Medicine and Health Sciences Commons^™

Thoughtful Integration Of Active Learning Teaching Strategies Into Physician Assistant Education, Daniel Berger

Doctor of Medical Science (DMSc)

Introduction:

The future of healthcare relies upon how we train student clinicians. It is integral to continually reevaluate our methodologies of teaching and work to better approach the challenging task of educating competent and compassionate physician assistants in a short two-to-three-year window. While the traditional modality of teaching has been primarily lecture-based, there has been a growing movement to incorporate active learning into medical education. This learner-driven model puts students in the driver’s seat and allows for greater amounts of self-directed learning prior to class followed by the reinforcement of concepts during class time. Though lecture-based teaching could be the …

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Oscar J. Castillo

Master's Projects and Capstones

Problem: The Quality Improvement (QI) Project focused on improving early sepsis management and sepsis bundle adherence among Emergency Department (ED) nurses to decrease sepsis mortality rates and avoidable length of hospital stays (LOS).

Context: A group of Clinical Nurse Leaders (CNL) students evaluated sepsis protocol compliance at Hospital A's ED, which provides critical care for patients with various medical conditions. The CNL students concentrated on patients identified with sepsis for the QI Project.

Interventions: Limitations and time did not allow for the implementation of interventions. Recommendations offered to management included increasing sepsis training biannually and intravenous placement skills, offering sepsis …

Minoritized Medical Students' Integration Of Professional Identities: A Phenomenological Study, Travis Erickson

Electronic Theses and Dissertations

This qualitative study fills a gap in the extant literature by exploring how medical students with minoritized identities make meaning about sense of self-definition and emerging professional identities while enrolled in medical school. More specifically, the focus of this study explored how minoritized medical students perceived their sense of self and dimensions of identity were shaped during their medical education, and what perceptions these medical students had about how they manage their professional identity development. Emergent themes included: (a) making connections between self-definition and professional identities, (b) past experience of difference shaping identities, (c) self-definition with complexity, (d) fluidity as …

Frequency Of Ciwa Scoring In Patients With Alcohol Dependence In A Mental Health Setting, Heather Mcmanis

Doctor of Nursing Practice Scholarly Project

The purpose of this quality improvement project was too assess the knowledge and attitudes of nursing staff toward assessing patients diagnosed with alcohol dependence who are detoxing from alcohol in a mental health facility. An educational intervention was done with nursing staff to assess their knowledge of the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scale and to stress the importance of frequent and accurate use of the scale. Data was collected for three months before the educational intervention and three months after the educational intervention on the total number of patients admitted to the facility with a diagnosis of …

Non-Clinical Perspectives On Sepsis: A Project For Enhanced Awareness, Anjali Kumari Singh

Master's Projects and Capstones

Problem: This project aimed to enhance non-clinical staff knowledge of sepsis through a targeted awareness campaign, while also seeking to uphold or enhance the organization's sepsis-related performance.

Context: Clinical Nurse Leader students conducted a microsystem assessment in five crucial non-clinical departments of an urban Bay Area hospital, each playing a vital role in the organization's efficiency at different levels.

Intervention: During Sepsis Awareness Month, a sepsis awareness campaign was implemented. This involved a concise presentation on sepsis, its consequences, and the significance of awareness in each department. Additionally, informational fliers detailing sepsis signs and symptoms were distributed.

Measures: A pre-and …

A Quality Improvement Project To Increase Awareness And Utilization Of Employee Assistance Program Services Among Healthcare Providers, Scarlet Gould

Doctoral Projects

Mental health distress among healthcare providers (HCP) is a common problem, yet Employee Assistance Programs (EAP) are consistently underutilized. Unmanaged workplace stress can lead to problems such as provider burnout and increased rates of turnover, which can result in decreased access to patient care. The purpose of this project was to increase awareness and utilization of EAP services by using the Plan-Do-Study-Act cycle (PDSA) for quality improvement. Nurse Practitioners at a community-based hospital were provided with a PowerPoint^® presentation via email that contained information regarding the facility’s employee assistance program, mental health wellness education, as well as ways to …

Strategies To Encourage Recall And Prevent Relapse After Full Mouth Rehabilitation Under General Anesthesia In Children, Claire Koukol

Capstone Experience

Background: Dental caries are preventable. Dentists utilize many prevention strategies in the office and provide at-home education to families. However, once a child develops Early Childhood Caries (ECC), especially in more severe cases, they may need general anesthesia (GA) to complete treatment. While this is an effective way to achieve full mouth dental rehabilitation (FMDR), this burdens the healthcare systems and families and does not come without risk to the patient. Patients with high caries experience remain at high risk of caries relapse after FMDR under GA, sometimes necessitating additional FMDR under GA. While there has been a significant amount …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Preserving The Force: A Quality Improvement Project To Reduce The Risk Of Opioid Use Disorder In The Military, Lecreshia S. Shields

Doctor of Nursing Practice

Military service members incur combat and noncombat related injuries which may lead to acute or chronic pain. Treatment of these conditions with opioids may place them at risk for opioid use disorder (OUD). Opioid related overdoses among the military community increased by 50% from 2010 to 2019. The Sole Provider Program (SPP) is recommended to address the risks of OUD among Veterans receiving care at military installations. The goal of this evidence-based project was to ensure that all persons who receive opioid prescriptions at a military facility were evaluated for inclusion into a SPP and prescribed naloxone. Objectives included: 1) …

Chronic Stressors, Obesity Pathogenesis, And The Moderating Effect Of Internalized Weight Stigma; A Quantitative, Illinois Study, Karyn Byrne

Dissertations

The obesity epidemic is a ‘wicked’ problem with a complex web of determinants and outcomes. While generally higher for minoritized populations, prevalence rates manifest in surprising, nonlinear patterns. There is no consensus regarding treatment protocols or mitigation efforts, except that current efforts remain largely ineffective. Much research evidence that a profusion of determinants of health support obesity pathogenesis through various physiological processes and mechanisms, including the allostatic load, mitochondria functioning, the gut microbiome, and epigenetics. Intervening to support markers of the allostatic load (immunity, inflammation, and metabolic health) may provide a more effective treatment outcomes than traditional approaches, which tend …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

A Qualitative Study Exploring Us Graduate Medical Education Program Directors Decision-Making Practices Regarding The Selection Of Surgical Residency Applicants For Interview, Lashari Valentin

Seton Hall University Dissertations and Theses (ETDs)

Background: The goal of the General surgery residency selection process is to select residents who will transition easily from medical school to residency, complete the training program, pass their boards, practice surgery in a safe and effective manner, and contribute to the advancement of the specialty. Residency training programs receive thousands of applications annually from which they must choose a select few for an interview. The reality is, if medical students do not get into a residency training program, they can never practice as a physician. Pin-pointing match-worthy applicants from an increasingly deep and similar applicant pool is an …

Exploring Nursing Faculty Perceived Individual And Organizational Readiness To Use Online Simulation As A Teaching Strategy, Luz-Patricia Torres

Seton Hall University Dissertations and Theses (ETDs)

Problem: Academic institutions have employed online simulations in nursing education to meet the needs of the growing nursing student population and demands for distance learning. While some nursing educators have been trained to use simulation learning experiences, few have specific training in applying online simulation as a teaching strategy. With a dearth of evidence in the literature specific to the use of online simulation in nursing education, exploring nursing faculty's perceived individual and organizational readiness to do so is warranted to optimize the use of this innovation.

Purpose: This study explored the nursing faculty's perceived individual and organizational readiness …

Jumping Ship And Going To The Other Side: Experiences Of Nurses Who Retrain As Doctors, Anne Robinson

Electronic Thesis and Dissertation Repository

Aim: To gain an understanding of the experience of medical training for nurses who retrain as doctors.

Methods: Using a Constructivist Grounded Theory design, semi-structured interviews were conducted with thirteen medical students and residents who had completed nursing training prior to entering medical school. Interviews were audiotaped and professionally transcribed. Transcripts were coded and analysis in an inductive manner to construct central themes.

Findings: Many left nursing due to negative effects of a hierarchal system. As preclinical medical students they felt both advantaged and burdened by their advanced clinical knowledge. During clinical placements, they experienced social distress and role confusion …

Improving Access To Cardiac Catheterization, Sunitha Dharman

Student Scholarly Projects

The American Heart Association lists cardiovascular disease as the underlying cause of death for 874,613 people who lost their lives in 2019 (Tsao et al., 2022). On average, someone in the United States has a myocardial infarction every 40 seconds, and someone dies of a stroke every 3 minutes and 30 seconds. Studies support coronary artery disease as a significant contributor to cardiac arrest in a non-hospital setting (Yannopoulos et al., 2019). The authors provide evidence supporting the importance of early cardiac catheterization. There is a 10-15% survival rate with a higher level of functioning compared to delayed or no …

Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist

Master of Science in Nursing Final Projects

Abstract

Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …

Prescribing Protocol For Postoperative Opioids In An Orthopedic Spine Practice, Kelly M. Manda

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: The opioid epidemic is magnified by excessive post-surgery prescriptions. Over six months at an orthopedic spine practice, 50% of patients received two or more opioid refills beyond their first. This highlighted the absence of a clear prescribing policy and emphasized the need for a structured protocol and to promote patient safety.

Aim of the Project: The primary aim was to implement a prescribing protocol to lower opioid refills provided to post-surgical patients in this surgical practice. The desired result was to reduce the number of opioid refills provided to patients after surgery.

Review of the Evidence: Evidence highlighted …

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …

The Changing Landscape Of Orthopaedic Surgery In Ontario: Where We Are, Where We Have Been, And Where We Are Going., Silvio Ndoja

Electronic Thesis and Dissertation Repository

Orthopedic surgery is a field which has often been talked about with regards to surgeon underemployment. This is particularly important given the paradoxical increasing demand for orthopedic care. There has not been well studied literature understanding the state of orthopedic surgery training in Ontario, Canada. Using a combination of various databases and surveying surgeons trained in Ontario we sought to provide some insight.

We demonstrated multiple important findings. More recent graduates are feeling less ready to enter practice and almost all graduates do at least 1 fellowship, with equal amount of 1 versus 2 fellowships. We showed an effect of …

A Quantitative Visualization Tool For The Assessment Of Mammographic Risky Dense Tissue Types, Margaret R. Mccarthy

Electronic Theses and Dissertations

Breast cancer is the second most occurring cancer type and is ranked fifth in terms of mortality. X-ray mammography is the most common methodology of breast imaging and can show radiographic signs of cancer, such as masses and calcifcations. From these mammograms, radiologists can also assess breast density, which is a known cancer risk factor. However, since not all dense tissue is cancer-prone, we hypothesize that dense tissue can be segregated into healthy vs. risky subtypes. We propose that risky dense tissue is associated with tissue microenvironment disorganization, which can be quantified via a computational characterization of the whole breast …

Factors Affecting The Healthcare Of Adults With Communication Difficulties Due To Autism Spectrum Disorder And/Or Intellectual And Developmental Disability, Kathryn L. Shady

MUSC Theses and Dissertations

Purpose: This dissertation explores the healthcare barriers and facilitators experienced by autistic adults and adults with intellectual and developmental disabilities (IDD) who have communication difficulties (CD).

Problem: Approximately 5-10% of Americans have CD, including difficulties such as stuttering, aphasia, apraxia, and other forms of language impairment(1,2). Communication difficulties are present in about 25-30% of autistic individuals and 57.9% of those with IDD, which accounts for a large and poorly studied portion of those with CD(3,4). Individuals with CD report negative healthcare experiences and decreased levels of satisfaction with healthcare providers secondary to practices such as communication solely with a …

Hidden In Plain Sight: Finding A Balance Between Assessment And Learning In Competency-Based Education In Canadian Health Care, Scott Murray

The Dissertation in Practice at Western University

Due to its emphasis on skill development and alignment with workforce demands, competency-based education (CBE) has garnered considerable attention in recent years. My organizational improvement plan (OIP) focuses on the potential benefits of incorporating learners’ voices into CBE in Canadian medical education and proposes a corresponding implementation framework. The traditional CBE model often lacks a critical component: the learner’s voice. My OIP reviews the literature and outlines its theoretical underpinnings (e.g., systems theory, adult education theory) within the scope of authentic leadership. The findings suggest incorporating learners’ voices into CBE to boost engagement, motivation, and agency. In response to such …

Reducing Falls And Fall-Related Hospital Transfers In Geriatric Assisted Living Residents, Laurissa Ash

Nursing (graduate) Student Scholarship

Background: Falls among older adults are frequent, rendering significant costs to both the individual and the healthcare system, and are preventable. In 2021, fall-related deaths in adults over the age of 65 were calculated at a rate of 78.0 per 100,000 people, and nonfatal falls were reported at 28% of all older adults (Centers for Disease Control and Prevention [CDC], 2023). In Pennsylvania, approximately 27.9% of older adults fell in 2020 (CDC, 2023). A multifactorial approach to reducing falls can be achieved through the implementation of fall risk screening tools and intervention bundles (Beato et al., 2019; Burland et al., …

Exploring The Experiences Of Underrepresented Students Pursuing Health-Related Graduate Or Professional Programs, Alison Williams

Electronic Theses and Dissertations

For many years graduate and professional education programs for the health professions have sought to increase the diversity of their student body to include students from a wider variety of backgrounds. Increasing the diversity of healthcare providers is an essential component of addressing inequities in healthcare. However, despite initiatives to increase racial and ethnic diversity in the health professions, these professions remain largely White and female. Previous researchers have sought to identify the reasons that racial and ethnic minorities are underrepresented in healthcare, and the barriers to persistence and success. Little research exists explaining why men are underrepresented in the …

Neurodiagnostic Program Director Perceptions On Low Enrollments, Daniella Krantz

Student Dissertations

Higher education enrollments have trended downward over the last several years and fallen further due to the impact of the COVID-19 pandemic. The problem addressed in this study was low student enrollment in neurodiagnostic programs in the United States, resulting in an increasing shortage of neurodiagnostic professionals working in the field. The purpose of this descriptive qualitative study was to explore the perceptions of neurodiagnostic program directors and their views on the low enrollments in neurodiagnostic programs in the United States. A descriptive qualitative design was used to understand the perspectives of these program directors. Human capital theory, the theory …

The Efficacy Of Analgesic Subdissociative Dose Ketamine In Trauma Casualties Treated By U.S. Military Special Operations Medical Professionals In A Prehospital Environment, Darin Schwartz

Theses & Dissertations

Research Focus. This study’s main objective was to determine the efficacy of sub-dissociative ketamine to reduce the pain of trauma casualties treated by U.S. military medical professionals in a prehospital environment evidenced by the 0–10 numeric rating scale (NRS) for pain. Research Methods. This quantitative study was accomplished using a pragmatic approach integrating social cognitive theory complemented by mixing methods using qualitative phenomenological influence through narrative inquiry. This exploratory retrospective, cross-sectional study, utilizing a quasi-experimental pretest-posttest design, used deidentified sample data (N = 47) for secondary analysis from U.S. Special Operations medical providers and were included in a casualty …

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

A Phenomenological Inquiry Into Healthcare Professionals Who Are Experts In Cannabinoid Therapy And The Endocannabinoid System (Ecs), Courtney Collins

Electronic Theses and Dissertations

Cannabis is a prevalent alternative treatment for many symptoms and conditions given its medicinal qualities and few side effects. As legalization for both medical and recreational purposes continue to develop quickly across the United States of America, there is serious discrepancy between legalization and clinical research. Clinical data is difficult since the U.S. federal government still classifies cannabis as a Drug Enforcement Agency (DEA) Schedule I drug with no clearly established medical value. This lag in evidence-base data has affected cannabinoid therapy and endocannabinoid system education (ECS) for healthcare professionals. There are gaps in medical school and continuing medical education …

Teaching Social Determinants Of Health In Physical Therapist Professional Education Programs: Exploring Curricular Approaches And Examining An Assessment Tool, Emily Jordan Hawkins

Rehabilitation Sciences Theses & Dissertations

There is a growing emphasis and need for physical therapists (PTs) to serve not only as clinicians but also as advocates to pursue health equity. Clinical practice for preventing and rehabilitating injuries and promoting physical activity will not eliminate health disparities resulting from the social determinants of health (SDH). Leaders in the field of physical therapy have charged physical therapist professional education programs to teach future PTs to address SDH, however, as of August 2023, the Standards and Required Elements for Accreditation of Physical Therapist Education Programs does not specifically require curricular content regarding SDH. The purposes of this dissertation …