Digital Commons Network^™

"Help Me Live It The Way You Do": Grounding Singaporean Responses To The Rorschach Situation, Casey Y. Lee

Electronic Theses and Dissertations

Contemporary research on the Rorschach and culture is striking for the latter’s disappearance as a variable of significance (Meyer et al., 2015; Meyer et al., 2007; Mihura et al., 2013; Viglione & Hilsenroth, 2001). This erasure is chronicled and reproduced in the narratives of universal objectivity, of extensive international meta-analyses, of replications, of standardized norms (Ritzler, 2004; Smith et al., 2018; Smith et al., 2020; Weiner, 2004). A different story emerges, however, when we ask, how has culture disappeared? The proposed study is a multimethod qualitative analysis of Singaporean responses to the Rorschach, aimed at generating sensitive yet critical discourses …

Bridging The Gap: Documenting The Effectiveness Of Counseling Education In A Speech-Language Pathology Graduate Program, Gianna Baker

Electronic Theses and Dissertations

This study aimed to examine the impact of a required counseling course through Duquesne University's Speech-Language Pathology program, particularly regarding student’s counseling self-efficacy and their ability to apply counseling skills within clinical practice. Nineteen first year Master’s students in Speech-Language Pathology at Duquesne University during 2025 participated in this study while enrolled in a counseling course and providing therapy to clients. Students completed the Counselor Activity Self-Efficacy Scales for SLPs (CASES) (Victorino & Hinkle, 2019) prior to beginning and after completion of the required counseling course. While observing video-recorded therapy sessions, the Counselor Competencies Scale-Revised (CCS-R) (Lambie & Swank, 2024) …

Quality Improvement Project From Novice-To-Expert: Training Nurse Faculty On Virtual Simulation, Dae'visha Kinniebrew

Doctor of Nursing Practice Projects

Virtual simulation is an evidence-based teaching strategy that enhances student learning; however, inconsistent faculty preparation limits its implementation in nursing education. A needs assessment identified a practice gap, with 70% of nursing faculty reporting no virtual simulation training within the previous 12 months. The purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to evaluate the effectiveness of a structured non-immersive virtual simulation training program on nursing faculty confidence, perceived competence, and technology readiness in an Associate Degree Nursing (ADN) program. The aim was to improve faculty preparedness to implement non-immersive virtual simulation. A quantitative, quasi-experimental, …

The Impact Of A Structured Education Program On Artificial Intelligence Use For Nursing Faculty On Teaching Practices, Katy White

Doctor of Nursing Practice Projects

Artificial intelligence (AI) is increasingly integrated into nursing education; however, nursing faculty report inconsistent preparedness, including gaps in AI knowledge and self-efficacy for responsible AI integration. This quality improvement project addressed inconsistent faculty preparedness through an asynchronous AI educational program. The purpose was to address gaps in AI knowledge and self-efficacy, and the aim was to evaluate changes in AI self-efficacy and AI knowledge while supporting AI integration into nursing education. Rogers' Diffusion of Innovations Theory served as the change theory, the Technology Acceptance Model served as the theoretical framework, and the Plan-Do-Study-Act framework guided implementation. A quantitative one-group pretest-posttest …

Parents’ Perceptions Of Aai’S Effect On Social Interaction & Communication For Individuals With Asd And/Or Adhd​, Alexis E. Morris, Zeida Gutierrez

Summer 2026 OTD Capstone Symposium

This research study will investigate the impact of animal-assisted interventions (AAI) on social interaction and communication skills of children or young adults formally diagnosed with autism spectrum disorder (ASD) and/or attention-deficit/hyperactivity disorder (ADHD) based on self or parent/caregiver report.

Children with ASD and ADHD experience deficits in communication and social participation that limit engagement in meaningful childhood occupations and peer relationships, highlighting the need for alternative, motivating intervention approaches. Animal-assisted interventions may provide a supportive and engaging environment that promotes emotional regulation, joint attention, and social reciprocity, and communication by enhancing participation in daily occupations.

The hypothesis for this study …

Ai-Enhanced Ct Reconstruction: Effects On Image Quality Across Dose Levels And Implications For Radiation Dose Optimization: A Systematic Review, Matthew R. Alberto

Radiologic Sciences

Purpose To evaluate how deep learning image reconstruction (DLIR) affects diagnostic image quality and noise characteristics at different radiation dose levels and how it influences dose optimization compared with conventional reconstruction methods.

Method A systematic review was conducted using major databases for studies published between 2020 and 2026. Eligible studies assessed DLIR across multiple dose levels, reported radiation dose, included quantitative image quality metrics, and compared DLIR with filtered back projection or iterative reconstruction.

Results Thirty‑seven studies met criteria, and 15 were synthesized. Three themes emerged: (a) DLIR reduced noise by 15–82% and often improved signal-to-noise and contrast-to-noise ratios while …

Reducing Mr Acquisition Times Using Artificial Intelligence: A Systematic Review, Fatin M. Arief

Radiologic Sciences

Purpose To synthesize existing evidence on artificial intelligence (AI) applications for reducing magnetic resonance (MR) imaging acquisition time, evaluate their impact on image quality, and identify challenges in clinical implementation.

Method A systematic literature review was conducted using PubMed, CINAHL, and Scopus including peer reviewed, English-language articles published between 2020 and 2026. Both qualitative and quantitative primary research were eligible and had to be on AI use in MR processes. Findings were analyzed through thematic synthesis, and the quality of each study was appraised using relevant critical appraisal tools.

Results Three major themes emerged: AI methods in MR procedures, perceived …

Administrative And Clinical Impacts Of Theranostic Program Expansion In Nuclear Medicine, Karmela Kljajic Pascual

Radiologic Sciences

Purpose To synthesize current evidence on theranostic trials, nuclear medicine clinical workflow models, and organizational readiness, with a focus on how healthcare organizations and medical imaging leaders are adapting to the rapid expansion of theranostic services.

Method A comprehensive search was conducted across Scopus, PubMed, MEDLINE, and Google Scholar. Inclusion criteria required peer‑reviewed articles published between 2002 and 2026 addressing nuclear medicine leadership, theranostic implementation, workflow design, and organizational factors influencing theranostic program development. Exclusion criteria removed editorials, blog posts, and nonpeer‑reviewed sources.

Results Four major themes emerged: workforce and staffing demands, infrastructure and resource requirements, regulatory and administrative pressures, …

Evaluating The Safety Of Mr Exposure For Electronic Devices And Implants: A Literature Review, Molly O'Dowd

Radiologic Sciences

Purpose To review literature examining the factors that determine magnetic resonance (MR) compatibility of electronic implants and wearable devices, including device materials, engineering design, regulatory approval processes, and clinical monitoring requirements.

Method An integrative literature review was conducted using peer-reviewed literature addressing MR safety and device compatibility. Databases searched included PubMed, Wiley Online Library, ScienceDirect, and Google Scholar. Studies were selected based on relevance to MR safety classifications, device design considerations, regulatory labeling, and monitoring requirements.

Results The literature demonstrated that MR compatible devices are engineered and tested to meet regulatory safety standards and approved for use under specific scanning …

Application Of Lean Six Sigma Strategies To Improve Diagnostic Imaging Departmental Performance Metrics: A Literature Review, Obinna Newman Osuji

Radiologic Sciences

Purpose To systematically evaluate the effectiveness of Lean and Six Sigma quality improvement approaches in enhancing diagnostic imaging workflows and departmental financial performance.

Method Literature for this review was retrieved from Scopus, CINAHIL Plus, PubMed, and Healthcare Administration Database in February and March 2026. Empirical studies and literature reviews were included if they addressed the utilization of Lean Six Sigma, Lean, or Six Sigma as a method of quality improvement within a diagnostic imaging departmental setting.

Results Database searches generated 1,624 articles, and 17 were deemed suitable for inclusion in the study. There were four studies that directly measured patient …

Assault Vs. Assistance: Radiologic Technologist Decision-Making When Fall-Risk Patients Decline Assistance, Pamela O'Dowd

Radiologic Sciences

Purpose To explore how radiologic technologists experience and respond to situations involving fall-risk patients who decline assistance during imaging procedures.

Method A cross-sectional survey design was used to collect data from practicing radiologic technologists recruited through the American Society of Radiologic Technologists. Descriptive statistics, including frequencies and percentages, were analyzed using SPSS to summarize participant responses, and a thematic analysis was conducted on open-ended responses.

Results A total of 87 respondents completed the survey. Results indicated that encounters with fall-risk patients who refuse assistance are common in clinical imaging practice. Sixty-three (72.4%) technologists reported having experienced situations in which a …

National Pacs And Electronic Health Records: Considerations, Challenges, And Implications For Radiomics, Darchelle Scott

Radiologic Sciences

Purpose To examine the considerations, challenges, and implications of implementing a national picture archiving and communication system (PACS) integrated with electronic health records (EHRs), with particular emphasis on interoperability, radiomics, and patient-centered data sharing.

Method A systematic literature review was conducted using books, peer-reviewed articles, original research studies, and government publications addressing radiomics, TEFCA, blockchain technology, PACS, and EHR integration. Literature was analyzed to evaluate national health information exchange, radiomics applications, and implementation challenges associated with a connected healthcare infrastructure.

Results Three primary themes emerged: (a) interoperable national PACS and EHR systems have the potential to improve continuity of care …

Quality Improvement Project: Experienced Nurse To Novice Adjunct Educator: Bridging The Gap, Karen Liddy

Doctor of Nursing Practice Projects

A formal mentoring program is an effective approach for enhancing mentee satisfaction and self-efficacy and decreasing turnover rates. Although evidence supports the benefits of mentoring, many universities lack formal mentoring programs for adjunct faculty. Utilizing the PDSA framework, this quality improvement Doctor of Nursing Practice (DNP) project executed and evaluated a structured adjunct faculty mentoring program to improve faculty self-efficacy and mentee satisfaction. The project was led by Bandura's Social Cognitive Theory and the Theory of Change and used a pre- and post-test design involving adjunct nursing faculty members with fewer than three years of academic teaching experience. Mentors and …

Improving Implementation Of The Cmqcc Obstetric Hemorrhage Risk Assessment Tool To Improve Maternal Hemorrhage Response And Outcomes, Emily Hobbs, Karla Beiswenger

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract Background: Postpartum hemorrhage (PPH) remains a leading cause of preventable maternal morbidity and mortality in the United States, despite advances in obstetric care and the availability of evidence-based management strategies (American College of Obstetricians and Gynecologists [ACOG], 2017; Federspiel et al., 2023). Standardized tools, such as the California Maternal Quality Care Collaborative (CMQCC) Obstetric Hemorrhage Risk Assessment Tool, have been shown to improve early identification of at-risk patients and enhance team preparedness when consistently implemented (Main et al., 2017; CMQCC, 2022). However, variability in clinical utilization limits their effectiveness. Purpose: The purpose of this quality improvement project was to …

Aquatic Therapy And Its Impact On Perceived Caregiver Strain, Amanda J. Carter, Cynthia Haynes, Katherine O'Hara

Summer 2026 OTD Capstone Symposium

Children with Autism Spectrum Disorder (ASD) frequently experience sensory dysregulation that significantly impairs their participation in daily occupations and increases caregiver strain (Lawson et al., 2020; Passarello et al., 2022). Although aquatic therapy has shown promise in improving sensory processing, motor skills, and social participation, there is limited research examining its specific impact on the caregivers’ ability to provide support at home (Butzman et al., 2022; Caputo et al., 2018; Güeita-Rodríguez et al., 2021).

This study is a mixed-methods, quasi-experimental pre/post-design. This study sought to investigate the impact of six weeks of aquatic therapy intervention on sensory regulation and its …

Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a lifelong genetic condition significantly impacting the physical, emotional, and social health of those affected. Nigeria has one of the highest global burdens of SCD, yet there is limited research on the psychosocial experiences of secondary school students living with SCD in educational settings. This qualitative study explored these experiences among students in Lagos State, Nigeria. Using the social ecological model and interpreted through the social model of disability, the study examined how school environments, educational practices, and institutional support influenced students' psychosocial well-being and perceived health. Twenty secondary school students participated in 4 in-person …

Improving Recognition And Communication Of Early Patient Condition Changes Through An Evidence-Based Staff Education Program, Raymond Mwanje

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education project aimed at enhancing recognition and communication of early changes in patients' conditions in a long-term care rehabilitation environment. Delayed recognition of patient deterioration is a major challenge in nursing practice, as subtle changes in a patient's condition may go unnoticed, leading to delayed intervention, avoidable complications, and unnecessary hospital transfers. Poor communication among staff can also hinder the escalation of care, impacting patient safety and quality of care. There is evidence that structured communication strategies and education interventions can help enhance communication between clinicians and aid earlier detection of patient deterioration. Resolving …

Standardized Proactive Glp-1 Prior Authorization Workflow, Ebote Etape

Walden Dissertations and Doctoral Studies

Summary This quality improvement project evaluated an organizational process change from a reactive, pharmacy-initiated prior authorization (PA) process to a standardized, proactive PA workflow for glucagon-like peptide-1 (GLP-1) receptor agonists in an outpatient primary care clinic. The evidence-based practice PICOT question was: In adult primary care patients prescribed GLP-1 receptor agonists (P), does a standardized, proactive prior authorization workflow (I), compared with a reactive pharmacy-initiated process (C), reduce time to approval and improve approval rate (O) over a 4-week period (T)? Baseline data showed that 3 of 19 PA requests were approved, while 16 were denied, resulting in a 15.8% …

Reducing Hospital-Acquired Pressure Injuries In Acute Care Using Structured Prevention Strategies, Yemisi Adesuyi Akinfenwa

Walden Dissertations and Doctoral Studies

Pressure injuries that patients develop while hospitalized continue to be a major safety concern in hospitals treating very sick patients. These wounds hurt, make infections more likely, keep people in the hospital longer, and increase expenses. On many units, the steps meant to stop these injuries, like checking each patient's risk level and turning patients regularly are not carried out the same way for everyone. Because of this inconsistency, some patients develop preventable pressure injuries. The purpose of this Doctor of Nursing Practice (DNP) project was to create a clinical practice guideline (CPG) for organized pressure injury prevention and to …

Staff Education To Increase Knowledge For Reducing Hospital-Acquired Pneumonia, Tenika Monique Mcmillan

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice (DNP) project was to address a critical gap in nursing knowledge regarding oral care and its role in preventing hospital-acquired pneumonia (HAP) through staff education. Although the relationship between oral care and pneumonia is well established, staff knowledge at the site varied, leading to inconsistencies in oral care practices. To address this problem, a targeted educational session using a pre- and post-test design was delivered to nursing staff. The practice-focused question was “Among nursing staff working in community living centers, does the implementation of targeted education on evidence-based oral hygiene guidelines, compared …

Staff Education Project To Teach Mobility And Sensory Aid Optimization Delirium Prevention Bundle For Older Patients In A Hospital Health System, Lerato Catherine Modise

Walden Dissertations and Doctoral Studies

Delirium is a preventable and manageable neuropsychiatric condition characterized by acute fluctuations in attention, awareness, and cognition. The burden of this acute confusion syndrome among older adults aged > 65 years is disproportionate higher, due to age-related neurocognitive vulnerabilities. Nurse-led delirium prevention interventions can reduce incidence from 70% to 20% following structured education, gaps persist in nursing knowledge around evidence-based prevention strategies. The purpose of this project was to evaluate whether a structured nursing education intervention on enhanced mobility and sensory aid optimization strategies, as components of the ABCDEF bundle, improved nursing knowledge compared to standard care practices. Nineteen registered nurses …

Staff Education On Improving Staff Knowledge Of Medication Adherence In An Outpatient Psychiatric Facility, Okechukwu Chidiadi

Walden Dissertations and Doctoral Studies

This project was a staff education initiative designed to improve staff knowledge of medication adherence at an adult psychiatric outpatient clinic. Addressing this matter is critical because it directly impacts the quality of patient care. The practice focus question was: Among psychiatric mental health staff in a behavioral health facility, what is the impact of a staff educational program on teaching medication adherence to patients on the staff’s knowledge? The purpose of this staff education project was to improve staff knowledge of medication adherence by equipping them with the tools and strategies needed to help patients manage their treatment plans …

Reducing Seclusion In Inpatient Psychiatric Units Through Staff Education, Amaka Nkala

Walden Dissertations and Doctoral Studies

Seclusion remains a restrictive intervention used in inpatient psychiatric settings despite evidence linking it to psychological trauma, physical harm, and adverse patient outcomes. This Doctor of Nursing Practice (DNP) staff education project evaluated the effectiveness of a trauma-informed care and de-escalation education program in improving nurses' confidence in managing patient escalation. The project used a pre- and post-intervention quality improvement design with 24 inpatient psychiatric nurses. Participants completed a 10-item, 5-point Likert-scale confidence survey before and after a 30-minute educational session delivered via PowerPoint. Descriptive statistics were used to compare pre- and post-intervention confidence scores. Mean confidence scores increased from …

Clinical Practice Guideline For A Capstone‑To‑Residency Transition Program, Rebecca Ginika Chinonso

Walden Dissertations and Doctoral Studies

The transition from student nurse to professional practice remains a vulnerable period marked by role ambiguity, stress, and early turnover. At a large medical center, the lack of a structured bridge between the final capstone experience and the residency program contributed to inconsistent onboarding, reduced confidence, and diminished resilience among new graduates. Addressing this gap is essential for strengthening retention, supporting workforce stability, and improving patient outcomes within nursing practice. An evidence‑based clinical practice guideline (CPG) outlining best‑practice recommendations for a new graduate transition program from capstone to residency was developed for the facility. The practice‑focused question asked whether the …

Reducing No-Show Rates In An Outpatient Behavioral Health Clinic Through A Multimodal Patient Engagement Intervention, Gwendoline Osong

Walden Dissertations and Doctoral Studies

Reducing No-Show Rates in an Outpatient Behavioral Health Clinic Through a Multimodal Patient Engagement Intervention

Development And Implementation Of A Clinical Practice Guideline To Standardize Social Determinants Of Health Screening And Social Services Referrals In Primary Care, Patricia Pottinger

Walden Dissertations and Doctoral Studies

Social determinants of health (SDOH) significantly influence health outcomes, yet many primary care organizations lack a standardized, evidence-based process for identifying patients' social needs and facilitating referrals to appropriate community resources. The purpose of this Doctor of Nursing Practice executive leadership project was to develop and implement a clinical practice guideline (CPG) to standardize SDOH screening and social services referrals in a primary care setting. The practice-focused question asked whether a CPG designed to standardize social services referrals would be approved by a panel of subject matter experts using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. …

Premarket Clinical Evidence Strength And Recalls Of High-Risk Therapeutic Medical Devices, Maryam Mooghali, Faaizah Arshad, Vinay K Rathi, Kushal T Kadakia, Alexander O Everhart, Joseph S Ross, Sanket S Dhruva

2020-Current year OA Pubs

IMPORTANCE: High-risk medical devices approved through the US Food and Drug Administration (FDA) premarket approval (PMA) pathway may be supported by limited premarket clinical evidence, leaving uncertainties about safety. Whether device, premarket clinical evidence, or regulatory characteristics are associated with subsequent device recalls is unknown.

OBJECTIVE: To examine the association between device, premarket clinical evidence, and regulatory characteristics and serious recalls among high-risk therapeutic devices.

DESIGN AND SETTING: This cross-sectional study reviewed 193 high-risk therapeutic medical devices approved through the FDA's PMA pathway between January 1, 2014, and December 31, 2023. Data were analyzed between August 2025 and December 2025. …

Understanding And Supporting Youth Affected By Trauma And Stress, Cara Murray, Anna Gilliam, Jared Hawkins, Christina Pay

All Current Publications

Adults who work with youth are central to creating environments where young people feel safe, supported, and able to succeed. However, some youth have experienced stress, adversity, or trauma that can make it more difficult for them to feel safe, connected, and successful. By learning how to support youth with compassion and consistency, caring adults can help buffer the effects of adversity and promote resilience.

Utilization Of An Open-Access Markerless Motion Analysis Software For A Biomechanics Movement Analysis Project., Tamra L. Llewellyn, Michael J. Nolan

Educational Practices in Kinesiology

The movement analysis project (MAP) is a common assignment in many undergraduate biomechanics courses. The purpose of this article is to introduce kinesiology educators to an open-source, AI-enabled, markerless software for motion capture, OpenCap, which can be used in MAP and research. This tool is currently being used in an in-person, upper-level, undergraduate biomechanics course where students are required to have taken Anatomy & Physiology. There is very little time, money, or expertise needed to implement this resource. Using 2 iPads on tripods and the OpenCap app and web-based interface, movements can be quickly converted to skeleton visualization and joint …

Comparative Analysis Of Artificial Intelligence (Ai) Implications For Active Learning And Assessment At Various Curricular Levels Of Stem And Health Sciences In Developed Versus Underprivileged Countries, Vinay Munlapudi, Santanu De

FDLA Journal

Today’s all-pervasive emergence of artificial intelligence (AI) necessitates a comprehensive evaluation of its role in education, especially for occupational disciplines in health sciences and STEM. AI has reshaped student learning and instructors’ navigation of the evolving, post coronavirus infectious disease (COVID-19) global academic landscape. This study aimed at encapsulating evidence-based AI implications for student-centered, active learning and assessment at various curricular levels of science, technology, engineering, mathematics (STEM) and health sciences education in developed versus underprivileged or less developed countries. An extensive, scoping review of 65 recent, scholarly publications was conducted over six months through diverse search engines (PubMed, Google …