Innovative Teaching Strategies: Ai Chatbots To Prepare Nursing Students For Difficult Conversations, Lindsay Iverson, Tamara Oliver, Steven Fernandes, Mandy Kirkpatrick, Kara Morgan, Lauren Guthrie, Trisha Beiermann, Melissa Taylor

International Nursing Research Congress (INRC)

Background and Significance: Therapeutic communication is a core competency in nursing and a consistently prioritized workforce requirement (Broeckelman-Post et al., 2022; McGunagle & Zizka, 2020; AACN, 2021). As AI and digital learning technologies advance, nursing programs are exploring technology-enabled strategies to better prepare students for emotionally complex patient interactions. Although AI chatbots have shown value in clinical training and simulation (Chang et al., 2021; Srinivasan et al., 2024), limited evidence exists on their use to prepare students for difficult or sensitive conversations. Addressing this gap supports student resilience and prepares future nurses for communication-intensive roles.

Purpose and Aims: This study …

Loralee Clark, Loralee Clark, Loralee Clark

Virginia Poets Database: A Literary and Educational Resource

No abstract provided.

Developing Ethical Reasoning And Teamwork In Nursing Students Via Organ Donation Simulation, Miranda M. Smith, Melissa Miasek, Laura Dunaway, Joseph Chamness, Mary Deason, Shikha Modi

International Nursing Research Congress (INRC)

Background: Organ donation is a critical healthcare priority, with 140,964 transplants performed worldwide in 2018 (Lewis et al., 2021). Nursing students often report limited exposure to donor referral processes, brain death determination, and communication with organ procurement organizations. Low baseline knowledge and confidence highlight the need for structured educational interventions (Alwesmi et al., 2023; Bertocchi et al., 2025). Evidence shows teaching and simulation-based learning enhance knowledge, attitudes, and competence in end-of-life donation care (Lewis, 2023). Simulation provides psychological safety, supporting teamwork, communication, clinical judgment, and emotional readiness for ethically complex situations (Masgaard & Svellingen, 2025).

Purpose/Methods: This study examined senior …

The Impacts Of Emotions On Thirst Among Heart Failure Patients, Chieh-An Yang, Hsing-Mei Chen, Tsung-Neng Tsai, Chieh-Yu Liu, Hui-Ju Lu, Ting-Ti Lin

International Nursing Research Congress (INRC)

Purpose: Thirst, characterized by sensations of oral dryness and a craving to drink, is a ubiquitous experience among heart failure (HF) patients. Besides reduced cardiac output, the clinical treatments for HF patients (e.g., diuretics, fluid restriction) may activate the renin-angiotensin-aldosterone system (RAAS), exacerbating their thirst distress.

Negative emotions are commonly experienced among heart failure patients. Previous studies have suggested that emotions (e.g., anxiety, depression) may activate the sympathetic nervous system, reducing the secretion of saliva, which, in turn, may increase sensations of dry mouth among HF patients. However, the relationship between emotions and thirst distress remains unclear. Therefore, the aim …

The Impact Of Covid-19 On The Mental Health And Well-Being Of Black And Latinx Nurses In California, Jerry John Ouner, Patience Afulani, David A. Asakitogum, Nneka Umeh, Monica Getahun, Jaffer Okiring, Michael Denyu, Orlando Harris, Osamuedeme Odiase

International Nursing Research Congress (INRC)

On January 31, 2020, Santa Clara County reported California’s (CA) first COVID-19 case. As the pandemic unfolded, health systems were severely strained, and health care workers faced dual exposure risks from their communities and households alongside heightened occupational risk from direct patient care.1,2 For Black and Latinx nurses, COVID-19’s disproportionate impact on their communities intensified stress, fear, and uncertainty, and when combined with the demands of frontline work, greatly increased their risk of psychological distress and burnout. We examined COVID-19’s impact on the mental health and well-being of Black and Latinx nurses in CA.

Method: We conducted an explanatory sequential …

Enhancing Nursing Narrative Interoperability: Omop-Cdm Representation Of Concern Features, Sujin Gan, Rae Woong Park, Youngjin Lee

International Nursing Research Congress (INRC)

Purpose: This study aims to standardize inpatient nursing narratives by mapping their semantic units to CONCERN features and implementing a structured, interoperable representation of nursing documentation within the OMOP-CDM.

Background: Nursing narratives capture nuanced assessments, clinical reasoning, and early signs of deterioration, yet remain unstructured and inconsistently represented across institutions, limiting interoperability and secondary use. The OMOP Common Data Model (CDM) provides a standardized framework for harmonizing clinical data, but nursing documentation has not been systematically incorporated. The CONCERN framework, developed to identify early deterioration signals from narrative nursing data, offers an appropriate conceptual basis. This study adopted CONCERN features …

Using Simulation To Translate Theory Into Practice: Lessons Learned & Next Steps, Margarett Alexandre, Fern Baudo, Vanessa Carew

International Nursing Research Congress (INRC)

NIH notes adverse events can be avoided (Patient Safety, 2023). Simulations using high-fidelity mannequins offer an interactive environment for students to learn critical thinking skills. Simulations allow students to practice skills in a safe environment before working with real patients (Zenani, 2023; Durham & Alden, 2008). Saylor, Graber, and Trinkaus (2024) note that simulation-based learning experiences can increase confidence in undergraduate nursing students.

Purpose: To explore the impact of increase simulation with senior nursing students in an upper-level med/Surg course, incorporating guided reflective journaling to address students’ assessment of knowledge, understanding of theoretical and practical skills learned, and reflect on …

Impact Of Debriefing Methods On Psychological Outcomes In End-Of-Life Simulation, Jennifer A. Wentzel, Julie Steele, Desireé Hensel

International Nursing Research Congress (INRC)

Introduction: Nursing students do not feel adequately prepared to care for patients at the end of life (EOL) (Yoong et al., 2023). Current EOL education focuses on students’ learning outcomes instead of their psychological needs (Harder & Harwood, 2019). This is the first study to compare the impact of debriefing methods on psychological outcomes in EOL nursing education.

Purpose: Guided by the Transactional Model of Stress and Coping and Kolcaba’s Comfort Theory, this study examined the impact of the Trauma-informed, Psychologically Safe (TiPS) debriefing method on coping with death, attitudes toward care of the dying, and debriefing experience in undergraduate …

Factors Influencing Pediatric Palliative Care Utilization: A 12-Year Retrospective Study In Taiwan, Tzu-Ying Yang, Wei-Wen Wu, Frank Leigh Lu, Shao-Yi Cheng, Tsung-Hsien Yu, Kristin Berg

International Nursing Research Congress (INRC)

Background and objective: Pediatric palliative care (PPC) improves the quality of life for children with life-limiting conditions and their families by addressing physical, psychological, and spiritual needs. Despite increasing recognition of its benefits, PPC remains underutilized, particularly in Asian contexts where early integration and service accessibility are still limited. This study aimed to examine trends and factors influencing PPC utilization among deceased children in a tertiary children’s hospital in Taiwan from 2012 to 2023, to provide evidence on predictors for more equitable access to PPC.

Methods: A retrospective study was conducted using medical records of children aged 1–18 years who …

More Than A Voice: Interpreters As Cultural Brokers In Serious Illness Conversations, Katherine Doyon, Sadia Abdulkadir, Sarah Darney, Sunny Smart, Hannya Ornelas, Alice Mwamba, Adebusola Oluwatoba-Adeyemi

International Nursing Research Congress (INRC)

Background: In serious illness and end-of-life care, effective communication is critical to honoring patients’ values and goals. For patients with refugee backgrounds, healthcare encounters may also evoke distress or (re)traumatization due to past experiences of displacement, persecution, or medical mistrust. Interpreters are essential in facilitating understanding and emotional safety. Yet, their role often extends beyond that of neutral language conduits, they act as cultural brokers, bridging cultural and religious divides, buffering emotions, and fostering trust between refugees and the healthcare team.

Objective: To explore how medical interpreters experience their role as cultural brokers in serious illness conversations.

Methods: A 126-minute …

Assessing Nursing Students’ Palliative Care Competence To Inform Course And Curriculum Design, Wen-Wen Li, Jung Eun Kim, Derrick Huang

International Nursing Research Congress (INRC)

Purpose: This project evaluated undergraduate nursing students’ competency and knowledge in palliative care (PC) before a semester-long course. Findings informed curriculum design to strengthen students’ understanding and application of PC concepts in clinical practice.

Background/Significance: Palliative care is vital in nursing education, yet integration into undergraduate curricula remains inconsistent (Lippe & Becker, 2021). Developing PC competence enhances patients’ and families’ quality of life (Alhaddar et al., 2025). Assessing students’ baseline knowledge helps identify learning gaps and align curricula with the American Association of Colleges of Nursing [AACN] CARES Competencies (AACN, 2021) in PC education.

Methods: A cross-sectional study was conducted …

Virtual Reality Simulation For End-Of-Life Communication: Case Development And Pilot Implementation, Kathryn M. Ledwin, Kylene Abraham, Karen Parker

International Nursing Research Congress (INRC)

Background: Registered nurses have reported feeling unprepared and lacking proper skills for critical end-of-life discussions with patients and their families (Kerr et al., 2020). Virtual reality (VR) simulation presents a novel approach to providing immersive opportunities to support learning and skill development (Liu et al, 2023; Sinurat et al.,2025). VR has been successfully integrated into nursing education to support clinical skill development (Foronda et al. 20220; Liu et al, 2023), however less research has focused on specific applications for complex medical discussions.

Purpose: This project aimed to develop and examine the feasibility of using VR simulation as an educational intervention …

“I Started Healing Myself”: Black Mothers’ Grief Journeys After Stillbirth, Carrie J. Henry, Sara Kaylor, Mallory Scogin

International Nursing Research Congress (INRC)

Introduction: Stillbirth (fetal death after 20 weeks gestation) occurs twice as often for Black mothers compared to White in the United States (Gregory et al., 2024), yet limited research has explored how Black mothers cope with stillbirth-related grief and distress (Boyden et al., 2014; Henry et al., 2023). Evidence suggests coping behaviors after perinatal loss differ across cultural and racial groups (Henry et al., 2024; Moore et al., 2022), yet most studies reflect mostly White samples. Understanding how Black mothers navigate the grieving process is essential to inform culturally responsive care and bereavement support (Fenstermacher & Hupcey, 2019; Henry et …

Ecological Momentary Assessment Of Caregiver Distress In Home Hospice Caregivers: A Study Protocol, Tuzhen Xu, Ya-Ching Huang

International Nursing Research Congress (INRC)

Background: Caregivers of hospice patients, often family or close friends, provide continuous support for individuals with a life expectancy of six months or less. In 2022, 1.72 million Medicare beneficiaries received hospice care, most at home, with an average stay of 98 days. Caregivers manage medications, symptoms, personal care, emotional support, and provider coordination, placing them at high risk for fatigue, anxiety, depression, sleep disturbance, and burnout. Traditional surveys or single-point interviews often fail to capture the dynamic nature of distress, especially during nighttime care or crises.

Purpose: To characterize real-time patterns of physical and psychological distress among home hospice …

Psychometric Evaluation Of The Chinese Version Of The Death Literacy Index Among Nursing Students, Shu-Fen Wu, Li-Er Hung, Hsiu-Chen Liao, Shih-Ting Lo, Chia-Yu Chen

International Nursing Research Congress (INRC)

Background: Death literacy encompasses the knowledge and skills enabling individuals and communities to access, understand, and act on end-of-life care options. For nurses, it influences communication, decision-making, and palliative care quality. However, few studies have examined death literacy among healthcare providers, and no validated Chinese instruments exist for its assessment.

Purpose: To translate the Death Literacy Index (DLI) into Chinese and examine its reliability and validity among nursing students in Taiwan.

Methods: A cross-sectional correlational study was conducted. The DLI underwent translation and back-translation to ensure conceptual and linguistic equivalence, followed by expert review for content validity. Convenience sampling was …

Parent Perspectives On The Potential For And Process Of Infant Organ Donation, Julia St Louis, Amy L. Wright, Sonny Dhanani, Charles Keown-Stoneman, Jennifer Woolfsmith, Danielle Joseph, Kimberley Widger

International Nursing Research Congress (INRC)

Introduction: Despite the potential to shorten waitlists for life-saving transplants, infant organ donation is rare globally (1). Infant donors (less than one year of age) can reduce waitlist mortality for both infants and children who require size-matched organs like hearts and lungs, and adults who can receive kidney transplants from infant donors (2). Infants can donate their organs after death by circulatory criteria (DDCC) (i.e., the heart stops beating)(1) if the death follows the withdrawal of life-sustaining measures (WLSM) (i.e., mechanical ventilation and hemodynamic supports like vasopressors). However, donation rates are very low(2). Providers have reported rarely offering donation due …

Impact Of High-Fidelity Simulation On Nursing Students’ Attitudes Toward Care Of The Dying, Meredith Joyner

International Nursing Research Congress (INRC)

Background: End-of-life (EOL) care is a vital yet often underemphasized component of nursing education. Limited clinical opportunities to engage with dying patients can leave nursing students unprepared to provide compassionate care. High-fidelity simulation provides an evidence-based, immersive learning environment that allows students to practice communication, decision-making, and emotional responses in a safe setting.

Research Question/Aims: This study aimed to determine whether participation in a high-fidelity simulation focused on EOL care would improve nursing students’ attitudes toward caring for dying patients. It was hypothesized that simulation participation would positively impact student attitudes as measured by a validated instrument.

Methods: A quantitative …

Growing Pains Of Sustainability: Scale, Care, And Counter-Infrastructures, Angela Ka Ki Lee

DRS Biennial Conference Series

Sustainability transitions are marked by growing pains: tensions between planetary and local scales, global urgency and lived experience. This paper argues that techno-centric, metric-driven, and scalable approaches obscure inequalities, conceal the labour of maintenance, and overlook affective dimensions. It proposes a counter-infrastructural approach that understands sustainability as emerging through infrastructural, ecological, temporal, embodied, and relational dynamics. Drawing on interdisciplinary theory, participatory workshops, and experiential experiments, the study shows how process-oriented practices can reconnect individuals to energy systems. Bioregional thinking, community-led initiatives, repair and maintenance, and sensory engagement are explored as alternatives that foreground resilience and interdependence. Through lenses of scale, …

Sketching Futures: Cultural Dimensions, Pedagogies, And Digital Transitions, Bryan F. Howell, Janwillem Hoftijzer, Mauricio Novoa Muñoz, Amos Scully

DRS Biennial Conference Series

This track gathers eighteen papers that consider the work of the sketch and sketching in a moment of accelerating cultural and technological change. Across three sessions: (1) Sketching for Thinking, Expression, and Information; (2) Visualising Narratives; and (3) Sketching & Generative AI, the authors examine analogue, hybrid, immersive, and AI-augmented practices to reveal how design sketching is evolving and rendering the seen and the unseen, the personal and the cultural, the speculative and the practical. Building on the conversation begun at DRS 2024 conference, this year's papers address cultural specificity, decolonial and feminist methodologies, narrative-driven generation, and the pedagogies that …

The Invisible Playground For Taboos: A Framework For Recognising And Designing For Inner Play To Engage With Death And Anticipatory Grief, Manuela Melo, Sofie Kinch, Andrew Tibbles, Allan Køster

DRS Biennial Conference Series

Death and Anticipatory Grief remain culturally taboo, limiting opportunities for open dialogue and emotional preparedness. This paper explores how design can facilitate such conversations through play. Inner Play is a form of imaginative and introspective play that aids engagement with taboos in an empathic way, but lacks ways to understand and evaluate how to design for it. Employing a Research-through-Design approach, the papers presents a speculative design project that mediates communication between the bereaved and the deceased with a game kit resulting in a shared grief artefact. Ten participants in five workshops engaged in an iterative prototyping process, which resulted …

Designing With Care For The End Of Life: A Reflective Co-Design Workshop Using Material Facilitation, Chenfei Yu, Michael Arnold Mages

DRS Biennial Conference Series

Conversations about end-of-life (EOL) care are often delayed until moments of crisis, leaving little time or emotional capacity for people to reflect on what matters most to them. This paper reports on a reflective co-design workshop in which fifteen participants used material-facilitated methods to explore their imagined EOL experiences. Through landscape making, journey mapping, and collaborative service model building, participants expressed hopes, fears, values, and priorities that are difficult to articulate through direct questioning. The materials created a low-pressure and supportive environment, allowing participants to approach a sensitive topic at their own pace and translate personal meaning into ideas for …

After Meat: Ruin, Decomposition, And The Epistemic Collapse Of Industrial Food Systems, Alexandra Kenefick

Dublin Gastronomy Symposium

The contemporary crisis of industrial meat is typically framed in environmental, ethical, or technological terms. This paper argues instead that the crisis is fundamentally epistemic, exposing the conceptual limits of modern food systems organized around abstraction, purification, efficiency, and control. Drawing on critical theories of modernity, political ecology, and design, it reframes meat not as food but as a designed industrial artefact. Through the lens of ruin, industrial breakdown is read as material disclosure, rendering visible the violences, dependencies, and exclusions that sustained modern abundance. Against technological solutionism and post-meat futurism, the paper develops decomposition as an alternative epistemic and …

Clinically Confounded: Pericardial Effusion As The Initial Presentation Of Diffuse Large B-Cell Lymphoma In A Patient With Cirrhosis, Aditya Lakkamsani Do, Ronak Patel Do, Samiuddin Syed Md, Viktoriya Bikeyeva Md, Shams Bufalino Md

Scientific Day

Introduction/Background:

Pericardial effusion as the initial manifestation of diffuse large B-cell lymphoma (DLBCL) is a rare, extranodal presentation that upstages the disease to stage IV, per Lugano classification. In patients with underlying cirrhosis or volume overload, such effusions can be misattributed, delaying oncologic evaluation. We present a case of new pericardial effusion found to be DLBCL in the setting of alcoholic cirrhosis.

Description:

A 79-year-old male with alcoholic cirrhosis presented with bilateral lower extremity edema, abdominal edema, and hypotension that was unresponsive to outpatient diuresis. On admission, day 0, imaging showed cardiomegaly concerning pericardial effusion and left pleural effusion. Echocardiography …

A Heart-Stopping Decision: An Ethical Dilemma Involving Pacemaker Deactivation At End Of Life, Hailee Grannan Md, Nora Badi Md, Kavita Sharma Md

Scientific Day

Introduction/Background:

Pacemaker deactivation at the end of life presents complex ethical and logistical challenges. While Heart Rhythm Society affirms a patient’s right to withdraw life-sustaining treatments, clinicians often experience moral distress when patients are pacemaker-dependent. Unlike defibrillators, pacemakers are perceived as integral to the body rather than external interventions, leading to concerns regarding hastening of death with pacemaker deactivation. In this case, we highlight how device manufacturer procedural requirements can also create obstacles to deactivation, resulting in unintended prolonged suffering and increased distress for the patient and family.

Description:

A 74-year-old male with metastatic renal cell carcinoma developed third-degree heart …

Balancing Safety And Quality With End-Of-Life Realities: A Single Inpatient Hospice Facility Review, Hailee Grannan Md, Sarah Riutta Phd, Kavita Sharma Md

Scientific Day

Background/Significance:

Patient safety in hospice care requires balancing traditional safety metrics with individualized, comfort-focused goals at the end of life. Inpatient hospice units manage complex symptoms, high-risk medications, and dynamic family preferences, yet limited literature characterizing safety events in this setting. Despite routine event reporting, no comprehensive evaluation of safety incidents has been conducted at Zilber Family Hospice (ZFH).

Purpose:

The purpose of this project was to characterize and analyze patient safety incidents at ZFH to identify patterns, clarify event categorization, and inform hospice-specific safety practices and staff education that support comfort and harm reduction.

Methods:

Safety incidents at ZFH …

Snowbound Strength: Stories, Tradition, Access, And Healing In Alaska, Annette Rearden, Katie Butler, Alicia Muller, Skyler Edwin

Talking Heads Seminar Series

Faculty staff and nursing students from Alaska Pacific University present a culturally safe perspective on nursing education and healthcare delivery across Alaska. APU students come from diverse backgrounds, including Alaska Native/American Indian, urban, rural, and international communities, bringing lived experiences that shape both learning and practice. This presentation examines healthcare access across Alaska, including the role of rural hospitals and clinics, community health aids and tertiary care centers typically located in urban hubs such as Anchorage. Presenters will describe how critical access hospitals and remote clinics operate across vast geographic distances, including the coordination of care with urban facilities and …

Improving Adherence To Comprehensive Gynecological Assessments In Female Rectal Cancer Patients Prior To Rectal Cancer Treatment, Rachael Smith, Eleanor Williams, Emily Young

Rowan-Virtua Research Day

Background: A retrospective chart review of 139 female patients with Stage I-III rectal cancer treated at our institution (2017-2022) revealed only 32.6% (n=45) had documented age-appropriate gynecologic screenings prior to surgical intervention. These findings were disseminated to colorectal surgeons, medical oncologists, and radiation oncologists through departmental meetings and tumor boards. This follow-up study evaluates the impact of that educational initiative on gynecologic referral patterns. 

Hypothesis: Targeted education of colorectal surgeons, medical oncologists, and radiation oncologists would significantly increase gynecologic referral rates for female rectal cancer patients. 

Methods: This pre-post quality improvement study compared gynecologic referral rates among female patients with …

Cold Agglutinin Disease A Case On Diagnostic Pitfalls And Decision-Making Strategy, Portia Shaheed, Shefali Waghray Do, Te Du Md, Phd

Rowan-Virtua Research Day

Cold agglutinin disease is a rare subtype of autoimmune hemolytic anemia (AIHA) characterized by complement-mediated hemolysis triggered by cold temperatures. Because of its rarity and variable presentation, cold agglutinin disease is frequently underrecognized, often leading to extensive and sometimes unnecessary diagnostic evaluations. By recognizing cold agglutinin disease as a differential diagnosis in patients with recurrent admissions for hemolysis, clinicians can avoid unnecessary workups, consults, and distress for their patients.

Extended Post-Discharge Venous Thromboembolism Prophylaxis After Colorectal Resection: A Marketscan Analysis Of 2017–2021 Surgical Outcomes, Bright Agbotui, Chelsea Mazonde, Grace Sibert, Great Onyedika Okereke, Ifeoluwanimi Shobayo, Maame Yaa Okrah, Michael Ago Tetteh, Miebaka Favour Roberts, Nfn Dangpa Wandji Nana, Prince Osei Sarpong, Rebecca Martha Nantale, Raymond Suonyir

Liberty University Research Week

Background: Venous thromboembolism (VTE) remains a major cause of preventable postoperative morbidity following colorectal surgery, with a substantial proportion of events occurring after discharge. Although professional guidelines recommend considering extended post-discharge prophylaxis (EPPx) for high-risk patients particularly those with malignancy, substantial comorbidity, or prolonged hospitalization national adoption remains inconsistent. Emerging real-world studies suggest that EPPx utilization is low; however, these investigations have largely focused on cancer-only cohorts or earlier time periods and may not reflect contemporary surgical practice, including increasing use of minimally invasive approaches and wider availability of direct oral anticoagulants (DOACs). As a result, there is limited understanding …

The Impact Of Social Interaction On Patient Well-Being With Transition Into Long-Term Care Settings: A Review Of Interventions For Improved Patient Outcomes, Helen Whitney Harmon

Epsilon Sigma at-Large Research Conference

Abstract

Purpose: When individual patients are transitioned from home or acute care settings to more long-term care environments such as skilled nursing units or assisted living facilities, the residents are at an increased risk of experiencing loneliness, which is linked to depression, anxiety, and increasing cognitive decline, and other detrimental outcomes.

Aims: Combinations of peer-reviewed qualitative and quantitative research studies were analyzed to determine what factors contributed to changes in patient well-being, mental health and overall quality of life during these transitions.

Methods: One article focusing on preventable healthcare transitions in patient population was able to link higher medical acuity …