Digital Commons Network^™

Staff Education To Improve Clinical Task Prioritization Among Outpatient Clinical Staff, Adebayo Arowolo

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Diagnostic Accuracy Through Implementation Of An Artificial Intelligence-Enabled Ambient Scribe In Skilled Nursing Psychiatric Practice, Ernest Glenn Gorleski

Walden Dissertations and Doctoral Studies

No abstract provided.

True North: Full Issue Download

Quill & Scope

Silence is embedded into the life of medical students. Silence pierces the air when you are standing in the back of a patient room observing the conversation, feet aching, wondering if your presence is unnecessary and overwhelming for the patient. We are transient members of the healthcare team. We contribute to patient medical records with out notes and bedside conversations, yet we lack power in the system---the authority to sign orders, be responsible to true coordination of care, the autonomy that residents wield to make healthcare decisions.

It is easy to lose your sense of self in this silence. We …

Staff Education On Lipoprotein (A) Screening And Clinical Follow-Up In Primary Care, Deshawntae Griffin

Walden Dissertations and Doctoral Studies

No abstract provided.

Improving Postoperative Handoff For Placenta Accreta: Implementing A Structured Handoff Communication Tool, Isabelle L. Gerrard

Doctor of Nursing Practice Final Project Abstract

Purpose Implement a standardized postoperative handoff tool to improve interdisciplinary communication during transfer of placenta accreta spectrum (PAS) patients from the operating room to an obstetric intensive care unit at an academic women's hospital.

Background Placenta accreta spectrum (PAS) is a high-risk obstetric condition requiring coordinated multidisciplinary care. At the project site, operating room (OR)-to-obstetric intensive care unit (OB ICU) handoffs lacked a standardized process. This resulted in inconsistent communication and omission of critical information. Nurses reported reduced confidence. Standardized handoff tools can improve communication and promote safer transitions of care.

Methodology This 10-week quality improvement project used Plan-Do-Study-Act methodology …

Values-Based Clinical Ethics: A New Model Of Health And Ethics Consultation For Patients Suffering In Extremis, Adam Trainer

Electronic Theses and Dissertations

This dissertation argues that contemporary clinical ethics is inadequately equipped to support patients suffering in extremis because it relies on an insufficiently discriminating account of health and a constrained model of moral reasoning. Drawing on Bernard Lonergan, it reconceives health as an emergent, multi-layered, heuristic notion shaped by biological, psychological, social, and existential goods. On that basis, it critiques principlism’s global applicability thesis and the undergirding claim that its principles form part of the common morality, arguing that this justificatory structure is philosophically insufficient and practically limited for clinical ethics in cases marked by profound suffering, moral plurality, and normative …

Modalities Of Vision Restoration In Optic Neuropathies And Retinal Disease, Batsheva Rubin, Fabio Lavinsky, Rachel Cain, Ajay E. Kuriyan, Gadi Wollstein, Ronald Zambrano, Joel Schuman

Wills Eye Hospital Papers

Visual impairment affects over 250 million people globally and carries a significant psychosocial and economic burden. In recent years, rapid advancements in biomedical engineering and regenerative medicine have driven the development of innovative therapies aimed at restoring visual function. Here, we first provide an overview of the visual pathway, imaging modalities, and the psychosocial and economic burden of vision loss. Then we review four vision restoration approaches: gene and stem cell therapies, optogenetics, retinal prosthetic devices, and visual pathway electrical stimulation. For each therapeutic approach, the mechanism of action, clinical outcomes, adverse events, and current limitations are discussed. Stem cell …

Hyposense: Multimodal Physiologic And Voc Wearable For Early Hypoglycemia Detection, Nidhi R. Patel

Honors Theses

Hypoglycemia remains a significant safety concern for insulin-dependent individuals, especially when blood glucose declines rapidly during exercise, sleep, or periods of impaired hypoglycemia awareness. Current continuous glucose monitors and automated insulin delivery systems have helped to improve diabetes management, but these technologies primarily respond to glucose trends after they have already started and may not actually provide sufficient warning before symptoms occur. This thesis describes the development of HypoSense, a noninvasive wrist worn wearable concept that is designed to support earlier hypoglycemia risk detection through multimodal physiologic and volatile organic compound emission sensing. HypoSense combines volatile organic compounds/gas sensing with …

Development Of An Evidence Based Pressure Ulcer Prevention Bundle For The Medical Surgical Unit, Fanhelea Morency

Walden Dissertations and Doctoral Studies

No abstract provided.

Left Out And At Risk: Post-Pandemic Continuation Of Organizational Service Reduction In Metropolitan New York City Coincides With Rise In Opiate Use And Mental Health Problems For Latinos, Ruth Lin Campbell, Smita Ekka Dewan

Publications and Research

Increasing opiate use and mental health problems among younger and older Latinos in urban US contexts prompted this investigation into the organizational resources that facilitate help-seeking efforts of Latinos in New York State (NYS). Guided by a Vulnerability Model and a framework of organizational enabling resources, this study used complementary longitudinal and cross-sectional designs. The longitudinal component examined changes in levels of organizational facilitators for Latino substance use disorder (SUD) help-seeking in Downstate NYS across three time periods, while the cross-sectional component compared post-pandemic facilitator levels across service types and regions. A convenience sample of 241 SUD clinicians participated in …

Practicing Professional Intake Consultations With Ai: An Experiential Assignment For An Exercise Prescription Course, Mark E. Hartman

Educational Practices in Kinesiology

The purpose of this article is to describe an assignment that integrates artificial intelligence (AI) with simulation-based learning in an upper-level undergraduate exercise prescription course. A large body of evidence supports the use of simulation-based education, though due to cost and feasibility limitations, it has largely been limited to medical education. This assignment leverages AI as a scalable, low-cost simulation tool, offering exercise science students a highly realistic practice simulation that reinforces both professional reasoning and interpersonal communication skills. In this assignment, titled Simulated Exercise Consultation Using ChatGPT, students practice conducting an intake session as a personal trainer while …

Nivolumab Plus Ipilimumab For Chemotherapy-Refractory Metastatic Castration-Resistant Prostate Cancer: Results From The Randomized Portion Of The Phase 2 Checkmate 650 Trial, Padmanee Sharma, Russell K Pachynski, Et Al.

2020-Current year OA Pubs

We report on the randomized portion of the phase 2, open-label CheckMate 650 trial (NCT02985957), in which docetaxel-experienced, biologically male patients with chemotherapy-refractory metastatic castration-resistant prostate cancer were randomized 2:2:1:2 to nivolumab 3 mg /kg plus ipilimumab 1 mg /kg (n = 73), nivolumab 1 mg /kg plus ipilimumab 3 mg /kg (n = 74), ipilimumab 3 mg /kg (n = 38), or cabazitaxel (n = 74). Primary endpoints were objective response rate and radiographic progression-free survival; key secondary endpoints included overall survival, prostate-specific antigen response rate, and safety. This portion of CheckMate 650 was not designed to statistically compare …

Inflammatory Markers In The Emergency Department And Ptsd Symptoms In The Aurora Study: A Longitudinal Cohort Study, Kristen Nishimi, Stacey L House, Et Al.

2020-Current year OA Pubs

BACKGROUND: Systemic inflammation is hypothesized to contribute to post-traumatic stress disorder (PTSD) vulnerability. Few studies have examined inflammation shortly after trauma as a predictor of later PTSD symptoms. We examined whether inflammation from the emergency department (ED) post-trauma is associated with PTSD symptom severity over the following 6 months.

METHODS: Our sample included 742 AURORA participants, a longitudinal cohort of patients in 29 EDs across the United States after a traumatic stressor, followed up to 6 months. Plasma cytokines were assessed from a study blood draw in the ED: an inflammatory index (standardized sum of generally pro-inflammatory markers interleukin [IL]-6, …

Challenges And Innovations In Tennis Coach Development: International Insights From Practitioners Across Continents, Miguel Crespo, Rafael Martinez-Gallego, Christine Nash

Journal of Coach Development

Tennis is a global sport with effective coaches being essential to the continued appeal, therefore the work of the coach developers within the International Tennis Federation (ITF) is crucial. This research examined the work and aspirations of coach developers in tennis using in-depth interviews with 10 ITF coach developers. Subsequently, we developed detailed pen portraits of two ITF coach developers at different levels of experience and engagement in order to highlight any differences in work, objectives or ambition. Findings from coach developers revealed three themes: support from ITF; barriers to learning; making learning less traditional. The pen portraits added further …

Anatomy Of Teamwork: Leveraging Peer Feedback To Build A Bespoke Team Charter Assignment, Emily Tenniswood, Stefanie Attardi

Posters

Post-COVID-19, students in our M1 Anatomical Foundations of Clinical Practice (AFCP) courses increasingly request faculty guidance or intervention in managing intra-dissection team conflict.

Licensed Massage Therapists On The Frontline Of Skin Cancer: Enhancing Early Detection And Prevention In Rural South Dakota, Kianna Thelen, Leah Naasz, Meagan Kray, Marc Dvorack

Scholarship Pathways Program

Title: Licensed Massage Therapists on the frontlines of skin cancer detection: A pilot educational intervention in rural South Dakota

Authors:

Kianna Thelen, MD | Mentor: Marc Dvoracek, MD

Introduction: Skin cancer is the most common malignancy in the United States. Early detection improves outcomes, yet rural communities face barriers to dermatologic care. Licensed massage therapists (LMTs) are uniquely positioned to observe skin changes during client encounters. This intervention aims to assess the impact of a tailored educational intervention on rural LMTs’ knowledge, confidence, and practices for identifying suspicious skin lesions.

Methods: Between July 2023 and January 2024, 46 LMTs and …

Visual Arts And Humanities In Medical Education, Lauren Schild, Craig Uthe

Scholarship Pathways Program

Introduction: In medicine today, physicians are expected to be impartial, emotionally intelligent, and have the observational skills to pick up on and interpret ambiguous body language, skin changes, and hygiene factors which may aid in a diagnosis. However, medical students are often not directly taught these observational or emotional intelligence skills. Art has historically been used by the artist to express thoughts and emotions for themselves and to allow viewers to explore their own feelings. The aim of this course is to provide an opportunity for students to advance their observation and communication skills through the study and creation of …

Nudging Implementation Of Low Tidal Volume Ventilation: A Stepped Wedge, Cluster Randomized Trial, Meeta Prasad Kerlin, Michael O. Harhay, Fan Li, Dylan S. Small, Yingying Lu, Wei Wang, Barry D. Fuchs, Mark E. Mikkelsen, Teresa Tran, Aerielle Belk, Jasmine A. Silvestri, Tamar Klaiman, Stefania Scott, Elizabeth Levy, Michael W. Sjoding, Rachel Kohn, Karsten J. Roberts, Rinad S. Beidas, Scott D. Halpern

College of Health Professions Faculty Papers

BACKGROUND: "Nudges" embedded in the electronic health record (EHR) facilitate desired decisions while preserving autonomy and may provide a scalable strategy to overcome the common implementation barrier of lack of knowledge about a best practice. We sought to test whether EHR-based nudges targeting two intensive care unit (ICU) clinician groups would safely increase evidence-based use of low tidal volume ventilation.

METHODS: We performed a stepped-wedge, cluster randomized, hybrid type 3 effectiveness-implementation trial in 12 ICUs from February 2021 to May 2023 to test three nudges targeting clinicians responsible for order entry and respiratory therapists responsible for operationalizing orders and documentation. …

Staff Education To Improve Appointment Adherence In Outpatient Behavioral Health, Yvonne Joseph

Walden Dissertations and Doctoral Studies

No abstract provided.

Fall-Prevention Program For A Long-Term Care Organization, Roslyn Y. Heyward

Walden Dissertations and Doctoral Studies

No abstract provided.

Expertise First: Reflections On Informal Artificial Intelligence Mentoring In An Asynchronous Nursing Faculty Community, Anna Liza D. Villena Phd, Rn, Fnp-Bc

Journal of Online Mentoring

The integration of generative artificial intelligence (AI) into higher education has arrived faster than the support structures designed to help faculty navigate it. This article reflects on one faculty member’s experience providing informal AI integration mentoring to nursing colleagues at Walden University, a fully asynchronous online graduate nursing program, where clinician-educators with deep disciplinary expertise often struggled to recognize that expertise as an asset in their interactions with AI tools.

Drawing on Rogers’ (2003) diffusion of innovations theory, the article describes the mentoring approach that emerged from practice, the central insight that faculty are not failing to integrate AI because …

Comparative Behavioral Impacts Of Neuroactive Pharmaceuticals On Crayfish Locomotion, Grace Elizabeth Smith

Masters Theses

Pharmaceuticals are increasingly recognized as contaminants of concern in aquatic ecosystems, often entering waterways due to incomplete removal by wastewater treatment plants. Despite frequent detection, the effects of these compounds on non-target, neurochemically sensitive organisms such as crayfish remains underexplored. Gabapentin, an anticonvulsant that binds to presynaptic voltage-gated calcium channels and reduces excitatory neurotransmitter release, is one such emerging contaminant. Given crayfish’s ecological importance and sensitivity to neuroactive substances, exposure to gabapentin may disrupt key behaviors such as locomotion. To place gabapentin’s effects in context, we also examined escitalopram (Lexapro), a selective serotonin reuptake inhibitor that elevates synaptic 5-HT, and …

The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson

Electronic Theses and Dissertations

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …

I Am God's Masterpiece: Ministry For Adults With Idd, Raegan M. Wilson

Occupational Therapy Doctorate Capstone Posters

This capstone project was completed in collaboration with Parkway Ministries in Corbin, Kentucky. My Applied Leadership Experience (ALE) took place in a community-based faith setting and focused on the ACOTE areas of Program Development, Education, and Advocacy. As part of a collaborative project to develop an inclusive Vacation Bible School (VBS) for adults with intellectual and developmental disabilities (IDD), my individual focus was supporting caregivers through education, resource development, and community engagement. A needs assessment and literature review identified caregiver burden, social isolation, limited educational resources, and reduced access to support services as common challenges for caregivers of adults with …

Program Development And Implementation Of A Sensory-Based Self Regulation Curriculum For Adults With Down Syndrome At Gigi’S Playhouse, Grace Blair

OTD Capstone Projects

This doctoral capstone project was completed through partnership with Gigi’s Playhouse Nashville, a non-profit organization offering free programming and services to individuals of all ages with Down syndrome and their families. The goal of this project was to develop and implement an educational curriculum for adult education programs focused on daily life skills, money management, physical health, self confidence, and a variety of other topics. A secondary focus of this project was to support sensory regulation in individuals with Down syndrome to promote overall health and participation. The results were physical and digital materials to be used for future adult …

Patient Reported Outcome Measure Use In Heart Transplant Care, Nichole Côté

Doctoral Projects

Despite growing evidence supporting Patient-Reported Outcome Measures (PROMs) in chronic disease management, no consistent application exists within the international heart transplant community. This Doctor of Nursing Practice project implemented the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) as a PROM within the a large volume heart transplant clinic, evaluating workflow feasibility, the association between Overall Summary Scores (OSS) and visit length, and clinician perceptions of PROM use. The KCCQ-12 was administered via a mobile health application with automated distribution. Workflow integration was assessed by calculating the percentage of scheduled visits with completed PROM documentation. Visit length was measured using electronic medical record …

Examining The Rural Workforce: Comparing Admissions Strategies And Training Pathways In U.S. Medical And Dental Education, Charolyn A. Harris

Honors Theses

Access to healthcare in rural and underserved communities remains a significant challenge in the United States, particularly in dental care, where workforce shortages are more pronounced. This study examines how medical and dental education programs develop rural healthcare providers, focusing on admissions strategies and training pathways. Using a structured scoping review and secondary data analysis, this research compares how each field incorporates known predictors of rural practice, such as rural background and training experiences, into workforce pipeline development. Findings indicate that while both medical and dental education recognize rural background as a strong predictor of rural practice, medical education more …

A Transgenerational Analysis Of Factors Influencing Fertility Among Jamaican Men, Shanique Deniellia Essuman

Walden Dissertations and Doctoral Studies

No abstract provided.

Staff Education On The Phq-9 Tool And Its Use, Claudine Agwi Mbah

Walden Dissertations and Doctoral Studies

No abstract provided.

I Am God's Masterpiece: Ministry For Adults With Idd, Kerrigan J. Creech

Occupational Therapy Doctorate Capstone Posters

Executive Summary 

My capstone Accreditation Council for Occupational Therapy Education (ACOTE) focus area included program development, with additional focus on education, advocacy, and leadership. For my Applied Leadership Experience (ALE), I worked with three other occupational therapy graduate students to develop and implement an inclusive Vacation Bible School (VBS) for adults with disabilities at Parkway Ministries. The purpose and overall goal of the project was to increase opportunities for adults with disabilities to participate in an inclusive Vacation Bible School through individualized supports and activity adaptations.

A needs assessment and SWOT analysis were completed and revealed that adults with disabilities …