Digital Commons Network^™

Quality Improvement Project Simulating Ethics: Improving Ethical Decision-Making In Nursing Undergraduates Through Simulation And Faculty Training, Shannon Brown

Doctor of Nursing Practice Projects

Nursing faculty often report limited confidence in teaching ethical principles, despite the essential role ethics plays in preparing students for complex clinical decision-making. This quantitative, quasi-experimental pre/post quality improvement project evaluated whether a structured ethics education module incorporating simulation could impact faculty confidence in teaching ethical principles. Guided by Lewin’s Change Theory and the Jeffries Simulation Framework, the project examined how organizational readiness for change and structured simulation design influence faculty development outcomes. Nursing faculty in a baccalaureate program participated in a single simulation-enhanced ethics session. Data were collected through anonymous pre/post Qualtrics surveys, and faculty confidence was measured using …

Hypothermia Management In Adult Trauma Patients: Enhancing Nursing Knowledge And Self-Efficacy In The Emergency Department, Shannon M. Rapert

Doctor of Nursing Practice Projects

Trauma-induced hypothermia is a significant, preventable condition that contributes to increased mortality. Evidence suggests that inconsistent recognition and management of hypothermia persist in the emergency department (ED), highlighting the need to strengthen ED nurses’ knowledge and self-efficacy in evidence-based warming strategies. The purpose of this quality improvement project was to evaluate the impact of an educational intervention on ED nurses’ knowledge and self-efficacy in managing trauma-induced hypothermia. Guided by the Iowa Model of Evidence-Based Practice, the ADKAR Change Model, and the Plan-Do-Study-Act framework, this quantitative, quasi-experimental, pretest–posttest project evaluated the effect of an instructor-led educational intervention in ED nurses at …

Integrating Oncology Into Entry-Level Physical Therapist Curricula, Shana Harrington, Christopher M. Wilson, Morgan Zaranec, Lori Boright

Oncology Rehabilitation in Practice

Print issue available for $25.

Background: Cancer and its treatments commonly result in adverse effects that impair function, well-being, and quality of life, necessitating access to skilled physical therapists (PTs). Although oncology is an essential component of physical therapist practice, entry-level education in cancer rehabilitation has historically been limited. In 2025, the Essential Competencies for Physical Therapy Entry-Level Education in Oncology were developed through a mixed-methods, modified Delphi process, establishing 19 competencies across six domains and defining minimum expectations for new graduates. To support translation of these competencies into academic curricula, a practical implementation resource was needed.

Purpose: To …

A Poetic Call For And A Reflection And Commentary On Clarity, Understanding, Hope, Courage, And Compassion, Carroy U. Ferguson

Psychology Faculty Publication Series

Finding a published poem I had written as a teenager, titled “The Heavens Weep.” this article uses that poem as the basis for a commentary that reflects on the state of the world today (2026),  As a commentary, the article uses the poetic and metaphoric words in the poem as a relevant "reality check" for what is still going on today.  In essence, the commentary is about a call for Clarity, Understanding, Hope, Courage, and Compassion, or what I call Archetypal Energies, Higher Vibrational Energies that operate deep within our individual and collective psyches to creatively urge us to "see" …

“Caring Makes Students Learn English More Easily And Enthusiastically”: Exploring The Emotional And Academic Outcomes Of Experiencing Teacher Care In Medical Sciences University Efl Classes In Iran, Kiyana Zhaleh, Shima Azizbeigi

The Qualitative Report

Previous research on teacher care in university second/foreign language (L2) classes have primarily concentrated on non-medical sciences students, resulting in a lack of insights into its effects in medical sciences education. This is surprising considering the field-specific challenges of medical sciences education, potentially influencing teacher caring behaviors in this context. Addressing this gap, this qualitative study employed the emotional response theory (ERT) and positive psychology to explore how Iranian medical sciences undergraduates perceive teacher care in university EFL classes, how they emotionally respond to it, and how their experiences of care impacted their academic outcomes. In this descriptive qualitative research …

Utilization Of An On-Site Primary Care Clinic – An Evaluation, Joulvous Jarvis Drake

Doctor of Nursing Practice Projects

Background: Employers incorporate on-site primary care clinics into their workplace health strategies to improve employees’ access to timely care and chronic disease management and reduce absenteeism and healthcare-related costs. Yet despite the demonstrated organizational and health benefits, many worksite clinics experience lower-than-expected utilization. Purpose: This evaluation project aimed to identify the behavioral and structural factors that influenced employee utilization of a corporate on-site primary care clinic. Method: A quantitative, cross-sectional design was used to evaluate the factors contributing to employees’ low utilization of the on-site primary care clinic. Approximately 1,000 eligible full-time employees at a large corporate campus in Texas …

Increasing Human Papillomavirus Vaccination Rates Among Adolescents In The Primary Care Setting: A Quality Improvement Project, Chioma Rosemary Ike

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. It is the most common viral infection of the reproductive system, and it is responsible for most cervical cancer cases worldwide. Many HPV-related cancer deaths can be prevented simply through vaccination. The vaccine is most effective when administered before exposure to the virus. Despite the HPV vaccine’s proven safety and efficacy, its uptake remains suboptimal. Purpose: This quality improvement (QI) project trained providers at a pediatric and family clinic in an effective communication strategy to increase HPV vaccination uptake among adolescents. It encouraged providers to …

Youth Agricultural Engagement And Its Association With Dietary Diversity, Household Food Insecurity, And Nutritional Status In Southwest Nigeria, Sherif Olasoji

All Graduate Theses and Dissertations, Fall 2023 to Present

Youth remain underserved in nutrition research, policy, and programming despite being an integral part of the food systems. While the nutrition-sensitive agriculture framework has been established, there is limited evidence demonstrating how youth engagement in agriculture can serve as a pathway to improve nutritional outcomes. The study assessed youth agricultural engagement and its association with household dietary diversity, household food insecurity, and nutritional status in southwest Nigeria.

Using a cross-sectional design, data on socio-demographic characteristics, agricultural engagement, dietary diversity, household food insecurity, body mass index, and skin carotenoids were collected from 143 youth aged 15 to 35 from Ekiti, Osun, …

Standardized Training Methodologies For Medical Laboratory Science Students And Their Importance For Student Success, Maria Simpson

Medical Laboratory Science Independent Study Projects

Clinical education is a critical component of Medical Laboratory Science (MLS) programs, serving as the primary bridge between academic instruction and professional practice. However, traditional clinical rotation training models often struggle to keep pace with rapid advancements in laboratory technology, expanding professional responsibilities, workforce shortages, and heightened patient safety expectations. The purpose of this capstone project is to examine the key factors driving the need to update training methodologies in MLS clinical rotations and to evaluate contemporary educational approaches that better prepare students for entry-level practice. This project addresses systemic challenges faced by clinical laboratories, such as staffing constraints, heavy …

The Effects Of Education And Training On Clinical Staff’S Knowledge, Perception, And Clinical Practice Of The Medication Reconciliation Process, Stephanie A. Williams

Doctor of Nursing Practice Projects

Medication-related harm affects approximately one in 30 patients in healthcare settings. Accurate medication reconciliation (MedRec) is essential for identifying medication discrepancies, preventing medication errors, and reducing adverse drug events. Clinical staff play a critical role in ensuring the accuracy of medication lists in primary care settings.

This evidence-based quality improvement project evaluated the effect of a structured MedRec training intervention on MedRec knowledge, perceptions, and practices among clinical staff in a primary care clinic in Southeast Texas. The project used a single-group, quantitative, quasi-experimental design. A convenience sample of 32 clinical staff members completed knowledge and perception assessments before and …

Hope Kit Program, Monica Reuber

Capstone Experience: Master of Public Health

Suicide is a leading cause of death in adolescents and young adults, with a disproportionate burden of those deaths in rural areas such as Kansas. High rates of depressive symptoms, suicidal thoughts, and suicidal attempts, combined with a shortage of mental health providers, emphasize the need for community-based intervention.

This capstone is designed to develop a plan for Hope Kits, a proposed suicide prevention program, among youth in grades 7-12 in Sheridan County, Kansas to improve coping skills, promote help-seeking behavior, and reduce suicide risks.

A logic model guides the program development, which aligns with available literature and Social Cognitive …

Online Group Neurobehavioral Therapy (Nbt) For Veterans With Epilepsy And Major Depressive Disorder (Mdd), Melissa F. Fadipe

Dissertations and Theses (Open Access)

Background: Veterans with epilepsy experience high rates of psychiatric comorbidity, most commonly major depressive disorder (MDD). Barriers to accessing mental health care—including geographic distance, transportation limitations related to seizure-related driving restrictions, and fragmented care between neurology and psychiatry, contribute to the underdiagnosis and undertreatment of MDD in this population. Neurobehavioral Therapy (NBT), a Cognitive Behavioral Therapy (CBT)-informed psychotherapy developed for individuals with seizures, has demonstrated benefits for psychological distress and quality of life. Internet-based interventions and short message service (SMS) text messaging offer promising strategies to address access barriers; however, limited research has examined the feasibility and acceptability of delivering …

Musical Training Increases Anticipatory Responding And Predictive Control In Sequence Learning, Li Ann Leow, Jarrad Lum, Sara Johnson, Emily Corti, Welber Marinovic

Research outputs 2022 to 2026

Musicians demonstrate advantages in acquiring motor sequences, showing faster learning and better explicit sequence knowledge than non-musicians. However, it is unclear whether this advantage extends beyond acquisition to the consolidation phase, which is when newly learned skills stabilize and become resistant to interference. Additionally, while interference from executing competing motor tasks is well-established, less is known about whether purely sensory information presented after learning can disrupt consolidation of a bimodal motor sequence. We investigated how post-acquisition sensory interference affects performance of a learned audio-visual sequence, and whether musical training moderates this vulnerability. Participants first learned an explicit sequence in a …

Yorga Moorditj Koort: Aboriginal And Torres Strait Islander Women’S Perspectives About Heart Health On Noongar Boodjar, Elia Bidgood, Cathy Garlett, Richard Chenhall, Amie Bingham, Francine Eades, Emily Banks, Melinda J. Carrington, Grace Joshy, Sandra Eades, Tabassum Rahman

Research outputs 2022 to 2026

In Australia, despite overall declines in cardiovascular disease (CVD)-related mortality, Aboriginal and Torres Strait Islander women develop heart disease earlier and experience more than twice the rate of related morbidity and mortality compared with non-Indigenous women. This study explores Aboriginal women’s understandings of the factors that shape their heart health and lived experiences of CVD. We spoke with 28 Aboriginal women aged ≥18 years—15 semistructured interviews and two yarning circles with an additional 13 Aboriginal women—with/without pre-existing CVD, and 10 healthcare professionals (HCPs) working with Aboriginal communities in the Perth metropolitan region, between May 2024 and April 2025. Data were …

Unilateral Numbers Need Context: Reference Values For Single-Leg Cmj Performance Relative To Bilateral Cmj Capacity, Karol Kruczek, Tim Gabbett, Jason Lake, Michał Nowak

Research outputs 2022 to 2026

The single-leg countermovement jump (SL CMJ) is widely used to assess limb-specific neuromuscular function, with interpretation commonly centred on inter-limb asymmetry. However, contextualising unilateral performance relative to bilateral capacity remains less clearly defined. This retrospective cross-sectional study aimed to develop exploratory descriptive benchmarks for SL CMJ kinetic, kinematic, and temporal variables expressed as a percentage of bilateral CMJ performance in a heterogeneous athletic cohort. A total of 348 athletes completed bilateral and unilateral CMJs using dual force plate sampling at 1000 Hz. The best trials were selected using the modified reactive strength index (mRSI), and averaged unilateral variables were expressed …

Dietary Patterns And Cognitive Decline In Older Adults: Findings From The Western Australia Memory Study, Carolina Blagojevic Castro, Samantha L. Gardener, Farzana Jahan, Juliana Chen, Belinda M. Brown, Ruey L. Loo, Kevin Taddei, Stephanie R. Rainey-Smith, Michael Weinborn, Ana Caroline R.Dos Reis, Manohar L. Garg, Ralph N. Martins, Hamid R. Sohrabi

Research outputs 2022 to 2026

Background: Preventive strategies, including adherence to specific dietary patterns, have received increasing attention as approaches to reduce cognitive decline and dementia risk. However, findings remain inconsistent, partly due to differences in dietary assessment methods, cognitive outcomes, and THE consideration of genetic susceptibility factors such as apolipoprotein E (APOE) genotype.

Methods: This study examined associations between dietary patterns and longitudinal cognitive change in 185 older adults without dementia from the Western Australia Memory Study. Participants completed a food frequency questionnaire at baseline and underwent comprehensive neuropsychological assessments at baseline and up to five follow-up visits at 18-month intervals. Composite scores were …

A Mixed-Methods Study Of The Lived Experiences Of Patients And Caregivers Receiving Home Health Occupational Therapy Services, Peyton A. Mendias

Student Capstone Papers

Home health occupational therapy (OT) supports individuals’ safety, independence, and participation in their natural environments; however, patients and caregivers may face barriers that affect the implementation of therapy recommendations. This capstone project explored patient and caregiver experiences with home health OT and identified factors influencing implementation of OT recommendations. We used a sequential explanatory mixed-methods design guided by the Capability, Opportunity, Motivation–Behavior (COM-B) model. Eight participants, including three patients and five caregivers, completed an electronic survey, and one caregiver participated in a follow-up semi-structured interview. We analyzed quantitative data using descriptive statistics and qualitative data using reflexive thematic analysis. Findings …

The Effectiveness Of Treatment Options For Localized Prostate Cancer: A Meta-Analysis Of Cross-Sectional And Cohort Studies, Pius Omolewa, John Bressan, Nassrine Noureddine

All Faculty Scholarship

Background: Prostate cancer is one of the most common malignancies among men worldwide, with incidence rates rising steadily over the past decades. Although the widespread adoption of PSA screening has improved early detection, it has also sparked extensive debate regarding overdiagnosis and overtreatment. Against this backdrop, balancing the avoidance of unnecessary interventions with the need to ensure favorable patient outcomes has become a central challenge in clinical decision-making. Methods: Articles published from 2010 through 2025 were searched in five databases. The cross-sectional and cohort studies examined the effects of treatment options on localized prostate cancer. Results: From the analysis of …

Improving Obesity Management In Primary Care Through Provider Education, Natalie Anderson

Doctor of Nursing Practice Projects

Background: Childhood obesity is a significant public health concern associated with metabolic, cardiovascular, and psychosocial complications. Despite the availability of evidence-based pediatric obesity management guidelines, adherence to these guidelines remains inconsistent in primary care settings. Purpose: This evidence-based quality improvement project aimed to determine whether provider education on the 2023 American Academy of Pediatrics (AAP) Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity, combined with implementation of an electronic health record (EHR) clinical decision support prompt, improved provider knowledge and adherence to guideline-recommended obesity management practices. Method: A pre-post quasi-experimental study was …

Experiential Learning In Child Life Education, Amanda L. Lockett

All Dissertations

Child life specialists support children and families during healthcare experiences and other stressful life events, making it important for child life students to develop both knowledge and practical skills before entering the profession. This study explored how current child life students and recent graduate experienced hands-on learning activities in their child life education. Through interviews, a survey, and follow-up reflection, participants described how activities like role play, case studies, realistic scenarios, activity play plans, and teaching plans influenced their learning and professional development. Participants shared these experiences helped them learn to apply what they learned in the classroom into real …

Safety And Effectiveness Of Behavioural Activation For Chronic Pain: A Protocol For A Systematic Review And Meta-Analysis Of Randomised Controlled Trials, Fangyuan Zheng, Laura Hynes, Richard J. Gray, Irene Ngune, Jacqueline Sin, Martin Jones

Research outputs 2022 to 2026

Background/Objectives: Chronic pain is a prevalent and complex condition associated with substantial physical, psychological, and social burden. Behavioural activation (BA), a structured psychological intervention originally developed for depression, may be relevant to chronic pain through its focus on reducing behavioural avoidance and increasing engagement in meaningful activities. Although BA has been applied in studies involving people with chronic pain, the safety and effectiveness of BA in this population have not been comprehensively synthesised. This systematic review and meta-analysis will examine the safety and effectiveness of BA for people with chronic pain.

The Reliability And Validity Of Manual Palpation To Assess Lower Limb Arterial Occlusion Pressure In Older Adults, For Application In Blood Flow Restriction Exercise, Michael Beere, Isaac Selva Raj, Jeremiah J. Peiffer, Keith D. Hill, Peter K. Edwards, Belinda Brown, Brendan R. Scott

Research outputs 2022 to 2026

(A) Investigate test-retest reliability of posterior tibial pulse palpation to determine arterial occlusion pressure (AOP) and examine validity against hand-held Doppler ultrasound. (B) Investigate the suitability of using 130% systolic brachial blood pressure for prescribing cuff inflation pressure for blood flow restriction (BFR) exercise. Repeated measures, crossover design. Lower limb AOP was assessed in 20 adults ≥ 60 years using hand-held Doppler ultrasound and posterior tibial pulse palpation. Brachial systolic blood pressure (bSBP) was measured to predict cuff inflation pressures (bSBP130%). On three occasions > 24 hours apart, three AOP measurements were recorded by the same blinded rater to determine intra-rater …

The Resilient Women's Collective: Empowering Women To Recognize Their Worth, Mary Campbell Johnstone

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

Mothers experiencing homelessness face challenges related to chronic stress, trauma, disrupted routines, and limited access to supportive resources, all of which negatively impact health, well-being, and occupational participation (Anderson et al., 2024). Occupational therapy is uniquely positioned to address these challenges through occupation-based, trauma-informed interventions that promote resilience, empowerment, and engagement in meaningful activities. This doctoral capstone addressed these complex needs through a multifaceted approach that included a scoping review, program development, advocacy, and educational initiatives. A scoping review examined stress-management interventions supporting single mothers experiencing homelessness in the United States. Although positive outcomes were reported, the literature revealed limited …

The Acute Effect Of A Single Dose Of Berberine On Blood Glucose Response Following A Standardized Meal And 2-Mile Walk Performance In Healthy Adults, Victor Emmanuel Obaro

Master's Theses

It is clear that exercise improves overall health status, and it is possible that berberine (BR) may work through some similar mechanisms to improve health status as well.  Purpose: The purpose of this study was to explore the acute effects of a single dose of BR on health status following a standardized meal and a 2 mile walk treadmill protocol with outcomes including blood glucose (BG), blood pressure (BP), heart rate (HR), rate of perceived exertion (RPE), and a two-mile walk time trial performance. Methods: This study used a cross-over design where 14 healthy, young adults were given berberine (BBR) …

Supporting Mental Health Through Occupation: Education For Women Living With And Beyond Breast Cancer, Rebekah Nicole Trammell, Lakeisa Boykin, Rebekah Jarrar

Summer 2026 OTD Capstone Symposium

Breast cancer is the most commonly diagnosed cancer among women in the United States, and these women experience high rates of anxiety, depression, and disruption to daily routines and meaningful occupations. Evidence shows that education on self-management strategies, mindfulness-based interventions, and targeted occupational therapy interventions can support the mental health of women experiencing breast cancer. Furthermore, remaining engaged in meaningful occupations is essential to improving overall well-being and quality of life. The purpose of this capstone project was to develop and deliver accessible, evidence-based education in digital and print formats that specifically target identifying mental health challenges, self-management strategies, and …

Attrition Of The Midwifery Workforce: Understanding Factors Associated With Leaving The Profession, E. Brie Thumm, Amy H. Goh, Elizabeth G. Phillips, Zachary Giano

College of Health Professions Faculty Papers

OBJECTIVE: To understand why advanced practice midwives (certified nurse-midwives and certified midwives) leave the workforce.

STUDY SETTING AND DESIGN: A multi-method, multi-source investigation included secondary analysis of certification data of advanced practice midwives and a cross-sectional online survey with closed- and open-ended items. Advanced practice midwives' active certification data were used to compare self-reported demographic characteristics of advanced practice midwives who reported working in the discipline of midwifery to those who did not (n = 9704). A survey was conducted in 2022 with individuals who allowed their certification to lapse between 2017 and 2021 (n = 303) and individuals who …

How Recent Medicaid Defunding Has Impacted San Bernardino County Residents Access To Health Care Services, Samantha I. Rios

Electronic Theses, Projects, and Dissertations

Background: Medicaid is a critical source of health insurance for low-income populations in the United States, providing access to essential preventative, primary, and reproductive health care services (Donohue et al., 2022). The Medicaid defunding of 2025 and policy changes that follow have raised concerns regarding increased barriers to care, particularly among low-income and vulnerable populations who rely on safety-net providers such as Planned Parenthood (Planned Parenthood, 2025). The purpose of this study was to examine how the 2025 Medicaid defunding has impacted access to general and reproductive health care services among residents of San Bernardino County, California.

Conclusion: The research …

Perceived Negative Acts And Emotional Well-Being In Healthcare Education At A Hispanic-Serving Institution: A Cross-Sectional Study, Deborah Rocha Seixas, Patricia Montemayor Garcia, Tyreen Heybeck, Eduardo Sanches Gonçales, Cláudia Cristina Biguetti

School of Podiatric Medicine Publications

Purpose: Negative acts (NA), including work-related bullying, person-related bullying, and physical intimidation, are inappropriate behaviors that should not occur in workplaces or schools. Healthcare students may be exposed to these experiences during their training, although exposure may vary across demographics. This study aimed to assess self-reported NA and the emotional well-being among healthcare students from different family immigration backgrounds at a Hispanic-serving institution on the U.S.–Mexico border and to explore potential associations between NA exposure and demographic characteristics. Methods: The NA Questionnaire-Revised (NAQ-R) assessed work-related bullying (WB), person-related bullying (PB), physical intimidation (PI), and total NAQ-R score (TNAQ-R). Participants also …

Facilitating Occupational Participation In Older Adults With Chronic Pain, Emily K. Ruesch

Occupational Therapy Capstone Presentations

This capstone project developed doctoral-level clinical skills in the management of chronic pain. This capstone project also implemented a six‑week chronic pain management program for independent community‑dwelling older adults at Dow Rummel Village. Eleven adults aged 50–95 participated in weekly 45‑minute group sessions addressing adaptive equipment use, graded exercise, energy conservation, nervous system regulation, stress management, and sleep hygiene. Seven participants completed pre‑ and post‑intervention measures using the Brief Pain Inventory–Short Form and the Pain Self‑Efficacy Questionnaire. A paired samples t‑test assessed changes in pain severity, pain interference, and self‑efficacy. Results demonstrated a decrease in pain severity (t(6) = −3.96, …

The Effects Of An Educational Intervention To Enhance Knowledge And Awareness Of The Prevention Of Sexually Transmitted Infections Among College Students, Darcy Yates

Doctor of Nursing Practice Projects

Purpose

The DNP student implemented a single group pretest-postest design underpinned by the Health Belief Model to address the PICOT question: Among a purposive sample of college students at a mid-west college (Population) to what degree does participation in an evidence-based intervention providing information about STIs (Intervention), compared with before that intervention (Comparison), result in to an increase in knowledge and awareness regarding STI infections and associated risks and treatment options (Outcomes) over a six-week period (Time)?

Methods

The pretest and postest scores of 15 students for the 27 items in the Sexually Transmitted Diseases Knowledge Questionnaire (STD-KQ) were evaluated. …