Digital Commons Network^™

Act And Posttraumatic Growth In Military Veterans: Growth Through Flexibility After Adversity, Andrew J. Moller

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Military veterans are disproportionately exposed to potentially traumatic events across service eras. While much of the clinical and research literature has focused on posttraumatic stress disorder (PTSD) and symptom reduction, a growing body of work highlights the possibility of posttraumatic growth (PTG) following adversity. PTG refers to positive psychological changes that may emerge through engagement with traumatic experiences, including enhanced appreciation for life, renewed purpose, personal strength, deepened relationships, and reintegration into community roles. Importantly, PTG does not imply the absence of distress but may coexist alongside ongoing trauma-related symptoms. Understanding processes that facilitate growth alongside suffering may support more …

Clinical Considerations For Black Student Athlete Development, Jahnia Margarita Green

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Black student athletes exemplify the complexity of navigating intersecting identities at pivotal points in their development. They are also more likely to make premature commitments to their athletic identity and in turn suffer from psychological distress during times of transition (Beamon, 2012). The focus on Black collegiate athletes is informed by persistent mental health challenges associated with higher levels of competition or transitions (e.g., injury or retirement) within collegiate athletics (Brewer & Petitpas, 2017; Menke & Germany, 2019). This paper aims to develop culturally informed clinical considerations through the analysis of the Black student athlete experience and structural aspects of …

Trauma Processing And Sleep Inconsistencies In Firefighters: A Proposed Program To Bridge Gaps And Set Heroes Up For Success, Megan Griffin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This doctoral paper presents a comprehensive review of the literature supporting the need for an integrated training program addressing sleep disruption, trauma exposure and processing, and substance use as a self-medication strategy among firefighter populations. Drawing on empirical research, the paper examines the prevalence and interaction of posttraumatic stress disorder (PTSD), moral injury, sleep disturbances, and substance use within this occupational group. The introduction provides operational definitions of PTSD and moral injury and synthesizes existing research on trauma exposure, sleep impairment, and substance use functions among firefighters. The literature review also highlights evidence-based, exposure informed interventions to facilitate adaptive trauma …

A Brief Self-Help Intervention For Anxiety And Depressive Symptoms Utilizing Cognitive Behavioral Therapy And Dialectical Behavior Therapy Within Correctional Settings, Genevieve L. Ray

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Individuals within incarcerated settings are far more likely to experience symptoms that meet criteria for a mental health disorder compared to the general population. This population is often underserved due to various financial and resource constraints. Self-help interventions have grown in popularity due to their proven effectiveness and accessibility for consumers, particularly for anxiety and depression symptoms. A self-help intervention for those in a correctional setting would not require extensive additional personnel amid financial constraints and would increase access to care. Many self-help interventions that are currently published apply to the community population, but readily accessible resources that reside in …

Diagnosis And Treatment Of Trauma In Adolescents: A Doctoral-Level Clinical Psychology Course, Jasmine M. Cervantes

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Adolescent trauma is a significant mental health concern that can profoundly disrupt emotional, cognitive, social, and developmental functioning. Although evidence-based interventions for adolescent trauma are well established, doctoral-level psychology training programs may provide limited instruction focused specifically on the unique developmental, cultural, and clinical considerations required when treating traumatized adolescents. This paper presents the development of a ten-week doctoral-level elective course designed to address this gap in clinical training. The curriculum provides foundational knowledge regarding the prevalence, developmental impact, diagnosis, and treatment of adolescent trauma, with an emphasis on posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD). Students …

Improving K-Card Observation Fidelity To Sustain A Culture Of Continuous Learning, John L. Ricks Iii

Master's Projects and Capstones

Problem

            Despite improvements in central line-associated bloodstream infection (CLABSI) attribution, variability in Kamishibai card (K-card) observation practices and documentation limited the unit's ability to identify, learn from, and correct persistent deviations from expected practice. Baseline data showed frequent incomplete documentation and a pattern of completing K-card observations outside bedside shift report.

Context

This project took place in a 20-bed medical-surgical ICU, using the existing K-card process to support high-reliability prevention of hospital-acquired conditions (HAC). Baseline assessment revealed inconsistent observation workflows, incomplete documentation, and unclear roles and expectations.

Interventions

A standardized K-card observation workflow was developed through rapid-cycle testing. Observations were …

Don’T Fall For It: Just-In-Time Staff Education To Reduce Patient Falls On An Adult Telemetry Unit, Forrest Wilcox, Kyle Knight, Jennifer Paiz, Zaira Garcia-Vega

Master's Projects and Capstones

Objective: Patient falls remain a leading cause of preventable harm among hospitalized adults and carry significant clinical and financial consequences. On an adult medical-surgical telemetry unit at this study site, a one-year review of 45 fall events found that most falls occurred among patients classified as high risk on the Morse Fall Scale, frequently without continuous observation or consistent purposeful rounding. Aim: The aim of this project is to reduce falls on the telemetry unit to the national benchmark of 3.2 falls per 1,000 patient days within a 6-month period. Methods: A just-in-time (JIT) education intervention was delivered to registered …

Healthcare Students’ Experiences Using Artificial Intelligence Simulation Tools In Clinical Simulated Laboratory Practice, Delicia S. Cousin

Student Dissertations

Artificial intelligence-driven simulation has become an important component of healthcare education by providing students with opportunities to strengthen clinical reasoning, decision-making, and technical skills in a safe learning environment. Despite its growing adoption, limited research has explored how healthcare students experience artificial intelligence-driven simulation during clinical laboratory practice. The purpose of this qualitative case study was to explore healthcare students’ experiences using artificial intelligence-driven simulation tools during clinical laboratory practice. Guided by Experiential Learning Theory and Transformative Learning Theory, the study examined how students interpreted, reflected upon, and learned from these experiences. Data were collected through a researcher-developed Qualtrics questionnaire …

Determinants Of Antenatal Care Utilization: A Community-Based, Cross-Sectional Study In Morang And Sunsari Districts, Eastern Nepal, Sunil Shah, Chandra Jha

Journal of Social, Behavioral, and Health Sciences

This study examined the factors influencing antenatal care (ANC) utilization in the eastern region of Nepal, focusing on the Morang and Sunsari districts, with the aim of identifying key determinants affecting ANC uptake and assessing the extent of ANC service utilization among mothers. Using lot quality assurance sampling, a community-based, descriptive, cross-sectional design was employed, surveying 164 mothers who had given birth within the previous 12 months; data were collected from June through November 2023. Data were collected through a semi-structured questionnaire and analyzed using SPSS, with descriptive statistics, chi-square tests, and logistic regression. Findings revealed that 80.5% of respondents …

The Effect Of Escape Room Simulation On The Self-Efficacy And Communication Levels Of Novice Critical Care Nurses, Lauren A. Femino, Kim Chapman, Julie A. Marshall, Shelby A. Trull, Jennifer A. Dibenedetto

The Lahey Journal

Abstract 

Introduction: Novice critical care nurses often report having low self-confidence and effective communication skills when transitioning to the ICU practice, often due to stress, limited experience, and unfamiliarity with critical care environments. These challenges can not only affect their job satisfaction and retention rates, but also pose serious risks to patient safety and outcomes. The purpose of this evidence-based practice (EBP) project was to assess the impact of an escape room simulation on the self-efficacy and communication skills of novice critical care nurses.

Methods: An evidence-based practice (EBP) project with pre-test and post-test design was conducted to …

From “Fixer” To “Facilitator”: A Clinical Review Of Shared Medical Appointments As A Strategy For Workforce Sustainability, Barbara A. Slusher

Lynchburg Journal of Medical Science

Clinician burnout remains a significant threat to workforce sustainability, particularly in resource-constrained settings managing complex chronic diseases. While shared medical appointments (SMAs) have demonstrated clear benefits in patient satisfaction and access, their impact on clinician well-being and professional fulfillment is less clearly defined. This review evaluates whether participation in SMAs improves clinician satisfaction and mitigates burnout by facilitating a conceptual transition from isolated “Fixer” to collaborative “Facilitator.”

A targeted literature search of PubMed, the Cochrane Library, and Google Scholar identified peer-reviewed publications examining shared medical appointments and clinician-centered outcomes, including burnout, clinician satisfaction, and workforce sustainability. …

Navigating The Maternal Health Crisis: Enhancing Maternal Health Outcomes In New Jersey, Nyrobi Barnes

Doctoral Dissertations and Projects

The purpose of the study was to better understand the implications of race and ethnicity on perinatal health experiences and maternal health outcomes in non-Hispanic Black women (nHBw) in New Jersey and mitigate the maternal health crisis. A secondary outcome was to propose an evidence-based initiative to elicit equitable care in New Jersey via grant-funded programs at the New Jersey Department of Health. Although New Jersey has made progress in improving maternal and infant health outcomes, racial disparities continue to persist. The research aims to further understand implications of race and ethnicity on adverse perinatal health experiences and maternal health …

Defining Quality Of Life: The Lived Experience Of Adults With Pulmonary Hypertension And The Impact Of Activity-Induced Respiratory Distress, Bethany Jean Adams

Walden Dissertations and Doctoral Studies

Pulmonary hypertension (PH) is a progressive, life-limiting disease that significantly affects quality-of-life (QoL). Limited research has explored lived experiences of individuals with PH. Guided by Parse’s human becoming theory, this qualitative descriptive phenomenological study explored the lived experiences of individuals affected by PH and examined how activity-induced respiratory distress affected QoL. The research Question was: How do individuals with PH describe the impact of activity-induced respiratory distress on their QoL. I conducted interviews with nine participants, including eight adults diagnosed with PH and one caregiver of an individual with PH. Data were analyzed using Saldaña's comparative coding framework to identify …

Predictors Of Academic Performance In First-Year Bsn Students: The Role Of Emotional Exhaustion, Alcohol Use, And Resilience, Jennifer Nerius

Doctoral Dissertations and Projects

The first year of nursing school can be academically demanding and emotionally challenging as students adjust to rigorous coursework, clinical expectations, and professional responsibilities. Understanding factors that influence student well-being and academic success is important for supporting students during this transition. The purpose of this quantitative longitudinal correlational study was to examine the relationships among emotional exhaustion, alcohol use, resilience, and academic performance in first-year Bachelor of Science in Nursing (BSN) students. Guided by Resilience Theory, the study explored whether resilience was associated with emotional exhaustion and alcohol use and whether emotional exhaustion, resilience, and alcohol use predicted academic performance. …

Staff Education To Enhance Nurse Knowledge Of Standardized Sud Screening Using The Dast-10 In An Outpatient Psychiatric Setting, Peters Olugbemiga Adu

Walden Dissertations and Doctoral Studies

The utilization of substance use disorder (SUD) screening tools at the practice site was inconsistent, contributing to limited identification and diagnosis of SUDs. The project was conducted at a psychiatric outpatient clinic in an urban region of Maryland that serves many patients with co-occurring mental health and substance use disorders. The purpose of the project was to develop, implement, and evaluate a staff education program focused on the Drug Abuse Screening Test (DAST-10). The primary goal was to improve staff knowledge and understanding of the DAST-10 screening tool. A 14-item multiple-choice questionnaire was administered before and after the educational intervention …

Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

Osteoarthritis In Saudi Arabia: Current Evidence, Public Perceptions, And Future Research: A Narrative Review, Khalid Yaseen

Journal of Medical Rehabilitation Science

Background and Purpose: Osteoarthritis (OA) is a leading cause of pain and disability worldwide and represents a growing public health concern in Saudi Arabia. This narrative review synthesises current evidence on OA in the Saudi context, with particular emphasis on epidemiology, risk factors, public perceptions, clinical management patterns, and the utilisation of physiotherapy and other conservative interventions. The aim is to inform clinical practice, public health strategies, and health system planning in alignment with Saudi Vision 2030.
Methods: A narrative review was undertaken, drawing on evidence from PubMed/MEDLINE, Scopus, Web of Science, Saudi Digital Library, Ministry of Health (Saudi Arabia) …

Staff Education To Nurses On Trauma-Informed Care, Lorna Sackey

Walden Dissertations and Doctoral Studies

Many nurses receive little formal instruction about trauma-informed principles and their practical application in behavioral health settings. To address this practice gap, the project implemented a staff education program for staff at an intensive outpatient program (IOP) and a partial hospitalization program (PHP) located in a northeastern state. The aim was to increase staff knowledge and confidence in trauma-informed principles within clinical practice. The education program emphasized the relevance of trauma-informed care (TIC) in outpatient behavioral health settings, its principles, and its application in nursing assessments, therapeutic communication, and patient interactions. A pretest and posttest questionnaire consisted of 12 multiple-choice …

Exploring Social Cognitive Learning In Simulation-Enhanced Interprofessional Education: A Case Study, William Nicholas Vasios Iii

Doctoral Dissertations and Projects

The purpose of this single-case design study is to explore the impact of observational and vicarious learning during simulation-enhanced interprofessional education (Sim-IPE) on the confidence and perceived self-efficacy of nursing students and IM residents at a southeastern university. Guided by Bandura’s social cognitive learning theory, which addresses the personnel, behavioral, and environmental factors of Sim-IPE, while answering the central research question: How does observational and vicarious learning during Sim-IPE impact participant confidence and perceived self-efficacy? This qualitative single-case study was conducted at a university in the southeastern United States, using data collected through visual confidence analog scale surveys, interviews, and …

Comparing The Difference In Nurses’ Knowledge And Attitudes Toward Near-Death Experiences (Ndes) Before And After Receiving Nde Education, Renata B. Mcallister

Doctoral Dissertations and Projects

Near-death experiences (NDEs) have been reported in approximately 6.3% to 39.3% of patients who survived death or critical illness. Research indicated that health care professionals, of whom nurses are the largest group, received little education or training on NDEs. Nurses' responses to a disclosure could help the patient integrate the experience or contribute to stress and isolation. National nursing standards do not address education or competencies specific to NDEs, and few studies have examined educational programs on the topic. This quasi-experimental study examined changes in nurses' knowledge and attitudes before and after a three-part asynchronous training on NDEs, measured with …

Exploring The Impact Of Spiritual Fitness On Combat Veterans In Their Recovery From Ptsd, Chronic Pain, And Sleep-Related Impairments, Minnette Danielle Sandoval Cornish

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore how combat veterans utilize and perceive spiritual practices in their recovery from PTSD chronic pain, and sleep-related impairments (SRIs). Guided by Self-Determination Theory (Deci & Ryan, 2017) the study sought to understand which spiritual practices combat veterans used, how they incorporated the practice into recovery, and how they perceived the impact of those practices in managing their symptoms. Participants included 13 combat veterans who self-identified as using spiritual practices in their recovery from PTSD, chronic pain, and SRIs. Data was collected through semi-structured interviews and a focus group. Interview and focus …

Implementation Of Staff Education To Reduce Or Prevent Pressure Injury, Beverley A. Moses

Doctoral Dissertations and Projects

Pressure injuries (PIs) present a significant clinical challenge in healthcare settings, particularly among patients with limited mobility, comorbidities, and complex musculoskeletal injuries. These injuries lead to adverse patient outcomes, such as increased morbidity, prolonged hospital stays, and an increase in healthcare costs. Despite advancements in clinical practice, PI prevention remains a critical area for quality improvement, necessitating a standardized, patient-centered approach to care. This Doctor of Nursing Practice (DNP) project aimed to improve patient outcomes by implementing a standardized educational initiative for nursing staff in a bone and joint unit at a private hospital in Upstate New York. The project …

Promoting Scientific Impact At The Nih, Fred D. Ledley M.D.

CISI Publication

We are honored to offer our comments on Promoting Scientific Impact at the NIH in response to NOT-OD-26-087: Request for Information on Measuring and Rewarding Scientific Impact.

These comments are informed by my professional experience as the founding director of the Center for Integration of Science and Industry at Bentley University, which has a mission to “advance the translation of scientific discoveries for public value by engaging science, business, and policy in transdisciplinary dialogue, scholarship, and education.” Our approach is to bring together the perspectives of natural science, business, analytics, economics, law, and policy to better understand, and advance, the …

Implementation Readiness For National Cancer Survivorship Care Standards, Christiane J. El Khoury, Meera Gupta, Maryem Shirzadi, Heidi Dowst, Martha Mims, Maysa Abu-Khalaf, Hoda Badr

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Cancer survivorship care is a growing public health priority, yet delivery remains variable across health systems. The National Standards for Cancer Survivorship Care provide a framework for high-quality care, but little empirical evidence exists regarding health system readiness to implement these standards in routine practice.

OBJECTIVE: To assess implementation readiness for the National Standards for Cancer Survivorship Care and identify perceived barriers to implementation.

DESIGN, SETTING, AND PARTICIPANTS: This real-time Delphi survey study was conducted from January to March 2025 at a National Cancer Institute-designated comprehensive cancer center. Participants were multidisciplinary experts involved in cancer survivorship care delivery, care …

2026 Focused Update Of The Saudi Heart Association Guidelines On Best Practices In The Management Of Chronic Coronary Syndromes, Owayed Alshammeri, Halia Alshehri, Shukri Alsaif, Mirvat Alasnag, Fatema Qaddoura, Fahad Alqahtani, Yosra Abdulahad A Turkistani, Walid Alharbi, Adel Tash, Mohammad Alshehri, Khalid Al Faraidy, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Chronic coronary syndromes (CCS) continue to impose a substantial clinical and economic burden in Saudi Arabia. Since publication of the 2022 Saudi Heart Association (SHA) CCS guidelines, important advances have emerged in diagnosis, pharmacotherapy, cardiometabolic risk reduction, antiplatelet management, and revascularization. This 2026 focused update selectively revises and clarifies key recommendations to reflect these advances within the Saudi context.

Methods: A multidisciplinary SHA expert panel conducted a structured review of randomized trials, meta-analyses, and relevant international guidance published since 2022. Updates were restricted to areas with substantive new evidence or evolving clinical practice. Recommendations were formulated through expert consensus …

Action Steps Toward Equity In Communication Sciences And Disorders: A Program Evaluation Of Student Self-Efficacy, Monica Bellon-Harn, Lekeitha Morris, Mark Trahan

Teaching and Learning in Communication Sciences & Disorders

Abstract

Purpose: Within communication sciences and disorders (CSD), preparing students for equitable practice requires instruction aligned with social justice principles. Because students’ confidence in engaging in these practices may influence future behavior, this study examined the effects of an asynchronous program, Action Steps toward Equity (ASE-CSD) on undergraduate and graduate CSD students’ self-efficacy for practices aligned with social justice principles.

Method: A pretest-posttest quasi-experimental design was used with undergraduate (n = 16) and graduate (n = 33) CSD students who completed ASE-CSD. Participants completed the Social Justice Scale (SJS; Torres-Harding et al., 2012), which assessed self-efficacy associated with …

Equity In Evaluation: Examining Grading Practices And Student Experiences In Speech-Language Pathology Education, Jennifer Essig

Teaching and Learning in Communication Sciences & Disorders

Traditional grading practices remain the norm in communication sciences and disorders (CSD) education, despite evidence these systems may exacerbate inequities and affect motivation and perceptions of learning. This study examined how traditional and alternative grading practices are experienced by undergraduate and graduate students enrolled in CSD programs. Using a convergent mixed-methods design, survey data were collected from 73 students regarding perceptions of grading, motivation to learn, and emotional responses to assessment. Quantitative analyses indicated that students in alternatively graded classrooms reported significantly higher perceptions of fairness, clarity, and learning than those in traditionally graded settings. Qualitative analysis revealed contrasting emotional …

Supporting Neurodivergent Students In Communication Sciences And Disorders: Best Practices Integrating Udl And Tilt In Academic Courses, Jacqueline A. Towson, Nancy Mcintyre, Alexis Cunha

Teaching and Learning in Communication Sciences & Disorders

In this tutorial, we explore effective andragogical strategies to support neurodivergent students in higher education programs, specifically within academic course in the field of communication sciences and disorders (CSD). By integrating the evidence-based education practices of Universal Design for Learning (UDL) and the Transparency in Learning and Teaching (TILT) framework, faculty can create inclusive and supportive learning environments in academic courses to better support neurodivergent students in CSD programs. We discuss practical applications of these frameworks through two sample assignments, supported by recent research, and provide actionable recommendations for faculty in higher education. The goal of this tutorial is to …

Csdeep Learning Seminar: Connecting Students, Faculty, And Alumni To Promote A Creative Path To Success, Chao-Yang Lee, Emily Jones

Teaching and Learning in Communication Sciences & Disorders

What do the best college students do to cultivate their intellectual and personal development? How does learning type lead to professional success and personal fulfillment? We report the design and implementation of a seminar in which undergraduate students in Communication Sciences and Disorders collaborated with peers, faculty, and alumni to explore the meaning and application of deep learning. Participants examined how learning type shapes college experience through book discussions and conversations with alumni. Feedback from participants suggests that the book discussions and alumni conversations broadened the students’ perspective on learning type, purpose of college education, and success and failure. The …

Simulated Participant Engagement In Communication Sciences & Disorders Programs: A Scoping Review, Jason Konzelmann, Richard I. Zraick

Teaching and Learning in Communication Sciences & Disorders

Introduction. Simulated participants (SPs) are widely used in medical and nursing education, but their application in allied health, including Communication Sciences and Disorders (CSD), remains limited. Despite accreditation standards supporting simulation in CSD training, student engagement with SPs is still uncommon.

Objectives. This scoping review examined recent literature on SP use in CSD programs involving speech-language pathology or audiology students or providers. We explored how SPs were integrated and identified gaps for future research.

Methods. Guided by PRISMA-ScR, we searched six databases and an internet search yielded one additional article. Studies published between 2019 and 2025 were included if they …