Digital Commons Network^™

An Exploration Of Student Approaches Towards Note-Taking In Medical School, Salah Eldein Elkattawy

Yale Medicine Thesis Digital Library

During medical school, students are exposed to a vast amount of knowledge they are expected to learn, understand, and apply to the care of patients. Various study strategies have been adopted by students over the years to facilitate this process, such as spaced repetition flashcards, the use of learning aids such as mnemonic devices, and the use of third-party resources to supplement their learning in the classroom. Instructors have also recognized the value in certain formats of classroom instruction, such as case-based learning or team-based learning, in keeping students more engaged and in reinforcing their learning in an interactive manner. …

Influence Of Demographics On Research Participation In Female Patients Undergoing Ambulatory Surgery, Tiana Fernandez

Yale Medicine Thesis Digital Library

Background: Historically, research on women and minorities has consisted of unethical experimentation, human rights violations, and crimes against humanity. Numerous examples can be found throughout the past two centuries, including the exposure of pregnant women to radioactive iron in the Tennessee-Vanderbilt Nutrition Project (TVNP), failure to treat cervical carcinoma in situ in the Unfortunate Experiment, surgical experimentation on female slaves by Dr. J. Marion Sims, failure to treat syphilis in the Tuskegee Syphilis Study, intentional exposure to and subsequent failure to treat sexually transmitted diseases in Guatemala, collection of biospecimens from Henrietta Lacks, and nontherapeutic experimentation on minority children in …

Associating Inflammatory Dermatoses And Gynecological Disorders Using The National Institutes Of Health’S All Of Us Research Program, Christine Myriam Hodelin

Yale Medicine Thesis Digital Library

There remains a gap in the knowledge about the relationship between inflammatory disorders and common gynecological disorders, despite significant quality of life concerns for both. We examined the association between hidradenitis suppurativa (HS) and endometriosis, and the association between atopic dermatitis (AD) and uterine leiomyomas, both with a cross-sectional study using electronic health record and survey data from the National Institutes of Health’s All of Us Research Program.

The All of Us Research Program has a large United States-based cohort and focuses on traditionally underrepresented populations in research. We compared cases and controls, all assigned female at birth, using Pearson’s …

Facial Harmony And Gender Congruence: Patient-Reported Outcomes Of Gender-Affirming Facial Surgery Using The Gender-Q And Gpsq, Helia Hosseini

Yale Medicine Thesis Digital Library

Background:Gender-affirming facial surgery (GAFS) addresses gender dysphoria by aligning facial features with gender identity, with historical emphasis on refining the upper facial third to render patients more attractive and feminine. The GENDER-Q, a novel patient-reported outcome measure (PROM), evaluates aesthetic, functional, and psychosocial outcomes, complementing the Gender Preoccupation and Stability Questionnaire (GPSQ) to assess effects of GAFS in this study. Methodology: Survey data from 86 patients was analyzed using GENDER-Q and GPSQ scores. Higher GENDER-Q scores indicated improved outcomes, whereas lower GPSQ scores reflected reduced gender dysphoria. Pre- and post-operative outcomes were compared using paired and unpaired t-tests. Spearman’s correlation …

"It Made Me Want To Get Into Healthcare Even More": A Simulation-Based Healthcare Mentoring Program, Jack Mccarthy

Yale Medicine Thesis Digital Library

The healthcare industry in the United States continues to experience rapid growth, yet workforce shortages persist across a wide range of medical professions. In order to increase the pool of qualified individuals pursuing healthcare, innovative strategies are needed to increase interest in healthcare fields among youth. Prior research has identified that healthcare career interest is driven in part by motivational characteristics including interest in math and science, self-efficacy, and social factors like the expectations of parents and caregivers. Mentoring, career exploration, and informal learning have been identified as strategies that increase student interest in and commitment towards healthcare careers. This …

The Deepfake Dilemma: Fake Images, Real Victims, And The Legal Void In Addressing Non-Consensual Deepfake Pornography, Elizabeth A. Safaryn

William & Mary Journal of Race, Gender, and Social Justice

This Note evaluates the various legal remedies available to victims of non-consensual deepfake pornography. As deepfakes are a relatively new but rapidly advancing technology, it is difficult for the law to keep up with the mass creation and distribution of AI-generated images on the Internet. With the competing interest of constitutionally protected speech, current deepfake laws fail to address non-consensual intimate image sharing (NCII) explicitly and lack the necessary deterrent effect to curb their proliferation. With an initial background on deepfakes and machine learning, this Note then explores the strained relationship between the First Amendment and the available civil remedies …

The New Transgender Tipping Point: Trumpism, Medical Necessity & Gender-Affirming Care, Molly J. Nunn

William & Mary Journal of Race, Gender, and Social Justice

Following the rise and eventual triumph of Trumpism 2024, President Donald J. Trump and his administration have sought to discredit the internationally recognized standards of effective health care practice for gender-affirming care. Now, ten years after Time Magazine published “The Transgender Tipping Point,” the political discourse of transgender identity is tipping again. Under the second Trump Administration, transgender identity sits at the edge of an abyss. Trumpism seeks to eradicate or significantly limit access to gender-affirming care through executive actions and the judiciary, despite the plethora of medical associations stating that that care is medically necessary. Public policies that widely …

Decreasing Work-Related Stress And Burnout In Advanced Practice Clinicians, Laura Vasquez

Doctor of Nursing Practice (DNP) Scholarly Projects

Background

Advanced practice clinicians (APCs) face ongoing job-related stress and career burnout. Work-related stress and burnout affect healthcare quality, safety, and patient satisfaction, yet evidence specific to job-related stress and career burnout from outpatient medical facilities in the South Texas region remains limited.

Purpose

A quality improvement (QI) project was implemented to decrease work-related stress and burnout among APCs working in an outpatient medical facility in the South Texas region.

Methods

Project participants included family nurse practitioners (FNPs) (n=7) and physician assistants (PAs) (n=4). Data was collected between January 2026 and March 2026. An intervention was implemented which included engagement …

Unseen Labour, Unmatched Impact: Struggles And Strategies Of Supervising Lawyers In Canadian Clinical Law Programs, Sarah Buhler, Gemma Smyth

Dalhousie Law Journal

Supervision has been described as the “beating heart” and the “core” of clinical legal education. Yet lawyers who supervise law students in clinical programs have challenging and poorly understood roles within Canadian legal education. This article analyzes interviews with lawyers who supervise students in Canadian law-school affiliated legal clinics. Supervising lawyers describe the tensions between their roles as lawyers, supervisors and mentors, university or non-profit employees, social justice advocates, members of law societies, and clinic team members. These tensions often exist within an environment of lower pay, poor job security, substandard treatment by colleagues, and inadequate training. Despite these challenges, …

Healthcare Discrimination Under The Canadian Charter Of Rights And Freedoms, Mélisande Charbonneau-Gravel, Sébastien Jodoin, Siobhan O’Connell

Dalhousie Law Journal

This paper explores the role that the Canadian Charter of Rights & Freedoms could and should play in addressing and redressing discrimination in the context of healthcare in Canada. Drawing on landmark as well as recent jurisprudence, we analyze how sections 7 and 15 of the Charter apply to three types of healthcare discrimination: (1) lack of access to healthcare and health services; (2) lower quality of services, and attitudes and biases faced in diagnosis and treatment; and (3) physical, verbal, psychological, and sexual abuse experienced by patients. Our analysis highlights the ongoing, problematic nature of the prevailing interpretations of …

Chapter 1 - Introduction And Overview, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

This Trial Manual is a how-to-do-it guidebook for handling criminal cases from beginning to end. It provides a compact guide through the stages of an ordinary criminal case, from arrest and investigation to appeal. Its focus is upon the key points at which defense counsel must make decisions and take actions. Options and factors to be considered in each decision, and steps that can be taken to assert a client’s rights and protect the client’s interests at each stage, are laid out.

Chapter 6 - Interviewing The Client, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

The first interview with a criminal client is probably the most important exchange that counsel will have with the client. It largely shapes the client’s judgment of the lawyer. Any initial impressions counsel makes may be indelible. At the least, this interview will strongly affect all future dealings between the two. The lawyer’s primary objective in the initial interview is to establish an attorney-client relationship grounded on mutual confidence, trust, and respect.

Chapter 6'S Interview Checklist § 6.15, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

The following checklist covers most of what the lawyer will have to learn from a client in order to develop an effective defense at all stages of a criminal case from first contact through trial. It models a thorough interviewing process; more than a single interview will ordinarily be needed to gather all of the information it includes. When the charge is relatively minor, less extensive fact-gathering may be adequate. But counsel will do well to assume at the outset that all of the subjects flagged by this checklist need to be on the agenda; decisions to curtail coverage should …

Chapter 5 - State-Paid Assistance For The Defense: Obtaining State Funding For Counsel’S Time And For Defense Services, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

As explained in § 2.3.4.2 supra, indigent defendants have a Sixth Amendment right to court-appointed counsel in all felony cases (Gideon v. Wainwright, 372 U.S. 335 (1963); Johnson v. Zerbst, 304 U.S. 458 (1938)) and on any charges of misdemeanors or petty offenses for which a term of imprisonment is going to be imposed as a result of conviction, “‘even for a brief period’” (Alabama v. Shelton, 535 U.S. 654, 657 (2002)), including cases in which the court imposes “a suspended sentence that may ‘end up in the actual deprivation of a person’s liberty’” (id. at 658) in the event …

Chapter 15 - Guilty Pleas: Preparing For And Conducting Plea Negotiations; Counseling The Client About A Plea Offer, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

This chapter examines the processes by which counsel prepares for and conducts plea negotiations with the prosecutor and advises the client about a bargained plea. The chapter leads off with a discussion (in § 15.2) of the relative roles of counsel and client in deciding whether the client should plead guilty rather contesting a criminal charge. Part B (§§ 15.3-15.7) discusses the benefits and costs to a defendant of resolving a criminal charge by pleading guilty. It then reviews the factors that counsel should consider in developing an advantageous plea bargain to propose to the prosecutor or in assessing a …

Chapter 8 - Dealings With The Police And Prosecutor, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Counsel should usually establish contact with the investigating officers as early as possible in the course of a case. Thereafter, s/he should speak to them whenever the needs of the client dictate. Similarly, counsel should establish contact with the prosecuting attorney as soon as one is assigned to the case and should communicate with him or her periodically thereafter. The purposes of these contacts are (a) to learn as much as possible about the charges against the defendant (those already lodged and others that may later be lodged) and potential prosecution evidence; about the temperament of the prosecutor and of …

Chapter 22 - Change Of Venue Or For Disqualification Of The Judge, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

The general principles governing initial venue in criminal cases are sketched in § 20.5 supra. As that section indicates, a charging paper filed in the wrong venue is usually subject to a motion to quash or to dismiss. In some jurisdictions, however, the defendant’s remedy may be merely a motion for transfer to the court of proper venue. Statutes, court rules, local practice, canons of judicial ethics, and opinions rendered by a jurisdiction’s professional-ethics committee or agency provide varying grounds and procedures for objecting to a particular judge’s presiding at trial or on pretrial matters.

Chapter 16 - Representing Clients Who Are Mentally Ill Or Intellectually Disabled, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

There are, however, some clients who are not competent to make decisions affecting their own welfare; and counsel may need to take special measures in these cases. If counsel reasonably believes that mental illness or an intellectual disability has so severely “diminish[ed]” the client’s “capacity to make adequately considered decisions in connection with the representation . . . [that] a normal client-lawyer relationship with the client” cannot be maintained, and if counsel furthermore “reasonably believes” that the client “is at risk of substantial physical, financial or other harm unless action is taken and [that the client] cannot adequately act in …

Chapter 27 - Motions To Suppress Identification Testimony, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

This chapter examines the various doctrines governing suppression or exclusion of identification testimony. Procedural requirements governing suppression motions and strategic considerations in drafting the motions are discussed in §§ 17.3-17.11. Techniques for conducting a suppression hearing are discussed in Chapter 24.

Chapter 30 - Retaining And Working With Expert Consultants And Potential Expert Witnesses, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

There is a host of types of experts that may be useful in a criminal case. For some examples, see § 5.2 seventh paragraph supra.

Chapter 31 - Interlocutory Review Of Pretrial Rulings By Means Of Prerogative Writs, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Yet in virtually every State there are excellent doctrinal bases to support interlocutory review. Appellate courts are generally given by statute the power to issue the prerogative writs of mandamus and prohibition. Traditionally, the writs lie to compel (in the case of mandamus) or to prohibit (in the case of prohibition) action by an inferior court that is conducting any proceeding in a manner rendered unlawful by lack of jurisdiction or gross abuse of discretion. Many pretrial rulings in criminal cases would seem susceptible of being brought within the framework of these concepts.

Chapter 26 - Motions To Suppress Confessions, Admissions, And Other Statements Of The Defendant, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

The doctrines described in this chapter supply grounds for suppressing not only confessions but any statement by the defendant – “whether inculpatory or exculpatory – that the prosecution may seek to introduce at trial” (Rhode Island v. Innis, 446 U.S. 291, 301 n.5 (1980) (emphasis in original); see also Miranda v. Arizona, 384 U.S. 436, 476-77 (1966)).

Chapter 35 - Opening Statements, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Immediately after the attorneys announce that they are ready to begin trial and before the first witness is called, the prosecuting and defense attorneys (in that order) are permitted to make opening statements, sometimes called opening arguments or opening speeches.

Chapter 34 - Trial: General Characteristics, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

Ordinarily a criminal trial cannot be held in absentia. See Drope v. Missouri, 420 U.S. 162, 182 (1975). The defendant “has a right to be present at all important stages of trial” (McKaskle v. Wiggins, 465 U.S. 168, 178 (1984) (dictum)). In most jurisdictions the right derives from several sources. It is often conferred by statute or rule of court (see, e.g., Crosby v. United States, 506 U.S. 255 (1993)); it is held to be protected by the common state constitutional guarantees of due process and of confrontation; and it is protected by the Due Process Clause of the Fourteenth …

Chapter 38 - Motion For Acquittal, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

At the close of the prosecution’s case, it is routine for defense counsel to move for a judgment of acquittal. (Terminology differs among jurisdictions. The motion is sometimes called a “motion to dismiss,” a “prima facie motion,” a “motion for a directed verdict” or a “demurrer to the evidence.”) But cf. Evans v. Michigan, 568 U.S. 313, 329 (2013) (dictum) (“Nothing obligates a jurisdiction to afford its trial courts the power to grant a midtrial acquittal, and at least two States disallow the practice. See Nev. Rev. Stat. § 175.381(1) (2011); State v. Parfait, 96,1814 (La.App. 1 Cir. 05/09/97), 693 …

Chapter 36 - Evidentiary Issues That Are Likely To Arise At Trial, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

General rules of evidence applicable in civil cases are also controlling in criminal cases. This chapter’s discussion of evidentiary matters will be limited to a few of the most important problems specific to criminal trials.

Chapter 39 - Presenting The Case For The Defense, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

In all jurisdictions, a trial court’s exclusion of relevant, material evidence proffered by a defendant is reversible error under applicable statutes or rules of court or as a matter of common-law practice. See, e.g., United States v. Barrow, 109 F.4th 521 (D.C. Cir. 2024); United States v. Yarbrough, 527 F.3d 1092 (10th Cir. 2008); State v. Santoro, 2024 MT 136, 417 Mont. 92, 551 P.3d 822 (2024); Commonwealth v. Molina, 2019 WL 2323825 (Pa. Super. 2019); Brown v. State, 227 So.3d 185 (Fla. App. 2017); State v. G.R.M., 272 Or. App. 737, 358 P.3d 301 (2015). It may also violate …

Chapter 48 - Sentencing, Anthony G. Amsterdam, Randy A. Hertz

Trial Manual for the Defense of Criminal Cases

In most jurisdictions, statutes or court rules authorize – and in some jurisdictions they require – a presentence investigation following conviction of some or all offenders. The investigation is ordered by the judge either on the court’s own initiative or upon application of either party after a verdict or finding of guilt or a plea of guilty. It is performed by an agency of the court, usually the probation department. Probation officers, ordinarily professionally trained in social work, interview the defendant and the defendant’s family, neighbors, employers, teachers, and minister. They collect the defendant’s previous court, juvenile court, prison, school, …

Improving Early Detection And Response To Clinical Deterioration Among Nurses Through Competency-Based Interventions, Courtney E. Miller

Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Clinical deterioration among hospitalized patients remained a significant contributor to preventable morbidity and mortality, often due to delayed recognition and response in general care settings (Choi et al., 2025; Chung & Jung, 2024).

PICOTS: For registered nurses working on a general level of care inpatient hospital unit (P), how did a competency-based training program bundle incorporating didactic educational intervention of learning how to use technology, machine learning (ML) based early warning system (EWS) of trends and patterns to identify at risk patients, and low-fidelity simulation-based education (SBE) (clinical readiness to improve confidence with education and coaching) (I), …

Implementing A Standardized Resilience Bundle For Neonatal Intensive Care Nurses, Jennifer Bouzid

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Nurse resilience is associated with improved psychological well-being, professional satisfaction, and retention. Neonatal intensive care unit nurses are frequently exposed to emotionally traumatic clinical events that may contribute to burnout, compassion fatigue, and turnover. A women’s hospital in central Texas identified increased nurse turnover and lower employee engagement scores related to well-being and intent to stay within the neonatal intensive care unit.

Purpose: The purpose of this quality improvement project was to implement and evaluate a standardized resilience support bundle for nurses following traumatic clinical events.

Methods: Guided by the Plan-Do-Study-Act framework, the project implemented a resilience bundle that …