Digital Commons Network^™

The Role Of Simulator Immersion On Learning And Transfer Of Decision-Making Skill In Sport, Zachariah G. Hoyne, Khaya Morris-Binelli, Sean Müller, Benjamin Piggott, Paola Chivers, Evan Dekker

Research outputs 2022 to 2026

Virtual reality has become popular in sport and other domains because it can immerse the user within a sporting context and solve logistical problems for additional off-field training. There is limited evidence, however, of whether immersion is crucial for learning and transfer. This study compared training of decision-making skill between 360-degree video virtual reality (360VR) and two-dimensional video. Twenty-eight Australian Rules Football players were randomly assigned to one of three training groups: 360VR, two-dimensional video, and control. Across four weeks, participants in the training groups were exposed to decision-making scenarios consisting of visual, contextual and auditory cues. Performance was assessed …

Chronic Pain And Mobile Health: Are The Apps That Occupational Therapists Recommend Of High Quality?, Jessica Smith, Thuy Tran, Jacqui Hunt, Katrina Liddiard

Research outputs 2022 to 2026

Introduction: Chronic pain is a biopsychosocial experience that can impact peoples' ability to participate in everyday occupations. Mobile health applications, or apps, have the potential to make chronic pain services more effective and accessible. However, the quality of many health apps is not known, which creates a critical challenge for occupational therapists who aim to deliver evidence-informed intervention. This study rated the quality of apps available for Australian occupational therapists to use with clients who have chronic pain.

Consumer and Community Involvement: No consumer and community involvement.

Methods: This study used a cross-sectional descriptive design to (1) identify chronic pain-relevant …

Training Apart, Together: Team Dynamics In Individual Sports And Surgical Residency, W. Jack Palmer, Dylan Bertoni, Elizabeth E. Cottrill, Colin T. Huntley

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Surgeons in training share notable parallels with competitive athletes, including rigorous training, skill specialization, and functioning under pressure. Surgical educators have leveraged this comparison, incorporating techniques from sports psychology, such as mental imagery and mindfulness, to improve trainees' individual performance and well-being. Surgical trainees and athletes both rely on effective teamwork for optimal outcomes, suggesting that residency leaders can glean valuable team-level insights from sports psychology. This article examines how the structure of surgical residency influences team dynamics, using concepts from sports psychology to identify evidence-based strategies for improving program cohesion and resident well-being. The surgical literature typically conceptualizes surgery …

Loma Linda Nurse - Vol. 35, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | From Behind the Lens to by the Bedside—Nicole Mackey

6 | Coming Home— CRNA Alumni Faculty Feature

8 | From NICU Miracle Baby to Nurse—Nito Gil

10 | Change the Game— Miguel Aguayo

12 | Standing in the Shadow of a Miracle—Joyce Rusch

LLUSN HIGHLIGHTS

14-21 | ALUMNI NEWS

22-29 | ACADEMICS

30-33 | HOMECOMING

34-38 | FACULTY UPDATES

Incorporating High-Quality Simulations Into The Undergraduate Health Management Curriculum: A Pragmatic Approach For Learner Engagement, Noemí Rodríguez, Laura M. Penalo

Publications and Research

Despite the well-documented benefits of simulation-based education, their use remains limited in undergraduate health management programs. Faculty might be unfamiliar with the processes required to design and implement high-quality simulations. This article presents a structured methodology—grounded in Healthcare Simulation Standards of Best Practice and The Jeffries Simulation Theory—through the experience of an undergraduate healthcare policy and management course at a large urban public university. This article focuses on describing the multilayered Online Standardized Participant Simulation including a detailed description of the simulation design, prebriefing, online standardized participant scenario, and debriefing. A unique feature of the shared simulation experience is the …

Strengthening Post-Fall Huddle Practices In Long-Term Care, Janette Perry

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: High resident fall rates and repeat falls caused by an unreliable nurse-only post-fall huddle (PFH) process that lacked structure, interdisciplinary participation, and timely root-cause analysis.

Aim of the Project: To reduce falls and fall-related injuries in long-term care units by implementing a standardized, evidence-based PFH workflow that strengthens root-cause analysis, improves interdisciplinary communication, and increases PFH reliability.

Review of the Evidence: Evidence from fourteen high-quality, peer-reviewed studies demonstrates that structured, interdisciplinary post-fall huddles are more effective than informal, nurse-only approaches in improving fall analysis and reducing repeat falls in long-term care settings. Structured PFHs strengthen root-cause analysis; interdisciplinary participation …

Analysis Of The Deborah Sampson Act Of 2020: Improving Women Veterans’ Care, Jessica N. Shipp

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Women Veterans are one of the fastest-growing populations served by the Veterans Health Administration (VHA), yet gaps persist in access to gender-responsive, trauma-informed care. Despite requirements established by the Deborah Sampson Act (DSA) of 2020, implementation remains inconsistent in Women's Health Primary Care Provider (WH-PCP) access, women's mental health (MH) services, military sexual trauma (MST) care, workforce capacity, care coordination, and accountability.

Aim of the Project: The aim was to evaluate the effectiveness, feasibility, equity, and implementation fidelity of the DSA using the Centers for Disease Control and Prevention (CDC) Policy Analytical Framework (POLARIS) and identify evidence-based recommendations to …

Flourishing Childhood Frameworks: A Scoping Review, Jacqueline A. Davis, Zenobia Talati, Lisa Y. Gibson, Jack Kennare, Christina Bethell, Christina Hinton, Hannah Block, Tara D'Silva, Desiree Silva, Susan L. Prescott

Research outputs 2022 to 2026

Objectives: Experiences in early life impact childhood, lifelong flourishing, and overall well-being. Yet a framework to guide promoting and measuring flourishing in early childhood has not emerged. The objective of this study was to identify frameworks and measures related to promoting and assessing early-childhood flourishing (0-5 years) to build on a preexisting, community-informed framework.

Methods: A systematic search was conducted across electronic databases and the gray literature for articles published between 2014-2026. Of 13 902 total references, 8592 were eligible for screening. A machine learning-assisted tool (Research Screener) was used to streamline screening of the abstracts against the inclusion criteria. …

Effectiveness Of An Integrated Activity-Based And Tele-Monitoring Intervention On Mental Health Literacy And Resilience Among Urban Older Adults In Thailand: A Quasi-Experimental Study, Khunatpakorn Makkabphalanon, Pramote Thangkratok, Jutamast Wongjan, Natchaya Palacheewa

Journal of Health Research

Background: Mental health problems among older adults are a growing public health concern, particularly in urban areas. Mental health literacy can enhance problem recognition, self-help, and help-seeking. This study examined changes in mental health literacy and resilience among urban older adults following an integrated activity-based and tele-monitoring intervention.

Methods: A one-group quasi-experimental repeated-measures study was conducted among 30 adults aged 60 years and older in urban communities in Thailand. Participants received a structured 3-hour activity-based mental health literacy intervention followed by 1 month of tele-monitoring support. Data were collected at baseline, immediately after the intervention, and at 1-month follow-up. Changes …

An Evaluation Of Southern Nevada’S Pediatric Care Ecosystem, David Damore, Tina Quigley, Nick Fiore

Policy Briefs and Reports

In 2024, The Lincy Institute and the Nevada Health and Bioscience Corporation released a report prepared by the consulting firm Tripp Umbach detailing the case for a stand-alone children’s hospital in Southern Nevada. Shortly thereafter, Intermountain Health announced it would build Nevada’s first such facility in Las Vegas, expected to open in 2030. To complement the hospital’s development, The Lincy Institute undertook an independent evaluation of the regional pediatric care landscape. The analysis draws on secondary data and discussions with advocates, health system administrators, practitioners, and providers. The report examines:

• Fiscal, resource, and workforce challenges underlying Nevada’s poor population-level pediatric …

Factors Associated With Adherence To Anti-Tuberculosis Drugs (Atds) In Samarinda, Fahmi Nur Indah Sari, Irfansyah Baharuddin Pakki, Nur Rohmah, Siswanto Siswanto, Muhamad Z. Saefurrohim

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) is an infectious disease that remains a major public health problem in Indonesia. Treatment success is highly dependent on the patient's adherence to taking Anti-Tuberculosis Drugs (ATDs). This study aimed to determine the relationship between perceived susceptibility, severity, benefits, barriers (stigma), cues to action (healthcare workers support), and self-efficacy with adherence to taking ATDs among TB patients in Samarinda City. This study employed a cross-sectional design with a quantitative approach involving 121 TB patients from four community health centers (Puskesmas) in Samarinda. Samples were selected using multistage sampling. Data were collected through structured interviews using questionnaires and analyzed …

Improving Provider Confidence In Suicide-Risk Screening Through Training On A Safe-T-Guided Pathway At Intake, Shukairo Mack Baker

Doctor of Nursing Practice Projects

Evidence supports structured suicide-prevention education, but inconsistent pathway use at outpatient intake prompted this quality improvement project to evaluate provider confidence. The aim was increased confidence after training on a Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) guided pathway. Donabedian's structure, process, and outcome model and the Awareness, Desire, Knowledge, Ability, and Reinforcement change model guided implementation through one Plan, Do, Study, Act cycle. A single-group pre-test and post-test design involved seven clinicians at one hybrid outpatient behavioral health clinic. All available eligible staff (100%) completed a 2.5-hour training and both surveys. The Suicide Risk Assessment Confidence Scale was administered …

Psychosocial And Demographic Determinants Of Work Stress Among Lecturers At University X, Natasha Putri Ayu Kayla, Fajaria Nurcandra, Dr. Dyah Utari, Nayla K. Fithri, Siti Norashikin Mohamad Shaifuddin

Jurnal Epidemiologi Kesehatan Indonesia

Occupational stress is a psychological pressure related to work conditions. Psychosocial and demographic determinants may be the influence. Lecturers are white collar workers who have the opportunity to experience occupational stress. The aim of this study is to determine the factors that influence occupational stress among lecturers in X University. This research is a quantitative study with a cross-sectional study design. The sampling technique used is Accidental Sampling. The number of samples used was 132 respondents. The study was conducted in April-June 2024. The Cox Regression Model was used to analyze. The instruments used were The Workplace Stress Scale, Multidimensional …

Elite Esports Players And Their Physical Health: A Systematic Review Of Injuries, Musculoskeletal Pain, And Fitness-Related Factors, Michal Steffl, Daniel Opelik, Vladimir Hlinka, Grzegorz Mikrut, Petra Hospodkova

Baltic Journal of Health and Physical Activity

Background: The rapid rise of competitive esports has sparked concerns over the physical health of elite players. Prolonged sedentary behaviour, repetitive movements, and poor ergonomic practices may predispose these athletes to injuries, musculoskeletal pain, and unfavourable body composition. Materials and methods: A systematic review following PRISMA guidelines was conducted by searching Pub-Med, Scopus, EBSCOhost, and Web of Science for cross-sectional studies on physical activity (PA), body composition, physical fitness, and musculoskeletal health in elite esports players. Data from 22 peer-reviewed studies involving 5,035 participants aged 16 to 35 were synthesized. Results: Findings consistently show that esports players engage in lower …

Quality Improvement Project: Improving Nurse Confidence In Managing Patient Aggression Using The Brøset Violence Checklist And Team-Based Strategies, Grace Amakulor

Doctor of Nursing Practice Projects

Workplace violence remains a concern in psychiatric nursing, particularly when changes in patient behavior are not recognized early or communicated consistently. This quality improvement (QI) project was conducted at a psychiatric recovery center in Central Ohio after identifying a practice gap in aggression risk assessment and response. The purpose was to implement and evaluate a multicomponent aggression-management approach using the Brøset Violence Checklist (BVC), structured team huddles, and individualized aggression care plans. The aim was to improve nurse confidence (primary outcome) and reduce aggressive behavioral incidents (secondary outcome) over four weeks. Bandura’s Social Cognitive Theory and Lewin’s Change Theory guided …

Quality Improvement Project: Enhancing Suicide Recognition Protocols With The Use Of Columbia-Suicide Severity Rating Scale In An Outpatient Mental Health Practice, Pamela Oxley

Doctor of Nursing Practice Projects

Suicide prevention in outpatient mental health settings requires prompt recognition of and an appropriate response to suicide-related concerns, including those initially communicated to administrative staff. Frontline administrative phone staff may first encounter patients expressing suicidal thoughts; however, evidence supports education and standardized processes to facilitate effective recognition and response. At the project site, a practice gap existed in administrative staff preparation and confidence in responding to suicide-related concerns. The quality improvement project addressed this gap through structured, standardized Columbia-Suicide Severity Rating Scale (C-SSRS) education paired with a standardized suicide-risk stratification and escalation protocol. The project aimed to improve administrative staff …

Quality Improvement Project: The Impact Of Proper Utilization Of Suicidal Ideation Screening Tools, Anuoluwapo Bode-Oloye

Doctor of Nursing Practice Projects

Suicide remains a significant public health concern, emphasizing the importance of consistent and evidence-based suicide risk assessment in outpatient mental health settings. The purpose of this Doctor of Nursing Practice quality improvement project was to determine how the provider’s implementation of the Columbia Suicide Severity Rating Scales (CSSRS) according to the recommendations of the Substance Abuse and Mental Health Services Administration would impact the confidence and the rate of completion of suicidal screening tools (Columbia Suicide Severity Rating Scales) compared to current clinic policy in an outpatient mental health clinic for over twelve weeks. This project used Lewin’s change model …

Quality Improvement Project: The Impact Of Provider Education On Antipsychotic Medication Side Effects, Anthony Emego

Doctor of Nursing Practice Projects

Weight gain is a frequent and clinically relevant side effect of antipsychotic medication. A needs assessment at the project site found that roughly 55% of patients on an antipsychotic treatment had clinically significant weight gain, and providers had no formal training on how to prevent and manage this. The purpose of this quality improvement project was to determine if a provider-focused educational intervention is effective in increasing provider confidence and decreasing antipsychotic-induced weight gain in adult psychiatric patients. This quantitative, one-group pre-post design utilized Lewin's Change Theory and Bandura's Social Cognitive Theory. It was conducted at an outpatient psychiatric clinic …

The Impact Of Provider Education On Medication Adherence In An Outpatient Psychiatric Clinic: A Quality Improvement Project, Tina Ezeh

Doctor of Nursing Practice Projects

Medication adherence is important in psychiatric care, as nonadherence can contribute to poor health outcomes and increased use of healthcare services. A needs assessment at an outpatient psychiatric clinic identified inconsistent medication adherence education, with only 30% of providers routinely providing education and 20% using a structured approach. The purpose of this quality improvement project was to evaluate structured provider education, with the aim of assessing changes in provider confidence and the frequency of medication adherence education over eight weeks. Kotter’s 8-Step Change Model guided project implementation, while the Donabedian Model was used for project evaluation. A quantitative, one-group pretest-posttest …

Quality Improvement Project: Evaluating The Impact Of An Emotional Support Program For Nurses In A Rural Outpatient Clinic, Tosheta Brown Greenfield

Doctor of Nursing Practice Projects

Nurse burnout is a persistent, well-documented threat to workforce sustainability and patient safety, with rural nurses at heightened risk due to chronic understaffing, geographic isolation, and limited access to organizational support. The purpose of this quality improvement project was to implement and evaluate an eight-week Emotional Well-Being Support Program (EWSP), with the aim of reducing burnout and perceived stress among nurses working in a small rural primary care clinic. Guided by Lewin's Change Model and the Iowa Model of Evidence-Based Practice, the project used a quasi-experimental pre-test/post-test single-group design with four participating nurses. Burnout was measured using the Maslach Burnout …

Quality Improvement Project: Providing Evidence-Based Practice Education On Administering The Edinburgh Postnatal Depression Screening During Visits Once Per Trimester And Postpartum, Megan Keeney

Doctor of Nursing Practice Projects

Perinatal depression (PND) is prevalent worldwide and frequently remains undetected and untreated due to inconsistent screening. At the project site, the Edinburgh Postnatal Depression Scale (EPDS) was administered postpartum only, without standardization. This quality improvement project implemented evidence-based provider education and a revised EPDS protocol, screening once per trimester and postpartum, to increase PND identification, provider self-confidence, self-efficacy, and behavioral health referral rates. This project was guided by Lewin’s Change Theory and the Donabedian framework. A quantitative pre-post design was used with nine providers in an outpatient women’s health clinic, alongside a retrospective and post-implementation electronic health record (EHR) review. …

Eeg-Emg Coupling And Functional Neuroplasticity In Elite Combat Athletes: Effects Of Neurofeedback Training On Corticomuscular Coherence And Performance, Alicja Markiel, Kinga Łosińska, Marcin Żak, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: Neurofeedback training has gained attention as a neuroplasticity based intervention for athletic performance, yet pathways linking cortical oscillatory modulation to neuromuscular adaptation and strength remain poorly characterized in elite combat athletes. Objective: This study examines whether EEG neurofeedback targeting sensorimotor alpha upregulation and frontal theta/delta modulation enhances cortico-muscular coherence, neuromuscular function, and maximal strength in elite MMA athletes. Methods: Thirty elite male MMA athletes (n = 10/arm) were randomized to intensive neurofeedback (E20G, 20 sessions), abbreviated neurofeedback (E15G, 15 sessions), or sham control. EEG spectral indices, EMG parameters (RMS, MF, iEMG, onset latency), beta band CMC, and maximal strength …

The Impact Of Implementing A Discharge Tool On Nurses’ Confidence And Press Ganey Patient Survey Scores In Discharge Planning, Cristan Ledbetter

Doctor of Nursing Practice Projects

A needs assessment at a rural hospital revealed an opportunity for improvement in discharge planning. The purpose and aim of this project was to improve nurses’ confidence in the discharge process and improve Press Ganey survey scores in communication about medicine domain and discharge information domain. Inadequate discharge planning leads to poor patient outcomes, concern for patient safety, increased healthcare costs, and inferior patient satisfaction. The quality improvement (QI) project utilized a one-group pretest/posttest QI design. An evidence-based, standardized discharge tool was implemented. The Susan Grundy confidence scale (C-Scale) was used to evaluate nurses’ confidence in the discharge process pre- …

Enhancing Healthcare Provider Confidence And Accuracy In Performing And Documenting The Abnormal Involuntary Movement Scale, Victoria Okoani-Nneji

Doctor of Nursing Practice Projects

Monitoring for medication-related movement disorders is essential for adults with schizophrenia receiving antipsychotic medications; however, inconsistent Abnormal Involuntary Movement Scale (AIMS) assessment and documentation can limit timely recognition of abnormal movements. This quality improvement project evaluated a six-week structured AIMS education program designed to improve provider confidence and documentation accuracy in an outpatient behavioral health setting in Central Ohio. Guided by Benner’s Novice-to-Expert Model and Kotter’s Eight-Step Change Model, the project used a one-group pretest-posttest design with 15 licensed behavioral health providers. Weekly sessions included instruction, demonstration, guided practice, case-based learning, scoring, interpretation, and electronic health record (EHR) documentation. Descriptive …

Quality Improvement Project: Determining Impact Of Mental Health Screening Provider Training, Sherri Bennett

Doctor of Nursing Practice Projects

Obesity is frequently associated with mental health concerns, yet these conditions may remain under identified when mental health screening is not consistently incorporated into medical weight-loss care. At the project site, fewer than 2% of patients who are overweight or obese were identified as needing mental health services, demonstrating a practice gap in screening and referral. The purpose of this quality improvement project was to evaluate whether targeted mental health screening education improved provider confidence. The aim was to increase confidence in conducting mental health screening among nurse practitioners in a medical weight-loss program. The Stetler Model provided the theoretical …

Intimate Partner Violence And Child Wasting Across Countries: An Ecological Cross-Sectional Study, Wanri Lumbanraja, I Ketut Kasta Arya Wijaya, Ruben Cornelius Siagian

Journal of Indonesian Health Policy and Administration

Intimate partner violence (IPV) is a public health issue that can affect the well-being of women, their families, and the child-rearing environment. Meanwhile, wasting in under-five children reflects acute malnutrition linked to food insecurity, infectious diseases, poverty, and access to healthcare services. This study aimed to analyze the relationship between the prevalence of IPV among women in the past 12 months and the prevalence of wasting in children under the age of five at the national level. This study addresses the gap in cross-national research, which remains limited in linking IPV as an indicator of social vulnerability with wasting as …

Perceived Susceptibility And Automatic Compliance In Indonesia's Triple Elimination Screening: A Mixed-Methods Study, Ratna Dewi Puspita Sari, Josef Maria Seno Adjie

Journal of Indonesian Health Policy and Administration

Despite global commitments to eliminating mother-to-child transmission of human immunodeficiency virus, syphilis, and hepatitis B, gaps remain in understanding the behavioral and systemic drivers of screening coverage in decentralized health systems such as Indonesia. This study aimed to analyze individual behavioral determinants and structural health system barriers affecting triple elimination screening coverage among pregnant women, focusing on perceived susceptibility and automatic compliance. A mixed-methods sequential explanatory study was conducted in Central Jakarta, Surabaya, and Karawang. The quantitative phase involved a cross-sectional survey of 1,224 pregnant women, with Health Belief Model variables analyzed using logistic regression. The qualitative phase comprised three …

Quality Improvement Project: Improving Nurses’ Confidence In Peripheral Intravenous Catheter Assessment Through The I-Decided Framework, Pepe Sanchez

Doctor of Nursing Practice Projects

Peripheral intravenous catheters (PIVCs) remain a patient safety concern because inappropriate management can increase the risk of catheter-related bloodstream infections, prolonged hospitalization, and increased healthcare costs. A vascular access assessment at an acute care hospital identified inconsistent PIVC assessment practices and inadequate documentation, highlighting the need for a standardized approach to vascular access management. This quality improvement project evaluated the impact of education on the I-DECIDED framework on nurses' confidence in PIVC assessment and clinical decision-making. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Lewin's Theory of Planned Change, the project used a quantitative, quasi-experimental, one-group pretest-posttest design. …

Social And Psychological Well-Being Of Aps Clients With Elder Mistreatment And Self-Neglect, Thara Ayyar

Summer Research Program Abstracts

No abstract provided.

The Impact Of Provider Medication Reconciliation Education On Hospital Readmissions In A Skilled Nursing Facility, Vivian Nwozu

Doctor of Nursing Practice Projects

Aging causes frailty and multiple comorbidities, necessitating polypharmacy. Complicated drug regimens predispose patients to adverse drug events and hospital readmissions. The practice problem was high rates of medication-related readmissions due to inadequate provider knowledge of medication reconciliation and the lack of a standardized tool. This project aimed at evaluating the impact of provider medication reconciliation education on hospital readmissions in a skilled nursing facility. A pretest-posttest study design was utilized. The Donabedian Model of Healthcare Quality guided the translation of evidence into practice, whereas Lewin’s Change Model and Plan-Do-Study-Act models guided implementation. Eight providers were educated on medication reconciliation using …