Digital Commons Network^™

Early Life And Post-Traumatic Growth Among Urban African Americans, J. Howard Streeter Iii

Walden Dissertations and Doctoral Studies

Post-traumatic growth (PTG) has received increasing attention in psychological research, yet the PTG experiences of African Americans remain underexplored. Trauma researchers have established the common prevalence of trauma within this population, but there have been very few studies on how African Americans traverse trauma according to PTG. Understanding PTG in this population is essential for clergy, coaches, parents, counselors, and others who work in these communities. The purpose of this quantitative survey study was to determine whether there was a statistically significant relationship between rumination, religious orientation, religious commitment, and stressful life events (SLEs) and PTG among urban African American …

Quality Improvement Project: Provider Education On An Evidence-Based Clinical Pathway For Diagnosing Adult Attention-Deficit Hyperactivity Disorder, Oluwadayo B. Adeyemo

Doctor of Nursing Practice Projects

Accurate diagnosis of adult Attention-Deficit Hyperactivity Disorder (ADHD) remains challenging in outpatient behavioral health settings, as variations in clinician training, diagnostic tools, and assessment methods can hinder accuracy and delay treatment. At the project site, providers reported low confidence and inconsistent use of standardized tools when evaluating adult ADHD, underscoring a critical need for structured education to improve diagnostic consistency and provider confidence. This quality-improvement (QI) project assessed the impact of an educational intervention on provider knowledge, confidence, and utilization of validated screening tools for adult ADHD. Guided by Donabedian’s Model of Quality Improvement and Lewin’s Change Theory, the project …

Quality Improvement Project: The Impact Of Genetic Testing Education For Mental Health Providers In An Outpatient Clinic, Ifeoma Uzoh-Anigbogu

Doctor of Nursing Practice Projects

Despite growing evidence supporting the use of genetic screening in psychiatric medication management, many mental health providers lack the confidence and knowledge to utilize this tool effectively. This quality improvement (QI) project aimed to enhance provider self-efficacy and increase the utilization of genetic screening through a structured education and training program in an outpatient mental health clinic. The purpose of the project was to determine whether provider education on pharmacogenetic testing improves confidence and screening frequency compared to those who do not receive the intervention. The Donabedian Model guided evaluation of structure, process, and outcome measures, while Rogers’ Diffusion of …

Quality Improvement Project, Communicating With The Dying Patient: A Simulation Experience For Nursing Students, Jason Weger

Doctor of Nursing Practice Projects

Effective communication with patients near the end of life is a crucial yet often underdeveloped skill among nursing students. Previous research highlights a persistent gap in training for end-of-life communication in nursing schools. This quality improvement project implemented a simulation-based educational intervention to improve end-of-life communication skills among first-semester nursing students at a community college in Oklahoma. A needs assessment identified significant gaps in students' readiness for emotionally charged patient interactions. Guided by Prosci’s Change Model and Jeffries Simulation Theory, the project used a faculty-led simulation experience to teach evidence-based communication strategies, including appropriate word choice, therapeutic presence, and active …

Resiliency For Nurse Educators: Incorporating Resiliency Training For Nursing Faculty, Rachael Holder

Doctor of Nursing Practice Projects

Nursing faculty frequently experience high levels of stress, workload demands, and burnout, which can negatively affect teaching effectiveness and retention. Literature supports resilience as a protective factor that enhances well-being and professional sustainability. The purpose of this quality improvement project was to impact resilience levels among full-time undergraduate nursing faculty through a self-paced online resiliency training program. Guided by Pender’s Health Promotion Model and Lewin’s Change Theory, this pre- and post-intervention design used the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) to assess changes in resilience. Eleven faculty members completed the pre-survey, and two completed the post-survey. The post-survey mean CD-RISC-10 scores …

Quality Improvement Project Implementation Of A Peer Mentoring Program In An Associate-Degree Nursing Program, Heather Baker

Doctor of Nursing Practice Projects

Peer mentoring is recognized as an evidence-based strategy that offers support to students and enhances retention. This project aimed to implement a peer mentoring program based on the Nursing Universal Retention and Success (NURS) model. The Plan-Do-Study-Act (PDSA) framework and Havelock’s Theory of Planned Change guided the implementation process. The goal was to assess the program's impact on first-semester nursing student retention rates and students’ perceptions of success. First-semester nursing students in a traditional associate-degree nursing program volunteered to participate in the peer mentoring program for one semester. At the end of the semester, an anonymous post-survey was distributed to …

Quality Improvement Project: Improving Emergency Medication Administration Safety In An Inpatient Psychiatric Unit, Sandra Anusiem

Doctor of Nursing Practice Projects

Psychiatric emergencies contribute to medication safety issues due to increased stress, inconsistent practices, and communication breakdowns. The problem was high rates of medication errors in psychiatric emergencies due to the lack of a structured, standardized medication management protocol. This Doctor of Nursing Practice (DNP) quality improvement project aimed to reduce medication errors in administering emergency medications in an inpatient psychiatric unit by using the Medication Administration Cross-Check (MACC) checklist. The project was completed using a quasi-experimental research design guided by the Donabedian Model of Healthcare Quality and Lewin’s Change Model. Pretest and posttest knowledge, confidence, attitude, and perceptions were obtained …

Establishing Nursing Excellence: A Quality Improvement Approach To Nursing Administration Evaluation Using Frontline Feedback, Meredith Sykora

Doctor of Nursing Practice Projects

In the increasingly complex environment of nursing education, leadership quality and responsiveness significantly influence workplace culture, faculty satisfaction, professional development, and student outcomes. Despite these realities, many academic nursing programs, including the Division of Nursing at a community college in Arkansas, lack formal structures for bidirectional leadership evaluation. This gap limits frontline faculty’s ability to provide formative feedback to program leaders, weakening shared governance and transparency. The purpose of this quality improvement project was to evaluate leadership effectiveness following the implementation of a structured bidirectional feedback process between nursing faculty and program leaders. Guided by Kouzes and Posner’s Leadership Practices …

Quality Improvement Project: Nursing Faculty Mental Health Literacy Assessment And Evaluation, Elesha Roberts

Doctor of Nursing Practice Projects

Mental illness is a major healthcare concern affecting young adults enrolled in college. College students enrolled in nursing programs in particular face intense academic pressure due to the demands and rigor of the program. Students commonly report symptoms associated with depression, anxiety, and suicide. Nursing faculty often do not feel comfortable approaching students about these concerns and other related mental health issues. Many faculty members lack the knowledge and skill to identify mental health issues and provide resources to support students in need. Faculty should be mental health literate and aware of campus resources. The purpose of this quality improvement …

Improving Self-Efficacy Among Clinical Instructors: The Impact Of Communication Education On Handling Lateral Violence, Emma Guidry

Doctor of Nursing Practice Projects

The quality improvement (QI) project aims to determine if clinical instructors perceive changes in self-efficacy in communication skills specific to lateral violence (LV) situations secondary to an educational intervention. Currently, clinical nurse instructors lack education specifically addressing communication strategies to utilize when LV occurs in the clinical setting. Banduras Social Cognitive Theory, Lewin’s Change Theory and the Plan-Do-Study-Act (PDSA) were employed as frameworks in the development of this project. Methods used in this quasi-experimental design project include administration of the Self Efficacy to Address Disruptive Behaviors Scale (SADBS) survey to project participants, nursing clinical instructors. The evidence-based practice (EBP) intervention …

Quality Improvement Project: Development And Implementation Of A Structured Certification Support Program And The Impact On Nurses’ Confidence And Medical Surgical Certification Rates, Mary Tran

Doctor of Nursing Practice Projects

Professional nursing certification is an important criterion of Magnet designation, and increased certification rates have been associated with positive patient outcomes. The literature supports peer support and group study as beneficial strategies to assist nurses in preparing for certification exams. A quality improvement project among medical-surgical (med-surg) nurses at a community hospital pursuing Magnet redesignation addressed the lack of formal processes and nursing perceived barriers to certification that may contribute to low certification rates. The purpose of this project was to develop and implement a structured medical-surgical certification support program following the Plan-Do-Study-Act (PDSA) cycle utilizing evidence-based strategies, including a …

Quality Improvement Project: Improving Nurse Competency In Caring For Patients With Dementia With Behavioral Disturbances In Long-Term Care, Lashunta Jackson

Doctor of Nursing Practice Projects

Dementia-related behavioral and psychological symptoms (BPSD) present major challenges for nurses in long-term care settings, often leading to inconsistent care, staff stress, and safety risks. Evidence-based, person-centered interventions are proven to improve outcomes but are frequently underutilized due to limited staff training. The purpose of this Doctor of Nursing Practice (DNP) project was to improve nursing staff competency in managing residents with dementia and behavioral disturbances through structured, evidence-based education. The problem identified was a lack of dementia-specific knowledge and confidence among nurses, which contributed to suboptimal care and increased behavioral incidents. A quasi-experimental pre-/post-intervention design guided by Knowles’ Adult …

Quality Improvement Project: Enhancing Diabetes Management Through Continuous Glucose Monitoring Device Education Among Providers Of Underserved Groups, Shaibu Rashid

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance diabetes management among underserved populations by increasing provider confidence and utilization of continuous glucose monitoring (CGM) devices in a Federally Qualified Health Center (FQHC). Despite CGM being recognized as a standard of care for patients requiring intensive insulin therapy, its adoption in FQHCs remains limited due to provider knowledge gaps, financial barriers, and workflow challenges. Based on Kurt Lewin’s change theory, the project employed a quasi-experimental one-group pretest–posttest design to evaluate the impact of an evidence-based educational intervention among six family practice providers. The intervention included interactive sessions on CGM device use, data …

Per Se Driving Under The Influence Of Cannabis Statutes And Blood Delta-9-Tetrahydrocannabinol Concentrations Following Short-Term Cannabis Abstinence, Robert L. Fitzgerald, Anya Umlauf, Raymond T. Suhandynata, David J. Grelotti, Marilyn A. Huestis, Kyle F. Mastropietro, Igor Grant, Thomas D. Marcotte

Institute of Emerging Health Professions Faculty Papers

BACKGROUND: Several US states have per se laws using 2 or 5 ng/mL of delta-9-tetrahydrocannabinol (THC) as cutpoints for driving under the influence of cannabis, while some have zero-tolerance statutes. These cutpoints are considered prima facia evidence of driving impairment.

METHODS: In a cohort of people who regularly use cannabis (N = 190) we measured baseline concentrations of THC after instructing participants to abstain from cannabis for at least 48 hours. Baseline driving performance was evaluated using a driving simulator. We also measured blood THC concentrations serially following a smoking session (placebo or active cannabis).

RESULTS: Forty-three percent of the …

Leveraging Student Data To Assess, Inform, And Develop Teachers Capacities, Nathan D. Koerber, Kenneth J. Fasching-Varner

Northwest Journal of Teacher Education

This quantitative study analyzed 47 survey responses to gauge in-service, pre-licensed teacher, and paraprofessional perceptions of cultural competency. Participants responded to the Central Vancouver Island Multicultural Society’s Cultural Competence Self-Assessment Checklist (Alpha = 0.7) to explore their awareness, knowledge, and skills in cultural competency. Moreover, through the application of Culturally Responsive Teaching (CRT) as a theoretical framework, this study highlighted how these perceptions related to culturally responsive teaching and provided several implications for their future preparation to further develop their cultural competency through the tenets of CRT. The analysis identified participant unfamiliarity with privilege and its impact, as well as …

Allan Leslie Combs: Reminiscence And Recommendation, Jonathan B. Bricklin

Journal of Conscious Evolution

The author recalls his first meeting with Allan Leslie Combs, identifying his defining trait of openness through the lens of the Trickster archetype. Drawing on the philosophy of William James, the essay concludes with a recommendation for a future edition of Combs’s book Synchronicity, specifically regarding the inclusion of precognition.

Keywords: trickster, synchronicity, William James, Allan Leslie Combs, precognition, openness

An International Comparison Of Staff Perceptions Of Professional Governance, Roberta Kaplow, Polly Willis, Birgit Vogt, Fanny Grüssel-Griethe, Janina Schweiger

Biennial Convention (CONV)

Objectives: The objectives of this study were to evaluate differences among RNs and nurse leaders’ perceptions regarding professional governance (PG), and discern differences in perceptions regarding demographic variables, and determine if there are differences in perceptions of SG between two hospitals.

Background: Data suggest a relationship between PG and improved patient outcomes, nurses’ job satisfaction, and workplace engagement.

Methods: A cross-sectional descriptive comparative design was used. Perception of SG at two academic medical centers were compared. The United States (US) center has Magnet designation; the German center is pursuing designation. Participants completed a demographics questionnaire and the IPNG 3.0 (50 …

A Double-Edged Sword: Ethical And Psychological Implications Of Apoe Genotype Disclosure Across The Lifespan, Diego Iacono

Department of Neurology Faculty Papers

The apolipoprotein E (APOE) gene is the strongest genetic risk factor for sporadic Alzheimer’s disease (AD), with the ε4 allele increasing risk and decreasing the average age of onset. While APOE genotyping is primarily used in research or clinical settings for patients with memory concerns, interest in disclosing APOE status to asymptomatic individuals—particularly during early adulthood—is growing. This trend is fueled by the rise of direct-to-consumer genetic testing and emerging prevention-focused clinical trials. However, ethical debates remain unresolved about the potential harms of early disclosure, including anxiety, stigma, and misunderstanding of probabilistic risk. Conversely, some argue that knowledge of APOE …

Once Upon An Early Writing Experience: Connecting Memory With Literacy Instruction In Pre-Service Teacher Education, Jue Wang, Jingru Lu

Northwest Journal of Teacher Education

Through a narrative-based case study design, this research connects pre-service teachers’ early writing memories with their studies in writing instruction to explore how multi-layered and multi-faceted writing experiences across time and space influence teaching beliefs and practices. This article invites audiences to vicariously experience these pedagogical encounters, reflect on journeys to becoming writing teachers, and shed light onto the implications of teaching early writing. Comic artifacts and interview data were collected from nine pre-service teachers who learned to teach early writing/language arts in a four-year public university in the Inland Northwest. Based on the participants’ comics and narratives, four themes …

Transforming Nurse Leaders: The Power Of Flexible Schedules In Healthcare, Emily Calabro, Rodica Pop

Biennial Convention (CONV)

Purpose: This pilot feasibility study investigated the impact of flexible work schedules on the mental, psychological, and physical health of healthcare workers within a large hospital system, aiming to identify innovative leadership strategies for workforce planning and development.

Background: Traditional work schedules often negatively impact productivity, well-being, and job satisfaction, contributing to challenges in recruiting and retaining nurses. This study explored the feasibility and benefits of flexible work schedules as a leadership initiative to improve workforce well-being and retention.

Methods: A quasi-experimental, mixed-methods, time-series design was implemented across a 12-hospital system with the partnership of 4-Day Global. Eligible leadership teams …

Knowledge Of Menopause And Sources Of Information In Women And Men In The United States, Roxanne Ropponen

Biennial Convention (CONV)

Problem: When it comes to health management, knowledge is power. Unfortunately, menopause education is gravely lacking in the U.S., despite the fact that menopause symptoms have a significant effect on women’s lives, including their relationships with men. Most people obtain health information from online sources or family and friends, both of which can vary from highly accurate to extremely inaccurate. Nurses, the patient educators of the health care team, are in a position to provide evidence-based menopause education. In order to create and implement such education there must be an established understanding of the population's current knowledge and sources of …

Internal Control Strategies To Reduce Occupational Fraud In Small Business, Karen Walauskas

Walden Dissertations and Doctoral Studies

Small businesses can be at a heightened risk of occupational fraud if their internal control strategies are not effective. This risk is a major concern for small business owners, who might face financial and operational challenges as a result. Grounded in Cressey’s fraud triangle framework, the purpose of this qualitative multiple case study was to explore effective internal control strategies to reduce the risk of occupational fraud from occurring. Participants were six small business owners in New England who had developed effective internal controls. Data were collected through semistructured interviews and employee handbooks. Through thematic analysis, four themes emerged, including …

Access To Care Barriers To Sacral Neuromodulation Implantation In Adults With Overactive Bladder From Georgia, Tamara Lynn Wojciechowski

Walden Dissertations and Doctoral Studies

Sacral neuromodulation (SNM) is a safe and physically well-tolerated third-line treatment using an implantable device for the management of overactive bladder syndrome (OAB). Other first- and second-line treatments for OAB are frequently ineffective and often poorly tolerated. SNM implantation appears to be underutilized compared to other third-line treatments even though SNM has been rated more effective in OAB symptom mitigation with fewer side effects. Thus, the purpose of this quantitative correlational cross-sectional study was to explore whether health services factors are barriers to utilizing SNM implantation as the third-line treatment for OAB in adults. Andersen’s behavioral model of health services …

Strategies Property Management Leaders Use To Strengthen Employee Engagement In The Workplace, Angela Hartleigh

Walden Dissertations and Doctoral Studies

Lack of employee engagement presents a significant risk and cost across the property management industry. Property management business leaders are concerned with this challenge because employee engagement directly affects performance efficiency and employee turnover costs. Grounded in the self-determination theory, the purpose of this qualitative pragmatic inquiry was to explore strategies property management leaders use to strengthen employee engagement in the workplace. The participants were six purposefully selected property management business leaders in the United States. Data were collected using semistructured interviews and a review of public industry documents. Through thematic analysis, six themes were identified: (a) communication, (b) mentorship, …

Spartan Daily, December 2, 2025, San Jose State University, School Of Journalism And Mass Communications

Spartan Daily, 2025

Volume 165, Issue 40

Patient-Reported Experience Measures For Person-Centred Care: A Survey For The Development And Psychometric Testing Of A Targeted Measure, The Epcc-14, Ryan Statton, Lena Rosenlund, James Close, Anna Dencker, Helen Lloyd

School of Psychology

Objectives This study aims to develop a robust, targeted measure of patient experiences of person-centred care (PCC), informed by the lived experiences of patients with chronic illness using the psychometric theory of Rasch measurement. Design The Rasch measurement model was used to analyse the psychometric functioning of 57 candidate items and select appropriate items for a targeted measure. Setting Participants were recruited from Prolific.com, having experience of both chronic or long-term illness and first-hand experience of primary or secondary care in the UK healthcare setting and completed a survey containing PCC items and descriptors of healthcare experience. Participants Data from …

Ctrl + Alt + Inner Speech: A Verbal–Cognitive Scaffold (Vcs) Model Of Pathways To Computational Thinking, Daisuke Akiba

Publications and Research

This theoretical paper introduces the Verbal–Cognitive Scaffold (VCS) Model, a cognitively inclusive framework which proposes the cognitive architectures underlying computational thinking (CT). Moving beyond monolithic theories of cognition (e.g., executive-function and metacognitive control models), the VCS Model posits inner speech (InSp) as the predominant cognitive pathway supporting CT operations in neurotypical populations. Synthesizing interdisciplinary scholarship across cognitive science, computational theory, neurodiversity research, and others, this framework articulates distinct mechanisms through which InSp supports CT. The model specifies four primary pathways linking InSp to CT components: verbal working memory supporting decomposition, symbolic representation facilitating pattern recognition and abstraction, sequential processing enabling …

Statistically Significant Association Does Not Imply Improvement In Prediction Of Clinical Outcomes, Shu Jiang, Bernard A Rosner, Graham A Colditz

2020-Current year OA Pubs

UNLABELLED: In the current landscape of clinical studies, the concept of statistically significant association is often mixed up with the expectation of improved prediction performance. We discuss the two concepts, association and prediction, and present the epidemiologic principles and statistical constructs that underlie the discrepancy between statistically significant associations and the rationale for their lack of impact on improving prediction in terms of discrimination. This issue is illustrated using an existing breast cancer dataset. The concept of statistically significant association should not be mixed up with the expectation of improved discrimination performance. Although some markers may not markedly improve discrimination, …

Talking Sudep: Gaps, Confidence And Training Needs Among Spanish Epilepsy Professionals, Rohit Shankar

Peninsula Medical School

Objective: Sudden Unexpected Death in Epilepsy (SUDEP) is a major cause of epilepsy-related mortality, yetdiscussions about SUDEP in clinical settings remain inconsistent. This study aimed to assess the perspectives,practices, and barriers related to SUDEP counselling for epilepsy professionals in Spain.Methods: A cross-sectional online survey of 17 Likert style questions was disseminated via the Spanish EpilepsySociety between September 2023 and February 2024 to epilepsy professionals in Spain using a nondiscriminatory exponential snowballing technique leading to non-probability sampling. The survey was a validated instrument previously employed in similar international studies. Questions revolved around SUDEPcommunication and counselling. Descriptive and comparative analyses were conducted.Results: …

The Rhetorical Discourse Of Uniate Writers’ Polemic Literature Of The End Of The 16th – First Half Of The 17th Century In The Retrospection Of Oratory's History, Ruslan Tkachuk

Occasional Papers on Religion in Eastern Europe

The examination of the poetics inherent in the polemical prose authored by Uniate writers during the late 16th and the first half of the 17th centuries holds substantial significance for comprehending rhetoric as a pivotal element in the stylistic evolution of Ukrainian literature throughout this period. The objective of this article is to explore the interrelationship between the works of Uniate polemicists and the framework of classical rhetoric, particularly by elucidating the functioning of rhetorical figures and argumentation techniques within their texts. To accomplish this aim, a range of literary methodologies were employed. Those methods included historical-cultural, comparative-historical, biographical, structural-analytical, …