Digital Commons Network^™

Supporting The Human Experience: Why Compassion Outperforms Empathy In Care Delivery, Katelyn Carey

Patient Experience Journal

Healthcare professionals are often taught that empathy, defined as imagining oneself in the emotional experience of another, is essential to providing excellent care. Yet in high-stress, high-stakes clinical environments, the very tool given to increase patient and employee connection can contribute to disengagement, burnout, and diminished resiliency. This research review article examines the longstanding conflation of empathy and compassion in healthcare and argues that the distinction between the two is not merely semantic but critical to provider well-being and patient outcomes. Drawing on research from neuroscience, psychology, and communication studies, the piece outlines how emotional, perspective-taking empathy activates the brain's …

Racial Concordance And The Assumption Of Trust: Why Engagement Is Often Mistaken For Partnership In The Care Of Black Men, Samantha Faith Calhoun, Lacretia Carroll, Y'Esha Williams-Click, Kola Brown

Patient Experience Journal

Race concordance between patients and clinicians is frequently promoted as a strategy to improve trust and engagement for Black men in healthcare. Evidence suggests that encounters with Black male clinicians often increase patient comfort and observable engagement; however, engagement alone does not necessarily reflect trust. Drawing on professional experience as a nurse and researcher working with Black men, and on prior research examining shared decision-making preferences among Black men with hypertension in the U.S. Mid-South, this Personal Narrative examines how race-concordant encounters may rely on presumed trust, leading clinicians to advance diagnosis and treatment planning without adequate co-construction of care. …

Building Or Breaking Trust In Healthcare Through Patient And Family Engagement In Research And Service Design: The Need For Authentic Engagement Practices, Lisa D. Hawke, Hajar Seiyad, Shoshana Hauer, Charlotte Munro, Natasha Y. Sheikhan

Patient Experience Journal

Trust in the healthcare system is an important driver of public health, but is sometimes lacking among individuals and communities. Patient and family engagement in research and service development is one proposed means of influencing trust. Patients and families can be engaged authentically and meaningfully as partners in the conduct of research and the development of healthcare services. When engagement is conducted following best practices, patients and families have the opportunity to build strong mutual relationships with project leads, hold a share of the power in the discipline, and exercise choice to influence the research and service development agenda. These …

Co-Designing Trust: Patient Experience, Relationships, And The Design Of Care, Toni Land

Patient Experience Journal

Trust can have a positive or negative impact on patients, families, and community healthcare experience. Although important, it is often treated as something soft and intangible rather than something intentionally measured and designed. Currently, healthcare organizations collect and report patient experience data related to communication, courtesy, respect, and responsiveness. But these measures do not capture the specific behaviors that influence whether trust builds or whether it stalls. This commentary explores trust as a foundational behavioral and environmental element in healthcare and challenges that improving trust requires more than good intentions; it requires bringing voices to the table through co-design. Starting …

A Modern Playbook For Trust Across The Health Ecosystem, Erin O'Malley

Patient Experience Journal

Public trust in health care delivery, public health, and biomedical innovation is at a historic low. While many place the blame on the COVID-19 pandemic and the proliferation of social media, the reality is that distrust is a deeply rooted structural challenge that has plagued the U.S. for centuries. It is tied to historical movements for medical freedom and centuries of systemic discrimination and earned mistrust among minoritized communities. Today, this crisis is compounded by a lack of shared values and facts and the rising dominance of tribal identity over objective science. The Coalition for Trust in Health & Science …

Healing The Social Covenant: Rebuilding Trust And Re-Humanizing Healthcare, Cynda Hylton Rushton

Patient Experience Journal

Violence against healthcare workers continues to escalate despite substantial investments in security measures, workplace violence prevention programs, and legislative protections. Although these interventions are necessary, they have not produced sustained improvements in workforce safety or retention, suggesting that workplace violence is more than a behavioral or security problem. This commentary argues that it also reflects a deeper erosion of trust within healthcare. Drawing on evidence linking workplace violence to burnout, moral injury, psychological distress, and turnover intention among nurses, we propose that repairing trust is essential to sustaining the workforce and healthcare.Building on our earlier work, Rebuilding a Foundation of …

Trust: Why A Commitment To Human Experience Matters, Jason A. Wolf

Patient Experience Journal

Trust is one of the most essential elements in our overall human existence. It is a critical part of our human experience, one that reaches well beyond the boundaries of healthcare. Trust is the element that holds society together. It emerges in the relationship of one human being connecting with another human being, and it reaches to the engagements people have with organizations, institutions, and systems as well. Trust, while hard to hold, is ever present. It is a powerful force that guides our way of being, our interactions, our choices, even if we ourselves are not directly conscious of …

The Registered Dietitian Nutritionist’S Implementation Of Dysphagia Screening In Clinical Practice: A Commentary, Nicole Wiksten, Holly Estes-Doetsch, Laura C. Boucher, Sarah Rusnak, Kristen M. Roberts

Journal of Dietetic Education

Background: The Accreditation Council for Education in Nutrition and Dietetics (ACEND) amended the competencies for the future education model (FEM) in dietetic education to include competency 3.6 stating that the Registered Dietitian Nutritionist (RDN) must be able to "Initiate and conduct bedside swallow screenings". There is no clear process for RDNs to implement dysphagia screening in practice or academia. The aim of this review is to inform clinicians and educators on current literature discussing current RDN and speech language pathology approaches to dysphagia screening and to provide a proposed curriculum for implementation of competency 3.6 in clinical practice and academia.

Assessing And Addressing Cultural Competence And Cultural Humility In Dietetic Education, Zoe Duran, Nicholas Slagel, Lisa Caldwell, Katie Kage

Journal of Dietetic Education

Limited theory-informed, dietetic-specific resources are available to guide the development, evaluation, and refinement of culturally competent (CC) curricula. This pilot study used a mixed-methods, theory-informed approach to evaluate CC integration within an undergraduate dietetics curriculum and examine the applicability of existing CC self-assessment tools for dietetic students. A senior-level undergraduate community nutrition curriculum was evaluated using the Tool for Assessing Cultural Competence Training (TACCT), guided by the Campinha-Bacote Model of Cultural Competence in Healthcare Delivery. James Banks’ Model of Multicultural Curriculum Reform was then applied to refine curricular content and learning activities. In addition, 74 students enrolled in a didactic …

Virtual Reality: The Future Of Didactic And Experiential Education For Nutrition And Dietetics, Michael Holik, Dexter Richardson

Journal of Dietetic Education

The integration of virtual reality (VR) into nutrition and dietetics education provides an innovative answer to challenges in accessing experiential learning. This study examined student perceptions of immersive VR experiences designed to simulate hospital foodservice operations and nutrition counseling sessions, guided by the Diffusion of Innovation Theory (DOI). A quasi-experimental design involved 55 participants who engaged with 360° VR modules featuring interactive elements, avatars representing key healthcare roles, and embedded critical-thinking questions. Results demonstrated strong support for VR’s educational value across DOI’s five key attributes: relative advantage, compatibility, complexity, trialability, and observability. Participants reported enhanced understanding of registered dietitian roles, …

Editors' Message, Volume 4, Issue 2, Diana Cuy Castellanos, M Elizabeth (Beth) Miller

Journal of Dietetic Education

In this edition, you will find research on the use of virtual reality in experiential food service learning, instruments to assess cultural competency and humility in dietetic students, and tools for measuring empathy—an area of growing importance in dietetic pedagogy. Additionally, this issue explores the inclusion of disability-related curricula in education programs and features a commentary on RDNs implementing swallow screenings within clinical practice, highlighting how this procedure falls within an RDN’s scope of practice when supported by proper training and demonstrated competency.

Cover, Table Of Contents, About The Journal

Journal of Dietetic Education

No abstract provided.

How Philip K. Dick Used The Unreliable Narrator To Transport Unwitting Acolytes, Michael Barros, Jordi Smith

Dialogue: The Interdisciplinary Journal of Popular Culture and Pedagogy

This essay examines the use of the unreliable narrator to transport the reader into narrative worlds, specifically in Philip K. Dick's fiction. By exploring the phenomenon of narrative transportation and the role of emotions in engagement with fiction, we argue that Dick's use of the unreliable narrator significantly engages and transports readers into his narrative worlds. Subsequently, we contend that his belief in the fundamental reality of those worlds is effectively positioning himself as a gatekeeper and mediator between the narrative world and the real world, which sets him, in his mind, as a prophet, using fiction as a tool …

An Architecture Of Vanishing: Toward A Protocol Of Archival Disappearance, Edgardo Civallero

Journal of Contemporary Archival Studies

This article rethinks the preservationist reflex that equates archival care with permanence. Drawing on post- and decolonial theory, it provincializes endurance as a historically situated ideal and foregrounds global traditions where disappearance, opacity, and cyclical renewal structure memory. It reframes vanishing as custodianship rather than neglect, introducing a taxonomy of protocols of epistemic disappearance—temporal, spatial, relational, semantic, and material—and a grammar of vanishing that operationalizes them as design tools. Extending to institutions, it outlines seasonal, dismantling, shadow, and nomadic archives as forms that measure success by their capacity to end well. A concluding framework articulates five principles—vanishing as care, duration …

Media Emotion Regulation And Executive Function In Childhood: Associations With Respiratory Sinus Arrhythmia, Lara M. Almeida

Theses and Dissertations

Media emotion regulation (MER), or the use of media to help children manage emotions, may influence children's development by shaping opportunities for practicing self-regulatory skills. Guided by the Dynamic, Relational, Ecological Approach to Media Effects Research (DREAMER) model, this study examined longitudinal associations between MER and executive functioning (EF) in early childhood and explored whether respiratory sinus arrhythmia (RSA), a physiological index of regulation, predicted developmental changes. Participants included 175 parent-child dyads assessed across two annual waves when children were approximately 4 and 5 years old. Structural equation modeling was used to test bidirectional associations between MER and EF while …

Emotion-Attention Relationships In Anxiety: A Multimodal Psychophysiological Network Analysis, Kyle O'Brien

Clinical Psychology Dissertations

Anxiety has long been associated with changes in attention processing, emotional salience detection, and emotional affect. Traditional methods of measuring anxiety frequently utilize self-report symptom measures, behavioral performance measures, and psychophysiological indicators. The current study integrates behavioral accuracy, self-report measures of psychological distress and well-being, and event-related potential markers of attention processing into an exploratory multimodal psychological network analyses to identify meaningful patterns across these indicators. The final sample of nonpatients included 36 anxious (low depression) and 24 control (low anxiety and depression) participants who completed an Emotion Attention Blink task while EEG data were collected to assess early, more …

Integrating Matrescence Into Birth Worker Practice: A Practice Improvement Project, Kelsey B. Green

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal mood and anxiety disorders (PMADs) affect 20–25% of mothers worldwide and are a leading cause of maternal complications. Stigma, fragmented care, and limited provider training leave families vulnerable, while birth workers offer trusted, continuous support.

Problem: Birth workers' maternal mental health (MMH) training is minimal and often excludes matrescence, the developmental transition to motherhood, limiting their ability to distinguish normal adjustment from clinical PMADs and delaying intervention.

Methods: A single-group, pre-/post-test design evaluated a matrescence-informed workshop at Roots Community Health's 2nd Annual Symposium. Anonymous surveys measured knowledge, attitudes, and confidence, analyzed with Mann–Whitney U, Wilcoxon signed-rank tests, and …

When Everyone Is A Librarian: Examining Job Titles And Responsibilities In California School Libraries, Mary Ann Harlan, Jeffrey Mattison, Jodi Hwang

Learning Hub

School libraries in California are staffed by a wide range of personnel, including credentialed Teacher Librarians (TLs) and paraprofessional staff working under a variety of job titles. Analysis of responses from the California School Library Survey revealed substantial variation in self-reported library staff titles, raising questions about the relationship between job titles, job descriptions, and professional responsibilities. This study examined the titles used by individuals working in California school libraries as paraprofessionals and analyzed corresponding job descriptions to determine whether distinctions exist between professional standards and descriptions and paraprofessional duties. Using survey data from the 2022–2023 California School Library Survey, …

Evaluating Gender Equity In The Berenstain Bears Picture Books, Christy Tisnawijaya, Geni Kurniati

Bahasa dan Seni: Jurnal Bahasa, Sastra, Seni, dan Pengajarannya

Picture books serve as a foundational medium in early childhood education, utilizing interrelated visual and verbal elements to foster linguistic, cognitive, and social development. Despite their pedagogical utility, certain literary works inadvertently perpetuate traditional gender roles, constraining children's conceptualizations of identity. This study evaluates gender representation within eleven selected titles of The Berenstain Bears series. Employing a qualitative multimodal content analysis, the study integrates Butler's gender performativity framework (1990), Callow's multimodal narrative approach (2020), and Adam and Harper's evaluative criteria (2021) to examine how domestic, social, and recreational roles are constructed. This study offers novelty by establishing a dual-lens multimodal …

Physical Activity, Trauma, And Posttraumatic Stress: The Indirect Role Of Exercise Addiction, Anastasiia Rozumna

Theses and Dissertations

Exercise is often conceptualized as a protective factor for mental health, including for individuals exposed to trauma. However, less is known about whether exercise may relate to posttraumatic stress symptoms differently when it is accompanied by compulsive or addictive features. The present study examined whether volume and intensity of physical activity were associated with posttraumatic stress symptom severity indirectly through exercise addiction symptoms. This secondary cross-sectional analysis included 557 adults living in the United States who reported regular participation in sport or physical activity. Participants completed self-report measures of physical activity behavior, exercise addiction symptoms, trauma exposure, and posttraumatic stress …

A Systematic Review Of Posttraumatic Stress Disorder Among Hispanic Immigrants In The United States, Rashel Acireale

Theses and Dissertations

This study systematically reviews the literature on posttraumatic stress disorder (PTSD) among Hispanic immigrants in the United States, a population exposed to cumulative trauma across the migration process. Stressors may occur before, during, and after migration and include violence, family separation, dangerous travel conditions, discrimination, and fear of deportation. Despite these risks, findings on PTSD prevalence remain mixed, and Hispanic immigrants are underrepresented in clinical research and culturally informed interventions. This review examines sample representation, types and timing of trauma, PTSD measurement approaches, and the inclusion of cultural and contextual factors such as acculturation and immigration-related stress. It also evaluates …

The Screening Tool Of Behavioral Self-Regulation “Head-Toes-Knees-Shoulders” Task: A Preliminary Adaptation To Greek Older Adults, Eleni Rachanioti, Dimitra Magkavila, Olga Fragkomichelaki, Magda Dinou, Effie Katsadima, Theodora Foti, Anastasia Tzalla, Anna Dougali, Christina Bourmpou, Maria Staikopoulou, Aphrodite Papantoniou, Fotini Varlami, Irene Dinaki, Maria Tsiountala, Konstantinos Staikopoulos, Tryfon Mavropalias, Efthymia Efthymiou, Demetra Tomprou, Maria Georgiadi, Dimitra Katsarou, Georgios Kougioumtzis, Ioanna Giannoula Katsouri, Harilaos Zaragas, Despina Moraitou, Maria Sofologi, Georgia Papantoniou

All Works

The aim of the present study was to examine the psychometric properties of the Head-Toes-Knees-Shoulders (HTKS) behavioral self-regulation (executive function) measure in a sample of Greek older population. Specifically, 88 cognitively healthy Greek older adults over the age of 65 participated in the study. The Greek version of HTKS was administered along with the Greek versions of the Mini-Mental State Examination (MMSE), the Raven's Educational CPM, the Number Series (NS) test, the Positive and Negative Affect Scale (PANAS), the Barratt Impulsiveness Scale (BIS-11) and the Impulsive Behavior Scale (UPPS-P). Exploratory factor analysis supported the unidimensional structure of the HTKS. The …

Wildfire Risk & Preparedness For Urban Rail Operators Supporting Large Stadium Events, Karl Kim, Eric Yamashita, Daniele Spirandeli, David Rother

Mineta Transportation Institute

The project team, in collaboration with partners and stakeholders, developed a four-hour training course designed to build a foundational understanding of how wildfire hazards affect rail systems infrastructure operations and how this knowledge can help equip urban rail operators with tools and best practices for proactive risk management. Led by the University of Hawaiʻi and the National Disaster Preparedness Training Center, in partnership with Haley & Aldrich, Inc., this technical report presents an overview of the four modules and scenario planning exercise that together make up the four-hour Wildfire Risk & Preparedness for Urban Rail Operators Supporting Large Stadium Events …

Enhancing Wildfire Resilience In The Rail Industry: Developing A Community Resilience Extreme Events Portal (Creep), Karl Kim, Eric Yamashita, Daniele Spirandeli, David Rother, Chris Chiesa, Greg Hampe, Michele Toner

Mineta Transportation Institute

The Community Resilience Extreme Events Portal (CREEP) provides a centralized platform for accessing wildfire danger indices, critical asset locations, and vulnerability scores for rail segments. The project team developed a data-driven, indicator-based vulnerability assessment framework that defines vulnerability as a function of exposure, sensitivity, and adaptive capacity. To build this framework, the team selected publicly available datasets, prioritizing national datasets whenever possible to ensure transparency, reproducibility, and scalability. The portal allows users to analyze and visualize vulnerability across 1-kilometer segments of Class I freight and passenger rail lines in California, supporting planning and mitigation prioritization to help reduce rail-related fatalities, …

#Narctalk: Analysis Of Perceptions Of Personality Disorders In Tiktok Content, Amanda C. Dediego, Auna Nelson, Feven Seifu, Amanda D. Tracy, Madeline Grubb, R.J. Schoen

Journal of Technology in Counselor Education and Supervision

No abstract provided.

Strategies For Integrating Death Education Into Asynchronous Online Counselor Training, Kara E. Wolff

Journal of Technology in Counselor Education and Supervision

Online counselor education has grown exponentially, with a greater number of courses being offered in an asynchronous format. This presents challenges and opportunities for counseling training in death education, a subset of grief counseling. Death anxiety and death avoidance can result in counselors-in-training's disengagement with strictly didactic materials in this area. Instead, death education must offer opportunities for experiential processing and personal reflection to be effective. Specific teaching strategies that foster the development of death acceptance and death competence within asynchronous online counselor education courses are offered.

Clinicians’ Reflections On Explainable Ai (Xai) In Counselor Education And Diagnostic Training: An Exploratory Qualitative Study, Kuo Deng, Xiaomeng Ye, Yi Li-Brown, Cara Miles, Angelina F. Pennino

Journal of Technology in Counselor Education and Supervision

Current approaches to teaching clinical diagnosis in counselor education and supervision often

rely on self-reports, brief vignettes, and supervisors’ recollections—methods that can be resource- intensive and prone to bias, contributing to diagnostic inaccuracy among trainees. While artificial

intelligence (AI) has gained traction in healthcare, many machine learning (ML) models function as “black boxes,” limiting transparency and educator trust. Explainable AI (XAI), which focuses on making AI processes interpretable, offers a potential solution for counselor training. This exploratory qualitative study examined eight licensed psychologists’ reflections after viewing a live demonstration of an original XAI model trained to predict depression. Using Reflexive …

Toward A Triadic Therapeutic Alliance: Understanding Client, Therapist, And Ai Relational Processes In Counseling, Jennifer Young

Journal of Technology in Counselor Education and Supervision

Artificial intelligence (AI) is integrated into counseling through chatbots, digital companions, and clinical decision-support tools. This integration challenges traditional models of the therapeutic alliance, which have historically centered on the dyadic relationship between client and therapist. To address this gap, the Triadic Therapeutic Alliance (TTA) Model of Client-Therapist-AI Relational Dynamics offers a new framework for understanding how relational processes unfold when AI becomes an active participant in therapy. The model extends alliance theory into a triadic structure that includes the client-AI and therapist-AI relationships alongside the traditional human alliance. Drawing on research in human-computer interaction and ethical frameworks of trust …

Exploring Chatgpt As A Simulated Client: A Feasibility Study In Undergraduate Counselor Training, Kayla E. Hayes, Rebecca L. Wilson, Joshua Wilson

Journal of Technology in Counselor Education and Supervision

Generative artificial intelligence (AI) offers new possibilities for simulation-based counselor training by enabling scalable, text-based interactions that mimic human dialogue. This exploratory feasibility study examined whether ChatGPT can serve as a simulated counseling client and feedback provider for undergraduate students learning counseling skills. Five upperclassmen completed a 45–60-minute text-based session with ChatGPT portraying “Sarah,” a college student experiencing depression and loneliness, followed by AI feedback and a semi-structured interview. Trained raters judged ChatGPT’s client portrayal and feedback as generally accurate, particularly for tone, empathy, and identification of students’ strengths. Accuracy was lower for rapport, summarizing, and pacing characteristic of an …

The Digital Tightrope: Navigating Social Media Ethics In Counseling, Kaitlynn Cornell-Mullane

Journal of Technology in Counselor Education and Supervision

Social media has become deeply integrated into both personal and professional lives, yet the use by counseling professionals remains underexplored. This study investigated how various roles within the counseling field experience and utilize social media in their professional development, identity formation, and ethical practice. A qualitative online survey was utilized to collect data from counseling professionals (N = 20). Findings revealed six themes: (1) Conflicting Perspectives on Client Social Media Use and Engagement, (2) Personal Discomfort and Ethical Ambiguity, (3) Counselors’ Varied Approaches of Social Media Use, (4) Social Media Use for Professional Development, (5) Mixed Perspectives on Social Media …