Medical Education Commons^™

Building Or Breaking Trust In Healthcare Through Patient And Family Engagement In Research And Service Design: The Need For Authentic Engagement Practices, Lisa D. Hawke, Hajar Seiyad, Shoshana Hauer, Charlotte Munro, Natasha Y. Sheikhan

Patient Experience Journal

Trust in the healthcare system is an important driver of public health, but is sometimes lacking among individuals and communities. Patient and family engagement in research and service development is one proposed means of influencing trust. Patients and families can be engaged authentically and meaningfully as partners in the conduct of research and the development of healthcare services. When engagement is conducted following best practices, patients and families have the opportunity to build strong mutual relationships with project leads, hold a share of the power in the discipline, and exercise choice to influence the research and service development agenda. These …

Co-Designing Trust: Patient Experience, Relationships, And The Design Of Care, Toni Land

Patient Experience Journal

Trust can have a positive or negative impact on patients, families, and community healthcare experience. Although important, it is often treated as something soft and intangible rather than something intentionally measured and designed. Currently, healthcare organizations collect and report patient experience data related to communication, courtesy, respect, and responsiveness. But these measures do not capture the specific behaviors that influence whether trust builds or whether it stalls. This commentary explores trust as a foundational behavioral and environmental element in healthcare and challenges that improving trust requires more than good intentions; it requires bringing voices to the table through co-design. Starting …

A Modern Playbook For Trust Across The Health Ecosystem, Erin O'Malley

Patient Experience Journal

Public trust in health care delivery, public health, and biomedical innovation is at a historic low. While many place the blame on the COVID-19 pandemic and the proliferation of social media, the reality is that distrust is a deeply rooted structural challenge that has plagued the U.S. for centuries. It is tied to historical movements for medical freedom and centuries of systemic discrimination and earned mistrust among minoritized communities. Today, this crisis is compounded by a lack of shared values and facts and the rising dominance of tribal identity over objective science. The Coalition for Trust in Health & Science …

Healing The Social Covenant: Rebuilding Trust And Re-Humanizing Healthcare, Cynda Hylton Rushton

Patient Experience Journal

Violence against healthcare workers continues to escalate despite substantial investments in security measures, workplace violence prevention programs, and legislative protections. Although these interventions are necessary, they have not produced sustained improvements in workforce safety or retention, suggesting that workplace violence is more than a behavioral or security problem. This commentary argues that it also reflects a deeper erosion of trust within healthcare. Drawing on evidence linking workplace violence to burnout, moral injury, psychological distress, and turnover intention among nurses, we propose that repairing trust is essential to sustaining the workforce and healthcare.Building on our earlier work, Rebuilding a Foundation of …

Trust: Why A Commitment To Human Experience Matters, Jason A. Wolf

Patient Experience Journal

Trust is one of the most essential elements in our overall human existence. It is a critical part of our human experience, one that reaches well beyond the boundaries of healthcare. Trust is the element that holds society together. It emerges in the relationship of one human being connecting with another human being, and it reaches to the engagements people have with organizations, institutions, and systems as well. Trust, while hard to hold, is ever present. It is a powerful force that guides our way of being, our interactions, our choices, even if we ourselves are not directly conscious of …

The Impact Of State Insulin Copayment Caps On Diabetics In The United States, Ryan C. Meyer

All Theses

Insulin is a life-saving medication for people with diabetes that helps regulate blood glucose levels throughout the body. A Type 1 diabetic cannot survive without insulin, and a Type 2 diabetic’s quality of life greatly diminishes without access and use of this drug. Currently, many diabetics skip, ration, or abstain from insulin due to financial barriers. As of June 2026, 29 states have enacted insulin copayment caps for state-regulated commercial health insurance plans to reduce the financial burden of insulin costs. This study examines the impact of these caps on all commercially insured diabetics in the United States, particularly on …

J Mich Dent Assoc July 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200-plus members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.

The July 2026 (Volume 108, No. 7) issue of the Journal is published in print format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

The July 2026 issue of the Journal of the Michigan Dental Association celebrates the 40th anniversary of the association's …

Enacting Leadership And Transforming The World: Hannah Arendt, The Private, The Public, And Transfigurations In Between, Xochitl Mendez

Educational Studies Dissertations

In this dissertation I propose a framework that emphasizes transitions between Private and Public. I argue that individuals can consciously reshape and reformulate these transitions to assert themselves in the world. How can the individual’s own internal realities, ventures, projects and selfhood assert themselves in a fraught world as an act of self-affirmation, leadership, and transformation? New approaches to this question can all be revealed by using transitions between Private and Public as actionable strategies. I re-interpret Hannah Arendt’s Private and Public as she presented them in The Human Condition (1958). I turn these into multivalent and multilayered spaces of …

Enhancing Provider Engagement Through Peer-To-Peer Coaching: The Provider Ambassador Program, Jason Vallee, Jodi Stewart, Sam Verkhovsky, Steve Del Giudice, Janet Aug, Amanda Higgins, James Perry, Alice Kennedy, Brant Oliver

Patient Experience Journal

Provider burnout and disengagement are associated with diminished patient satisfaction, reduced clinical quality, and adverse organizational outcomes. Peer-to-peer coaching has emerged as a promising, scalable intervention to support provider engagement and improve the patient care experience. This study evaluates the effectiveness of the Provider Ambassador Program, a structured peer-to-peer coaching initiative designed to improve patient satisfaction by enhancing provider communication, professional behavior, and patient engagement skills. A pre-post quasi-experimental design was used to assess changes in provider CG-CAHPS ``Provider Overall'' top-box scores following coaching. Eligible providers (n = 83) across five BLANK Health locations were identified based on top-box scores …

A Hybrid Coaching Model In A Multi-Center Networked Care Experience Learning Collaborative, Elizabeth Rizzo, Victoria Adams, James Perry, Nicole Szalay, Samuel Verkhovsky, Megan Morse Holthoff, Alice Mae Kennedy, Brant Oliver

Patient Experience Journal

Coaching teams and leaders conducting quality improvement (QI) has shown to be an effective method for project success. Our coaches were well versed in Lean Six Sigma and IHI Model for Improvement methods. Certified Lean Six Sigma Blackbelts coaches were assigned to project teams. Routine participation in project team meetings and one-on-one coaching sessions reenforced tools necessary to complete improvement work. Additionally, coaches met with one another to discuss their methods, work through challenges, and celebrate successes. Fourteen improvement teams led work in Care Experience related projects. Eleven project leaders certified in Lean Six Sigma methodology through the Value Institute …

Documentation And Dashboard Driven Quality And Safety Improvement In Interpreter Services For Limited English Proficient Patients, Richard T. Dillehay, Samuel Verkhovsky, Andrew Bohm, Harley Friedman, Dawn Welshman, Ann Morong, Vidya Karthikeyan, Jessica Dampier, Amanda Racine, Brant Oliver

Patient Experience Journal

Limited English Proficiency is known as an independent driver of disparities in patient's access to healthcare and their healthcare outcomes. The Joint Commission standards require that health systems document language services delivery to patients with limited English proficiency in a systematic way. Our health system had not historically utilized a methodical system for documenting language services utilization prior to the launch of this initiative. By utilizing a Lean Six Sigma approach, a project team comprised of leaders from interpreter services, operations, data analytics, and data informatics codesigned an Epic SmartForm data collection instrument and series of Tableau dashboards to monitor …

``We'll Be Right With You'', Improving Patient Experience With Complaint Management Within A Learning Health System Collaborative, James J. Perry, Mackenzie Hahn, Angela Kmiec, Brant J. Oliver

Patient Experience Journal

An improvement team at Cheshire Medical-Dartmouth Health participated in the Care Experience Collaborative aimed at enhancing the patient and workforce experience. Utilizing a hybrid Lean Six Sigma DMAIC approach alongside modified Institute for Healthcare Improvement learning techniques, local teams were coached by quality improvement specialists. The project's focus was on improving the complaint management process to boost hospital ratings and recommendations. Initial assessments revealed significant inefficiencies, such as delays in response times and poor tracking of complaint resolutions. Implementing a new digital monitoring system in conjunction with standardized training resulted in substantial improvements: complaint resolution times decreased by 53%, while …

From Talking The Talk To Walking The Walk: Reflection On Dartmouth Health's Care Experience Week, Rosie Bartel, Corey Kimpson, Tanya Lord, Victoria Lyons, Tony Serge, Brant Oliver

Patient Experience Journal

This article explores the participation of expert members from the Beryl Institute's Global Patient and Family Advisory Board (GPFAB) during Dartmouth Health's Care Experience Week, under the theme ``From Talking the Talk to Walking the Walk.'' This week aligns with the national Patient Experience Week. The Patient Family Advisor (PFA) presenters and authors of this article have shared their lived experience locally, nationally, and internationally through conferences, webinars, podcasts, videos, blogs, white papers, journal articles, books, and in many other ways for and as PFA members of a multitude of healthcare organizations co-create change that improves outcomes for all human …

Improving Human Experience In Health Care: Leveraging ``Humanistic Learning Health Systems'' To Accelerate Change At Scale, Brant J. Oliver, Jason A. Wolf

Patient Experience Journal

Included in a special segment in this issue of the Patient Experience Journal, are a series of reports on improving HX in healthcare supported by a humanistic LHS– the Dartmouth Promise Partnership Coproduction Learning Health System in New Hampshire, USA. Promise is a strategic partnership between a medical school and a multi-center rural academic health system. It integrates translational science education and research, data informatics, and scaled and networked humanistic applied change initiatives. One of these initiatives is the Care Experience Collaborative, a multi-center improvement initiative across the health system focused on improving HX. This special segment includes five reports …

Patient Engagement In Developing Radiology Patient Education Materials, T Arleo, Harrisd Harrisd, J Hislop, J Moon, H Li, N Kadom

Patient Experience Journal

Purpose: This initiative aimed to engage patients in the process of developing patient education materials (PEM) on the major imaging modalities at our institution. Materials and Methods: PEM were created for computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), fluoroscopy, and radiography. Content was sourced from various sources, consolidated into a draft, and iteratively updated: They were simplified using a ChatGPT-4.0 prompt designed to achieve a 7th grade reading level; they were reviewed for accuracy by subject matter experts (SME); they were assessed for readability and understandability using the Flesch-Kincaid Grade Level (FKGL) and the Patient Education Materials Assessment …

Utilization Of Visual Metaphors For Improving Health Literacy, Kadir Alp Özler, Morgan Dressel, Madeline Weiner, Robert D Lucito, Alice Fornari

Patient Experience Journal

Health education is practiced in patient encounters via verbal communication and educational pamphlets. However, these techniques are faulty and do not provide true patient comprehension of their conditions and treatments reform is necessary to prevent the mortality and hospitalization rates that are linked to poor health literacy. Visual aids and metaphors are individually known to be powerful educational tools. A student organization at Stony Brook University, Artists in Medicine, has sought to synergize these tools to create visual metaphors artwork that links everyday concepts to patient illnesses to facilitate comprehension of this information. For example, one project “Aortic Dissections” depicts …

Patient Experience (Px) In Low- And Middle-Income Countries (Lmics): A Scoping Review, Yara Abou Harb, Geoffrey A. Silvera

Patient Experience Journal

Patient Experience (PX) is a growing subject in the healthcare industry due to its association with improved clinical outcomes, patient safety, and business motives. While PX is well studied in high income countries, little is known about the state of PX in Low and Middle-income countries (LMICs). Objective: The study aims to examine literature on PX and related concepts in LMICs. Methods: This study executes a PRISMA literature review of academic databases (Ovid Medline, CINAHL, EMBASE and Google Scholar) as well as hand searching of PX related websites from 2005 to 2024. Results: 67 references met search criteria. Four themes …

Multilevel Factors Shaping The Patient Experience With Health Services In Torbat Heydarieh, Iran, Fatemeh Pourhaji, Mohammad Hossein Delshad

Patient Experience Journal

Background: One of the main aims of public health is to ensure that health services are used and available. However, access alone does not guarantee a positive patient experience, which is critical to achieving optimal health outcomes and ensuring health equity. Aims: The objective of this study is to analyse in a comprehensive way the multiple factors influencing the patient experience and subsequent use of healthcare services by households in Torbat Heydarieh, Iran, by examining the independent and interactive contributions of individual, household and environmental (community) determinants using THUMS data. Methods: This analytical study, which covered a 1-year period, looked …

Factors Influencing Patient Satisfaction In Health Services: A Cross-Sectional Study In The Holy City Of Najaf, Ahmed Abdul Hasan Mohsin, Lamees A. Abdul-Lateef, Noor Ismeal Nasser

Patient Experience Journal

The healthcare system in the city of Najaf works to improve the quality of services provided to patients. Since patient satisfaction serves as a key measure of service quality, this study was designed to identify the potential factors that influence satisfaction within these facilities. cross-sectional study was conducted for 300 patients using public healthcare services in Najaf. the selection of patients based on the stratified random sampling across hospitals and primary health centers. Data were collected using a 24-item structured questionnaire that measured four domains: accessibility, staff attitude, service quality, and physical environment, rated on a four-point Likert scale. The …

Nursing Staff Attitude Towards Nurse-Physician Collaboration In The Neonatal Intensive Care Unit In Al Ahsa City, Saudi Arabia, Makarim Taqi Al Helal, Yaqoub Yousef Al Mousa

Patient Experience Journal

Objective: Effective nurse-physician collaboration is fundamental to ensuring quality healthcare delivery, particularly in Neonatal Intensive Care Units (NICUs), where patient outcomes rely heavily on coordinated teamwork. This study aimed to assess nursing staff attitudes toward nurse-physician collaboration in NICUs, examine the influence of demographic and professional characteristics, and provide evidence-based recommendations to strengthen interprofessional collaboration. Methods: A quantitative, non-experimental, cross-sectional survey was conducted from April to June 2024 in the NICU of Maternity and Children's Hospital, Al Ahsa, Saudi Arabia. A total of 180 nurses with at least one year of NICU experience participated. Data were collected using the …

Do Allied Health Professionals' Workplace Experiences Affect Their Decisions To Stay? A Quantitative Investigation Into The Relationship Between Wellness And Employee Retention In United States Hospitals, Dina Jarjees, Lihua Dishman

Patient Experience Journal

Allied Health Professionals (AHPs) are university-trained practitioners with specialized skills essential for preventing, diagnosing, and treating health conditions. AHPs play a vital role in comprehensive healthcare, including hospitals, where they comprise a significant portion of the workforce and recurrent health expenditures. However, AHPs experience considerable burnout and emotional distress, negatively impacting retention. This issue worsens workforce shortages and limits access to care, which jeopardizes patient safety. This national, cross-sectional, quantitative study examined the relationship between AHPs' wellness dimensions (physical, emotional, mental, social, and spiritual) and AHPs' retention in United States hospitals. A self-developed survey instrument included 10 demographic and 25 …

Investigating The Effectiveness Of Different Modalities In Interprofessional Training, Rose Ann Mathai, Sean Lopez, Maureen Emlund, Jim Scherrer, Elisa Buzinski, Julia Sonnichsen, Myra Carew

Patient Experience Journal

Background: Interprofessional education (IPE) highlights the importance of values and ethics, teamwork, communication, and roles and responsibilities for healthcare professionals. Different modalities have been used to teach these skills. The most effective teaching modality must be determined to enhance the collaborative learning experience. Purpose: This study evaluated the changes in student perceptions on each interprofessional competency with respect to the teaching modality. Two groups were evaluated for this study. One was taught using a hybrid curriculum and the other in-person. Methods: This study utilized the Students' Perceptions of Interprofessional Clinical Education (SPICE-R2) survey to determine the changes in student …

Exploring Patient Satisfaction: Descriptive And Predictive Insights From Hcahps Surveys In U.S. Hospitals, Naveen Gudigantala, Tanush Sistla, Ramu Gudigantala, Naga Vemprala

Patient Experience Journal

This study analyzes patient experience data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys across three time periods: 2020–21, 2021–22, and 2022–23. Utilizing both descriptive and predictive analytics, we examined ten key variables related to patient communication, hospital environment, discharge information, and overall hospital ratings. Descriptive analytics using longitudinal data analysis revealed that while patient experience metrics were strong in 2020–21, a significant downturn was observed in 2021–22, followed by a marked recovery in 2022–23. These results suggest that while COVID-19 pandemic negatively impacted patient satisfaction metrics in 2021–22, the emerging evidence suggests U.S. healthcare system …

Patient Satisfaction And Perceived Quality Of Care: A Population-Based Cross-Sectional Study Of United States Adults, Samuel Ofei-Dodoo, Carter Altenbernt, Yessin Wael, Hayrettin Okut, Alex Watkins, Nola Tran, Alishka Rojas-Addari

Patient Experience Journal

Patient satisfaction and perceived quality of care are key indicators of health care performance, yet the relative influence of demographic versus communication-related factors remains underexplored. Using data from 7,278 non-institutionalized United States adults in the nationally representative Health Information National Trends Survey, descriptive statistics summarized respondent characteristics and experiences with health care professionals, and survey-weighted multinomial logistic regression identified predictors of perceived health care quality. Respondents generally reported positive experiences, with communication-related factors emerging as the strongest predictors of excellent ratings. Patients who were always included in decisions (OR = 3.44; 95% CI, 1.11-10.69), received clear explanations (OR = 11.24; …

System-Level Barriers To Patient Engagement With Electronic Medical Records, Corey Adams, Reema Harrison, Guncag Ozavci, Kathleen Gray, Nilmini Wickramasinghe, Vicky Yuan, Tracey Bucknall, Elizabeth Manias

Patient Experience Journal

Objective: Electronic medical records (EMRs) can support patient-centered care, but system-level barriers often limit how patients engage with EMR systems. This study explored the system-level barriers and enablers to patient engagement with EMRs from the perspectives of healthcare leaders. Methods: Semi-structured interviews were conducted with 20 participants in senior EMR-related roles across healthcare organizations in two Australian states. Data were analyzed using reflexive thematic analysis to identify key system-level influences on patient engagement. Results: Seven themes were identified: 1) EMRs for digital storage, not connection, 2) Privacy rules create challenges to accessing information, 3) Communication barriers when using EMRs, 4) …

Virtual Caregiving And The Evolving Role Of Carers And Patients: Virtual Hospital Interview Analysis, Kanesha Ward, Tim Jackson, Jenna Bartyn, Shannon Saad, Sue Amanatidis, Owen Hutchings, Annie Y.S. Lau

Patient Experience Journal

Virtual hospitals are transforming healthcare by enabling remote monitoring and management of patients, improving accessibility and care continuity. As part of the transformation, there are changes to the roles and responsibilities of patients and their carers as they engage in virtual hospital care. The impact on family caregiving remains underexplored. Guided by Family Systems Theory, this qualitative study investigated how family caregiving roles adapt within a virtual hospital and identified opportunities to further support families. Semi-structured interviews were conducted with patients, carers, and healthcare workers from one model of care, at a metropolitan virtual hospital in New South Wales, Australia. …

Leveraging Digital Patient And Family Advisory Councils To Drive Patient Engagement, Priya Radhakrishnan, Shambhavi Mishra, Melissa Price, Cammy Sanders, Fiker Bekele, Kathi Zarubi, Craig Kartchner, Amrit Singh Johal, Carol Mayer, Craig Norquist

Patient Experience Journal

Patient and Family Advisory Councils (PFACs) have been integral in enhancing patient care, but their limited reach often excludes underrepresented populations. Digital PFACs present an opportunity to overcome these barriers and engage a broader spectrum of patients and families, fostering more inclusive healthcare decision-making. We implemented a Digital Patient and Family Advisory Council (DPFAC) at HonorHealth, as part of the Patient Centered Outcomes Research Institute (PCORI) capacity building grant. We used the RE-AIM and PRISM frameworks to engage participants through a digital platform. The process began with a needs assessment and was followed by the development of the platform, during …

Supporting Families Of Children With Craniosynostosis: A Qualitative Exploration Of Parental Usage Of Online Forums, Elisha L. Rea, Rachel M. Roberts, Amanda J. Osborn

Patient Experience Journal

Objective: Craniosynostosis is characterised by the early fusion of cranial sutures, resulting in an abnormal head shape. This study examines the psychosocial impact of a child's craniosynostosis diagnosis on families, by analysing online forum discussions. While surgery is often needed to address appearance-related and neuropsychological concerns, parents face challenges navigating their child's diagnosis. Many seek support through online forums, yet research on their experiences remains limited. This study aims to understand parental needs and experiences by analysing forum discussions. Method: Online forums were analysed using reflexive thematic analysis. Significant features of the data were systematically coded and themes reflecting …

Validation Of A Copd Patient-Reported Experience Measure (Prem-C9) In Ontario, Canada, Elaine Zibrowski, Floriana Islami, Alyson Kellar, Christopher Licskai, Madonna Ferrone, Shannon L. Sibbald

Patient Experience Journal

Objective: Patient-reported experience measures (PREM) are important tools for evaluating healthcare quality, yet their implementation in chronic obstructive pulmonary disease (COPD) care within Canada remains limited. Our objective was to examine the construct validity of the PREM-C9 instrument in a Canadian context and explore its potential clinical applications beyond measuring patient experience. Methods: A two-phase, prospective, cross-sectional, mixed-methods study was conducted across 41 Best Care COPD sites in Ontario, Canada. In the quantitative phase, confirmatory factor analysis assessed the construct validity of the PREM-C9. In the qualitative phase, focus group interviews with COPD case managers explored implementation experiences and perceived …

A Study To Assess Prom And Prem Of Cld Patients In A Tertiary Care Hospital, Anagha Nandakumar, Rubasree M, Priya Nair, Dr. Dinesh Nair, Krishnapriya S

Patient Experience Journal

Chronic liver disease (CLD) leads to progressive liver dysfunction, significantly affecting patients quality of life (QOL). Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are critical in evaluating the health status and care experiences of CLD patients. This study aimed to assess the impact of PROMs and PREMs in CLD patients undergoing endoscopic procedures. A prospective study was conducted in the Gastroenterology and Hepatology Department over three months, involving 245 CLD patients (160 inpatients and 85 outpatients). PROMs were assessed using the Liver-specific PROM (LC PROM), which focused on daily living, symptom management, psychological well-being, and treatment effectiveness. PREMs …