Medicine and Health Sciences Commons^™

Effectiveness Of Point-Of-Care Ultrasound Education For Advanced Practice Providers, Nicole Brumfield

DNP Projects

Abstract

Background: Provider shortages and demands for inpatient providers have led to an increase in the utilization of Advanced Practice Providers (APPs). The increased use and specialization of APPs has brought attention to education and skills that have been instituted for other provider types but remains missing from the APP curricula. One such example is point-of-care ultrasound (POCUS) education. This technology and skill set have been shown to enhance clinical skills, confidence levels, and provide useful information for the provider to enhance clinical decision making for the patient.

Purpose: The purpose of this project was to evaluate the effectiveness of …

Other People’S Families: How Social Ties Shape Entrance Into The Medical Profession, Lillian Sims

Theses and Dissertations--Educational Policy Studies and Evaluation

Not enough members of low-income, rural, and minoritized populations are successfully prepared for and recruited into medical school, exacerbating issues of unequal access to healthcare and limiting access to the profession. While a multitude of factors contribute to this problem, early social exposure to others in a field can act as a key contributor to career interest and a key advantage for entering the profession. Meanwhile, students without early social exposure to healthcare may take unconventional paths to medical school or may struggle to fit into the unique culture of medicine when they do enter training, especially if they belong …

Developing Physical Exam Skills In Residency: Comparing The Perspectives Of Residents And Faculty About Values, Barriers, And Teaching Methods, John W. Ragsdale, Catherine Habashy, Sarita Warrier

Internal Medicine Faculty Publications

Background: The physical examination (PE) skills of residents are often not improved since medical school. Unfortunately, how residents learn PE is not well understood. There is a paucity of research on the factors involved and the differences between resident and faculty perspectives. The authors sought to determine resident and faculty perceptions about the value of PE, the major barriers to learning PE, and the most effective teaching methods.

Methods: Based on a rigorous process of literature review and semi-structured interviews, the authors developed an online survey which was sent to 406 internal medicine residents and 93 faculty at 3 institutions. …

Applicant Selection To A Regional Medical Training Program: A Structural Analysis Of Interviewer Assessments, Terry D. Stratton, Paula K. Arnett, Anthony D. Weaver, J. Bodie Stevens, Carol L. Elam

Behavioral Science Faculty Publications

Introduction: For regional campuses with specific program foci, assessing applicant fit necessarily extends beyond academic and professional factors. Based on assessments of applicants to a regional Rural Physician Leadership Program (RPLP), this study explores the relationship of academic and socio-demographic factors with interviewers’ ratings of: (1) likelihood of eventually practicing in a rural area of the state; and (2) overall acceptability to medical school.

Methods: The study population consisted of 163 first-time RPLP applicants interviewed independently from 2009-2016 by two faculty members at both main and regional medical campuses. Path analysis was used to calculate direct, indirect, and total effects …

Evaluating The Effectiveness Of Undergraduate Clinical Education Programs, John W. Ragsdale, Andrea Berry, Jennifer W. Gibson, Christiane R. Herber-Valdez, Lauren J. Germain, Deborah L. Engle

Medical Student Education Faculty Publications

Medical schools should use a variety of measures to evaluate the effectiveness of their clinical curricula. Both outcome measures and process measures should be included, and these can be organized according to the four-level training evaluation model developed by Donald Kirkpatrick. Managing evaluation data requires the institution to employ deliberate strategies to monitor signals in real-time and aggregate data so that informed decisions can be made. Future steps in program evaluation includes increased emphasis on patient outcomes and multi-source feedback, as well as better integration of existing data sources.

Leading Well: Anesthesiology Program Directors As Servant Leaders And Their Development Of Resident Wellness Programs, Amy Noel Dilorenzo

Theses and Dissertations--Education Sciences

Anesthesiology residents are at significant risk of developing serious issues during training including burnout, depression, and substance abuse. Recent accreditation requirements mandate that these well-being issues be addressed by residency training programs. Program directors, as the leaders of residency programs, are charged with protecting the wellness of residents and leading wellness initiatives. The program director role can be well-described in a servant leadership construct because they are charged with caring for the individual needs of their residents.

This dissertation is a report of a mixed-methods study that explores anesthesiology program directors’ self-perceptions as servant leaders and their efforts to lead …

Implementing A Multicomponent Intervention To Improve Nursing Knowledge Of Delirium And Interprofessional Communication Of Delirium In Intensive Care Patients, Daniel Bryan Williams

DNP Projects

PURPOSE: The purpose of this project is to evaluate the implementation of a standardized delirium education program, delirium assessment protocol, and a standardized CAM-ICU reporting method. The goal of the project is to improve nursing delirium knowledge, CAM-ICU documentation compliance, and interdisciplinary discussion of patient’s delirium status during Multidisciplinary Rounds (MDR). This project has four distinct objectives. 1) Implement a standardized delirium assessment and communication protocol within the Lexington VAHCS ICU. 2) Increase the nursing knowledge and self-confidence of assessing ICU delirium, by 50% using a multifaceted educational approach. 3) Achieve a 90% documentation compliance rate for the CAM-ICU delirium …

Evaluation Of A Concussion Management And Discharge Education Training Module For Emergency Department Nurses, Carmen Frede

DNP Projects

Purpose: The purpose of this project was to improve the Emergency Department (ED) nurses’ knowledge on identifying patients at risk for concussions and delivering effective concussion discharge education using an educational training intervention.

Methods: This project used a descriptive, non-randomized pre-post survey design. Participation involved three stages: a pre-education survey to assess baseline concussion education knowledge, an educational intervention consisting of a narrated PowerPoint presentation, and a post-education survey to evaluate knowledge on concussion discharge education. The intervention was delivered online via the UK Canvas educational platform.

Results: The majority of nursing staff participants were female (97%) and had a …

Engaging Patients To Prevent Harm: Implementation Of Hospital Acquired Pressure Injury Prevention Education Videos, Sarah Buschmann

DNP Projects

PURPOSE: The purpose of this proposal is to evaluate the introduction of pressure ulcer prevention videos to at risk adult patients in the intensive care unit within the acute care health setting.

METHODS: The study design is a retrospective chart review to analyze the effect of the pressure ulcer prevention videos on the number of pressure ulcers and incidence rate while comparing Jackson/Cubbin scores. As pressure ulcers continue to rise, patient education through the Get Well Network is a required intervention. This project is relevant in reducing pressure ulcers and increasing patient safety. Data collection took place from July 1 …

Effectiveness Of A School-Based Asthma Education Program For 8-10-Year-Old Children, Laura Hunt

DNP Projects

Background: Asthma is the most common chronic condition to affect children in the United States Five million children throughout the United States and approximately 112, 000 children in Kentucky are living with the diagnosis of asthma (CDC, 2017; CHFS, 2017). Based on current rates 1 out of 10 elementary school-age students will likely have asthma (CDC, 2019). Educating elementary-age students about asthma and symptoms of an asthma exacerbation is very important and could save a life.

Methods: A school-based asthma education program targeting children in third and fourth grades was implemented at two elementary schools in Central Kentucky. The asthma …

Nurse Driven Enteral Nutrition Protocol For Mechanically Ventilated Patients, Deena Shewekah

DNP Projects

Introduction: Delayed enteral nutrition in critically ill patients increases the risk of complications and poor outcomes. Current evidence-based guidelines recommend initiation of enteral nutrition within 24-48 hours of intensive care unit (ICU) admission. The quality improvement (QI) project aim was to examine whether enteral nutrition was initiated within 24- 48 hours of mechanical ventilation after implementation of QI intervention in order to determine practice change.

Methods: The QI protocol was introduced to the Cardiovascular ICU (CVICU) at UK Chandler Hospital (UKHC) nurses via an education session. A post-education electronic survey identified the nurse’s understanding of the protocol. To identify nursing …

Device Related Concerns Pertaining To Primary Caregivers Of Lvad Patients, Nicole Smith, Carissa Smith

DNP Projects

Abstract

PURPOSE: The purpose of this project was to focus on caregiver education with an emphasis on caregiver concerns regarding the LVAD; additionally, evaluating the efficacy of an educational video acknowledging those device-related concerns identified by caregivers. The goal of this project is to improve caregiver knowledge and decrease the rate of device related concerns among the primary caregivers.

METHODS: This project is a single center cross-sectional, pre-post-test implementation design to determine the efficacy of device related concerns education on primary caregivers’ knowledge and concerns. A 16-point device related concerns scale was designed to appraise primary caregiver concerns. The scale …

Main And Regional Campus Assessments Of Applicants To A Rural Physician Leadership Program: A Generalizability Analysis, Terry D. Stratton, Clarence Kreiter, Carol L. Elam

Behavioral Science Faculty Publications

While the selection of qualified applicants often relies, in part, on scores generated from a medical school pre-admission interview (MSPI), the growth of regional medical campuses (RMCs) – many with specialized rural tracks, programs, or missions – has challenged schools to accommodate a wider range of stakeholder input. This study examines the reliabilities of main (urban) and regional (rural) campus interviewers’ assessments of applicants to a Rural Physician Leadership Program (RPLP) located in the southeastern United States.

Data from RPLP applicants completing MSPIs on two campuses from 2009-2017 (n = 232) were examined in a generalizability analysis. In two separate …

Teach Students, Empower Patients, Act Collaboratively And Meet Health Goals: An Early Interprofessional Clinical Experience In Transformed Care, Maria Gabriela Castro, Melanie Dicks, Keisa Bennett, Carol Hustedde, David Sacks, Lynn Joyce Hunter, William Elder

Family and Community Medicine Faculty Publications

Purpose: Transformation of care teaching is often didactic and conceptual instead of practical and operational. Clinical environments, slow to transform, limit student exposure to key experiences that characterize transformed care. We describe the design and implementation of TEAM Clinic (Teach students, Empower patients, Act collaboratively, Meet health goals) – an early clinical learning experience to address this gap.

Methods: The TEAM Clinic curriculum was based on a review of existing curricula and best practice recommendations for the transformation of care. Three key elements were selected as the focus for a low-volume, high-service clinic: patient centeredness, interprofessional collaboration and team-based care. …

Cancer Screening For Transgender Patients: An Online Case-Based Module, Devin Oller

Internal Medicine Faculty Publications

Introduction: Guidelines recommend that primary care providers complete organ-based routine cancer screening for all transgender patients. Training on critical transgender health topics like cancer screening, as well as residents' confidence in addressing issues their transgender patients may face, remains limited among graduate medical education (GME) programs. Online case-based modules are an effective tool for skills improvement in GME, but their application to transgender health topics has not been assessed.

Methods: I developed a brief online module on cancer screening for transgender patients using Google Forms and offered it to first-year internal medicine residents. The module was optional and asynchronous with …

Gay Men And Satisfaction With Health Care Interactions, Michael Huggins

Theses and Dissertations--Nursing

The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care …

The Effect Of An Educational Video On Device-Related Concerns In A Single-Center Left Ventricular Assist Device Population, Devan Costelle

DNP Projects

PURPOSE:The purpose of this study is to evaluate the prevalence of various concerns among left ventricular assist device (LVAD) patients and evaluate the effect of an educational video intervention on reducing those concerns in a single-center adult LVAD population.

METHODS:A 15-point LVAD Concerns Scale was created to evaluate the prevalence of specific device-related concerns. An educational video was created to address the concerns presented in the LVAD Concerns Scale. Data collection took place from November 2018 to February 2019. A cross-sectional, pre- post-test implementation study design was used to both identify various device-related concerns that exist among LVAD patients and …

Development Of Unit-Specific Educational Interventions For Inpatient Palliative Care Needs, Michael S. Myers

DNP Projects

Purpose: The purpose of this project is to determine the need for palliative care at Norton Women’s and Children’s Hospital as well as assess the knowledge and attitudes of the healthcare workers in that facility concerning palliative and end of life care. Methods: For the purposes of this study, the units of the hospital were divided into four categories: intensive care unit (ICU), progressive care unit (PCU), oncology, and medical surgical. A needs assessment of each type of unit was conducted in two parts. The first part was a retrospective chart review to determine the volume of patients on each …

Evaluation Of Emergency Department Use By Adult Patients With Established Primary Care Provider, Sherry Tolentino

DNP Projects

BACKGROUND: Overutilization of the Emergency Department (ED) contributes to the unnecessary use of healthcare resources. One common cause is related to barriers to Primary Care access. Patients use the ED for conditions that can be managed in primary care due to the perception of urgency and convenience.

PURPOSE: The purpose of this project was to evaluate factors contributing to the use of the ED for adult patients with primary care providers (PCP). METHODS: A retrospective chart review was completed on 280 randomly selected patients over the age of 18 who presented to the ED between January and June 2018. Only …

Inspiring The Next Generation Of Academic Physicians: The Academic Health Careers Program, Jennifer K. Brueckner-Collins, Terry D. Stratton, Rosemarie L. Conigliaro

Medical Student Education Faculty Publications

There is growing evidence in the medical education literature for the aggressive need to recruit and retain the next generation of academic physicians. In 2008, the University of Kentucky College of Medicine (UK COM) developed an academic health careers (AHCs) program for preclinical medical students as an introduction into the practice of academic medicine. The goals of this elective experience included (1) highly customized training and mentorship experiences in research, teaching, and other aspects of academic medicine; (2) information and perspectives to assist students in making informed career choices, including options for academic careers; (3) access to academic career mentors …

A Cross-Sectional Study Of The Use And Effectiveness Of The Individual Development Plan Among Doctoral Students, Nathan L. Vanderford, Teresa M. Evans, L. Todd Weiss, Lindsay Bira, Jazmin Beltran-Gastelum

Toxicology and Cancer Biology Faculty Publications

Background: The Individual Development Plan (IDP) was introduced as a tool to aid in career planning for doctoral trainees. Despite the National Institutes of Health and academic institutions creating policies that mandate the use of IDPs, little information exists regarding the use and effectiveness of the career planning tool.
Methods: We conducted a multi-institutional, online survey to measure IDP use and effectiveness. The survey was distributed to potential respondents via social media and direct email. IDP survey questions were formatted using a five-point Likert scale (strongly agree, agree, neutral, disagree and strongly disagree). For data analysis purposes, responses were grouped …

Analysis Of Student Performance Outcomes Using Virtual Dispensing Exercises, Sophia Brown, Clark D. Kebodeaux, Keith Sewell, Aric Schadler, Keenan Beaumont

Pharmacy Practice and Science Presentations

The objective of this study was to compare performance outcomes between PY1 and PY2 students on an identical exercise required during their final objective structured clinical exam (OSCE).

Procedural Competency Training During Diagnostic Radiology Residency: Time To Go Beyond “See One, Do One, Teach One”!, Driss Raissi, Qiong Han, Michael A. Winkler, Edward J. Escott

Radiology Faculty Publications

Objectives: Achieving procedural competency during diagnostic radiology residency can impact the radiologist's future independent practice after graduation, especially in a private practice setting. However, standardized procedure competency training within most radiology residency programs is lacking, and overall procedural skills are still mainly acquired by the traditional “see one, do one, teach one” methodology. We report the development of a simple standardized procedural training protocol that can easily be adopted by residency programs currently lacking any form of structured procedural training.

Materials and Methods: An ad hoc resident procedural competency committee was created in our radiology residency program. A procedural certification …

Does The Foundational Model Of Anatomy Ontology Provide A Knowledge Base For Learning And Assessment In Anatomy Education?, Melissa D. Clarkson, Mark E. Whipple

Institute for Biomedical Informatics Faculty Publications

Throughout the development of the Foundational Model of Anatomy (FMA) ontology, one of the use cases put forth has been anatomy education. In this work, we examine which types of knowledge taught to anatomy students can be supported by the FMA knowledge base. We first categorize types of anatomical knowledge, then express these patterns in the form “Given ____, state ____”. Each of the 33 patterns was evaluated for whether this type of knowledge is compatible with the modeling and scope of the FMA.

Methods To Improve Interprofessional Collaboration In Administrative Dyads, Julie Lee Hudson

DNP Projects

Abstract

PURPOSE: The primary objective of this project was to determine if specific interventions, to include education, rounding, and regular meetings, improved collaboration and communication for nurse/physician dyads working in acute care hospital administrative roles.

METHODS: The study employed a prospective pre-test and post-test comparison of participants’ scores on a validated survey tool. This tool (JeffSATIC) measured perception of collaboration between nurses and physicians. The objective was to evaluate the differences in these scores in participants before and after an intervention.

RESULTS: This study sought to discover if specific interventions impacted scores on a tool measuring collaboration among dyad pairs. …

Medium To Long Term Impacts On Former Participants Of The Shoulder To Shoulder Global Brigades To Ecuador, Craig Borie

Theses and Dissertations--Community & Leadership Development

Medium to Long Term Impacts on Former Participants of the Shoulder to Shoulder Global Brigades to Ecuador. International service learning and voluntourism programs in global health evoke benefits for both community and the intervener. While it is clear that the Shoulder to Shoulder Global program at the University of Kentucky provides a service to an economically resource poor community in Santo Domingo, Ecuador, what is unclear is the impact these interprofessional experiences have on the participants that travel with the four times a year health brigades. This study proposes to answer the question of what are the educational, personal and …

University Of Kentucky Rural Physician Leadership Program: A Programmatic Review, Paula K. Arnett, Terry D. Stratton, Anthony D. Weaver, Carol L. Elam

Health Management and Policy Faculty Publications

This article describes the characteristics and results of the Rural Physician Leadership Program (RPLP) at the University of Kentucky College of Medicine. RPLP is a successful example of a regional medical campus designed to train physicians at a regional medical campus to serve rural areas through local partnerships.

Professional Competencies For E-Helpers: A Telepractice Resource, Hannah M. Schlaak

Theses and Dissertations--Communication Sciences and Disorders

The primary purpose of this study was to craft and validate a set of core competencies necessary for an e-Helper to possess. A review of the literature guided the creation of the initial competencies. Following expert review, the competencies were revised and formatted into an online survey which was sent to respondents in four target groups: (a) school administrators who had adopted telepractice as a service delivery model; (b) SLPs experienced in telepractice within a school setting; (c) current e-Helpers, and (d) scholars experienced in telepractice. Sixty percent (21 out of 35) of the competencies were rated as “important” by …

Assessment Of The Need For Provider Education On Screening For Depression In Patients With Select Dermatologic Problems, Sarah B. Zerhusen

DNP Projects

PURPOSE: The purpose of this project is to evaluate the knowledge, attitudes, perceptions, skills, and self-efficacy of dermatology providers’ assessment of depression in patients with chronic skin disease to determine the need for continuing education programs.

METHODS: This is a single practice, multi site, quantitative correlational design study to assess provider use, comfort, and proficiency of screening and discussion of depression in patients suffering from plaque psoriasis and atopic dermatitis. Data was collected through the use of a questionnaire dispensed in January of 2018. The sample consisted of 23 dermatology providers in a dermatology practice with clinics in Louisville, Lebanon, …

Roadmap For Creating An Accelerated Three-Year Medical Education Program, Shou Ling Leong, Joan Cangiarella, Tonya Fancher, Lisa Dodson, Colleen Grochowski, Vicky Harnik, Carol Hustedde, Betsy Jones, Christina Kelly, Allison Macerollo, Annette C. Reboli, Melvin Rosenfeld, Kristen Rundell, Tina Thompson, Robert Whyte, Martin Pusic

Family and Community Medicine Faculty Publications

Medical education is undergoing significant transformation. Many medical schools are moving away from the concept of seat time to competency-based education and introducing flexibility in the curriculum that allows individualization. In response to rising student debt and the anticipated physician shortage, 35% of US medical schools are considering the development of accelerated pathways. The roadmap described in this paper is grounded in the experiences of the Consortium of Accelerated Medical Pathway Programs (CAMPP) members in the development, implementation, and evaluation of one type of accelerated pathway: the three-year MD program. Strategies include developing a mission that guides curricular development – …