC, Welch L. 2005. Family perspectives on end-of-life care experiences in nursing homes. The Gerontologist 45 (5): 642-650. (2005)
  • Teno JM., Clarridge BR, Casey V, Welch LC, Wetle T, Shield R and Mor V. 2004. Family perspectives on end-of-life care at the last place of care. JAMA 291 (1): 88-93. (2004)
  • Wetle T, Teno J, Shield R, Welch L, Miller SC. 2004. END OF LIFE IN NURSING HOMES: EXPERIENCES AND POLICY RECOMMENDATIONS. Washington, D.C. AARP Public Policy Institute, #2004-14. (2004)
  • Shield R. and Aronson SM. 2003. AGING IN TODAY'S WORLD: CONVERSATIONS BETWEEN AN ANTHROPOLOGIST AND A PHYSICIAN. New York: Berghahn Books (Paperback issued 2005). (2003)
  • Shield R. 2003. Wary partners: Dynamics of interactions between nursing assistants and family members in nursing homes. In Stafford P (Ed.) Gray Areas: Ethnographic Encounters with Nursing Home Culture. Santa Fe (NM): SAR Press. (2003)
  • Shield R. 2002. DIAMOND STORIES: ENDURING CHANGE ON 47TH STREET. Ithaca: Cornell University Press. (Paperback issued 2005) (2002)
  • Shield R. 1997. Liminality in an American nursing home: The endless transition. In Sokolovsky J (Ed.) The Cultural Context of Aging: Worldwide Perspectives. NY: Bergin & Garvey. Revised 2nd edition. (1997)
  • Shield R. 1997. AGING 2000: CASE STUDY. Health Care Financing Administration Report. (1997)
  • Shield R. 1996. Managing the care of nursing home patients: The challenge of integration. In Annual Review of Gerontology and Geriatrics, Volume 16. Focus on Managed Care and Quality Assurance. Newcomer R and A Wilkinson (Eds.) NY: Springer Publishing Company. http://books.google.com/books?id=uRxeWiDnvLcC&pg=PA60&lpg=PA60&dq=renee+rose+shield&source=bl&ots=vbRpFIfH5h&sig=NpJggyI2FnTkMcRwpjX7aoe_9bE&hl=en&ei=2oeuSvOyBc7VlAf-6tnFBg&sa=X&oi=book_result&ct=result&resnum=7#v=onepage&q=renee%20rose%20shield&f=false (1996)
  • Shield R. 1995. Ethics in the nursing home: Dynamics of decision-making in a nursing home ethics committee. In The Culture of Long Term Care: Nursing Home Ethnography. Henderson, JN and M Vesperi (Eds.) Westport (CT): Greenwood Press. (1995)
  • Shield R. 1988. UNEASY ENDINGS: DAILY LIFE IN AN AMERICAN NURSING HOME. Ithaca: Cornell University Press. (1988)