Digital Commons Network^™

Medical Simulation In Toxicology: Enhancing Clinical Competence, Decision Making And Patient Care In Resource-Limited Settings, Rakesh Ghimire, Anjana Thapa, Sanjeev Kharel, Shristi Kharel Ghimire, Rabin Basnet, Farshad Mazda Shirazi, Allan J. Hamilton

Research outputs 2022 to 2026

Medical simulation has emerged as a transformative approach in toxicology education. By providing immersive, hands-on experience, simulation enhances learner engagement, critical thinking, and long-term knowledge retention while offering a safe environment to practice clinical decision-making without jeopardizing patient safety. Despite these advantages, the integration of simulation-based training remains limited in low-and middle-income countries (LMICs) due to resource constraints, lack of standardized curricula, and limited access to high-fidelity simulators. Additionally, little research has explored its optimal application in these settings. This review explores available evidence regarding the effectiveness of medical simulation in the diagnosis and treatment of toxicological emergencies in LMICs. …

Key Insights From The International Icu Diary Conference 2025, Peter Nydahl, Bev Ewens, Anne Sophie Debue, Xavier Fiorilla, Kristin Gabriel, Alessandro Galazzi, Louise Gallie, Nikolas Groth, Carly Hickey, Mark Hudson, Fiona Lynch, Nicola Maxwell, Margo Van Mol, Caroline Renner, Louise Rose, Kate Tantam, Lioudmila Karnatovskaia, Christina Jones

Research outputs 2022 to 2026

We report on the 2025 International ICU Diary Conference that provided a comprehensive update on current knowledge, innovations and global practices related to ICU diaries. Held in a 6-week online format, the event featured 23 speakers and was attended by mean 69.7 (SD 20.5) participants per session. Topics included development of ICU diaries, use in special settings, digital diaries, survivors' and families' experiences, Post-Intensive-Care Syndrome and follow-up and implementation projects. Highlights were innovative solutions for digital diaries and the report of persons with lived and living experiences with diaries, changing the focus on humanising critical care. Relevance for Practice: ICU …

Neuromuscular Performance Changes In Response To The Australian Special Forces Selection Course, Angela Uphill, Kristina L. Kendall, Stuart Guppy, Michael Vacher, Simon Parker, Hannah Brown, Brendan Ashmore, Travis Zomer, G. Gregory Haff

Research outputs 2022 to 2026

Introduction: Strenuous military activities, such as Special Forces (SF) selection courses, are known to involve high physical loads in the presence of food and sleep deprivation, which can have detrimental impacts on physical performance. Understanding the magnitude of performance deficit and the time required for recovery associated with these events, is important for injury prevention and maintaining operational readiness. The purpose of this study was to investigate the changes in physical performance in response to the Australian SF Selection Course (SF-SC) and to monitor recovery throughout 8 weeks following the course. Materials and Methods: Ninety-three healthy male participants (age: 28 …

Show And Tell: Integrating The Arts Into Transdisciplinary Public Health And Community Organizing Education, Bree L. Hemingway, Margaret Hawkins

The Transdisciplinary STEAM+ Journal

This field note examines the integration of arts-based pedagogy into a transdisciplinary graduate course that brings together students from public health, medicine, the social sciences, humanities, education, technology, and the arts. Central to the course is the Show and Tell assignment, in which students select and present a work of art connected to a social movement. Over three years and 42 student submissions, this assignment has served as an accessible entry point for exploring how artistic expression shapes activism, fosters community, and deepens understanding of justice-oriented work. Through an inductive content analysis of student-selected artworks and presentations, five major thematic …

Leading Academic Health Centers In Times Of Uncertainty, Wendy L. Ward

Marshall Journal of Medicine

Times of uncertainty and rapid change can negatively impact academic health centers (AHC) in complex ways, creating challenges for leaders. These include policy uncertainty, financial instability, workforce stress, reputational risk, operational disruptions, and advocacy pressure. There are also potential opportunities for AHCs during this time of immense change and disruption. This perspective piece reviews the diverse negative and positive impacts of political turmoil on academic health centers. Five considerations are offered for leaders navigating times of uncertainty.

An Innovative Model For Graduate Medical Education Faculty Development Through Physician-In-Training Delivery, Daniel A. Nguyen, Dustin Wilkes, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Background

Faculty development is a core requirement for Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs. Successfully delivering content to faculty can be challenging. This pilot study aimed to assess expert-developed sessions delivered by resident physicians to faculty at the completion of their clinical rotations.

Methods

A prospective cohort project was conducted, involving precepting faculty and resident physicians in a dermatology residency program. Each resident, at the end of their rotation, delivered a faculty development program to their attending physician. Each resident participated in the program for 1-3 years. The faculty development programs were based on faculty development programs …

A Scalable Model For Resident And Faculty Well-Being: Applying Self-Determination Theory And The Job Demands-Resources Framework In Graduate Medical Education, Gregory Guldner, Adam Neufeld

HCA Healthcare Journal of Medicine

Despite growing attention to burnout in graduate medical education (GME), many institutional efforts remain fragmented and lack theoretical coherence. In response, HCA Healthcare developed a system-wide initiative grounded in Self-Determination Theory (SDT) and the Job Demands-Resources (JD-R) framework to guide leadership development, learning climate improvement, and resident and faculty well-being. What began as a single-program effort evolved into a multi-year, system-wide initiative involving more than 5800 residents across 366 programs at 85 hospitals. In collaboration with workplace psychologists from Claremont Graduate University and Immersyve Health, the initiative integrated theory-informed leadership workshops, validated assessment platforms, and continuous quality-improvement processes to help …

Icare Compassionately: An Innovative Approach To Improving Nursing Education, Lori M. Brodie

HCA Healthcare Journal of Medicine

Historically, compassionate care has been briefly introduced in nursing education, without a sustained focus throughout nursing programs. Compassionate care models define the essential qualities needed to deliver meaningful care. Many of the traditional compassionate care models rely on high-level concepts that can be difficult to operationalize in academia. Further, current compassionate care models are typically limited to specific settings and are taught separately from other parts of the nursing curriculum. To address these concerns, a single purpose nursing college created and implemented the iCare Compassionately Model, which emphasizes both measurable behaviors and concepts related to compassion. As a result of …

Owning Difficult Outcomes: Navigating Medical Error Disclosure For Trainees In Accordance With Acgme Standards, Sara Andrabi, Anita Rohra, Kelly Keene, Alison Haddock, Daniela Ortiz

HCA Healthcare Journal of Medicine

Background

The American College of Graduate Medical Education (ACGME) mandates that physicians promote patient safety and high-quality care, including training trainees in disclosing adverse events to patients and families. Despite its importance, many trainees lack formal preparation in error disclosure, leading to inconsistent practices. Structured training programs are essential to meet societal expectations and professional responsibilities.

Methods

A simulation-based curriculum was integrated into our annual "Difficult Communications" simulation day in response to feedback from residents. The curriculum employs standardized patients to create realistic error disclosure scenarios. Sessions include pre-briefing with faculty facilitators and standardized patients, simulated encounters, and structured debriefings. …

Building A Better Clinical Competency Committee: A Multi-Institutional Approach To Improving The Quality Of Resident Feedback Through Appreciative Inquiry, Nikita Khetan, Emma Omoruyi, Elizabeth Hanson

HCA Healthcare Journal of Medicine

Background

The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric faculty to convene twice yearly as a Clinical Competency Committee (CCC) to review resident performance and provide feedback. Variability in review processes and limited feedback quality remain common challenges. Incorporating Appreciative Inquiry within a Deliberate Practice framework may enhance the quality of summative feedback provided to residents.

Methods

This project was conducted with pediatric residents and faculty during the 2019–20 academic year at The University of Texas Health Science Center at Health San Antonio (UTHSA) and during the 2021-22 academic year at The University of Texas Health Science Center …

Establishing Nurse Innovator Competencies: A Collaborative Initiative, Lori M. Brodie, Susan B. Patton, Dara Lanman, Ismail Dilek, Noah R. Zanville, Tracy A. Ortelli

HCA Healthcare Journal of Medicine

Background

Rapid advancements in augmented and artificial intelligence (AI) are reshaping health care, necessitating a strategic approach to integrating innovation into nursing education and practice. This article details a collaborative initiative between academic and practice partners aimed at the initial steps towards establishing the required knowledge, skills, and abilities for nurses to lead change through the creation of Nurse Innovator Competencies.

Methods

After an extensive review of literature, the team identified the absence of established Nurse Innovator Competencies. Through a collaborative and iterative process involving subject matter experts (SMEs) in both innovation and academia, key domains for the competencies, including …

Enhancing Resident Preparedness For The American Board Of Surgery Certifying Exam Through Low-Stakes Mock Oral Sessions, Camila R. Guetter, Taylor Locklear, Omar Haque, P Nina Scalise, Saptarshi Biswas, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

The American Board of Surgery (ABS) requires trainees to pass both a written qualifying examination (ABSQE) and oral certifying examination (ABSCE) to achieve board certification. The high-stakes nature of the ABSCE, which assesses knowledge, clinical judgment, and decision-making, necessitates extensive preparation. To address the challenges of the ABSCE format and associated trainee stress, structured mock oral programs have been developed. Here we evaluate the impact of structured mock oral sessions on residents' comfort levels and familiarity with the ABSCE at a single institution.

Methods

A mixed-methods survey was given to 50 general surgery residents in different training years who …

Lost In The Fine Print: A Phenomenological Inquiry Of Adhd, Student Loans, And Scarcity, Gaurav R. Sinha, Lakshya Kadiyan, Leon Banks, Kannappa V. Shetty

Journal of Student Financial Aid

The primary objective of this phenomenological study was to explore the cognitive and affective challenges faced by individuals experiencing ADHD and their student loans, particularly through the lens of “scarcity theory”. We analyzed 250 posts (~86 pages/67,000 words) from an online community on Reddit, where individuals experiencing ADHD shared experiences related to student debt. Thematic analysis was employed to identify key themes in these posts. Four key themes emerged: (1) ADHD and baseline mental bandwidth, highlighting preexisting executive functioning challenges that limit cognitive and affective capacity; (2) demands of student loan debt, which intensify stress through complex repayment systems and …

Physical Therapy Management Of An Adult Patient Diagnosed With Spindle Cell Rhabdomyosarcoma: A Case Report, Jennifer Carrano

Oncology Rehabilitation in Practice

Background: Rhabdomyosarcoma (RMS) is a rare soft tissue sarcoma that primarily affects children and adolescents. Adult RMS is uncommon and associated with poorer prognosis and limited evidence to guide rehabilitation.

Case Description: A 29-year-old male presented with right facial pain, hearing loss, tinnitus, and right facial and tongue paresthesia. Imaging and biopsy revealed spindle cell RMS of the right masticator space. He had no cancer-related family history, did not smoke, and used alcohol occasionally. Treatment included neoadjuvant chemotherapy, major oncologic resection with scapular free flap reconstruction, and adjuvant radiation. He was referred to outpatient physical therapy with trismus, restricted …

Editorial Board Message: About This Issue, Bryan A. Spinelli

Oncology Rehabilitation in Practice

Bryan Spinelli provides a summary of the contents of the issue.

Epilepsy And Cluster C Personality Disorders: A Saudi Cross-Sectional Study, Mohammed A. Aljaffer, Ahmad H. Almadani, Ayedh H. Alghamdi, Mohammad N. Aljarba, Azzam A. Alotaibi, Mohammed A. Alorayyidh, Abdulaziz M. Alawwad, Rakan S. Alromayan, Faisal M. Alkhunein, Sohaila A. Alshimemeri, Bandar N. Aljafen

Neurosciences

Objective: Epilepsy is a neurological disorder with profound impacts on various aspects of life. It may lead to significant medical and psychiatric comorbidities, one of which is personality disorders (PDs). This study aims to assess the prevalence of Cluster C PDs among adult patients with epilepsy (PWE) at a tertiary care hospital in Riyadh, Saudi Arabia. Method: This cross-sectional study, conducted between January 2024 and April 2025, enroled 360 adult PWE using convenience sampling. The study tool included the Structured Clinical Interview for DSM Disorders criteria, along with additional demographic and epilepsy-related questions developed by the research team. Results: Cluster …

From Pages To Practice: Course Design For Integrative And Connected Learning, Prutha Deshpande

UNLV Best Teaching Practices Expo

The poster provides resources for the design of courses to incorporate considerable reading, paired with purposeful activities and reflection questions that deepen understanding of key points of learning, support knowledge transfer, and encourage dialogue and connection.

Facilitating Freirean Pedagogy And Asset-Based Learning In An Asynchronous Environment In A Doctoral Public Health Course, Manoj Sharma, Liliana Davlos, Sharmistha Roy

UNLV Best Teaching Practices Expo

The Department of Social and Behavioral Health offers an asynchronous course, Advanced Applications of Social and Behavioral Theories (HED 762), to doctoral students in public health. In this course, commonly used behavior and social change theories are taught. One such theory is the Freirean theory of adult education, which emphasizes dialogue, critical conscientization, praxis, transformation, and critical consciousness. The instructor of this course uses a variety of methods to imbibe this pedagogy that comprise (a) the use of the fourth-generation multi-theory model (MTM) of health behavior change to motivate students, (b) Freirean dialogue in the Canvas discussion forum with students …

Psychedelic Research In The Modern Day: Good Or Bad?, Shane Miller

Mechanical Engineering Student Research

This work is about the usage/safety of psychedelic substances, and I explain whether they are good or bad in terms of other drugs, such as alcohol.

Test-Retest Reliability And Internal Consistency Of The Occupational Resilience Measure (Orm 1.0), Bernard A. Muriithi, Milan Bimali, Kara Gore

Occupational Therapy Faculty Scholarship

Background: The Occupational Resilience Measure (ORM 1.0) is a 20-item, multidimensional self-report tool for measuring occupational resilience, a construct defined as an individual’s ability to persist in performing occupations despite barriers. Objective: This study evaluated test-retest reliability and internal consistency and explored the extent to which ORM 1.0 is a reliable measure across a diverse range of activity types. Methods: Ninety-four participants completed the test and retest measurements within a 2- to 3-week period. A total of 202 activities were included in the analysis, grouped into leisure (LE) [94], productivity (PD) [35], and self-care (SC) [73]. Findings: The …

Cuidarte También Es Trabajar: Hábitos Saludables Para Una Vida Laboral Plena, Lady Carolina Díaz Jurado, Francisco Javier Laguna Polanía

Ciencias de la Salud

El sedentarismo se ha convertido en un problema recurrente en la salud, especialmente en el ámbito laboral donde predomina la ausencia de actividad física prolongada. Diversos estudios indican que pasar mucho tiempo sentado aumenta notablemente las probabilidades de desarrollar enfermedades cardíacas, metabólicas y del sistema musculoesquelético. Ante esta problemática, surge esta publicación a modo de guía práctica y educativa sobre cómo implementar, de forma segura y progresiva, rutinas de HIIT y MISS, basada en el macroproyecto de investigación “Entrenamiento HIIT vs MISS, una mirada desde la salud ocupacional y los efectos cardiovasculares dirigido al personal administrativo de la Universidad de …

Perceptions Of Instructional Accommodations Among Nursing Students With Information Processing Disorder, Imaobong Aliyu

Walden Dissertations and Doctoral Studies

Instructional accommodations in nursing education often emphasize testing adjustments, while classroom-based instructional support for students with information processing challenges remains underexamined. This descriptive qualitative study explored pre-licensure nursing students’ perceptions of instructional accommodations for students with information processing disorders in Southern California. Guided by humanistic learning theory, the study addressed the research question: What are the perceptions of instructional accommodations in the classroom setting among pre-licensure nursing students with information processing disorders? Seven pre-licensure nursing students participated in semistructured Zoom interviews. Data were analyzed using an inductive process consistent with Saldaña’s analytic approach. Analysis revealed one overarching theme- Instructional accommodations …

Staff Education On The Implementation Of Walking Interventions, Cynthia Ononobi

Walden Dissertations and Doctoral Studies

The doctoral project was a staff education project aimed at improving the knowledge of psychiatric nurses on the use of structured walking interventions to manage depression. The practice problem was related to the lack of consistency in the application of walking as a treatment for depression. This gap was significant to address because psychiatric nurses are in the center of behavioral activation, and insufficient knowledge may deny patients the right to potentially valuable, affordable, and nonpharmacological treatment. The practice-based question was: Among psychiatric nursing staff does education on structured walking intervention, compared to standard care, improve staff knowledge and skills …

Prevalence Of Low Energy (Lea) Risk In Division Iii Female Distance Athletes, Ciara Murphy

Masters Theses/Capstone Projects

Context 

Low energy availability (LEA) occurs when energy intake is insufficient to support normal physiological functions after exercise (Loucks, 2011). Prolonged LEA can negatively affect metabolic functions, reproductive health, and bone density, and contribute to the development of the female athlete triad and relative energy deficiency in sport (RED-S) (Papageorgiou, 2017).

Objective

The objective of this study was to explore the prevalence of LEA among Division III female distance athletes.

Design

Cross-sectional study

Setting

Online questionnaire administered through Qualtrics

Participants 

A total of 12 Division III female distance athletes (ages 18-23).

Intervention

Anonymous, electronic questionnaire assessing symptoms associated with low …

Our Children Our Community: Supporting Autistic Youth To Thrive, Rosaline Owusu Crnp, Fnp-Bc, Marie Noelle Akegnan

Department of Family Medicine

No abstract provided.

Occupational Stressors And Health Impacts Among First Responders, Mason N. Roach

Honors College Theses

The United States 911 emergency response system is an interconnected web of public services that seeks to provide its community with care, resources, and safety in times of need. However, the impact of this support on the employees providing the service often goes unnoticed. This review identifies and analyzes the unique strains on first responders' physical and mental health using the Job Demand-Control Model and the Allostatic Load Model. A review of available research literature supports the conclusion that occupational-related stress, including trauma exposure, shift work, poor leadership, and inadequate communication, can have long-lasting negative impacts on provider health.

Quality Improvement Project: Impact Of An Escape Room Simulation Tool On Nursing Confidence, Farren M. Moore

Doctor of Nursing Practice Projects

This quality improvement project aims to address the need for innovative teaching strategies to meet the demands of licensure exams and the increasing complexity of patient care. Evidence supports simulation-based learning as an effective method to enhance critical thinking and clinical judgment; however, faculty members lack confidence in implementing innovative strategies in their courses. The purpose of this project is to determine whether a standardized escape room simulation tool would impact faculty’s self-confidence in developing and implementing simulation-based activities. Guided by the National League for Nursing (NLN) Jeffries Simulation Theory and Lewin’s Change Theory, the project evaluates the change in …

Effect Of Music Therapy And Music Focused Interventions On Fall Rates In A Memory Care Unit, Emily Spanier, Cassie Howe, Hannah Reiter, Paige Mauer

Celebrating Scholarship and Creativity Day (2018-)

This quality improvement project examined the effect of music therapy and activity-focused interventions on fall rates in a memory care unit at a long-term care facility. The project was developed after staff identified falls as a major safety concern, with the memory care unit accounting for a disproportionate number of facility-wide falls. Through audits and observations, the team found that boredom, wandering, restlessness, and lack of meaningful engagement were common contributing factors to falls among residents with dementia. To address this issue, the team implemented low-cost, person-centered interventions including playing familiar music through Alexa, encouraging participation in simple arts and …

The Lived Experience Of Vicarious Trauma In Specialist Nurses Facilitating Organ Donation: A Narrative Review, Sharon Johnson, Kevin Hambridge

South West Clinical School Journal

#400 words: knowledge and action

The Relationship Between Consumption Frequency And Energy Intake Of Ultra-Processed Food And Obesity Based On Body Fat Percentage Among Fph Ui Students In 2025, Sarah Keisya Budiargo, Triyanti Triyanti, Asih Setiarini, Dieta Nurrika

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is the accumulation of excessive body fat and increases the risk of various non-communicable diseases. Obesity prevalence among FPH UI students based on health examination data in 2022-2024 has reached 13.6%, exceeding the public health concern threshold and requiring more accurate measurement than Body Mass Index. This study aimed to determine the relationship between ultra-processed food (UPF) consumption frequency and energy intake with obesity incidence based on body fat percentage among 147 FPH UI students in 2025. This cross-sectional study utilized the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) based on NOVA classification to assess UPF intake. Body fat percentage was …