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Medicine and Health Sciences

South Dakota State University

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Full-Text Articles in Social and Behavioral Sciences

General Adversarial Networks In Tumor-Related Research: A Review And Agenda For Moving Forward, Andrew James Behrens, Cherie Noteboom Feb 2022

General Adversarial Networks In Tumor-Related Research: A Review And Agenda For Moving Forward, Andrew James Behrens, Cherie Noteboom

SDSU Data Science Symposium

Recent advances in Generative Adversarial Networks (GANs) have led to many new variants and uses of GANs. The latest advancements have allowed researchers and practitioners to apply this technique to tumor-related problems with limited data. One of the trends in this problem domain is to develop different variants of GANs suited explicitly to particular problems. The variants of GANs are numerous but share a common characteristic of expanding the dataset by creating synthetic data from the original dataset. This paper aims to develop a research agenda through a systematic literature review that investigates practitioners' and researchers' emerging issues and current …


An Analysis Of The Factors That Impact Medicaid Recipient Tobacco Quit Rates, Raegan Winder May 2021

An Analysis Of The Factors That Impact Medicaid Recipient Tobacco Quit Rates, Raegan Winder

Schultz-Werth Award Papers

Background and Objectives: Tobacco use is the leading preventable cause of disability and disease in the United States. Individuals of low socioeconomic status are more likely to use tobacco, suffer from tobacco related illness, and fail to quit or stay quit. Medicaid recipients enrolled in the South Dakota QuitLine have significantly lower quit rates than participants who aren’t enrolled in Medicaid. The purpose of this paper is to review the factors that impact Medicaid recipients’ ability to quit or stay quit.
Methods: Tobacco use and demographic data were collected at enrollment and seven months post-enrollment using standardized assessments for 16,323 …


Disease Cured In The Least Expected Way: Communication., Bailey Pickering May 2021

Disease Cured In The Least Expected Way: Communication., Bailey Pickering

Schultz-Werth Award Papers

Communication is an important factor in all doctor-patient relationships. This non-technical skill could potentially lead to better patient wellness outcomes. Since communication proficiencies are not a basic skill for everyone, most complaints about doctors are because of communication issues. However, the decline in communication skills begins early in a doctor’s career – in medical school. With increasing communication showing proven benefits, doctor’s communication abilities are vital to improving their patient’s wellness outcomes. Gaps in current literature include exactly how much communication benefits patient wellness outcomes. This literature review will fill in some of those gaps and also highlight what factors …


Education On My Healthevet To Increase Access To Psychiatric Healthcare For Veterans, Roxann Hackbarth Jan 2021

Education On My Healthevet To Increase Access To Psychiatric Healthcare For Veterans, Roxann Hackbarth

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Introduction: Access to mental health care can be challenging for many veterans. The Veterans Health Administration (VHA) developed the patient portal My Healthevet (MHV) to increase access to healthcare services. Despite this program, many veterans still do not take advantage of the portal. The goal of this literature review was to gain knowledge on benefits and barriers of using patient portals, identification of patients who use and do not use patient portals, and interventions to increase the use of patient portals.
Evidence Summary: The use of patient portals, including the VHA portal MHV, helps to increase interactions between clinicians and …


Go Talk To Your Employee: A Sequential Mediation Analysis Of Leader Communication Frequency And Employee Turnover Intent, Max Weaver Jan 2021

Go Talk To Your Employee: A Sequential Mediation Analysis Of Leader Communication Frequency And Employee Turnover Intent, Max Weaver

Electronic Theses and Dissertations

Employee turnover has significant negative costs to healthcare organizations. While leadership communication styles and quality have been empirically supported to reduce turnover intentions, our understanding of specific modalities of leader intervention is not well understood. This paper sought to understand how the specific act of communication frequency reduces turnover. Through the lens of Leader-Member Exchange (LMX) and role dynamic theories, mediating effects of LMX quality and job satisfaction were investigated to further understand this proposed relationship in a sample of healthcare workers in the Midwest/US. Results indicate that communication frequency was negatively related to turnover intent. Furthermore, while LMX and …


South Dakota State University : Research 2020, Division Of Research And Economic Development Dec 2020

South Dakota State University : Research 2020, Division Of Research And Economic Development

Research: South Dakota State University

[Page] 2 New respirator design to capture, kill coronavirus
[Page] 3 SDSU scientists to examine how coronavirus infects cells
[Page] 4 State diagnostic lab fulfills need for human COVID-19 testing
[Page] 5 Isaacson to help develop tribal palliative care programs
[Page] 6 Sun Grant funding fuels bioprocessing research
[Page] 8 Prairie AquaTech exporting high-protein feed ingredient
[Page] 11 New connection makes building repair fast, cost-effective
[Page] 12 Record-setting wildfire season drastically increases emissions
[Page] 14 Engineering study examines sunflower stem growth
[Page] 15 State Poet Laureate unveils ‘South Dakota in Poems'
[Page] 16 Reineke receives NIH grant to help eradicate …


The Relationship Between Alcohol Consumption, Academic Success, And Athletic Identity In Collegiate Student-Athletes, Zoe Arnold, Hung-Ling (Stella) Liu Oct 2020

The Relationship Between Alcohol Consumption, Academic Success, And Athletic Identity In Collegiate Student-Athletes, Zoe Arnold, Hung-Ling (Stella) Liu

Health and Nutritional Sciences Faculty Publications

Upon entering college, students around the United States are exposed to alcohol and the potentially dangerous experiences and ef­fects that come with consuming alcohol. Whether the individual is a general col­lege student or a college student-athlete, the issues are prevalent. According to the 2014 United States Census, there are ap­proximately 23 million students attending U.S. colleges. According to the National Collegiate Athletic Association (NCAA), there are 460,000 student-athletes across the United States (NCAA, 2017). When National Association of Intercollegiate Athletics (NAIA) student-athletes are in­cluded, the overall number then surpasses 500,000. A student-athlete (SA) can be defined as an individual who …


The Journal Of Undergraduate Research: 2019 Jan 2020

The Journal Of Undergraduate Research: 2019

The Journal of Undergraduate Research

This is the complete issue of the South Dakota State University Journal of Undergraduate Research, Volume 17.


Early Adolescent Social Isolation, Hope, And Well-Being During A Pandemic, Alicen Hauck Jan 2020

Early Adolescent Social Isolation, Hope, And Well-Being During A Pandemic, Alicen Hauck

Electronic Theses and Dissertations

Social isolation is often divided into two subcategories of objective and subjective. The COVID-19 pandemic has led to an increase in objective social isolation in the form of social distancing and fewer social events. Research delineating the relationship between social isolation and adolescent well-being utilize measures of subjective social isolation. Whereas, measures of objective social isolation are more commonly used with geriatric populations. Therefore, there is a lack of information specific to the impact of objective social isolation on adolescent well-being, particularly during a pandemic. The effects of social isolation due to COVID-19 will not be short lived. Deciphering the …


Impact Of Coaching By Extension Professionals On Rural Wellness Coalition Success, Taylor Willhite Jan 2020

Impact Of Coaching By Extension Professionals On Rural Wellness Coalition Success, Taylor Willhite

Electronic Theses and Dissertations

Objective: To quantitatively assess coaches perceived confidence in coaching rural wellness coalitions and to qualitatively determine barriers and facilitators to success in coaching rural wellness coalitions.
Design: A mixed methods design was utilized with quantitative (scorecard) and qualitative (key informant interviews) methodologies.
Setting: Six rural South Dakota wellness coalitions.
Participants: Extension wellness coalition coaches (n=7), one previous and six current.
Intervention: A component of the broader SDSU Extension 1416 Centers for Disease Control (CDC) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) intervention.
Analysis: STATA was utilized for the quantitative scorecard data by running paired ttests. NVivo was utilized in the …


South Dakota State University : Research Fall 2019, South Dakota State University Oct 2019

South Dakota State University : Research Fall 2019, South Dakota State University

Research: South Dakota State University

[Page] 2 Curcumin formulation on its way to health product market
[Page] 4 Flexibility key to forging research partnership with Kodo Kids
[Page] 6 Researcher examines hope among children in Flint, Michigan
[Page] 7 Plant pathologist battles stem canker
[Page] 8 Removing ‘Typhoid Marys’ restores health of Custer bighorn sheep herd
[Page] 10 Breeder, food scientist help improve quality of oats, increase local production
[Page] 13 SDSU, community leaders explore new ways to drive research, partnerships
[Page] 14 SDSU, community leaders explore new ways to drive research, partnerships
[Page] 16 Engineering builds business connections through Research Park
[Page] 17 Research …


The Relationship Between Campus Wellness Center Usage And Symptoms Of Depression In College Freshmen, Allison Leonard Jan 2019

The Relationship Between Campus Wellness Center Usage And Symptoms Of Depression In College Freshmen, Allison Leonard

Electronic Theses and Dissertations

There is limited research done on the relationship between the program utilization at a campus wellness facility and the symptoms of depression in college freshmen. College students have been found to have a higher prevalence of depressive symptoms than the general population, possibly due to the stressors college life can add. Studies have been done on the effects of physical activity as an intervention for depression as well as on the benefits of campus wellness facilities; however, there have been few studies that look at both campus recreation and depression. The author’s purpose for this study was to see if …


Wellness Policy Awareness Among School Leaders And The Impact On Written Policy Scores, Mariah Reil Jan 2019

Wellness Policy Awareness Among School Leaders And The Impact On Written Policy Scores, Mariah Reil

Electronic Theses and Dissertations

Background: All schools participating in the National School Lunch Program must possess a written School Wellness Policy (SWP) as mandated by the Healthy, Hunger- Free Kids Act of 2010.1 School officials and leaders play a major role in SWP implementation. It is essential to written SWP implementation that school level officials and leaders in the district are aware of the SWP. However, the association between school leader awareness of SWP and policy quality has not yet been studied.
Purpose: The purpose of the present study was to determine if school leader awareness of a SWP impacts the written SWP quality. …


Qualitative Analysis Of Grocery Store And Farmers Market Manager Perceptions Regarding Use Of Fruit And Vegetable Educational Materials, Lacey Mccormack, Shelly Brandenburger, Karlys Wells, Suzanne Stluka Jan 2018

Qualitative Analysis Of Grocery Store And Farmers Market Manager Perceptions Regarding Use Of Fruit And Vegetable Educational Materials, Lacey Mccormack, Shelly Brandenburger, Karlys Wells, Suzanne Stluka

Health and Nutritional Sciences Faculty Publications

The Pick it! Try it! Like it! (PTL) educational resource set, developed to display in grocery stores and farmers markets, teaches individuals how to shop for and prepare healthy fruit and vegetable dishes. Because program buy-in must be obtained from location managers before implementation occurs, the purpose of this study was to qualitatively examine the perceptions that grocery store and farmers market managers have regarding PTL implementation. Locations that requested PTL materials during 2013-14 were contacted and asked to answer 13 questions. Responses were analyzed using the content analysis method with themes generated and frequencies reported. Analyses examined manager perceptions …


Baseball In The Background: Season Ticket Holder Retention In Summer Collegiate Baseball, Susan Wallrich Jan 2018

Baseball In The Background: Season Ticket Holder Retention In Summer Collegiate Baseball, Susan Wallrich

Electronic Theses and Dissertations

The purpose of this study was to investigate season ticket purchasing motives in summer collegiate baseball, specifically in the Northwoods League. The Sport Fan Motivation Scale (Wann, Schrader, & Wilson, 1999) was used in this study to determine fan attendance motives at summer collegiate baseball games. The literature review examines fan motivation, sports as entertainment, and season-ticket holder retention. The results from this study were obtained by administering a modified version of the Sport Fan Motivation Scale (Wann et al., 1999), a 20-question, 5 point, Likert scale survey to season ticket holders of a Northwoods League team. The outcome of …


Listening To Unheard Voices: Nurses’ Communication Experiences With The Nrs Pain Scale, Matthew H. Barton, Kevin Stein Oct 2017

Listening To Unheard Voices: Nurses’ Communication Experiences With The Nrs Pain Scale, Matthew H. Barton, Kevin Stein

Discourse: The Journal of the SCASD

This study examines nurses’ experiences with the Numeric Rating Scale (NRS). These responses characterize the communication trials that nurses face with pain diagnosis, pain management, and overall patient care. Interviews with 20 nurses reveal three themes: subject dissatisfaction, feeling limited, and subjective satisfaction. An analysis of these themes reveals the need for renewed discussion about the way pain is communicated and the challenging expectations nurses must regularly confront. Implications for listening to important, but often quiet, even silent, voices in pain management and clinical practice are discussed.


Research: South Dakota State University, Spring 2017, Christie Delfanian, Emily Weber Apr 2017

Research: South Dakota State University, Spring 2017, Christie Delfanian, Emily Weber

Research: South Dakota State University

Pharmacy researcher investigates how aspirin kills cancer cells [page] 1
Problem-solving, cornerstone of SDSU research [page] 2
Fluid flow model evaluates clotting risk in new stent graft design [page] 2
Sanford research project inspires graduate student [page] 3
Experience key to nurses' comfort in communicating with terminally ill patients [page] 4
Nondigestible starch feeds gut microbes, reduces inflammation [page] 5
Researchers investigate workings if antibody therapeutics [page] 6
DNA, RNA sequencing available in campus to researchers statewide [page] 7
QUBIC-R software helps researchers model, visualize gene expression networks [page] 8
Scientists assess survival of swine viruses in imported feed ingredients …


Brookings Supports Breastfeeding: Using Public Deliberation As A Community-Engaged Approach To Dissemination Of Research, Jenn Anderson, Rebecca A. Kuehl, Sara A. Mehltretter Drury, Lois Tschetter, Mary Schwaegerl, Julia Yoder, Heidi Gullickson, Jammison Lamp, Charlotte Bachman, Marilyn Hildreth Mar 2017

Brookings Supports Breastfeeding: Using Public Deliberation As A Community-Engaged Approach To Dissemination Of Research, Jenn Anderson, Rebecca A. Kuehl, Sara A. Mehltretter Drury, Lois Tschetter, Mary Schwaegerl, Julia Yoder, Heidi Gullickson, Jammison Lamp, Charlotte Bachman, Marilyn Hildreth

Communication Studies Publications

Empirical evidence demonstrates myriad benefits of breastfeeding for mother and child, along with benefits to businesses that support breastfeeding. Federal and state legislation requires workplace support for pumping and provides protections for public breastfeeding. Yet, many are unaware of these laws, and thus, support systems remain underdeveloped. We used a community-based approach to spread awareness about the evidence-based benefits of breastfeeding and breastfeeding support. We worked to improve breastfeeding support at the local hospital, among local employers, and throughout the broader community. Our coalition representing the hospital, the chamber of commerce, the university, and local lactation consultants used a public …


The ‘Pumpgate’ Incident: Stigma Against Lactating Mothers In The U.S. Workplace, Mary Bresnahan, Jie Zhuang, Jennifer Anderson, Yi Zhu, Joshua Nelson, Xiaodi Yan Mar 2017

The ‘Pumpgate’ Incident: Stigma Against Lactating Mothers In The U.S. Workplace, Mary Bresnahan, Jie Zhuang, Jennifer Anderson, Yi Zhu, Joshua Nelson, Xiaodi Yan

Communication Studies Publications

Studies conclude that breastfeeding for six months is associated with better lifelong health for mother and child. Mothers in the U.S. returning to work after maternity leave report difficulty with the need to take frequent breaks to pump breastmilk so many stop breastfeeding. Factors discouraging pumping breastmilk in the workplace motivated a content analysis of public comments posted in response to a legal deposition that occurred in January of 2011 in which an attorney who was a new mother was challenged about taking a break to pump breastmilk. A total of 899 public comments posted on Yahoo in 2015-2016 in …


Integrating Malaria Surveillance With Climate Data For Outbreak Detection And Forecasting: The Epidemia System, Christopher L. Merkord, Yi Liu, Abere Mihretie, Teklehaymanot Gebrehiwot, Worku Awoke, Estifanos Bayabil, Geoffrey M. Henebry, Gebeyaw T. Kassa, Mastewal Lake, Michael C. Wimberly Feb 2017

Integrating Malaria Surveillance With Climate Data For Outbreak Detection And Forecasting: The Epidemia System, Christopher L. Merkord, Yi Liu, Abere Mihretie, Teklehaymanot Gebrehiwot, Worku Awoke, Estifanos Bayabil, Geoffrey M. Henebry, Gebeyaw T. Kassa, Mastewal Lake, Michael C. Wimberly

GSCE Faculty Publications

Background: Early indication of an emerging malaria epidemic can provide an opportunity for proactive interventions. Challenges to the identification of nascent malaria epidemics include obtaining recent epidemiological surveillance data, spatially and temporally harmonizing this information with timely data on environmental precursors, applying models for early detection and early warning, and communicating results to public health officials. Automated web-based informatics systems can provide a solution to these problems, but their implementation in real-world settings has been limited.
Methods: The Epidemic Prognosis Incorporating Disease and Environmental Monitoring for Integrated Assessment (EPIDEMIA) computer system was designed and implemented to integrate disease surveillance with …


Evaluation Of The Volunteer Doula Program At Brookings Health System, Jenn Anderson, Rebecca A. Kuehl Jan 2017

Evaluation Of The Volunteer Doula Program At Brookings Health System, Jenn Anderson, Rebecca A. Kuehl

Communication Studies Publications

The 12-month research project included interviews and focus groups with key stakeholders, as well as an evaluation of promotional materials. An interdisciplinary team of researchers from South Dakota State University (SDSU) partnered with OB and PR/Marketing staff at Brookings Health System (BHS) to evaluate the volunteer doula program. The team collaboratively recruited participants and developed interview questions for key stakeholders, including: OB nurses and doctors, volunteer doulas, expectant parents, and mothers. Promotional materials were also evaluated by a persuasion expert. Our findings are drawn from interviews with 15 BHS staff, 9 doulas,


Blending Qualitative, Quantitative, And Rhetorical Methods To Engage Citizens In Public Deliberation To Improve Workplace Breastfeeding Support, Jenn Anderson, Rebecca A. Kuehl, Sara A. Mehltretter Drury Jan 2017

Blending Qualitative, Quantitative, And Rhetorical Methods To Engage Citizens In Public Deliberation To Improve Workplace Breastfeeding Support, Jenn Anderson, Rebecca A. Kuehl, Sara A. Mehltretter Drury

Communication Studies Publications

To improve breastfeeding support in local businesses in Brookings, SD, researchers from South Dakota State University partnered with Brookings Health System, the Brookings Area Chamber of Commerce, local breastfeeding advocates, and an expert public deliberation moderator to conduct community-based participatory research leading to a public deliberation event. The collaborative team took a mixed-methods approach, using qualitative, quantitative, and rhetorical methods to collect and analyze data across two phases of the project: formative research (Phase I) and implementation (Phase II). During Phase I, the team conducted focus groups and marketed the project. Results from Phase I shaped the conversations at the …


Short Message Service (Sms) Appointment Reminder Project, Kathryn Wermers Jan 2017

Short Message Service (Sms) Appointment Reminder Project, Kathryn Wermers

Doctor of Nursing Practice (DNP) Practice Innovation Projects

The purpose of this quality improvement project was to decrease the appointment no-show rate at a mid-western primary care clinic by implementing short message service (SMS) appointment reminders. The project director analyzed the cost of the SMS appointment reminders and patient satisfaction with the intervention via telephone participant opinion surveys. The guiding theoretical framework was Nola Pender’s Health Promotion model (HPM). The subjects involved were the primary care patients who had access to cellular phones with SMS capability. The project assistant received verbal consent to send the SMS appointment reminder for a participant. Then the participant’s cellular phone number was …


Associations Between Personality Style, Perceptions Of Health Coaching And Percent Of Starting Weight In Meal Replacement Program Participants, Anne E. Sawyer Jan 2017

Associations Between Personality Style, Perceptions Of Health Coaching And Percent Of Starting Weight In Meal Replacement Program Participants, Anne E. Sawyer

Electronic Theses and Dissertations

Purpose: To determine if personality style and an individual’s perception of their health coaching experience impact their ability to lose weight and/or maintain weight loss. Methods: An electronic survey was distributed to 20,000 current and past meal replacement program participants. Personality style was assessed via the Ten Item Personality Inventory, providing individual perceptions of each of the Big Five personality domains (extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience). The Working Alliance Inventory (Short Revised) was used to assess three key perceptions of health coaching: 1) agreement on the goals of coaching (goal), 2) agreement on the tasks of …


Yoga And The Ability To Counteract Negative Effects Of Stress And Trauma, Allison R. Steinwand, Staci L. Born Jan 2017

Yoga And The Ability To Counteract Negative Effects Of Stress And Trauma, Allison R. Steinwand, Staci L. Born

Counseling and Human Development Faculty Publications

Many individuals today struggle with the effects of chronic stress, whether due to social and environmental factors or as a result of trauma embedded in their psychophysiology. Research has demonstrated that once an individual endures a traumatic event, there are undesirable changes that occur in the brain and body It is of the utmost importance that mental health counselors consider the relationship between the body and mind. The purpose of this paper is to describe the negative impact traumatic experiences and chronic stress has on the brain and body. Furthermore, the ways in which yoga practice can mitigate trauma symptoms …


Monitoring Pollen Counts And Pollen Allergy Index Using Satellite Observations In East Coast Of The United States, Murat Cagatay Kececi Jan 2017

Monitoring Pollen Counts And Pollen Allergy Index Using Satellite Observations In East Coast Of The United States, Murat Cagatay Kececi

Electronic Theses and Dissertations

Allergic diseases have become increasingly common over the world during the last four decades, and they are affecting millions of people. Pollination is an important process in the life cycle of plants. However, pollen exposure is associated with allergic diseases such as asthma and seasonal allergic rhinitis (hay fever). As a result, the total annual expenditure for asthma-associated morbidity is about $56 billion in the United States, and the overall cost of allergic diseases is over $18 billion annually. For allergic rhinitis, the annual medical cost is approximately $3.4 billion. The intensity and frequency of the pollen exposures can be …


Relationship Of Stress, Sleep, Physical Activity, And Food Insecurity On Eating Behaviors And Obesity, Amy Lee Richards Jan 2017

Relationship Of Stress, Sleep, Physical Activity, And Food Insecurity On Eating Behaviors And Obesity, Amy Lee Richards

Electronic Theses and Dissertations

There is an urgent need to find effective interventions to prevent and reduce obesity as it is associated with chronic disease and decreased quality of life. Gaining a better understanding of how modifiable variables such as stress, sleep, physical activity, and food insecurity are related to eating behaviors associated with obesity is essential to guide the direction of future interventions and research. Interventions that hold promise need to be tested to determine if they have merit or not. This dissertation presents three papers. Two papers are cross-sectional studies evaluating associations between eating behaviors, obesity, and modifiable variables (stress, sleep, physical …


Research: South Dakota State University, Spring 2016, Christie Delfanian, Emily Weber Apr 2016

Research: South Dakota State University, Spring 2016, Christie Delfanian, Emily Weber

Research: South Dakota State University

CONTENTS:

Genome Researcher investigate impact of L1 jumping genes [Page] 2
CRP funds important resource for hunters [Page] 3
Nurse-researchers help health-care facilities develop, improve tobacco-free policies [Page] 3
MS: Exercise scientist improves movement, quality of life for MS patients [Page] 5
Plant scientists defend South Dakota crops against diseases [Plant] 7
Investigating influenza D virus earns doctoral student scholarship [Page] 9
Steel shavings trap phosphorous, protecting water quality [Page] 10


Student-Athlete: A Study Of Student-Athlete Workload Compared With Traditional Student Workload, Chuck Provencio Jan 2016

Student-Athlete: A Study Of Student-Athlete Workload Compared With Traditional Student Workload, Chuck Provencio

Electronic Theses and Dissertations

Purpose: The purpose of this study was to collect and analyze data on the workload of students and student-athletes to determine if there is a significant difference in the workloads of student-athletes compared with non-athletes, including undergraduate and graduate students. It was hypothesized that student-athletes would spend more time in athletic activities, but would sacrifice time in other areas. Method: This analysis of variance study collected data from 22 students at South Dakota State University using the Student Activity Log and categorized those students using a combination of three of six labels (student-athlete or non-athlete, undergraduate or graduate, and working …


Identity Theory And Women’S Choice Of Medical Specialty, Kelli A. Rolfsmeyer Jan 2016

Identity Theory And Women’S Choice Of Medical Specialty, Kelli A. Rolfsmeyer

Electronic Theses and Dissertations

The purpose of this study was to answer the research question: Does a self theory of social action account for female physicians’ perceptions of past choice of specialty? Perceptions of self changed as she prepared herself to become a physician. During her medical training, a medical student gains a better sense of who she is as a person who will become a doctor. The ability to act back on one’s self, called selfreflexivity, is the mechanism involved in the transitions of a physician’s biographical self. The data for this study was collected through interviews centered on questions chosen from the …