Medicine and Health Sciences Commons^™

Does Cardiopulmonary Bypass Influence Outcomes In Stage 2 Palliation? A Meta-Analysis And Systematic Review, Abdullah Almehandi, Yahya Ali, Adel Altarkait, Mohammad Alhajri, Abdulrahman O. Al-Naseem, Ahmed A. Jamjoom, Hamood Al Kindi, Saif Awlad Thani

Sultan Qaboos University Medical Journal

Objectives: The bidirectional Glenn (BDG) procedure, a key palliative intervention for single-ventricle physiology, is conventionally performed using cardiopulmonary bypass (CPB) despite its associated complications and costs. However, the comparative impact of CPB versus off-pump techniques on perioperative safety, neurological risk and long-term outcomes remains controversial. Therefore, this meta-analysis aimed to determine whether performing the BDG procedure without CPB improves perioperative outcomes (including morbidity, mortality, and neurological events), resource utilisation, and long-term survival compared to the conventional on-pump approach. Methods: This review systematically searched PubMed, EMBASE and Cochrane Central from inception until January 2025 for comparative randomised and observational studies reporting …

Optimizing Heart Failure-Specific Disease Management Programs And Patient Care In Saudi Arabia: A Saudi Heart Association Position Statement, Abeer Bakhsh, Fakhr Al Ayoubi, Fayez Elshaer, Hanan B. Albackr, Hanin A. Bogari, Ibrahim Jelaidan, Ismail Raslan, Kamal Al Ghalayini, Maryam Alqaseer, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Heart failure (HF) represents a major and growing health burden in Saudi Arabia, with high morbidity, frequent hospitalizations, and substantial system-level costs. Despite advances in guideline-directed medical therapy, gaps in diagnosis, care coordination, and longitudinal management persist. Structured, multidisciplinary heart failure–specific disease management programs (HF-DMPs) have been shown to improve outcomes and healthcare efficiency, yet their implementation remains inconsistent across the Kingdom.

Methods: The Saudi Heart Association (SHA) convened a multidisciplinary expert panel to develop a national position statement on HF-DMPs. Recommendations were formulated through structured consensus, informed by a comprehensive review of international guidelines, clinical trials, real-world evidence, …

Monitoring Spoken Language In Infants And Toddlers Who Are Deaf Or Hard Of Hearing Using The Lena Developmental Snapshot, Monika-Maria Oster, Kimberly A. Peters

Journal of Early Hearing Detection and Intervention

Purpose: This retrospective analysis evaluates the Developmental Snapshot as a language monitoring tool for infants and toddlers with bilateral hearing loss who use listening and spoken language.

Method: Data were obtained from the educational and clinical records of 147 children with bilateral hearing loss. For each child, the LENA (Language ENvironment Analysis) Developmental Snapshot, a standardized online language assessment that relies on parent report, had been completed at least once. When available, scores from other standardized language assessments (PLS-5, CDI, and DAYC-2) were also obtained.

Results: LENA Developmental Snapshot standard scores were characterized by high variability and mean scores in …

A Survey Study On Physiological Hearing Assessment Practice In The Usa, Malina Mangrum, Hasan Saleh, Sangamanatha Ankmnal Ankmnal Veeranna, Kimberly Ward, Charles G. Marx

Journal of Early Hearing Detection and Intervention

Background: In the United States, limited information exists regarding the physiological measures and testing parameters used in infant hearing assessments. To address this gap, we conducted a nationwide survey to identify the types of physiological tests and procedures currently employed by audiologists.

Method: A structured survey was distributed to audiologists across the country to gather information about the auditory tests and recording parameters used in infant hearing evaluations.

Results: Most respondents reported using Auditory Brainstem Responses (ABRs) to estimate infant hearing thresholds, primarily relying on traditional stimuli rather than chirp stimuli. The Auditory Steady-State Response (ASSR) was not widely used …

Measuring Family Involvement In Early Intervention Services For Children Who Are Dhh: A Scoping Review, Marie Martinez, Blair Richlin, Kristina Blaiser

Journal of Early Hearing Detection and Intervention

Background: Family involvement after a child has been identified as deaf or hard of hearing (DHH) is often recommended as “best practice” for Family Centered Early Intervention (FCEI; Szarkowski et al., 2024) and a catalyst for improved outcomes. Defining actions of a family will inform high-quality family support programs. This scoping review aims to explore and document family involvement as well as the current systems of measurement used in early intervention DHH family-centered services.

Purpose: The specific aim of this scoping review was to identify the operational definitions of family involvement and metrics used with families of children who are …

Wildfires And Adolescent Mental Health: A Call To Action, Troy Allan

All Current Publications

Although wildfires affect people across the lifespan, adolescents warrant focused attention because wildfires can disrupt several systems that are especially important during this developmental period, including family relationships, peer networks, schools, routines, housing stability, and a developing sense of safety and identity. This fact sheet provides an overview of current research and a practical response pathway for professionals and families.

Association Between Pain Catastrophising And Functional Limitation In Patients With Knee Osteoarthritis: A Cross-Sectional Study In A Tunisian Rehabilitation Setting, Soumaya Elarem, Ikram Haddada, Ameni Ameur, Ferdaous Blel, Nedra El Feni, Aymen Fekih, Aymen Haj Salah, Mouna Sghir, Wassia Kessomtini

Sultan Qaboos University Medical Journal

Objectives: Knee osteoarthritis (KOA) is a common reason for consultation in rehabilitation settings, responsible for pain and restricted autonomy. This study aimed to determine the association between catastrophising and functional limitation in patients followed for KOA in physical medicine and rehabilitation. Methods: This cross-sectional analytical study was conducted from June to August 2025 at the Department of Physical Medicine and Functional Rehabilitation in Taher Sfar University Hospital, Mahdia, Tunisia. Demographic data, the history of KOA as well as the radiographic stage of Kellgren and Lawrence were collected from patients with KOA. Functional impairment was assessed by the Lequesne knee index …

A Brief Self-Help Intervention For Anxiety And Depressive Symptoms Utilizing Cognitive Behavioral Therapy And Dialectical Behavior Therapy Within Correctional Settings, Genevieve L. Ray

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Individuals within incarcerated settings are far more likely to experience symptoms that meet criteria for a mental health disorder compared to the general population. This population is often underserved due to various financial and resource constraints. Self-help interventions have grown in popularity due to their proven effectiveness and accessibility for consumers, particularly for anxiety and depression symptoms. A self-help intervention for those in a correctional setting would not require extensive additional personnel amid financial constraints and would increase access to care. Many self-help interventions that are currently published apply to the community population, but readily accessible resources that reside in …

Act And Posttraumatic Growth In Military Veterans: Growth Through Flexibility After Adversity, Andrew J. Moller

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Military veterans are disproportionately exposed to potentially traumatic events across service eras. While much of the clinical and research literature has focused on posttraumatic stress disorder (PTSD) and symptom reduction, a growing body of work highlights the possibility of posttraumatic growth (PTG) following adversity. PTG refers to positive psychological changes that may emerge through engagement with traumatic experiences, including enhanced appreciation for life, renewed purpose, personal strength, deepened relationships, and reintegration into community roles. Importantly, PTG does not imply the absence of distress but may coexist alongside ongoing trauma-related symptoms. Understanding processes that facilitate growth alongside suffering may support more …

Trauma Processing And Sleep Inconsistencies In Firefighters: A Proposed Program To Bridge Gaps And Set Heroes Up For Success, Megan Griffin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This doctoral paper presents a comprehensive review of the literature supporting the need for an integrated training program addressing sleep disruption, trauma exposure and processing, and substance use as a self-medication strategy among firefighter populations. Drawing on empirical research, the paper examines the prevalence and interaction of posttraumatic stress disorder (PTSD), moral injury, sleep disturbances, and substance use within this occupational group. The introduction provides operational definitions of PTSD and moral injury and synthesizes existing research on trauma exposure, sleep impairment, and substance use functions among firefighters. The literature review also highlights evidence-based, exposure informed interventions to facilitate adaptive trauma …

Diagnosis And Treatment Of Trauma In Adolescents: A Doctoral-Level Clinical Psychology Course, Jasmine M. Cervantes

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Adolescent trauma is a significant mental health concern that can profoundly disrupt emotional, cognitive, social, and developmental functioning. Although evidence-based interventions for adolescent trauma are well established, doctoral-level psychology training programs may provide limited instruction focused specifically on the unique developmental, cultural, and clinical considerations required when treating traumatized adolescents. This paper presents the development of a ten-week doctoral-level elective course designed to address this gap in clinical training. The curriculum provides foundational knowledge regarding the prevalence, developmental impact, diagnosis, and treatment of adolescent trauma, with an emphasis on posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD). Students …

Sober Curious: A Treatment Manual For A Semi-Structured Interpersonal Process Group Targeting Substance Misuse In Emerging Adults, Annalise G. Floody

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper presents Sober Curious, an original treatment manual for an eight-session, semi-structured interpersonal process group for emerging adults ages 18–25 with mild-to-moderate substance misuse concerns. This group is designed for university counseling centers and outpatient treatment settings, particularly for individuals who experience substance-related distress, impairment, risk, or ambivalence but may not identify with abstinence-based recovery or formal diagnostic substance use disorder (SUD) language. The manual is grounded in epidemiological data, established substance use treatment guidelines, meta-analytic findings on group psychotherapy and substance use interventions, and the developmental theory of emerging adulthood. Key intervention elements include motivational interviewing (MI) to …

The Evaluation Of The Epic Epidural Assessment Event And The Effects Of The Conversion Of Epidural To General Anesthesia For Cesarean Sections, Rebecca Turney, Bridget Shinnick

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Unplanned conversion from labor epidural analgesia to general anesthesia (GA) for cesarean delivery is associated with increased maternal and neonatal risk and may occur when inadequate epidural function is not recognized before operative delivery. This Doctor of Nursing Anesthesia Practice quality improvement project evaluated implementation of the Epic Epidural Assessment Event, a structured electronic medical record documentation tool designed to standardize epidural assessment during labor at a high-acuity obstetric referral center in Western Pennsylvania. Using a Plan-Do-Study-Act framework, the project compared pre- and post-implementation epidural-to-GA conversion trends, reviewed Epic audit data for documented tool utilization, and collected anonymous anesthesia provider …

A Quality Improvement Project On Maternal Hemorrhage Protocol Adherence, Cyrus Masih, Richard Zapata

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage is a leading cause of preventable maternal morbidity and mortality and requires rapid, coordinated response among obstetric, anesthesia, nursing, and blood-bank teams. This quality improvement project implemented and evaluated a California Maternal Quality Care Collaborative (CMQCC)-based Code OB maternal hemorrhage intervention at a western Pennsylvania hospital. The project aimed to improve anesthesia provider knowledge, confidence, and readiness to recognize, stage, and respond to maternal hemorrhage using standardized guidance, quantitative blood loss (QBL) measurement, and point-of-care cognitive support. Guided by the Institute for Healthcare Improvement Model for Improvement and a Plan-Do-Study-Act cycle, the intervention included a focused educational presentation …

Healthcare Students’ Experiences Using Artificial Intelligence Simulation Tools In Clinical Simulated Laboratory Practice, Delicia S. Cousin

Student Dissertations

Artificial intelligence-driven simulation has become an important component of healthcare education by providing students with opportunities to strengthen clinical reasoning, decision-making, and technical skills in a safe learning environment. Despite its growing adoption, limited research has explored how healthcare students experience artificial intelligence-driven simulation during clinical laboratory practice. The purpose of this qualitative case study was to explore healthcare students’ experiences using artificial intelligence-driven simulation tools during clinical laboratory practice. Guided by Experiential Learning Theory and Transformative Learning Theory, the study examined how students interpreted, reflected upon, and learned from these experiences. Data were collected through a researcher-developed Qualtrics questionnaire …

Early Immune Dysregulation In Mtb/Siv Co-Infection Resists Cart Treatment At The Single-Cell Level, Riti Sharan, Yi Zou, Zhao Lai, Korri Weldon, Todd Bradley, Xi Luo, Hulin Wu, Shabaana A Khader, Deepak Kaushal

Faculty, Staff and Student Publications

Using single-cell transcriptomics of bronchoalveolar lavage cells from Mtb/SIV co-infected rhesus macaques on cART, we reveal profound immune dysregulation during early SIV co-infection of latent tuberculosis. SIV induces a sharp decline in CD4+ T cells, NK, and NKT cells, with incomplete recovery of Mtb-specific TH1 effector responses despite viral suppression. Instead, a persistent TH17-skewed environment emerges, alongside sustained myeloid inflammation driven by Type I interferon signaling and pro-inflammatory regulators such as KLF6 and NFKB1. Ligand-receptor network analyses demonstrate expanded CD4+ T cell-macrophage crosstalk and loss of immune homeostasis that cART fails to fully restore. These findings expose …

Rejection Of Fe (Iron) And Kmno4 (Organic Substance) Parameters In Peat Water Using Organic Membranes, Muhamad Rafli Sakti Mulia Gonera, Siti Umi Kalsum, Sarah Fiebrina Heraningsih

Journal of Materials Exploration and Findings

Peat water is a surface water source widely used by people in swampy and lowland areas, but it has poor quality characteristics such as high organic matter content, low pH, and dissolved metal levels such as iron that exceed the threshold. These conditions can cause health problems and reduce the quality of clean water so that effective treatment technology is needed. This study aims to analyze the effectiveness of ultrafiltration membranes made from chitosan from shrimp shell waste in rejecting iron (Fe) and organic substances in peat water, and to determine the effect of pressure on separation performance. This study …

Exploring Red Palm Oil As A Sustainable Plasticizer For Carbon Black-Filled Ssbr/Br Tire Tread Compounds: A Comparative Evaluation Of Commercial Alternatives, Norma Arisanti Kinasih, Mohamad Irfan Fathurrohman, Santi Puspitasari, Dewi Kusuma Arti, Abdulhakim Masa

Journal of Materials Exploration and Findings

This study investigates the application of red palm oil (RPO) as an alternative vegetable oil resource to substitute petroleum-based plasticizers, which have environmental and health concerns, in carbon black (CB)-filled SSBR/BR tire tread compounds. The plasticizing effects of RPO were thoroughly evaluated by comparing them with a commercial bio-based plasticizer, Epoxidized Soybean Oil (ESBO), and two safer petroleum-based oils, Naphthenic Oil (NYNAS) and Treated Distillate Aromatic Extract (TDAE). The initial investigation shows that fatty acid composition is imposing regarding the plasticizing effect. The higher unsaturated fatty acid content in RPO than in ESBO improved tensile strength and degraded rolling resistance …

Metallurgical Investigation Of A Modified Eye Bolt Failure Caused By Improper Weld Extension, Specification Deviation, And Crevice Corrosion, Dimas Muhammad Fawwaz, Reza Miftahul Ulum, Johny Wahyuadi Soedarsono, Yudha Pratesa

Journal of Materials Exploration and Findings

A modified eye bolt from the David Arm Manhole Storage Tank underwent thorough metallurgical study due to the consequences of the bolt's malfunction during operation. Safety issues arose when the manhole door detached during operation. The mechanical testing and chemical composition analysis of the bolts indicated they were manufactured from an ASTM A193 Grade B7 material used for high-temperature bolting. This material did not conform to the engineering drawing, which mentioned SA 563A, which is about nuts, not bolts. This contradiction clearly shows that the eye bolt which was installed does not conform to the intended design. Welded connections of …

Determinants Of Antenatal Care Utilization: A Community-Based, Cross-Sectional Study In Morang And Sunsari Districts, Eastern Nepal, Sunil Shah, Chandra Jha

Journal of Social, Behavioral, and Health Sciences

This study examined the factors influencing antenatal care (ANC) utilization in the eastern region of Nepal, focusing on the Morang and Sunsari districts, with the aim of identifying key determinants affecting ANC uptake and assessing the extent of ANC service utilization among mothers. Using lot quality assurance sampling, a community-based, descriptive, cross-sectional design was employed, surveying 164 mothers who had given birth within the previous 12 months; data were collected from June through November 2023. Data were collected through a semi-structured questionnaire and analyzed using SPSS, with descriptive statistics, chi-square tests, and logistic regression. Findings revealed that 80.5% of respondents …

Improving K-Card Observation Fidelity To Sustain A Culture Of Continuous Learning, John L. Ricks Iii

Master's Projects and Capstones

Problem

            Despite improvements in central line-associated bloodstream infection (CLABSI) attribution, variability in Kamishibai card (K-card) observation practices and documentation limited the unit's ability to identify, learn from, and correct persistent deviations from expected practice. Baseline data showed frequent incomplete documentation and a pattern of completing K-card observations outside bedside shift report.

Context

This project took place in a 20-bed medical-surgical ICU, using the existing K-card process to support high-reliability prevention of hospital-acquired conditions (HAC). Baseline assessment revealed inconsistent observation workflows, incomplete documentation, and unclear roles and expectations.

Interventions

A standardized K-card observation workflow was developed through rapid-cycle testing. Observations were …

The Effect Of Escape Room Simulation On The Self-Efficacy And Communication Levels Of Novice Critical Care Nurses, Lauren A. Femino, Kim Chapman, Julie A. Marshall, Shelby A. Trull, Jennifer A. Dibenedetto

The Lahey Journal

Abstract 

Introduction: Novice critical care nurses often report having low self-confidence and effective communication skills when transitioning to the ICU practice, often due to stress, limited experience, and unfamiliarity with critical care environments. These challenges can not only affect their job satisfaction and retention rates, but also pose serious risks to patient safety and outcomes. The purpose of this evidence-based practice (EBP) project was to assess the impact of an escape room simulation on the self-efficacy and communication skills of novice critical care nurses.

Methods: An evidence-based practice (EBP) project with pre-test and post-test design was conducted to …

Minimally Invasive Percutaneous Endoscopic Foraminotomy And Discectomy In A French Bulldog With Intervertebral Disc Extrusion, Tanhatai Krajarngjang, Luksamee Limpongsai, Panutda Darapong, Woraphanit Sonbanpai, Mataya Taweechart

The Thai Journal of Veterinary Medicine

A six-year-old female French Bulldog was referred for neurological diagnostic tests and treatment for progressive paraparesis over an 8-day period. The dog had a history of intervertebral disc extrusion (IVDE) surgical correction two years prior. Neurological examination revealed T3–L3 myelopathy. Magnetic resonance imaging of the thoracolumbar spine confirmed IVDE with spinal cord compression at T13–L1. A minimally invasive percutaneous endoscopic foraminotomy and discectomy (PEFD) was performed to remove the extruded disc material. The patient regained the ability to stand and showed voluntary limb movement 48 hours post-surgery. At the 4-week follow-up, the patient showed a complete recovery to her baseline …

Leadership Style And Employee Outcomes In Private Practice Outpatient Physical Therapy Clinics, Catherine Beuerle Martin, Debra Ann Beazley

Lynchburg Journal of Medical Science

Background: Workforce retention, employee engagement, and job satisfaction are ongoing challenges in outpatient physical therapy practice. Leadership style has been identified as a potentially modifiable organizational factor that may influence clinician experience and workplace outcomes. Despite extensive leadership research in other health professions, evidence specific to outpatient physical therapy settings remains limited. 

Purpose: To examine the relationships between private practice outpatient physical therapy clinic directors’ perceived leadership styles and staff physical therapists' work engagement, job satisfaction, turnover intention, leadership effectiveness, satisfaction with leadership, and willingness to exert extra effort.

Methods: This cross-sectional correlational study surveyed licensed staff physical …

From “Fixer” To “Facilitator”: A Clinical Review Of Shared Medical Appointments As A Strategy For Workforce Sustainability, Barbara A. Slusher

Lynchburg Journal of Medical Science

Clinician burnout remains a significant threat to workforce sustainability, particularly in resource-constrained settings managing complex chronic diseases. While shared medical appointments (SMAs) have demonstrated clear benefits in patient satisfaction and access, their impact on clinician well-being and professional fulfillment is less clearly defined. This review evaluates whether participation in SMAs improves clinician satisfaction and mitigates burnout by facilitating a conceptual transition from isolated “Fixer” to collaborative “Facilitator.”

A targeted literature search of PubMed, the Cochrane Library, and Google Scholar identified peer-reviewed publications examining shared medical appointments and clinician-centered outcomes, including burnout, clinician satisfaction, and workforce sustainability. …

Umbilical Artery Doppler In Fetal Growth Restriction, Britanie Dollard

Lynchburg Journal of Medical Science

Umbilical artery (UA) Doppler velocimetry is a noninvasive tool used to assess placental vascular resistance and improve risk stratification in pregnancies complicated by suspected fetal growth restriction (FGR). Placental insufficiency remains a leading cause of stillbirth and neonatal morbidity, making early identification critical for optimizing perinatal outcomes. This clinical review synthesizes current evidence regarding the role of UA Doppler in identifying placental insufficiency, outlines key waveform interpretations, and evaluates how Doppler findings guide clinical management and delivery planning. Evidence and major society guidelines support UA Doppler as a targeted surveillance tool in high-risk pregnancies complicated by suspected FGR. Progressive abnormalities, …

Hidden Infarctions: Understanding And Managing Myocardial Infarction With Non-Obstructive Coronary Arteries Through A Multimodal Lens, Catalina Esquivel

Lynchburg Journal of Medical Science

Myocardial infarction with non-obstructive coronary arteries (MINOCA) accounts for 5–15% of myocardial infarctions and disproportionately affects women and minority populations. It is defined by clinical evidence of myocardial ischemia with <50% coronary stenosis on angiography and carries morbidity and mortality comparable to obstructive coronary artery disease–related MI. This narrative review summarizes current diagnostic and management strategies for MINOCA, with emphasis on prognostic assessment using multimodal cardiac imaging and blood biomarkers. A review of key evidence and guidelines was conducted to evaluate established diagnostic approaches and treatments for common etiologies, including plaque disruption, coronary vasospasm, microvascular dysfunction, and spontaneous coronary artery dissection. Early use of cardiac magnetic resonance imaging, optical coherence tomography, and intravascular ultrasound improves diagnostic accuracy and facilitates the identification of underlying mechanisms. However, treatment remains highly individualized due to heterogeneity in etiology and limited evidence guiding therapy. Prognosis varies by cause but is consistently associated with significant long-term cardiovascular risk. Key challenges include diagnostic variability, delayed imaging, and a lack of standardized treatment protocols. Future priorities include randomized trials of mechanism-directed therapies and the development of standardized diagnostic algorithms incorporating functional testing and advanced imaging. Recognition of MINOCA as a distinct clinical entity and early, mechanism-based evaluation are essential to improving outcomes in this diverse, historically underrecognized population.

Countering Hpv Vaccine Misinformation On Social Media: Practical Strategies For Healthcare Providers, David Baldwin

Lynchburg Journal of Medical Science

Human papillomavirus (HPV) vaccination is a highly effective strategy for preventing cervical and other HPV-related cancers; however, vaccine hesitancy remains a significant barrier to optimal vaccination rates. Social media has become a major source of health information while simultaneously amplifying misinformation that influences parental attitudes toward HPV vaccination. This narrative literature review examined the relationship between social media misinformation and HPV vaccine hesitancy and identified evidence-based strategies healthcare providers can use to improve vaccine confidence.

A literature search of PubMed and Google Scholar identified 31 articles published between 2016 and 2025, of which 19 met inclusion criteria. The literature demonstrates …

Professional Values And Workplace Alignment In Dpt Alumni: A Quantitative Cohort Analysis, Debra Ann Beazley, Stephen Elam, Penny S. Elam, Lawrence S. Ramiscal, Pt, Dpt, Ph.D.

Lynchburg Journal of Medical Science

Background: Professional values are foundational to physical therapy practice and are emphasized throughout Doctor of Physical Therapy (DPT) education. Although identity formation literature suggests that core values may persist after graduation, less is known about how workplace context, career stage, and clinical performance relate to the long-term enactment of values among practicing clinicians.

Purpose: To examine whether professional values among DPT alumni differ across demographic groups, career stages, and outpatient settings, and to explore associations among organizational support, workplace value alignment, and historical educational performance.

Methods: A cross-sectional survey study was conducted among University of Lynchburg DPT alumni …

Exploring Social Cognitive Learning In Simulation-Enhanced Interprofessional Education: A Case Study, William Nicholas Vasios Iii

Doctoral Dissertations and Projects

The purpose of this single-case design study is to explore the impact of observational and vicarious learning during simulation-enhanced interprofessional education (Sim-IPE) on the confidence and perceived self-efficacy of nursing students and IM residents at a southeastern university. Guided by Bandura’s social cognitive learning theory, which addresses the personnel, behavioral, and environmental factors of Sim-IPE, while answering the central research question: How does observational and vicarious learning during Sim-IPE impact participant confidence and perceived self-efficacy? This qualitative single-case study was conducted at a university in the southeastern United States, using data collected through visual confidence analog scale surveys, interviews, and …