Medicine and Health Sciences Commons^™

Facilitators And Barriers To Reducing Maternal Mortality Rates In Non-Hispanic Black Women: An Integrative Review, Melissa Marie Andersson, Elizabeth L. Goes

All Electronic Theses and Dissertations

Introduction - Black maternal mortality remains a crucial public health crisis in the United States despite a plethora of research on the incidence. This presents in the persistent disparities in health outcomes between Black and White mothers and newborns. While numerous studies have explored isolated factors contributing to this issue, few have synthesized the full scope of barriers and facilitators influencing Black maternal health outcomes in the United States specifically.

Research Aim - This integrative review aims to identify and organize the key facilitators and barriers to reducing Black maternal mortality in the United States using the socio-ecological model as …

Breaking Down Silos: Creating And Implementing A Longitudinal Interprofessional Education Curriculum For Graduate Health Science Professional Students, Robert Wellmon, Jill D. Black, Wendy Wachter-Schutz, Kathleen M. Youse, Adrienne N. Pinckney, Lori L. Felker

Health Professions Education

Background. Accreditation standards for graduate health professional programs require the inclusion of interprofessional learning and collaboration (IPL/C) activities in entry-level curricula. This implementation necessitates collaboration among educators from multiple disciplines and openness to innovation and to educate students in a manner that breaks down uni-professional curriculum silos that are known barriers to the creation of meaningful IPL experiences.

Objective. The purpose of this paper is to describe one institution’s process for creating a longitudinal interprofessional education (IPE) curriculum that aligns with accreditation mandates and meets the call to foster IPC competency skills.

Methods. Widener University established an interprofessional thread of …

The Remote Supervision Road To Registrar Training In Australia - Paving The Path With Pixels And Phones (A Narrative Review)., Nicholas Coburn, Kylie Fitzgerald, Brett Vaughan

Health Professions Education

Purpose: Specialist medical training in rural or remote Australia is limited due to current requirements of specialist medical colleges to supervise and train registrars onsite. Remote supervision, where the registrar is supervised via telephone and videoconferencing technology remotely, offers a solution that allows doctors to train in rural or remote areas. This review describes the opportunities, challenges, and recommendations to pave the path for a best practice model of remote supervision for private practice focused registrar training in Australia which may offer insights for other countries with rural and remote medical workforces.

Methods: Ovid Medline and Ovid Embase were …

Procedural Skills Gaps And Ultrasound Training In Saudi Medical Interns: A Cross-Sectional Survey, Rajkumar Rajendram, Abdullah Abdulrahman Alshamrani, Waleed Khalid Jarwan, Afnan Ali Alghamdi, Arif Hussain

Health Professions Education

Purpose: Medical internships lay the foundation for physicians' careers. While the scope of medical practice has broadened, the emphasis on procedural skills remains crucial. However, concerns persist regarding the adequacy of current internship training programs, particularly in the context of the increasing importance of ultrasound-guided procedures (UGPs). This study aims to assess the perceived relevance of procedural skills training and identify skill gaps among medical interns at our institution.

Aim: To assess medical interns' perceptions of the relevance of procedural skills training, with a specific focus on ultrasound guidance and to identify skill gaps within the internship program at our …

Enhancing Learning Methods In Medical Education: Effective Strategies For Student Success, Syed Tawassul Hassan, Syeda Kashaf Batool, Muhammad Liaquat Raza

Health Professions Education

This perspective highlights three often overlooked but highly effective methods for boosting student performance in medical education. Active recall, which involves retrieving information from memory during learning, helps strengthen understanding and retention of complex medical concepts. Spaced repetition, spreading out study sessions over time, enhances long-term memory formation and reduces forgetting. Both techniques have been shown to outperform traditional passive review and cramming. We have also emphasized the importance of lifestyle factors, particularly sleep and diet, in academic success. Studies using wearable devices have linked better sleep quality to higher grades, with poor sleep habits significantly hurting performance. To implement …

The Students’ Conceptions Of Assessment (Scoa) Instrument: A Validation Study In Medical Education Context, Diantha Soemantri, Nadia Greviana, Najila Ramadhina

Health Professions Education

Purpose: To validate the Students’ Conceptions of Assessment (SCoA) instrument for the medical education context as a tool to examine Indonesian medical students’ conceptions of assessment in general before its implementation.

Method: A cross-sectional study was conducted to validate the translated SCoA instrument. The original 45-item instrument was translated to Indonesian with some modifications. The study was conducted on a total of 308 preclinical and clinical participants in two public medical schools: Universitas Indonesia and Universitas Udayana.

Results: The samples were found to be suitable for exploratory factor analysis, as indicated by a high Kaiser–Meyer–Olkin value (0.949) and a significant …

Active Learning In Respiratory Care Education: A Narrative Review, Tisha Ann Skariah, Udaya Kumar Rao, Manjush Karthika

Health Professions Education

Purpose: This study evaluates the effectiveness of active learning strategies in respiratory care (RC) education, specifically examining their impact on student engagement, critical thinking, and clinical competency to address limitations inherent in traditional passive instructional methods.

Methods: A comprehensive narrative review of peer-reviewed literature was conducted using databases such as PubMed, Web of Science, and Scopus. Thematic analysis was utilized to explore the influence of key active learning methodologies, including simulation-based learning (SBL), flipped classroom (FC), problem-based learning (PBL), and team-based learning (TBL).

Results: The findings demonstrate that active learning approaches significantly enhance clinical decision-making, collaborative skills, and knowledge retention …

“Globes" Module (Guiding Learners Towards One Health, Biodiversity, And Environmental Stewardship): Catalyzing Synergies To Advance Leadership And Scholarly Engagement With One Health In Under Graduate Medical Education, Krishna Mohan Surapaneni

Health Professions Education

Background: The concept of One Health addresses the interconnected health of humans, animals, and the environment, offering a critical framework for tackling complex health challenges. However, gaps in the integration of One Health principles into medical education limit the ability of future healthcare providers to operationalize this knowledge in practice. The "GLOBES" module (Guiding Learners towards One health, Biodiversity, and Environmental Stewardship) was designed to bridge these gaps, aligning with Sustainable Development Goals (SDG 3, 13, 14, 15) to promote holistic and interdisciplinary healthcare education. Methods: The "GLOBES" module was developed with 22 competencies across ten categories, incorporating case-based learning, …

Effect Of Problematic Smartphone Usage On Reaction Time And Critical Flicker Fusion Frequency Among Medical Undergraduate Students In Chennai, South India - A Cross-Sectional Study, Saisubramanian Abeetha, Angappan Suba, Mourali Chitra, Chirag D Jain, Saisubramanian Sadhana

Health Professions Education

Purpose: Smartphones are vital for communication and learning, especially among medical students, but excessive use can cause physical, psychological, and cognitive issues. Problematic Smartphone Usage (PSU), marked by compulsive use, is linked to attention deficits and reduced cognitive function. Reaction Time (RT) reflects sensory-motor speed, while Critical Flicker Fusion Frequency (CFFF) indicates sensory processing and neural fatigue. Prolonged smartphone use may impair these parameters. Despite growing concern, data on PSU’s impact on RT and CFFF in medical students is limited. This study explores their association among undergraduates in Chennai.

Methods: This cross-sectional study was conducted among 402 medical undergraduate students …

Artificial Intelligence In Pharmacy Education: Balancing Technological Advances And Ethical Concerns Among Aspiring Pharmacists, Ubada Aqeel, Shibu John

Health Professions Education

Background Artificial intelligence (AI) is transforming healthcare, including pharmacy practice, by enhancing access to information, reducing errors, and supporting decision-making. However, its integration into pharmacy education remains underexplored. This study investigated pharmacy students' perceptions of AI's impact on their profession and the need for curriculum reform. Materials and Methods A cross-sectional survey was conducted among 245 Bachelor of Pharmacy (BPharm) students from Jamia Hamdard, India. Data were collected using a structured questionnaire covering knowledge, perceptions, and opinions on AI in pharmacy. Responses were analyzed using non-parametric tests, including the Mann-Whitney U and Kruskal-Wallis H tests, to examine group differences. Exploratory …

Analyzing The Impact Of Geographic Location, Owner Knowledge, And Veterinary Guidance On Equine Vaccination Protocols, Colleen Mcanally

Murray State Theses and Dissertations

This study explored how equine owners decide which diseases their horses are vaccinated for based on their geographic location, the knowledge they have on specific equine diseases, and how much they rely on their veterinarian’s recommendations. A total of 55 horse owners throughout the United States completed an online survey. The results showed that while most owners vaccinate for common core vaccines including West Nile Virus, Tetanus, and Rabies, fewer vaccinated for risk-based vaccines like Leptospirosis. Many owners felt confident in their knowledge of national guidelines for annual core vaccinations, but only a small number of owners were able to …

Online Learning-Driven Human Intent Estimation And Control For Human-Robot Interaction, Irfan Ganie, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents a novel Stackelberg-game theoretic multilayer-online learning framework for cooperative control of nonlinear Physical Human-Robot Interaction (pHRI), where the human is modeled as the leader guiding a robot follower. This hierarchical interaction is captured as a dynamic Stackelberg game, with the human's intention estimated in real-time through online multilayer neural networks (MNNs). We introduce SVD-based weight update laws for actor-critic MNNs, which approximate value functions and control inputs for both human and robot, eliminating the need for predefined basis functions. In this framework, the human objective is first inferred and used to guide the robot actions by shaping …

Improved Optimal Tracking Of Uncertain Nonlinear Discrete-Time Systems Using Experience Replay, Maxwell Geiger, Sarangapani Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper addresses the infinite horizon optimal tracking control problem for partially uncertain control-affine nonlinear discrete-time (DT) systems, where the control input dynamics are known. Multi-layer critic and actor neural networks (MNNs) are utilized for online estimation of the infinite horizon value function and optimal control input. The NN weights are tuned online using a direct temporal difference error (TDE)-driven learning approach, which modifies the singular values of the gradient with respect to the NN weights to accelerate their convergence. The critic NN uses a novel experience replay technique to improve sample efficiency without introducing biased TDEs and guarantee the …

Multi-Model Safe Neuro-Optimal Output Tracking Control Of Autonomous Surface Vessels With Explainable Ai, Behzad Farzanegan, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents a safety-aware deep reinforcement learning (DRL)-based trajectory tracking control of autonomous surface vessels (ASVs). A multilayer neural network (MNN) observer estimates the ASV's state and uncertain dynamics. By utilizing the estimate state vector from the observer, a safety-aware DRL-based optimal policy is formulated using control barrier function (CBF) and Karush-Kuhn-Tucker (KKT) conditions. An actor-critic MNN with singular value decomposition (SVD)-based update mitigates vanishing gradients. To enhance adaptability, an online safe lifelong learning (SLL) scheme counters catastrophic forgetting across varying ASV dynamics. The Shapley Additive Explanations (SHAP) method identifies key features influencing the control policy. Simulations on an …

Online Adaptive Optimal Tracking Control Of Uncertain Strict Feedback Discrete-Time Systems With Hardware Verification Using A Quadrotor Uav, Maxwell Geiger, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This article considers the infinite time horizon optimal tracking control problem for discrete time (DT) partially uncertain strict feedback systems with application to quadrotor UAVs. First, the strict feedback DT system is transformed into an equivalent affine nonlinear DT system in terms of tracking error dynamics. The optimal tracking control problem is solved using an augmented system approach, where a horizon of future reference trajectory points are used in the augmented state, as compared to using a single point. The internal dynamics of the original nonlinear strict feedback system and the transformed affine system in terms of error dynamics are …

Reinforcement Learning-Based Nonlinear Optimal Discrete-Time Control Of Power Systems, Vijay Kumar Singh, Behzad Farzanegan, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents a partially model-free adaptive optimal tracking control method for power systems, specifically targeting a synchronous generator connected through a reactive transmission line. By integrating the tracking error dynamics with reference trajectory dynamics, an augmented system is created. A discounted performance function is introduced to address the nonlinear tracking problem optimally. Unlike traditional methods that compute feedforward and feedback terms separately, the proposed approach calculates both simultaneously by minimizing the discounted performance function. The discrete-time tracking Bellman and Hamilton-Jacobi-Bellman (HJB) equations are derived, and a reinforcement learning (RL)-based technique is employed to solve the optimal policy online without …

Exploring Institutional Stratification: Minority-Serving Institutional Pathways To Medical School Acceptance In The United States, Amanda K. Burbage, Eushekia Y. Hewitt

EVMS School of Health Professions Faculty Publications

Introduction

Recruiting and training a diverse pool of physicians from historically excluded groups is vital to solving complex scientific problems and increasing access to patient care. Disparate educational and health outcomes of COVID-19 amplified this need. In stratified higher education systems, underfunded institutions that serve greater numbers of underrepresented in medicine (URM) students face unique barriers to entering physician training. However, pathways from historically underfunded minority-serving institutions (MSIs) in the United States to medical school (MD) are not well understood.

Method

A hierarchical logistic regression analysis of 328 488 de-identified applicants to US MD-granting medical schools for academic years 2017-2018 …

Team Science In Interdisciplinary Health Professions Education Research: A Multi-Institutional Case Study, Peggy Gesing, Joni Tornwall, Violet Kulo, Sarah Mcbrien, Thuha Hoang, Hyun-Jin Jun, Amanda Burbage, Yuane Jia, Christina Cestone

EVMS School of Health Professions Faculty Publications

The interdisciplinary nature of health professions education requires exploration of problems by interdisciplinary research teams. Drawing on the Dynamics of Cross-disciplinary Research Development conceptual framework, this study explores the processes and experiences of an interdisciplinary research team, identifying elements of successful collaboration. Case study data were collected from a team of nine researchers from six universities. Data included meeting minutes and researcher reflections. Researcher reflection and meeting minute themes converged within the framework constructs: Contexts and inputs, social learning processes, social capital outcomes, and knowledge and human capital outcomes. This study provides a blueprint for interdisciplinary researchers indicating that successful …

The Short And Sweet On Sodium-Glucose Cotransporter Inhibitors And Glucagon-Like Peptide-1 Receptor Agonists In Heart Failure, Jose L. Batista, Tracy Makuvire, Jonathan D. Davis, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Heart failure (HF) affects 6 million people in the US, and type 2 diabetes (T2D) is a significant risk factor for HF. Since 2008, regulatory agencies have required cardiovascular safety trials for new T2D therapies, and these have consistently demonstrated the cardiovascular benefits of glucose-lowering drugs. Sodium-glucose cotransporter inhibitors (SGLTi) and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs)/glucose-dependent insulinotropic polypeptide (GIP) reduce major adverse cardiovascular events and deaths, regardless of diabetes status, and improve cardiorespiratory fitness. SGLTis, such as dapagliflozin and empagliflozin, benefit patients with reduced and preserved ejection fraction, significantly reducing HF hospitalizations and cardiovascular deaths. The DAPA-HF and EMPEROR-Reduced …

Artificial Intelligence In Cancer-Related Malnutrition And Cachexia: A Transformative Tool In Clinical Nutrition, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

[Introduction] Malnutrition and cachexia are common complications in cancer patients, and they negatively influence prognosis, treatment efficacy, and tolerability as well as quality of life [[1], [2], [3]]. Accurately identifying and effectively managing malnutrition and cachexia in this population remains a clinical challenge. Conventional validated screening tools may lack the sensitivity and specificity required for early detection and personalized intervention in diverse cancer types and treatment settings [4,5]. Over the last decade, the use of artificial intelligence (AI), including machine learning (ML) and deep learning (DL) strategies, has shown promising results in clinical nutrition, with the potential to revolutionize nutritional …

Influence Of Faculty-Derived Concept Maps On Student Study Strategies, Kaitlin P. Hardy, Amanda K. Burbage, Julie A. Kerry

EVMS School of Health Professions Faculty Publications

Background

Concept mapping is a well-established tool for students to actively organize information into a visual and spatial framework. However, some students are resistant to adopting concept mapping as a study strategy due to the time and effort involved in generating the maps. In this study, we explored student perceptions of faculty-derived concept maps (FD-maps) developed to accompany content within a Foundational Science module in a medical school curriculum. We subsequently investigated whether student use of FD-maps helped overcome resistance to adoption of concept mapping.

Methods

Student evaluation data was analyzed using a mixed methods approach to explore student perceptions …

Enhanced Continual Reinforcement Learning-Based Output Feedback Control Of Heterogeneous Quadrotors Formation, Ehsan Soleimani, S. Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper presents a unified framework for the safe and optimal control of heterogeneous quadrotor unmanned aerial vehicles (QUAVs) in formation, enabling multitask missions without requiring precise system dynamics. To address partial state observability, a multilayer neural network (MNN) observer is designed to estimate unmeasured states. Reinforcement learning (RL) is employed for optimal control utilizing an MNN ensuring adaptability. Barrier Lyapunov Functions (BLFs) are integrated into the RL framework to enforce safety by maintaining QUAVs within predefined constraints. An enhanced continual learning (ECL) method is proposed to improve the adaptability of MNNs. This method enables effective multitask learning while mitigating …

Third Party Negotiated Hospital Pricing In Rural And Urban Hospitals Within 12 U.S. States, Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert

Rural & Underserved Health Research Center Publications

No abstract provided.

Inconsistency In Physician Orders For Life-Sustaining Treatment (Polst) Documentation, An Opportunity For Improvement, William Carmichael, Zachary Matuzsan Do, Timothy J. Friel Md, Katie Best Rn, David B. Burmeister Do, Facep, Cpe, Justin Stauffer Pa-C, Katelyn Mclain, Jessica K. Eygnor Do, Marna R. Greenberg Do, Mph, Facep, Jennifer Allen Md

Department of Emergency Medicine

No abstract provided.

Gaps In Advance Care Planning Among High End-Of-Life Index Ed Patients Destined For Psychiatric Facilities, Jacob Adams, Jessica K. Eygnor, Courtney Moore Md, David B. Burmeister Do, Facep, Cpe, David M. Richardson Md, Jennifer Allen Md, Justin Stauffer Pa-C, Katie Best Rn, Katelyn Mclain, Matthew Mccambridge Md, Timothy J. Friel Md, Zhe Chen, Chadd K. Kraus Do, Shadi Jarjous Md, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

Paving Professional Development Tracks: Create A Road From Scholarship To Program Requirements, Nathalie Torres Do, Shawn M. Quinn Do, Gavin C. Barr Jr. Md, Alexandra Amaducci Do, Mary Nemeth, Dawn M. Yenser, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

The Effects Of The Image Attributes Of Golf Star Athletes Supported By Adult Amateur Golfers On Sports Participation Desire And Continuation Intention, Ji-Hye Yang, Ga Young Kim, Hye Jin Yang, Chulhwan Choi, Chul-Ho Bum

Human Movement Studies & Special Education Faculty Publications

The image attributes of sports star athletes demonstrate positive effects on sports fans' psychological factors. In the context of golf, fans are also influenced by the players they support, experiencing a range of emotions. Therefore, this study aimed to examine the effects of the image attributes of golf star athletes—supported by adult amateur golfers—on the desire for sports participation and the intention to continue. This study involved 356 adult amateur golfers in Korea (253 male, 103 female). Questionnaires were used to measure participants' perceptions of image attributes, their desire for sports participation, and their intention to continue participating in the …

A Study Of Differences In Enjoyment, Exercise Commitment, And Intention To Continue Participation Among Age Groups Of Adult Amateur Golfers, Hye Jin Yang, Ji-Hye Yang, Chulhwan Choi, Chul-Ho Bum

Human Movement Studies & Special Education Faculty Publications

Golf is one of the leisure sports that offers various benefits and has become a popular public sport with participation from people of various age groups. A total of 262 questionnaires were distributed online, with 240 valid responses collected after excluding 22 with non-responses or partial answers. The results showed statistically significant differences in enjoyment by age group, except for recognition from others. Regarding physical health, those in their 60s and above had higher mean scores than other age groups, and those in their 50s scored higher than those in their 30s. Stress relief was greater among those in their …

A Comparative Analysis Of Stress Relief, Life Satisfaction, And Quality Of Life Based On Marriage Status And Gender Among Members Of Society Participating In Exercise, Ji-Hye Yang, Sicheol Jung, Hyejin Yang, Chulhwan Choi, Chul-Ho Bum

Human Movement Studies & Special Education Faculty Publications

Modern members of society tend to feel stressed in their workplace and at home, but exercising has been shown to effectively reduce stress and increase quality of life and satisfaction. This study aimed to investigate and compare stress relief, life satisfaction, and quality of life based on marriage status and gender among members of society who participate in exercise. We used a questionnaire survey with 311 participants, and the data were analyzed using descriptive statistics, validity and reliability, a multivariate analysis of variance (MANOVA), and a post hoc analysis. The study results showed that the single groups demonstrated higher mean …

Minimizing Fasting Requirements To Maximize Patient Satisfaction Prior To A Scheduled Cardiac Catheterization, Kierra Thies

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Patients are often kept NPO (nil per os), or “nothing by mouth,” longer than necessary before cardiac catheterization procedures. Local Problem: Patients scheduled for cardiac catheterization procedures receive instructions to begin fasting at midnight on the day of their procedure regardless of their scheduled procedural start time. This directive results in patient dissatisfaction as patients are fasting longer than current guideline recommendation.
Methods: The facility updated its order set to align with the American Society of Anesthesiologists (ASA) fasting guidelines for scheduled cardiac catheterizations. To evaluate patient satisfaction, a 6-item survey was administered to 169 individuals undergoing cardiac catheterization. …