Other Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

A Proof Of Concept For Detection Of Palato-Lingual Contact Without Intraoral Electrodes In A Human Participant, Amitava Biswas

Master's Theses

The author of this thesis conceived and investigated an unexpected electrical signal that may not be noticed during regular electroglottography (EGG) when electrodes are conventionally placed on the anterior surface of the throat. It appears that there is a measurable electrical signal from the EGG equipment when electrodes are placed over the frontal cheek (belly of zygomatic muscle), and the tongue is elevated to contact the hard palate, or the tongue is lowered to break the contact. Therefore, this phenomenon is designated as unconventional electroglottography (UEGG, Dr. Steven Cloud, private communication, July 17, 2022).

Two distinctive patterns of waveforms were …

The Relationships Among Proprioception, Balance, And Cognitive Perception Of Body Awareness In College Students, Courtney Helmick

Honors College Theses

Introduction: Proprioception is an important physiological function that is essential for activities of daily living as well as exercise and sport performance. Integration of proprioceptive signals plays a key role in both static and dynamic balance. Previously, researchers have assessed the relationship between balance and proprioception, however, the effect of cognitive perception of body awareness has not previously been included in this research. The aim of this pilot study was to explore the relationships among lower extremity proprioception, dynamic balance, and cognitive perception of body awareness in college students.

Methods: Nineteen apparently healthy college students (age 21.26 ± 1.10 years, …

Higher Sexual Excitation Is Associated With An Increase In Sex-Linked Substance Use In Women With A History Of Unwanted Sexual Contact, Harper R. Jones, Tierney K. Lorenz

Center for Brain, Biology, and Behavior: Faculty Publications

Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce sexual anxiety or shame (i.e., reduce sexual inhibition), a phenomenon termed sex-linked substance use (SLSU). A predominant assumption in the literature is that women with unwanted sex histories are more likely to disengage during sex, suggesting greater inhibition-related SLSU; however, there is little prior research directly examining if women who have unwanted sex …

Pre–Post Intervention Exploring Cognitive Function And Relationships With Weight Loss, Intervention Adherence And Dropout, Amanda N. Szabo-Reed, Laura E. Martin, Cary R. Savage, Richard A. Washburn, Joseph E. Donnelley

Center for Brain, Biology, and Behavior: Faculty Publications

Objective: To evaluate the association between baseline cognitive function, intervention dropout, adherence and 3-month weight loss (WL) when controlling for confounding demographic variables.

Methods: 107 (Mage = 40.9 yrs.), BMI in the overweight and obese range (BMI = 35.6 kg/m2), men (N = 17) and women (N = 90) completed a 3-month WL intervention. Participants attended weekly behavioral sessions, comply with a reduced calorie diet, and complete 100 min of physical activity (PA)/wk. Cognitive function tasks at baseline included Flanker (attention), Stroop (executive control) and working memory, demographics, body weight and cardiovascular fitness were assessed at baseline. Session attendance, adherence …

Concussion-Related Disruptions To Hub Connectivity In The Default Mode Network Are Related To Symptoms And Cognition, Heather C. Bouchard, Kate L. Higgins, Grace Amadon, Julia M. Laing-Young, Arthur C. Maerlender, Seima Al-Momani, Maital Neta, Cary R. Savage, Douglas H. Schultz

Center for Brain, Biology, and Behavior: Faculty Publications

Concussions present with a myriad of symptomatic and cognitive concerns; however, the relationship between these functional disruptions and the underlying changes in the brain are not yet well understood. Hubs, or brain regions that are connected to many different functional networks, may be specifically disrupted after concussion. Given the implications in concussion research, we quantified hub disruption within the default mode network (DMN) and between the DMN and other brain networks. We collected resting-state functional magnetic resonance imaging data from collegiate student-athletes (n = 44) at three timepoints: baseline (prior to beginning their athletic season), acute post-injury (approximately 48 hours …

Manydogs Project: A Big Team Science Approach To Investigating Canine Behavior And Cognition, Daniela Alberghina, Emily E. Bray, Daphna Buchsbaum, Sarah- Elizabeth Byosiere, Julia Espinosa, Gitanjali E. Gnanadesikan, C.-N. Alexandrina Guran, Elizabeth Hare, Daniel J. Horschler, Ludwig Huber, Valerie A. Kuhlmeier, Evan L. Maclean, Madeline H. Pelgrim, Bryan Perez, Dana Ravid-Schurr, Liza Rothkoff, Courtney L. Sexton, Zachary A. Silver, Jeffrey R. Stevens

Center for Brain, Biology, and Behavior: Faculty Publications

Dogs have a special place in human history as the first domesticated species and play important roles in many cultures around the world. However, their role in scientific studies has been relatively recent. With a few notable exceptions (e.g., Darwin, Pavlov, Scott, and Fuller), domestic dogs were not commonly the subject of rigorous scientific investigation of behavior until the late 1990s. Although the number of canine science studies has increased dramatically over the last 20 years, most research groups are limited in the inferences they can draw because of the relatively small sample sizes used, along with the exceptional diversity …

Reliability Of Accelerometer-Based Reaction Time Tests, Jacob Hepp, Warner Rhodes, Jordan Walton, Rahul Soangra, Brent Harper

Student Scholar Symposium Abstracts and Posters

Concussions are traumatic brain injuries that affect the function of the brain. One of the primary symptoms of a concussion is a lack of reaction time. The people that are most susceptible to concussions are athletes; Laker’s (2011) study found that 135,000 patients that suffer concussions from playing sports are expected to be hospitalized each year, with football making up 75% of concussions at high school and college levels. Honda et al. (2018) suggested reaction time as an important biomarker of concussion. Laboratory camera-based motion capture data, while reliable, is not a realistic tool to use outside of a laboratory …

Three-Dimensional Motion Analysis For Occupational Therapy Upper Extremity Assessment And Rehabilitation: A Scoping Review, Stephen W. Hill, Samantha Mong, Quyen Vo

The Open Journal of Occupational Therapy

Background: Three-dimensional (3D) human motion analysis provides objective, quantitative, and reliable kinematic data that are valuable in rehabilitation. Clinicians, including occupational therapists and other specialists, can apply this technology to quantify patients’ upper extremity (UE) motion during functional tasks. A better comprehension of altered body mechanics serves to guide clinical reasoning, develop evidence-based interventions, and monitor patients’ progress through follow-up. However, the scientific literature has yet to emphasize the practicality of using 3D motion analysis as a clinical measurement tool.

Method: This scoping review appraised 20 articles that used 3D motion analysis to quantify UE movements for individuals …

Explicit And Implicit Emotion Processing In The Cerebellum: A Meta‑Analysis And Systematic Review, Jordan E. Pierce, Marine Thomasson, Philippe Voruz, Garance Selosse, Julie Péron

Center for Brain, Biology, and Behavior: Faculty Publications

The cerebellum’s role in affective processing is increasingly recognized in the literature, but remains poorly understood, despite abundant clinical evidence for affective disruptions following cerebellar damage. To improve the characterization of emotion processing and investigate how attention allocation impacts this processing, we conducted a meta-analysis on task activation foci using GingerALE software. Eighty human neuroimaging studies of emotion including 2761 participants identified through Web of Science and ProQuest databases were analyzed collectively and then divided into two categories based on the focus of attention during the task: explicit or implicit emotion processing. The results examining the explicit emotion tasks identified …

The Role Of Reported Affective Symptoms And Anxiety In Recovery Trajectories After Sport-Related Concussion, Bernadette A. D'Alonzo, Abigail C. Bretzin, Douglas J. Wiebe, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty Publications

Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited.

Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery.

Study Design: Cohort study; Level of evidence, 3.

Methods: …

Age-Dependent White Matter Disruptions After Military Traumatic Brain Injury: Multivariate Analysis Results From Enigma Brain Injury, Heather C. Bouchard, Delin Sun, Emily L. Dennis, Mary R. Newsome, Seth G. Disner, Jeremy Elman, Annelise Silva, Carmen Velez, Andrei Irimia, Nicholas D. Davenport, Scott R. Sponheim, Carol E. Franz, William S. Kremen, Michael J. Coleman, M. Wright Williams, Elbert Geuze, Inga K. Koerte, Martha E. Shenton, Maheen M. Adamson, Raul Coimbra, Gerald Grant, Lori Shutter, Mark S. George, Ross D. Zafonte, Thomas W. Mcallister, Murray B. Stein, Paul M. Thompson, Elisabeth A. Wilde, David F. Tate, Aristeidis Sotiras, Rajendra A. Morey

Center for Brain, Biology, and Behavior: Faculty Publications

Mild Traumatic brain injury (mTBI) is a signature wound in military personnel, and repetitive mTBI has been linked to age-related neurogenerative disorders that affect white matter (WM) in the brain. However, findings of injury to specific WM tracts have been variable and inconsistent. This may be due to the heterogeneity of mechanisms, etiology, and comorbid disorders related to mTBI. Non-negative matrix factorization (NMF) is a data-driven approach that detects covarying patterns (components) within high-dimensional data. We applied NMF to diffusion imaging data from military Veterans with and without a self-reported TBI history. NMF identified 12 independent components derived from fractional …

Differential Associations Of Conduct Disorder, Callous‑Unemotional Traits And Irritability With Outcome Expectations And Values Regarding The Consequences Of Aggression, J. Elowsky, S. Bajaj, J. Bashford‑Largo, R. Zhang, A. Mathur, A. Schwartz, M. Dobbertin, K. S. Blair, E. Leibenluft, D. Pardini, R. J.R. Blair

Center for Brain, Biology, and Behavior: Faculty Publications

Background: Previous work has examined the association of aggression levels and callous-unemotional traits with outcome expectations and values regarding the consequences of aggression. Less work has examined the outcome expectations and values regarding the consequences of aggression of adolescents with Conduct Disorder (CD). Also, no studies have examined links between irritability (a second socio-affective trait associated with CD) and these social cognitive processes despite the core function of anger in retaliatory aggression and establishing dominance.

Method: The current study, investigating these issues, involved 193 adolescents (typically developing [TD; N = 106], 87 cases with CD [N = 87]). Participants completed …

Comparative Kinematic Gait Analysis In Adults With Multiple Disabilities, Lauren Rumbalski

Undergraduate Honors Thesis Projects

The purpose of this research is to identify abnormal gait parameters or patterns amongst young adults with multiple disabilities enrolled in a work transition program sponsored by a public-school system. Gait disorders are commonly seen in individuals with neurologic disorders, with significant research in children with autism. Gait disorders have been linked with fall and injury risk, with significant research in elderly populations. Gait analysis technology can be used to identify gait characteristics in populations that are abnormal or contribute to gait disorders. In an observational design, students from the transitional program promoted by Westerville City Schools, housed on Otterbein …

A Physical Therapy Mobility Checkup For Older Adults: Feasibility And Participant Preferences From A Discrete Choice Experiment, Dalerie Lieberz, Hannah Borgeson, Steven Dobson, Lindsey Ewings, Karen Johnson, Kori Klaysmat, Abby Schultz, Rachel Tasson, Alexandra L. Borstad

Journal of Patient-Centered Research and Reviews

Purpose: Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment.

Methods: Adults over 55 years of age were recruited from the community. In the study’s first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the …

Progression Through Return-To-Sport And Return-To-Academics Guidelines For Concussion Management And Recovery In Collegiate Student Athletes: Findings From The Ivy League–Big Ten Epidemiology Of Concussion Study, Douglas J. Wiebe, Abigail C. Bretzin, Bernadette A. D'Alonzo, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Objective To examine the progression of collegiate student athletes through five stages of a return-to- activity protocol following sport-related concussion (SRC).

Methods In a multisite prospective cohort study, we identified the frequency of initial 24–48 hours physical and cognitive rest, and the sequence of (1) symptom resolution and return to (2) exertion activity, (3) limited sport, (4) full sport and (5) full academics. In resulting profiles we estimated the likelihood of return to full sport ≤14 days or prolonged >28 days and tested for variability based on timing of the stages.

Results Among 1715 athletes with SRC (31.6% females), 67.9% …

Head Impact Exposure In Youth And Collegiate American Football, Grace B. Choi, Eric P. Smith, Stefan M. Duma, Steven Rowson, Eamon Campolettano, Mireille E. Kelley, Derek A. Jones, Joel D. Stitzel, Jillian E. Urban, Amaris Genemaras, Jonathan G. Beckwith, Richard M. Greenwald, Arthur C. Maerlender, Joseph J. Crisco

Center for Brain, Biology, and Behavior: Faculty Publications

The relationship between head impact and subsequent brain injury for American football players is not well defined, especially for youth. The objective of this study is to quantify and assess Head Impact Exposure (HIE) metrics among youth and collegiate football players. This multiseason study enrolled 639 unique athletes (354 collegiate; 285 youth, ages 9–14), recording 476,209 head impacts (367,337 collegiate; 108,872 youth) over 971 sessions (480 collegiate; 491 youth). Youth players experienced 43 and 65% fewer impacts per competition and practice, respectively, and lower impact magnitudes compared to collegiate players (95th percentile peak linear acceleration (PLA, g) competition: 45.6 vs …

Constructing Neural Network Models From Brain Data Reveals Representational Transformations Linked To Adaptive Behavior, Takuya Ito, Guangyu Robert Yang, Patryk Laurent, Douglas H. Schultz, Michael W. Cole

Center for Brain, Biology, and Behavior: Faculty Publications

The human ability to adaptively implement a wide variety of tasks is thought to emerge from the dynamic transformation of cognitive information. We hypothesized that these transformations are implemented via conjunctive activations in “conjunction hubs”—brain regions that selectively integrate sensory, cognitive, and motor activations. We used recent advances in using functional connectivity to map the flow of activity between brain regions to construct a task-performing neural network model from fMRI data during a cognitive control task. We verified the importance of conjunction hubs in cognitive computations by simulating neural activity flow over this empirically-estimated functional connectivity model. These empiricallyspecified simulations …

Affective Flexibility As A Developmental Building Block Of Cognitive Reappraisal: An Fmri Study, Jordan E. Pierce, Eisha Haque, Maital Neta

Center for Brain, Biology, and Behavior: Faculty Publications

Cognitive reappraisal is a form of emotion regulation that involves reinterpreting the meaning of a stimulus, often to downregulate one’s negative affect. Reappraisal typically recruits distributed regions of prefrontal and parietal cortex to generate new appraisals and downregulate the emotional response in the amygdala. In the current study, we compared reappraisal ability in an fMRI task with affective flexibility in a sample of children and adolescents (ages 6–17, N = 76). Affective flexibility was defined as variability in valence interpretations of ambiguous (surprised) facial expressions from a second behavioral task. Results demonstrated that age and affective flexibility predicted reappraisal ability, …

Creating Reel Designs: Reflecting On Arthrogryposis Multiplex Congenita In The Community, Iris Layadi

Purdue Journal of Service-Learning and International Engagement

Because of its extreme rarity, the genetic disease arthrogryposis multiplex congenita (AMC) and the needs of individuals with the diagnosis are often overlooked. AMC refers to the development of nonprogressive contractures in disparate areas of the body and is characterized by decreased flexibility in joints, muscle atrophy, and developmental delays. Colton Darst, a seven-year-old boy from Indianapolis, Indiana, was born with the disorder, and since then, he has undergone numerous surgical interventions and continues to receive orthopedic therapy to reduce his physical limitations. His parents, Michael and Amber Darst, have hopes for him to regain his limbic motion and are …

In-Season Concussion Symptom Reporting In Male And Female Collegiate Rugby Athletes, Emily E. Kieffer,, P. Gunnar Brolinson, Arthur C. Maerlender, Eric Smith, Steven Rowson

Center for Brain, Biology, and Behavior: Faculty Publications

Symptom inventories are generally only collected after a suspected concussion, but regular in-season monitoring may allude to clinical symptoms associated with repetitive subconcussive impacts and potential undiagnosed concussions. Despite sex-specific differences in symptom presentation and outcome of concussion, no return-to-play protocol takes sex into account. The objective of this study was to monitor a cohort of contact-sport athletes and compare the frequency and severity of in-season concussion-like symptom reporting between sexes. Graded symptom checklists from 144 female and 104 male athlete-seasons were administered weekly to quantify the effect of subconcussive impacts on frequency and severity of in-season symptom reporting. In-season, …

Mobile Phone Sensors Can Discern Medication-Related Gait Quality Changes In Parkinson's Patients In The Home Environment, Albert Pierce, Niklas König Ignasiak, Wilford K. Eiteman-Pang, Cyril Rakovski, Vincent Berardi

Psychology Faculty Articles and Research

Patients with Parkinson's Disease (PD) experience daytime symptom fluctuations, which result in small amplitude, slow and unstable walking during times when medication attenuates. The ability to identify dysfunctional gait patterns throughout the day from raw mobile phone acceleration and gyroscope signals would allow the development of applications to provide real-time interventions to facilitate walking performance by, for example, providing external rhythmic cues. Patients (n = 20, mean Hoehn and Yahr: 2.25) had their ambulatory data recorded and were directly observed twice during one day: once after medication abstention, (OFF) and once approximately 30 min after intake of their medication …

Does Subthalamic Deep Brain Stimulation Impact Asymmetry And Dyscoordination Of Gait In Parkinson’S Disease?, Deepak K. Ravi, Christian R. Baumann, Elena Bernasconi, Michelle Gwerder, Niklas K. Ignasiak, Mechtild Uhl, Lennart Stieglitz, William R. Taylor, Navrag B. Singh

Physical Therapy Faculty Articles and Research

Background. Subthalamic deep brain stimulation (STN-DBS) is an effective treatment for selected Parkinson’s disease (PD) patients. Gait characteristics are often altered after surgery, but quantitative therapeutic effects are poorly described. Objective. The goal of this study was to systematically investigate modifications in asymmetry and dyscoordination of gait 6 months postoperatively in patients with PD and compare the outcomes with preoperative baseline and to asymptomatic controls without PD. Methods. A convenience sample of thirty-two patients with PD (19 with postural instability and gait disorder (PIGD) type and 13 with tremor dominant disease) and 51 asymptomatic controls participated. Parkinson patients …

The Therapeutic Benefits Of Attunement Through Lindy Hop, Sarah Trowbridge

Expressive Therapies Capstone Theses

Dance/movement therapy (DMT) was developed as a tool to aide in therapeutic healing. A foundational aspect of DMT is attunement, the emotional/kinesthetic connection between two people that allows for meaningful and healing bonds to emerge. Lindy Hop is a partnered dance that fosters an environment of attunement, as it is accessed both subconsciously and consciously. This research explores Lindy Hop as a possible method of therapeutic treatment. The literature indicates the physiological need for attunement and how safety plays a key role in strengthening senses of self-identity, nervous system development, and worldview. Four experienced Lindy Hoppers were recruited to engage …

Deep-Learning-Based Multivariate Pattern Analysis (Dmvpa): A Tutorial And A Toolbox, Karl M. Kuntzelman, Jacob M. Williams, Phui Cheng Lim, Ashtok Samal, Prahalada K. Rao, Matthew R. Johnson

Center for Brain, Biology, and Behavior: Faculty Publications

In recent years, multivariate pattern analysis (MVPA) has been hugely beneficial for cognitive neuroscience by making new experiment designs possible and by increasing the inferential power of functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and other neuroimaging methodologies. In a similar time frame, “deep learning” (a term for the use of artificial neural networks with convolutional, recurrent, or similarly sophisticated architectures) has produced a parallel revolution in the field of machine learning and has been employed across a wide variety of applications. Traditional MVPA also uses a form of machine learning, but most commonly with much simpler techniques based on …

Resting Cerebral Oxygen Metabolism Exhibits Archetypal Network Features, Nicholas A. Hubbard, Monroe P. Turner, Kevin R. Sitek, Kathryn L. West, Jakub R. Kaczmarzyk, Lyndahl Himes, Binu P. Thomas, Hanzhang Lu, Bart Rypma

Center for Brain, Biology, and Behavior: Faculty Publications

Standard magnetic resonance imaging approaches offer high-resolution but indirect measures of neural activity, limiting understanding of the physiological processes associated with imaging findings. Here, we used calibrated functional magnetic resonance imaging during the resting state to recover low-frequency fluctuations of the cerebral metabolic rate of oxygen (CMRO2). We tested whether functional connections derived from these fluctuations exhibited organization properties similar to those established by previous standard functional and anatomical connectivity studies. Seventeen participants underwent 20 min of resting imaging during dual-echo, pseudocontinuous arterial spin labeling, and blood-oxygen-level dependent (BOLD) signal acquisition. Participants also underwent a 10 min normocapnic and hypercapnic …

Somatosensory Dysfunction Is Masked By Variable Cognitive Deficits Across Patients On The Alzheimer’S Disease Spectrum, Alex I. Wiesman, Victoria M. Mundorf, Chloe C. Casagrande, Sara L. Wolfson, Craig M. Johnson, Pamela E. May, Daniel L. Murman, Tony W. Wilson

Center for Brain, Biology, and Behavior: Faculty Publications

Background: Alzheimer’s disease (AD) is generally thought to spare primary sensory function; however, such interpretations have drawn from a literature that has rarely taken into account the variable cognitive declines seen in patients with AD. As these cognitive domains are now known to modulate cortical somato-sensory processing, it remains possible that abnormalities in somatosensory function in patients with AD have been suppressed by neuropsychological variability in previous research. Methods: In this study, we combine magnetoencephalographic (MEG) brain imaging during a paired-pulse somatosensory gating task with an extensive battery of neuropsychological tests to investigate the influence of cognitive variability on estimated …

Relationship Between Preoperative Frailty And Postoperative Outcomes After Lvad Implantation, Katherine L. Wilhelm

DNP Projects

Abstract

Background: Frailty is common in many patients with advanced heart failure, including those who undergo left ventricular assist device (LVAD) implantation. Frailty has been associated with worse outcomes after other cardiac surgeries; however, little is known about the effect of frailty on postoperative outcomes after LVAD implant.

Purpose: The purpose of this project was to evaluate whether preoperative frailty [as determined by either short physical performance battery (SPPB) score ≤ 7/12 or 6-minute walk test (6-MWT) <200 >meters] is associated with poorer postoperative outcomes after LVAD implantation than non-frailty in adults with advanced heart failure.

Setting and Sample: This project …

Diagnostic Accuracy Of Mcmurry’S Test In The Diagnosis Of Meniscal Tears, Jessica Smyth, Hartwell Rainey

Physician Assistant Capstones, 2020-current

No abstract provided.

Developing A Computer-Controlled Treat Dispenser For Canine Operant Conditioning, Walker Arce, Jeffrey R. Stevens

Center for Brain, Biology, and Behavior: Faculty Publications

When performing canine operant conditioning studies, the delivery of the reward can be a limiting factor of the study. While there are a few commercially available options for automatically delivering rewards, they generally require manual input, such as using a remote control, in accordance with the experiment script. This means that human reaction times and transmission distances can cause interruptions to the flow of the experiment. The potential for development of non-supervised conditioning studies is limited by this same factor. To remedy this, we retrofitted an off-the-shelf treat dispenser with new electronics that allow it to be remotely controllable as …

An Unexpected Outcome Of A Pediatric Simulation Encounter For Occupational Therapy Students., Anne H. Zachry, K. Booker, S. B. Lancaster

Faculty Presentations

This presentation reviewed how to plan and implement a pediatric simulated educational experience to align with the targeted course learning objective(s). Participants learned how to incorporate best practices into simulation education in order to advance occupational therapy education.