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Lived Experiences Of Eye Movement Desensitization And Reprocessing (Emdr) Certified, Staci Ekblad Apr 2026

Lived Experiences Of Eye Movement Desensitization And Reprocessing (Emdr) Certified, Staci Ekblad

Walden Dissertations and Doctoral Studies

This phenomenological study explored counselors’ lived experiences of utilizing Eye Movement Desensitization and Reprocessing (EMDR) with children ages 8 to 12 years of age. Guided by a Husserlian approach, the research examined how clinicians make meaning of adapting EMDR—traditionally conceptualized as a structured, eight-phase protocol—for developmental and relational responsiveness within child psychotherapy. Through phenomenological reduction and epoché, counselors described a shift in consciousness from viewing EMDR as a rigid procedure to experiencing it as a flexible, relationally attuned process grounded in the child’s lived world. Counselors described the phenomenon of implementing EMDR with children with playful adaptations and co-regulation. The …


Perceptions And Experiences Of Federal Employees Following The Dissolution Of Deia Initiatives, Angela Silva Apr 2026

Perceptions And Experiences Of Federal Employees Following The Dissolution Of Deia Initiatives, Angela Silva

Walden Dissertations and Doctoral Studies

The federal government faces the ongoing challenge of sustaining a workforce that represents the diversity of the American public while navigating through policy changes that eliminated diversity, equity, inclusion, and accessibility initiatives. The federal government is public serving and is one of the largest employers in the United States. The purpose of this generic qualitative study was to explore the perceptions and experiences of government employees navigating the termination of all diversity and inclusion programs through the lens of the antecedents and outcomes of inclusions model, which showed that inclusive leadership, climate and practices contribute to positive employee and organizational …


Highly Skilled First-Generation Immigrant Kenyan Women’S Lived Experiences With Workplace Integration Strategies In California, Lily Quiette Otieno Apr 2026

Highly Skilled First-Generation Immigrant Kenyan Women’S Lived Experiences With Workplace Integration Strategies In California, Lily Quiette Otieno

Walden Dissertations and Doctoral Studies

Unlocking the potential of highly skilled first-generation immigrant women in the workplace is critical in an era of globalization and multiculturalism. The social problem is that organizations face challenges integrating highly skilled first-generation immigrant women into the U.S. workforce due to a limited understanding of effective workplace integration strategies. The purpose of this qualitative phenomenological study was to explore the lived experiences of highly skilled first-generation Kenyan women with workplace integration strategies in California. The study was grounded in Graen and Uhl-Bien’s leader-member exchange theory and Crenshaw’s intersectionality theory to understand how leadership relationships and intersecting identities shaped workplace experiences. …


Staff Education To Improve Knowledge On Discharge Planning And Transitions Of Care For Chronically Ill Patients, Cynthia Adebisi Kadiri Apr 2026

Staff Education To Improve Knowledge On Discharge Planning And Transitions Of Care For Chronically Ill Patients, Cynthia Adebisi Kadiri

Walden Dissertations and Doctoral Studies

Patients with chronic conditions have the tendency to return to the hospital. Staff education to address high-rate re-hospitalization among patients with chronic conditions is the focus of my Doctor of Nursing Practice project. This is a significant practice problem, since patient outcomes and increased healthcare costs is compromised. Regarding re-hospitalization prevention and ultimate aid in reducing readmissions among people with chronic conditions, the project was used to enhance the knowledge of the nursing staff and competence in transitions of care and discharge planning. The project included 10 nurses who are regularly involved in discharging patients in the medical outpatient clinic. …


Psychosocial Characteristics Of North American Male Cannibals, Sheila A. Murphy Apr 2026

Psychosocial Characteristics Of North American Male Cannibals, Sheila A. Murphy

Walden Dissertations and Doctoral Studies

Criminal cannibalism is a rare form of violent offending that remains understudied despite public attention. This gap limits understanding of the psychosocial characteristics and life experiences of individuals who engage in cannibalistic behavior. The purpose of this qualitative study was to explore psychosocial characteristics within the life experiences of North American males who engaged in cannibalistic behavior and identify common themes. Grounded in social control theory and self-control theory, the study examined how weakened social bonds and diminished self-regulation may relate to extreme deviance. The guiding research question focused on identifying common psychosocial characteristics within this population. A descriptive phenomenological …


Psychometric Properties Of A Newly Developed Self-Report Scale To Determine The Relationship Between Retained Primary Reflexes And Behavioral Signs And Symptoms In An Adult Population, Joan Marie Macmillan Apr 2026

Psychometric Properties Of A Newly Developed Self-Report Scale To Determine The Relationship Between Retained Primary Reflexes And Behavioral Signs And Symptoms In An Adult Population, Joan Marie Macmillan

Walden Dissertations and Doctoral Studies

Many adults suffer from mental health issues, often caused by retained primary reflexes. There are current gaps in the literature surrounding primary reflex assessment methods. The purpose of this quantitative psychometric study was to evaluate the psychometric properties of a new behavioral self-assessment scale used to identify retained primary reflexes from behavioral indicators, while also determining if statistically significant relationships exist among study variables. The theoretical foundation for this cross-sectional study was based on the neurodevelopmental and neurobehavioral work of Melillo, while conceptually benefiting from several neuroplasticity related frameworks, such as those developed by Ayres, Bach-y-Rita, and Masgutova. The self-report …


Shift Work And Shift Change And Police Officers’ Subjective Well-Being, Macey Silano Apr 2026

Shift Work And Shift Change And Police Officers’ Subjective Well-Being, Macey Silano

Walden Dissertations and Doctoral Studies

This phenomenological study explored the lived experiences of police officers working second and third shifts and how these schedules impacted their subjective well-being, mental health, relationships, and life satisfaction. This study addressed an important research problem because limited research has examined how night shifts and shift changes impact police officers’ well-being. The purpose of this qualitative study was to examine how police officers experienced shift work and shift changes while working second and third shifts and how they made meaning of these experiences in relation to subjective well-being. Using interpretative phenomenological analysis, this study was grounded in restorative rest and …


Using Geospatial Environmental And Income Variables As Predictors Of Diabetes In Appalachia, John Kunicki Huth Apr 2026

Using Geospatial Environmental And Income Variables As Predictors Of Diabetes In Appalachia, John Kunicki Huth

Walden Dissertations and Doctoral Studies

Diabetes remains disproportionately prevalent in Appalachia, and macroenvironmental contributors remain poorly understood. Guided by spatial epidemiology, this quantitative, cross-sectional ecological study examined whether county-level environmental factors including distance to mine, distance to landfill, distance to water, mean annual precipitation, mean annual temperature, forest classification, distance to impervious surface, and median income were independently and collectively associated with diabetes cases per capita in West Virginia, used as a surrogate for Appalachia. Research questions addressed environmental predictors of diabetes cases per capita with and without controlling for median income. Publicly available county-level data from 53 West Virginia counties representing adults aged 20 …


Early Childhood Educators’ Experiences Teaching Literacy Acquisition Skills, Dena Renee Crews Apr 2026

Early Childhood Educators’ Experiences Teaching Literacy Acquisition Skills, Dena Renee Crews

Walden Dissertations and Doctoral Studies

The problem investigated through this study was that early childhood educators struggle to help students with literacy acquisition skills in a Title 1 elementary school. The purpose of this qualitative study was to investigate early childhood educators’ experiences with the challenges of teaching literacy acquisition skills and their suggestions for improving resources and training for teaching literacy acquisition skills. The study was grounded in Clay’s emergent literacy theory and Bronfenbrenner’s ecological systems theory. For this basic qualitative design, semistructured interviews with 14 participants were conducted with the following themes emerging: Early childhood educators were challenged due to (a) students’ background …


Exploring The Role Of Family Engagement In Youth Behavioral Health Programs, Jordon R. Washington-Trahan Apr 2026

Exploring The Role Of Family Engagement In Youth Behavioral Health Programs, Jordon R. Washington-Trahan

Walden Dissertations and Doctoral Studies

The behavioral health leaders at Organization X do not have a clear and practical way to engage family members in youth behavioral health programs. When caregivers are not actively involved in youth behavioral health treatment, youth may disengage from missed appointments and discontinue treatment prematurely. The present case study focused on Organization X, a small behavioral health organization located in the Southeastern United States. The Baldrige Framework of Excellence was the conceptual framework for this study, with a focus on consumer engagement and workforce operations. Semi structured and structured interviews were conducted with three behavioral health leaders. Data were collected …


Out-Of-Pocket Costs And Antihypertensive Medication Use Among Veterans: A Natural Experiment, Alexander R. Zheutlin, Alexander Chaitoff, Daniel Addo, Joshua A. Jacobs, Catherine G. Derington, Eric L. Stulberg, Peter A. Glynn, Bernardo Modenesi, Jordana B. Cohen, Adam P. Bress Apr 2026

Out-Of-Pocket Costs And Antihypertensive Medication Use Among Veterans: A Natural Experiment, Alexander R. Zheutlin, Alexander Chaitoff, Daniel Addo, Joshua A. Jacobs, Catherine G. Derington, Eric L. Stulberg, Peter A. Glynn, Bernardo Modenesi, Jordana B. Cohen, Adam P. Bress

Department of Neurology Faculty Papers

BACKGROUND: Blood pressure (BP) control remains suboptimal in the United States despite available low-cost antihypertensive medications. Even small out-of-pocket medication costs may contribute to adherence. We determined whether $0 versus >$0 out-of-pocket costs for antihypertensive medications is associated with differences in adherence, discontinuation, BP control, and cardiovascular outcomes.

METHODS: We included veterans with newly diagnosed hypertension who initiated antihypertensive medication in the Veterans Health Administration from 2004 to 2022. A fuzzy regression discontinuity design with 2-stage residual inclusion leveraged differences in medication copay policy at a 50% service-connected disability threshold (≥50% service-connected disability: $0 out-of-pocket cost versus < 50%: $8 monthly cost). Outcomes included 1-year medication nonadherence (proportion of days covered < 80%), 1-year medication discontinuation (no medication in the final 90 days of the study year), 1-year BP control (systolic BP/diastolic BP < 140/90 mm Hg and < 130/80 mm Hg) and cardiovascular disease events (myocardial infarction, coronary revascularization, peripheral artery disease, or stroke).

RESULTS: Among 417 …


Cardiovascular Disease And Dyslipidemia In Pediatric Type 1 Diabetes, Grace K Kim, Preneet Cheema Brar, Nidhi Bansal Apr 2026

Cardiovascular Disease And Dyslipidemia In Pediatric Type 1 Diabetes, Grace K Kim, Preneet Cheema Brar, Nidhi Bansal

Faculty, Staff and Students Publications

Purpose of review

Despite advances in type 1 diabetes (T1D) management, mortality is still increased, with cardiovascular disease (CVD) as the leading cause. Dyslipidemia is a highly prevalent modifiable CVD risk factor. We reviewed the existing literature on CVD mortality in T1D to highlight CVD risk in pediatric patients with T1D.

Recent findings

Pathophysiology of T1D and premature CVD risk is still not fully understood. Dyslipidemia remains a highly prevalent and undertreated CV risk factor in T1D. Statins have been shown to be safe and effective to improve CVD risk in adults with T1D, and in children with familial hypercholesterolemia, …


Obstructive Sleep Apnea Treatment Modifies The Effectiveness Of Catheter Ablation For Atrial Fibrillation: Post Hoc Analysis Of The Cabana Trial, Matthew W Segar, Kaleb D Lambeth, Brett Doliner, Joshua R Hirsch, Abdi Rasekh, Mehdi Razavi Apr 2026

Obstructive Sleep Apnea Treatment Modifies The Effectiveness Of Catheter Ablation For Atrial Fibrillation: Post Hoc Analysis Of The Cabana Trial, Matthew W Segar, Kaleb D Lambeth, Brett Doliner, Joshua R Hirsch, Abdi Rasekh, Mehdi Razavi

Faculty, Staff and Students Publications

No abstract provided.


Rhesus Macaques With An Opa1 Mutation Demonstrate Features Of Autosomal Dominant Optic Atrophy, Tracy N Jaggers, Ana Ripolles-Garcia, Ala Moshiri, Brett D Story, Jun Wang, Rui Chen, Lucy G Moore, Leandro B C Teixeira, Jaeho Shim, Ana C Raposo, Maria Isabel Casanova, Sophie M Le, Sangwan Park, Laura J Young, Soohyun Kim, Karolina P Roszak, Vanessa Ureno, Paige M Karpinen, Nayeli Echeverria, Monica Ardon, Brian C Leonard, Marguerite Knipe, Eliza Bliss-Moreau, Brad Fortune, J Timothy Stout, Jeffrey Rogers, Nicholas Marsh-Armstrong, Sara M Thomasy Apr 2026

Rhesus Macaques With An Opa1 Mutation Demonstrate Features Of Autosomal Dominant Optic Atrophy, Tracy N Jaggers, Ana Ripolles-Garcia, Ala Moshiri, Brett D Story, Jun Wang, Rui Chen, Lucy G Moore, Leandro B C Teixeira, Jaeho Shim, Ana C Raposo, Maria Isabel Casanova, Sophie M Le, Sangwan Park, Laura J Young, Soohyun Kim, Karolina P Roszak, Vanessa Ureno, Paige M Karpinen, Nayeli Echeverria, Monica Ardon, Brian C Leonard, Marguerite Knipe, Eliza Bliss-Moreau, Brad Fortune, J Timothy Stout, Jeffrey Rogers, Nicholas Marsh-Armstrong, Sara M Thomasy

Faculty, Staff and Students Publications

Autosomal dominant optic atrophy (ADOA) is an inherited optic neuropathy primarily caused by mutations in OPA1. We identified and defined a spontaneous nonhuman primate (NHP) model of ADOA using rhesus macaques heterozygous for a missense mutation (OPA1A8S). With ocular examinations, ophthalmic imaging, electroretinography, histopathology, immunohistochemistry, and transmission electron microscopy (TEM), we documented retinal nerve fiber layer (RNFL) thinning, retinal ganglion cell (RGC) loss and dysfunction, OPA1 mislocalization, and reduced axonal mitochondrial density in affected macaques. Our investigation revealed substantial phenotypic variability among affected macaques, shedding light on the pathogenesis of ADOA. The retinas were evaluated using techniques …


Prodromal Lewy Body Disorder Features In Rem Sleep Behavior Disorder With Biomarker-Defined Synucleinopathy, Daniel Weintraub, Michele K York, Roseanne Dobkin, Anuprita R Nair, Ryan Kurth, David-Erick Lafontant, Chelsea Caspell-Garcia, Roy N Alcalay, Ethan G Brown, Lana M Chahine, Christopher Coffey, Tatiana Foroud, Douglas Galasko, Karl Kieburtz, Kenneth Marek, Kalpana Merchant, Brit Mollenhauer, Kathleen L Poston, Andrew Siderowf, Cristina Simonet, Tanya Simuni, Caroline M Tanner, Thomas F Tropea, Aleksandar Videnovic, Parkinson's Progression Markers Initiative Apr 2026

Prodromal Lewy Body Disorder Features In Rem Sleep Behavior Disorder With Biomarker-Defined Synucleinopathy, Daniel Weintraub, Michele K York, Roseanne Dobkin, Anuprita R Nair, Ryan Kurth, David-Erick Lafontant, Chelsea Caspell-Garcia, Roy N Alcalay, Ethan G Brown, Lana M Chahine, Christopher Coffey, Tatiana Foroud, Douglas Galasko, Karl Kieburtz, Kenneth Marek, Kalpana Merchant, Brit Mollenhauer, Kathleen L Poston, Andrew Siderowf, Cristina Simonet, Tanya Simuni, Caroline M Tanner, Thomas F Tropea, Aleksandar Videnovic, Parkinson's Progression Markers Initiative

Faculty, Staff and Students Publications

Objective: Isolated rapid eye movement sleep behavior disorder (iRBD) is a prodromal state for Lewy body disorders and exhibits biological heterogeneity that may influence clinical expression and progression. We examined clinical features in individuals with iRBD and biomarker-defined synucleinopathy.

Methods: Parkinson's Progression Markers Initiative (PPMI) is a longitudinal, multi-center observational study. Participants included polysomnogram (PSG)-confirmed iRBD individuals who were cerebrospinal fluid (CSF) α-synuclein seed amplification assay positive with no clinical diagnosis of Parkinson's disease or dementia with Lewy bodies, along with robust healthy controls (HCs). Clinical and biological features of prodromal PD and DLB, including mild cognitive impairment (MCI), subthreshold …


Designing Next-Generation Cardiometabolic Outcome Trials For Obesity Medicines, Elke Platz, Alexander Peikert, Biykem Bozkurt, Bart Van Der Schueren, Javed Butler, Ildiko Lingvay, Darren K Mcguire, Faiez Zannad, Naveed Sattar Apr 2026

Designing Next-Generation Cardiometabolic Outcome Trials For Obesity Medicines, Elke Platz, Alexander Peikert, Biykem Bozkurt, Bart Van Der Schueren, Javed Butler, Ildiko Lingvay, Darren K Mcguire, Faiez Zannad, Naveed Sattar

Faculty, Staff and Students Publications

The prevalence of obesity has reached pandemic proportions and is having enormous public health effects. Obesity increases the risk of type 2 diabetes, hypertension, chronic kidney disease, and cardiovascular (CV) disease including coronary artery disease, heart failure, atrial fibrillation, and stroke. Although initial randomized clinical trials of weight-loss strategies through diet and exercise or early medical therapies did not lead to improved CV outcomes, more recent trials using glucagon-like peptide-1 (GLP-1) receptor agonists in individuals with obesity have demonstrated CV benefits. At present, there are multiple cardiovascular outcome trials (CVOTs) of novel GLP-1 receptor agonists and investigational products targeting multiple …


Revised Draft Final Butte Priority Soils Operable Unit (Bpsou) Unreclaimed (Ur) Sites New And Mahoney (Ur-23) Construction Completion Report (Ccr), Pioneer Technical Services, Inc. Apr 2026

Revised Draft Final Butte Priority Soils Operable Unit (Bpsou) Unreclaimed (Ur) Sites New And Mahoney (Ur-23) Construction Completion Report (Ccr), Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.


Improving Advanced Practice Provider Knowledge Of Urinary Tract Infection In Geriatric Populations, Ashley Denise Lang Apr 2026

Improving Advanced Practice Provider Knowledge Of Urinary Tract Infection In Geriatric Populations, Ashley Denise Lang

Walden Dissertations and Doctoral Studies

Urinary tract infections (UTIs)in the geriatric population present unique diagnostic and management challenges. Improper classification and treatment plans contribute to increased morbidity, hospitalization, and mortality. This Doctor of Nursing staff education aimed to address a gap in Advanced Practice Provider knowledge regarding the differentiation of complicated versus uncomplicated UTIs in the geriatric population. Guided by the John Hopkins evidence-based practice model, a targeted educational intervention was developed and implemented. Evidence synthesis included 20 high-quality articles representing level 1-5 evidence. A pretest, educational PowerPoint presentation, and posttest were used to assess APP baseline knowledge and understanding of the education post-presentation. There …


The Relationship Between Leadership Communication Strategies And Employee Productivity, Motivation, And Engagement, Christopher Tucker Apr 2026

The Relationship Between Leadership Communication Strategies And Employee Productivity, Motivation, And Engagement, Christopher Tucker

Walden Dissertations and Doctoral Studies

Business leaders are concerned that change leaders’ communication strategy impacts organizational productivity and performance. These challenges can be attributed to business leaders and human resources managers not understanding the relationship between employee motivation, engagement, productivity, and leaders’ communication strategy. Grounded in the composite conceptual framework of Kotter’s eight-step model for change and the Burke-Litwin causal model of organizational performance, the purpose of this quantitative correlational project was to examine the relationship between employee’s motivation, engagement, productivity, and leaders’ communication strategy. The participants were 77 human resources professionals in the United States with at least 5 years of experience in their …


Leadership Practice And Organizational Culture In Reducing Burnout Among Sud Supervisors, Christine Arismendi Apr 2026

Leadership Practice And Organizational Culture In Reducing Burnout Among Sud Supervisors, Christine Arismendi

Walden Dissertations and Doctoral Studies

Burnout in supervisors/managers working in residential substance use disorder (SUD) treatment settings poses serious threats to the agency, staffing, and client care. Behavioral health leaders need to understand how organizational culture and leadership practices shape burnout and resilience in their teams. This qualitative case study drew on the Leadership and Workforce categories of the Baldrige Excellence Framework to examine the influence of leadership and organizational culture on staff emotional well-being and resilience at a Boston-area nonprofit residential SUD treatment center. The study sought to answer: (a) how organizational culture and leadership affect supervisor and manager well-being and resilience; and (b) …


Perceived Bias And Barriers Among Black Women In Professional Leadership, Rochelle Wilhelmina Gilbert Apr 2026

Perceived Bias And Barriers Among Black Women In Professional Leadership, Rochelle Wilhelmina Gilbert

Walden Dissertations and Doctoral Studies

Black women have long contributed to leadership in academia, government, and the nonprofit sector, yet they remain significantly underrepresented in senior leadership roles in higher education. When Black women are missing from leadership, institutions lose out on talent, students lose out on representation, and society loses out on the full range of perspectives needed to solve complex problems. Grounded in Black Feminist Thought, this general qualitative study explored the experiences and perceptions of bias and barriers among Black women serving in leadership roles at the dean level and above in higher education. Data were collected through structured interviews with seven …


Church, Mosque, And State: The Impacts Of Sectarian Politics On Lebanon’S Democracy, Tonia Attie Apr 2026

Church, Mosque, And State: The Impacts Of Sectarian Politics On Lebanon’S Democracy, Tonia Attie

Departmental Honors & Graduate Capstone Projects

As Lebanon seeks to reform multiple sectors of the country, it is crucial to understand how its consociational government, centered on religious identities, interacts with its citizens. Electoral accountability is the process by which an electorate holds politicians liable for their actions while in office. While previous studies, such as Vincent Hutchings’ “Public Opinion and Democratic Accountability,” have shown how electoral accountability functions within traditional party systems based on political ideology, there is little research on how accountability mechanisms operate in confessional party systems based on religion. This paper posits that within countries with confessional systems, voters are less able …


What's The Scoop On Life In New Hampshire? Youth Perspectives On New Hampshire As A Place To Live, Learn, And Work After High School, Elliot Ng, Jayson Seaman, Cindy L. Hartman, Andrew D. Coppens, Kate Moscouver, Hannah Falcone Apr 2026

What's The Scoop On Life In New Hampshire? Youth Perspectives On New Hampshire As A Place To Live, Learn, And Work After High School, Elliot Ng, Jayson Seaman, Cindy L. Hartman, Andrew D. Coppens, Kate Moscouver, Hannah Falcone

Carsey Publications

To support its long-term economic vitality, New Hampshire must cultivate and retain its young talent. This brief analyzes the perspectives of New Hampshire youth and proposes actionable strategies that encourage them to build their futures in the state. While a majority of New Hampshire youth leave the state after high school, retention opportunities lie in leveraging what youth already love about the Granite State: Its natural environment, abundant outdoor amenities, and safe communities. By leveraging these assets and complementary policies such as expanding career-connected learning, promoting the abundance of in-state opportunities, and developing centralized social spaces, New Hampshire can create …


Defenders Assemble: A Blueprint For Building Antiracist Public Defender Offices, Ieshaah Murphy Apr 2026

Defenders Assemble: A Blueprint For Building Antiracist Public Defender Offices, Ieshaah Murphy

Seton Hall Law Review

No abstract provided.


Bail, Detention, And The Nature Of The Offense, Anna Vancleave Apr 2026

Bail, Detention, And The Nature Of The Offense, Anna Vancleave

Seton Hall Law Review

No abstract provided.


Board Of Officers - Vol. 56, No. 4 2026 Apr 2026

Board Of Officers - Vol. 56, No. 4 2026

Seton Hall Law Review

No abstract provided.


The Roots Of Reasoning: An Analysis Of Irac’S Reductive Framework And The Restoration Of The Rhetorical Foundation, Leslie Patrice Culver Apr 2026

The Roots Of Reasoning: An Analysis Of Irac’S Reductive Framework And The Restoration Of The Rhetorical Foundation, Leslie Patrice Culver

Seton Hall Law Review

No abstract provided.


Look To The Children: How New Jersey's Anti-Bullying Bill Of Rights Can Provide A Framework For Workplace Bullying, Bridget Knodel Apr 2026

Look To The Children: How New Jersey's Anti-Bullying Bill Of Rights Can Provide A Framework For Workplace Bullying, Bridget Knodel

Seton Hall Law Review

No abstract provided.


Using Chatgpt Ai To Analyze Clinical Judgment In Immersive Virtual Reality Simulation From Prelicensure Nursing Students, Shari Ann Fehrenbach Apr 2026

Using Chatgpt Ai To Analyze Clinical Judgment In Immersive Virtual Reality Simulation From Prelicensure Nursing Students, Shari Ann Fehrenbach

Dissertations (1934 -)

This retrospective, descriptive study examined how clinical judgment was demonstrated across two immersive virtual reality simulation (IVRS) experiences in a cohort of Direct Entry Master of Science in Nursing (DEMSN) students using a generative large language model artificial intelligence, ChatGPT, for categorization of clinical judgment cognitive processes. The National Council of State Boards of Nursing (NCSBN) Clinical Judgment Measurement Model (CJMM) guided the study (NCSBN, 2022). Nurse expert-derived CJMM-aligned scoring rubrics were applied to deidentified, developer-generated IVRS performance reports, and ChatGPT categorized whether rubric actions were demonstrated and generated case-level, scored excel files. Total CJMM and cognitive component scores were …


Losing The Loop: Iteratively Autonomous Artificial Intelligence And The Question Of Human Operational Involvement, Elise Annett, James Giordano Apr 2026

Losing The Loop: Iteratively Autonomous Artificial Intelligence And The Question Of Human Operational Involvement, Elise Annett, James Giordano

Strategic Insights

As AI systems evolve from analytic tools to iteratively autonomous systems, they assume greater roles in filtering information, structuring decision pathways, and shaping operational outcomes. This transition alters human involvement, moving operators from direct decision-makers to supervisors, while distributing authority across designers, commanders, and operators. Growing reliance on AI introduces cognitive and behavioral shifts, including reduced critical scrutiny and increased dependence on machine-generated outputs. These dynamics can create self-reinforcing decision loops in which AI-generated data and assessments are recursively validated without sufficient grounding in real-world conditions. Such conditions risk obscuring attribution, degrading command and control, and increasing the likelihood of …