Higher Education and Teaching Commons^™

Increasing The Rate Of Infants Rooming In With Their Mothers With Low-Acuity Congenital Heart Disease, Anna Nelson, Amy Marks, Ekta Patel

Research Days

This quality improvement study aimed to increase the number of infants with low-acuity congenital heart disease that could room-in with their mothers in a high-risk delivery center.

Automate Isolation Infection-Prevention Precautions (Aid-Ip): Improving The Efficiency Of Hospital Isolation With Viral Respiratory Infections, Timothy Burchard, Michael Platt, La'sonya Buford

Research Days

The AID-IP project is a QI study working to improve the process of isolation and de-isolation regarding respiratory viruses at Children's Mercy Hospital. Specifically, we aim to improve adherence to proper isolation precautions, minimize cognitive workload regarding the maintenance of isolation for staff, and improve family satisfaction with isolation practice.

Nrp, Pals, And Their Utilization During Code Events In A Pediatric Quaternary Hospital: A 'Compressed' Analysis, Mitch Kinkor, Deepa Kumar, Allison Taber, Stephen Pfeiffer, Jessica Brunkhorst, Danielle Reed

Research Days

Both the Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation Program (NRP) algorithms are utilized for resuscitation during pediatric codes. The optimal time period to transition from NRP to PALS is not well studied. This study describes the utilization of chest compressions, prescribed medications, and patient outcomes during and after code events organized by the algorithm used to direct resuscitation (PALS or NRP) in a similarly aged patient population.

Improving Awareness And Utilization Of Safety Net Resources After Extremity Firearm Injury, Colleen M. Moreland, Caleb W. Grote, Richard M. Schwend, Julia G. Harris

Research Days

The orthopaedic surgery department can improve follow-on care for pediatric survivors of extremity firearm injuries by creating and implementing a checklist of defined safety net resources.

A Quality Improvement Project To Improve Antibiotic Choice For Children Admitted With Urinary Tract Infections (Utis), Philip Jurasinski Do, Pgy-3, Adrienne Deporre Md, Kathleen Berg Md, Allison Hadley Md, Viktoriya Stoycheva Mha, Rn, Cpn, Rana El Feghaly Md

Research Days

This is an antibiotic stewardship quality improvement project focused on improving antibiotic choices for children with urinary tract infections who are in the Children's Mercy Kansas City system. This project aims to improve the rates of cefazolin or cephalexin for treatment from 27% to 60%. 96% of urinary tract infections in our system are caused by E. Coli that are susceptible to these first generation cephalosporins.

More Of Less: Optimizing Opioid Prescriptions For Acute Fractures In The Emergency Department At A Children’S Hospital, Colton Schwarz, Spencer Wittmeyer, Mitch Kinkor, Michelle Dephillips, Elizabeth Edmundson, Ryan Mcdonough, Warren Teachout, Nicholas Clark

Research Days

Quality improvement project that aims to improve opioid stewardship in acute fracture management.

Characterization Of Nationally Reported Pediatric Deaths Involving Fentanyl Ingestions In Missouri, Margaret Campbell, Mary Moffatt, Emily Killough, Terra Frazier

Research Days

There has been a dramatic rise in pediatric deaths associated with synthetic opioid use, with the most prominent being Fentanyl. This is a retrospective cohort study using data from the National Center for Fatality Review and Prevention with the goal of identifying risk factors that increase the vulnerability of children to Fentanyl ingestion. Ultimately this research may help lead to improved identification of at risk children with the goal of implementation of targeted prevention programming.

How Neonates Die: Mortality Trends And Associations In A Level Iv Neonatal Intensive Care Unit, Erin Bolen, Ashley K. Sherman, Julie Weiner, Jotishna Sharma

Research Days

Background

Modes of neonatal mortality include withdrawal of life-sustaining interventions, non-escalation of interventions, and secondary to a code event. Mortality trends have been examined broadly, but the impact of clinical and demographic factors on the mode of neonatal mortality has yet to be evaluated. A greater understanding of this information would help guide medical decision-making and identify potential inequities. The aim is to evaluate the impact of clinical and demographic factors on the mode of neonatal death in a level IV neonatal intensive care unit (NICU).

Study Design/Methods

Data were collected via retrospective chart review of patients who died at …

Understanding Inpatient Diagnostic Imaging Use In Children’S Hospitals To Prioritize Stewardship Efforts, Megan E. Collins, Matt Hall, John Stephens, Jessica L. Markham

Research Days

We utilized the Pediatric Health Information System to perform a retrospective cohort study of hospitalized children across 45 hospitals to describe diagnostic imaging studies among hospitalized children with the highest prevalence, cost, rates of repetition, and hospital variation to help inform de-implementation efforts.

Defining Faculty’S Role In Supporting Student Mental Health Needs In Higher Education, Erica B. Riba

Student Theses

The subject of mental health among college students has been prevalent for decades. Today, college students are facing more challenges to mental wellness than ever before. Faculty are often the first and only point of contact for many students. Faculty have a role to play in supporting student mental health, but that role has not been clearly defined. This study aims to bring clarity to some of these critical issues and offers a lens into this broad topic from faculty themselves. A mixed-methods design was used for this study. 889 people who have downloaded The Jed Foundation’s Faculty Guide to …

Vmed 531: Introduction To Animal Welfare A Faculty-Led Inquiry Into Reflective Scholarly Teaching Benchmark Portfolio, Amy Walton

UNL Faculty Course Portfolios

This benchmark portfolio documents course design, student learning, and reflection of teaching methods for VMED 531 Introduction to Animal Welfare. This one credit hour course provides an overview of animal welfare topics and assessment through a veterinary medical lens. Participants are first year veterinary students that have been accepted into Professional Program of Veterinary Medicine (PPVM). This course creates a foundational knowledge base regarding animal welfare topics and fosters critical thinking with how veterinary treatments, surgeries, and animal-use practices influence animal welfare. The ability to utilize critical thinking skills and science-based evidence to create a sound solution is essential regarding …

Coping Strategies And Stress Of The Undergraduate Nursing Student In The Clinical Setting: An Evidence Based Practice Quantitative Study, Ashley Calverley

Electronic Theses and Dissertations

The assessment of perceived stress and coping behaviors related to first-semester clinical might benefit students in nursing education. The assessment of most common coping behaviors and perceived stress related to the clinical setting is essential due to difference in personalities, learning abilities, and coping behaviors among nursing students today. Previous research has suggested the initial clinical period results in adverse outcomes, such as poor academic performance, elevated burnout levels, and diminished personal well-being. These factors are detrimental to academic success in nursing programs. Evidence supports that helping students develop positive stress/coping abilities will aid in adapting in both the academic …

Course Portfolio For Biochemistry 1: Structure And Metabolism (Bioc431), Didier Mena

UNL Faculty Course Portfolios

This benchmark portfolio encapsulates a comprehensive exploration aimed at enhancing the educational landscape of the BIOC431 course, a part of the general biochemistry course series (431 and 432). These courses are designed to offer a general introduction to the structure and function of cells in the body, along with their chemical reactions. Specifically, BIOC431 focuses on the structure, function, and metabolism of proteins, lipids, carbohydrates, and other major metabolic pathways. The three primary objectives addressed in this portfolio were the reevaluation of learning objectives, reassessment of assessment methods, and documentation of effective classroom strategies. Through background design, the learning objectives …

A Survey Of Occupational Therapy Program Leaders: Perceptions Of The Essential Elements For Early Career Faculty, Kathleen Cummer, Angela Maccabe, Kurt Hubbard, Tracy Jirikowic

Journal of Occupational Therapy Education

The rapid growth of academic occupational therapy programs in the United States, combined with an increase in senior faculty retirement, requires a new, growing, robust and well-prepared faculty workforce. In addition to the growth of programs, faculty shortages necessitate proactive strategies for preparing transitioning clinicians for successful academic careers. Faculty development training should be a part of preparation to ensure success of early career faculty. However, it is unknown what the perceptions of occupational therapy leaders are towards faculty development training, what components should be included in training, and the importance of these components. Through this survey research, key findings …

Digital Storytelling As An Innovative Approach To Prehospital Education: The Experiences Of Teaching Academics., Andrew Van Noordenburg, Georgina Seaman

Health Professions Education

Purpose. To explore teaching academics' experiences of utilising digital storytelling as an innovative approach to prehospital education.

Method. This study describes an innovative learning activity, digital storytelling, developed for an undergraduate paramedicine program. The experiences of teaching academics were then explored through semi-structured interviews. Thematic analysis was used to evaluate the data.

Results. Three themes were identified through thematic analysis. The first theme was ‘the impact of friction on learning’ which describes how a learning activity’s design can negatively impact learning. The second theme ‘connecting with the teaching resources’ outlines how having access to sufficient resources is necessary to facilitate …

Incorporating Sex-Diverse And Gender-Inclusive Perspectives In Higher Education Biology Courses, Breanne N. Harris, A Kelsey Lewis, Sam L. Sharpe, Teri J. Orr, Christopher T. Martine, Chloe C. Josefson

Faculty Journal Articles

Inclusive teaching is teaching in a way that reaches all students in the classroom; this is beneficial for everyone, particularly for those with minoritized identities. Instructors play a critical role in scaffolding how students are exposed to and learn science content in the classroom. In this manuscript, we discuss how biology instructors can make their classrooms more inclusive with regard to sex and gender diversity content. Many topics in biology are based on androcentric, heteronormative, and oppressive framing, even though those lenses are more reflective of our own history and culture than they are of the diversity we see in …

Visualize Whole-Self Model - An Instructional Design For Occupational Therapy Education, Mark White, Mary Smith, Adebimpe Obembe, Kristin Haas

Journal of Occupational Therapy Education

Innovative teaching approaches are changing traditional approaches by using a variety of teaching and learning methods to allow learners to succeed. This paper describes a new instructional model for healthcare education based on the science of learning, educational theories, and best practices in lesson design. The Visualize Whole-Self (VW) Model was designed to provide a learning structure for faculty as they guide the instruction of students in health professions. From the beginning of the program, students visualize themselves as professionals while working with faculty to learn content. The Visualize Whole-Self Model requires students to continually assess their strengths and weaknesses …

Steps On Establishing A Faculty Development Curriculum For Health Science Educators In A New Medical School, Beatriz Tapia, Karina Madrigal, Robert Nelson

Research Colloquium

Purpose: New Medical Schools need health science educators, to teach throughout the medical education continuum from basic science to clinical years. The need to establish a defined faculty development curriculum for health science educators will aid in standardizing best teaching practices and build a potential master teacher to move the curriculum toward active learning and innovation. The UTRGV SoM is a distributed campus, to achieve increase outreach we will offer synchronous and asynchronous online faculty development during the pandemic. This poster will share our progress to date.

Methods: A pilot, faculty development program, was established from faculty needs assessment data, …

On-Campus Mental Health Service Use Among College Students With Autism: A Case Study Applying The Andersen Behavioral Model Of Health Services Use, Estella C. Lilyquist

Electronic Theses and Dissertations

The unique set of impairments and limitations presented by students with autism spectrum disorder (ASD) make the accessing of campus-based nonacademic resources more difficult and complicated than their typically developed peers. Each year, the rate of students entering college with disabilities continues to grow, but their mental well-being is relatively poor. The purpose of this qualitative case study was to apply the conceptual framework of the Andersen behavioral model of health services use (ABMHSU) to the experiences of college students with ASD to understand and predict their utilization of campus-provided mental health resources. The participants were seven college students with …

Student Preferences For Active Learning And Their Beliefs, Experiences, And Knowledge, Tammy Shilling, Jerome Thayer, Anneris Coria-Navia, Heather Ferguson

Teaching and Learning in Communication Sciences & Disorders

Active teaching methods are believed to facilitate higher-order thinking skills and prepare allied health students for independent clinical decision-making. This quantitative, correlational study aimed to explain the relationships between student preferences for active over traditional methods and their beliefs, the frequency and positiveness of their experiences, and the extent of knowledge they have received regarding active and traditional teaching methods. Two hundred and thirty students completed a 53-item online survey. Students were enrolled in a Doctor of Physical Therapy, Masters in Speech-language Pathology, or Bachelor of Science Nursing program in one of seventeen participating institutions across a ten-state Midwest region. …

Vmed 589: Anesthesiology & Small Animal Surgery: Faculty-Led Inquiry Into Reflective Scholarly Teaching (First) Project, Beth Galles

UNL Faculty Course Portfolios

A Doctor of Veterinary Medicine degree requires a strong background in basic and clinical sciences. Clinical sciences are typically presented as laboratory-heavy courses, ideally with experiential learning components. Veterinary surgery and anesthesia are a high-stakes disciplines that requires a foundation of didactic instruction followed by repeated hands-on practice. VMED 589 Anesthesiology and Small Animal Surgery is the first course in anesthesia that students encounter in their four-year curriculum and the second course in surgery. It is designed to deliver the basic principles of anesthesia, followed by repetitive practice to ensure the safety of the veterinary patient. Anesthetic risk assessment, induction, …

First Course Portfolio For Bioc205: Scientific Analysis And Technical Writing, Lindsey B. Crawford

UNL Faculty Course Portfolios

BIOC205: Scientific Analysis and Technical Writing is a core course for the Department of Biochemistry at the University of Nebraska-Lincoln. This course is geared for second year (sophomore students) with minimal prerequisites and as a foundation for future classes. Challenges include 1) teaching the needed scientific background and elements of scientific analysis and writing to a broad cohort of students with diverse backgrounds and interests, 2) building student skills towards analysis of primary peer-reviewed scientific literature, 3) developing students as writers of scientific information for different audiences. This course used Genetic Engineering as a broad topic choice to capture students …

Magnetic Resonance Image-Based Estimates Of Hepatic Blood Flow In Children With And Without Obesity; Implications For Physiologically-Based Pharmacokinetic Models, Yoon Cho, Sherwin S. Chan, Chance S. Friesen, Valentina Shakhnovich

Research Days

Background: Physiologically based pharmacokinetic models for simulating drug pharmacokinetics are useful to guide drug dosing for pediatric patients. Hepatic blood flow could be a useful variable to use in these models.

Objectives/Goal: In this study, we explored 2-D phase contrast non-invasive magnetic resonance imaging (MRI) to measure hepatic blood flow in children with and without obesity.

Methods/Design: In this IRB-approved study, we imaged pediatric patients with abdominal MRI with 2D phase contrast imaging of the descending aorta (AO) at the diaphragm, the inferior vena cava (IVC) at the right atrium, and inferior to hepatic drainage above the renal vein confluence …

Persistent Pediatric Breast Abscesses Following Initial Treatment At Tertiary And Community Centers, Derek Marlor, Kayla Briggs-Groves, Shai Stewart Md, Nelimar Cruz-Centeno, Charlene Dekonenko, Jason D. Fraser

Research Days

Introduction: Little data exist on the management of pediatric breast abscesses that fail initial treatment. Therefore, this study aimed to evaluate and report outcomes in these patients.

Methods: All patients <18-years-old treated for a breast abscess between January 2008 and December 2018 were included. Patients were divided into 2 groups: initial treatment at our institution (Group 1) and initial treatment at referring centers (Group 2). The primary outcome was disease persistence following treatment at our institution. Secondary outcomes included treatment modalities and patient characteristics.

Results: In total, 145 patients were identified: 111 in Group 1 and 34 in Group 2. Antibiotics alone were the initial treatment in 52.3% (n=58) of Group 1 patients and 64.7% (n=22) of Group 2 patients. Invasive treatment was more common in Group 1 (45.9% vs 5.8%; p<0.00001). Patients with persistent disease in Group 1 were treated with aspiration (n=7, 50%), I&D (n=5, 35.7%), antibiotics (n=1, 7.14%), and manual expression (n=1, 7.14%.), while Group 2 patients were treated with antibiotics (50%, n=17), aspiration (26.47%, n=9), I&D (17.65%, n=6), and manual expression (5.88%, n=2). Group 2 patients with persistent disease were more likely to be treated with antibiotics or a change in antibiotics (50% vs 7.14%; p=0.005). Following treatment at our institution, the rate of persistent disease was similar between groups (12.6% vs 11.8%).

Conclusions: Persistent breast abscesses may be treated with antibiotics in appropriate cases. Damage to the developing breast bud should be minimized. Disease …

Stewardship Opportunities For Cervical Lymphadenitis And Deep Neck Space Abscesses, Aaron Shaw, Brian R. Lee, Lauren Kazmaier, Emily Baker, Tina Dao, Sandra Arnold, Angela Myers

Research Days

Background: Cervical lymphadenitis (LAD) and deep neck space abscesses (DNSA) are common pediatric infections caused by similar bacteria. We sought to determine differences in presentation, diagnosis, and treatment between LAD and DNSA to identify antimicrobial and diagnostic stewardship opportunities.

Methods: Charts were obtained using ICD9/10 codes for retropharyngeal and parapharyngeal abscessed (DNSA), and LAD between 1/1/10-12/31/20 from two pediatric centers. 1981 charts were identified. Charts were excluded if the diagnosis was not a bacterial infection (e.g. Kawasaki disease), if the LAD was not in the neck, or if caused by less common bacteria (e.g. tuberculosis). Data on presenting signs, symptoms, …

Respiratory Pathogen Panel Use In Hospitalized Infants <2 Months Of Age And Impact On Patient Management., Edward Lyon

Research Days

Background: Respiratory pathogen panels (RPP) are multiplex PCR platforms able to simultaneously detect several respiratory viruses. RPP utilization is not well described in infants < 2 months of age, who frequently require hospitalization for management of acute respiratory illness (ARI) and/or fever. Detection of a viral pathogen in this age group could impact the clinician’s decision to perform additional evaluation and administer antimicrobials.

Objectives/Goal: We sought to understand predictive features and clinical management impact of RPP use in infants < 2 months of age.

Methods/Design: Between October 2017 to September 2021, participants, aged < 18 years, hospitalized with an acute respiratory infection (ARI) were enrolled in Kansas City’s New Vaccine Surveillance Network (NVSN). Eligible patients were residents of Jackson County, had symptoms consistent with ARI (e.g., cough, fever, nasal congestion) lasting < 14 days, and enrolled within 48 hours of admission. For this study, only participants < 2 months of age were included. All participants had a research RPP, but results were not available to the clinician. Per provider discretion, some infants also received a clinical RPP (cRPP). Demographic characteristics, laboratory evaluations, and antimicrobial management were compared between infants with and without a cRPP.

Results: Of the 139 participants < 2 months of age, 57 (41%) had a cRPP (table 1). A cRPP was more frequently obtained in infants < 1 month of age (n=34 [47%]) compared with infants 1-2 months of age (n=23 [35%]; p=0.17). 35 (61%) participants with a cRPP had a parental report of fever while 41 (50%) of those without a cRPP had one reported. Only 20 (35.1%) of White, non-hispanic participants had a cRPP compared to 42 (51.2%) p=0.082 who did not have a cRPP. Participants who had blood or CSF culture collected were more likely to have a cRPP obtained, 47 (82.5%) p=

Conclusions: Overall, < 50% of infants < 2 months of age hospitalized with ARI received cRPP testing. Obtaining a blood or CSF culture was associated with increased cRPP usage. The length of stay was not different between the two groups. 35 viral infections went undetected in participants without a cRPP even with accounting for positive rapid NAAT testing, further investigation is needed to understand how this may influence clinical care.

Association Between Remote Monitoring And Interstage Morbidity And Mortality In Single Ventricle Patients Across Socioeconomic Groups, Bianca Cherestal

Research Days

Background: Despite improvements in outcomes over time, morbidity and mortality for infants with single ventricle (SV) heart disease remains high. Among other risk factors for mortality, infants of low socioeconomic status (SES) are known to be particularly vulnerable following stage 1 palliation.

Objectives/Goal: We sought to determine whether use of a novel remote monitoring program, CHAMP (Cardiac High Acuity Monitoring Program), mitigates differences in outcomes by SES for infants with SV during the interstage period.

Methods/Design: Using the CHAMP database, we identified 610 infants across 11 institutions enrolled in the program between 2014–2021. All enrolled patients’ families were provided with …

Pilot Study Using Sideline Hand-Grip Dynamometry To Assess Strength Changes In A High School Baseball Season: A Feasibility Study, Thomas Munro, Jason D. Yoderq, Brian R. Lee, Brian S. Harvey

Research Days

Background: Upper extremity injuries are common in baseball players. Objective measurements could assist in determining early signs of fatigue before injury occurs. Using HGD to measure strength changes may help identify early signs in the injury process. To our knowledge, HGD has not been tested on high school baseball players in the sideline setting. It is feasible to perform hand-grip dynamometry on-site at the high school level and HGD measurements will change throughout the season in varsity baseball athletes. Secondary aim: Asses HGD measurement in the context of injury/pain/fatigue/pitching.

Objectives/Goal: It is feasible to perform hand-grip dynamometry on-site at the …

Therapeutic Plasma Exchange To Alleviate Ventricular Tachycardia After Diphenhydramine Ingestion, Kaushal Dosani, Lejla Music Aplenc, Stephen Pfeiffer

Research Days

Background: The Covid-19 pandemic has adversely affected the mental health of children causing an increased incidence of suicide attempts. Diphenhydramine is a common household medication and is frequently ingested by children. Toxic doses of diphenhydramine can affect the cardiovascular and central nervous system. In the heart, diphenhydramine blocks fast sodium channels and potassium channels which can result in conduction abnormalities including sinus tachycardia, widening of QRS duration, ventricular tachycardia and torsades de pointes. Massive ingestion can cause severe cardiovascular collapse which may require ECMO support

Objectives/Goal: To describe a novel method of clearing highly protein-bound diphenhydramine molecules from circulation after …

Genes Predictive Of Aggressive Infant Acute Lymphoblastic Leukemia, Meghana Bhumireddy

Research Days

Background: Acute Lymphoblastic Leukemia (ALL) is a rapidly progressive cancer in which the bone marrow makes too many immature leukocytes that divide uncontrollably. KMT2A, or MLL, is a methyltransferase found in many types of leukemia, whose rearrangement (KMT2A-r) is present in approximately 2/3 of infants with ALL. KMT2A-r is associated with a very poor prognosis: roughly ⅔ of patients relapse within 1 year of diagnosis, and the relapsed KMT2A-r ALL is resistant to treatment (having nearly 100% morality). We explored gene expression in patient samples from three groups at diagnosis: KMT2A-r patients who relapsed, KMT2A-r patients who did not relapse, …