Medical Education Commons^™

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

Exploring Available Information On The Gut-Brain Axis And Alzheimer’S Disease For Clinicians Making Dietary Recommendations: A Scoping Review, Megan Gibson

Electronic Theses and Dissertations

Abstract: Alzheimer’s Disease (AD) is a complex neurodegenerative disease that requires interprofessional collaboration. Pharmacological options are currently ineffective, increasing the need for preventative strategies to combat the rise of AD. Considerations of gut-targeted interventions have increased as a key component in the prevention of AD, based on the understanding that the state of the gut microbiome can impact cognitive function through the pathway known as the gut-brain axis.

Methods: This scoping review explored information on the gut-brain axis in persons with AD. A comprehensive search was conducted in November 2023. Forty reviews and 13 human studies were analyzed.

Results: There …

Prenatal Genetic Counselors' Perceptions Of Non-Invasive Prenatal Testing (Nipt): A Look At The Informed Consent Process And Common Patient Misconceptions, Emma Duarte, Alaina Swendseid

Human Genetics Theses

Our study investigated prenatal genetic counselors’ perspectives on and overall satisfaction with the current practice of informed consent for non-invasive prenatal testing (NIPT). With the routinization of NIPT, it is increasingly necessary for healthcare providers other than genetic counselors to facilitate pretest counseling. This in turn raises concerns that time constraints and non-genetics providers’ lack of knowledge about NIPT will leave patients unprepared to make an informed decision about prenatal testing. To explore the frequency of perceived patient misconceptions and their perceived sources and identify potential strategies to address current challenges in the informed consent process, we created an online …

Evaluation Of Seizure Recognition And First Aid Training Course And Improving Self-Efficacy Related To Medical Emergencies In Mississippi, Anna Katherine Herrington, Collin Earl Wayne Crawson, Daniel Robert Zuckerman

Honors Theses

Within recent years, there has been increased attention to the growing physician shortage across the United States. This shortage has placed substantial strain upon regions of lower healthcare access, particularly those of rural regions such as much of the state of Mississippi. As rural healthcare providers are placed under more strenuous conditions, they encounter issues of increased patient volume, lack of a trauma team, or adequate transportation to higher-level care facilities. These issues may exacerbate the present inequities in cost of living, access to adequate healthcare, and the distress caused by these concerns. Individuals with epilepsy are one cohort with …

Navigating Asynchronous Online Learning: The Impacts Of Active Learning And Assigned Group Work On Student Motivation, Belonging, And Inclusion, Shea Elisabeth Carr

Theses and Dissertations--Biology

Motivation, belonging, and inclusion are all critical factors for student success but can be difficult to support in asynchronous online courses. Active learning and required group work have been shown to increase student motivation in in-person and synchronous online courses, but little is known about their impact in online asynchronous settings. This dissertation aimed to 1) evaluate the effect of active learning on student motivation in an online asynchronous setting and 2) evaluate the impact of assigned group work on student motivation and perceptions of belonging and inclusion within the context of an online, asynchronous physiology laboratory course. It was …

Implementation Of Prognosticator Algorithm For Initiation Of Serious Illness Discussions And Improving The Rate Of Palliative And Hospice Referrals, Joy Isebor

Doctor of Nursing Practice (DNP) Scholarly Projects

Context: Early serious illness conversations related to end-of-life and goals of care with seriously ill patients have been associated with improving patients' outcomes and quality of care (Bernacki et al., 2015). However, initiating these serious illness discussions has been challenging in the home-based primary care setting.

Objectives: To train and support home-based primary care clinicians in integrating best practices in serious illness discussions and decision-making engagement among patients sixty-five and older with serious illnesses, optimize the alignment between patient goals and the medical care they receive, improving their quality of life and the rate of palliative care and hospice referrals. …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects

Abstract

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. …

A Quantitative Visualization Tool For The Assessment Of Mammographic Risky Dense Tissue Types, Margaret R. Mccarthy

Electronic Theses and Dissertations

Breast cancer is the second most occurring cancer type and is ranked fifth in terms of mortality. X-ray mammography is the most common methodology of breast imaging and can show radiographic signs of cancer, such as masses and calcifcations. From these mammograms, radiologists can also assess breast density, which is a known cancer risk factor. However, since not all dense tissue is cancer-prone, we hypothesize that dense tissue can be segregated into healthy vs. risky subtypes. We propose that risky dense tissue is associated with tissue microenvironment disorganization, which can be quantified via a computational characterization of the whole breast …

An Interdisciplinary Approach To Online Genetics Education, Pinar Ozmizrak

All Dissertations

This dissertation presents an interdisciplinary approach to online genetics education.

Chapter I provides an overview of remote education and a brief history of genetics. While the COVID-19 pandemic prompted a turn to emergency online education, exposure to this form of delivery has led to increased intentional online education.

Chapter II focuses on computer and technology use in healthcare by nursing students. This study investigated nursing students’ perspectives using a modified version of the Pretest for Attitudes Toward Computers in Healthcare (PATCH) assessment scale to explore students’ ideas about computers and technology in healthcare delivery. According to the PATCH scale, the …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

Using Critical Incident Debriefing After Code Blue Events To Support Registered Nurses, David L. Boyd

Doctor of Nursing Practice (DNP) Projects

Using Critical Incident Debriefing after Code Blue Events to Support Registered Nurses

Section I: Abstract

Background: During a code blue event (CBE), the environment becomes highly stressful and intense. Nurses rapidly transition from performing life-saving procedures on their patients to carrying out their usual duties. Without proper debriefing, nurses cannot properly process their emotions leading to increased burnout and secondary traumatic stress (Stamm, 2010).

Local Problem: In 2021, the nurses at Providence Saint John’s Health Center (2021a) responded to 110 CBEs, a 43% increase from 2020. Without a process for critical incident debriefing (CID), these nurses were exposed to trauma …

Improving Traumatic Brain Injury Outcomes: Early Identification And Management Of Paroxysmal Sympathetic Hyperactivity, Randi Rockwell

Doctor of Nursing Practice Projects

Abstract

Background: Paroxysmal sympathetic hyperactivity (PSH) can occur in patients with acutely acquired brain injury and is associated with mortality, poor clinical outcomes, prolonged hospitalizations, physical disability, and increased healthcare costs. The most common cause of PSH syndrome is traumatic brain injury (TBI). Symptoms consist of hyperthermia, diaphoresis, arterial hypertension, tachycardia, tachypnea, and extremity motor dystonic posturing, often in response to evoked stimuli and occurs in 8% to 33% of TBI patients. Critical care nurses are at the forefront of providing direct patient care to TBI patients and are often the first to identify PSH.

Purpose: The objective of this …

Gut Microbial Metabolite Indole: A Stimulator Of Enteroendocrine Cell Differentiation Via Activation Of Aryl Hydrocarbon Receptor, James Hart

Theses, Dissertations and Capstones

Enteroendocrine cells (EECs) regulate energy balance and glucose homeostasis by releasing hormones in response to food intake. Dysregulated EEC differentiation is observed in obesity, while gut microbiota metabolites influence this process. Here, we investigated the role of indole, a biologically active gut microbial metabolite, in EEC differentiation through aryl hydrocarbon receptor (AhR) activation. Human intestinal organoids derived from jejunal mucosal biopsies were exposed to indole. Indole treatment significantly increased mRNA levels of chromogranin A, an EEC marker. The effect was reversed by an AhR antagonist, indicating AhR involvement. Indole also upregulated AhR target gene mRNA levels. These findings highlight the …

Genetics And Genomics Education Among Physician Assistants, Wesley Patterson

All Dissertations

This dissertation comprises five chapters to describe genetics and genomics education among physician assistant/associate (PA) students and practicing PAs. Chapter I introduces the gap in supply and demand of genetic services, the need for non-genetics healthcare providers to fill the gap, and the PA profession as a solution.

Chapter II is a rapid literature review that summarizes the available literature regarding genetics and genomics education for PAs. A paucity of literature exists to describe the current state of PA genetics-genomics education. The few studies retrieved describe content being taught in PA programs, the number of genetics-genomics contact hours PA students …

Characterization Of Gangliosides And Fatty Acids In Extracellular Vesicles From Human Milk, Aliya Amin

Food Science (MS) Theses

Extracellular vesicles (EVs) are bioactive components of human milk that may impact functionality to regulate growth, cognitive development, metabolism, and immunity in newborns. The biogenesis of EVs and the mechanism by which EVs elicit biologic effects in vivo have not been characterized entirely. Gangliosides and fatty acids are integral in the formation, release, stability, and functionalities of EVs. Presumably, EV function is related to EV composition and lipids in EVs influence the bioavailability of EV cargo and downstream functions of EVs. The objective of this research was to characterize the fatty acid and ganglioside composition of EVs in human milk. …

Evaluation Of A Hands-On Cooking Class And Its Effects On Self-Efficacy In Relation To Healthy Eating In Type 2 Diabetics, Codi A. Jenshak-Gorzinski

DNP Scholarly Projects

The prevalence of Type 2 diabetes is alarming and poses a great threat to U.S. national health. Chronic diabetes can lead to serious conditions such as heart attack and stroke, and can result in premature mortality (World Health Organization, 2018). Diabetes can be prevented or treated by eating a healthy diet. Cooking classes are a potential way to improve American’s knowledge of nutritional principles and help them become confident that they have the capacity to eat a healthy diet. The purpose of this DNP project was to determine if participation in cooking classes enhanced self-efficacy as it pertains to healthy …

The Process And Case Study Approach To Implementing A Nutrition-Specific Dissemination And Implementation Science Training In Appalachia, Ayron E. Walker

Graduate Theses, Dissertations, and Problem Reports

Introduction: Nutrition professionals face implementation challenges due to their lack of knowledge to incorporate D&I science into intervention design. To improve intervention outcomes, nutrition professionals must be trained in D&I science, which are currently absent in the field.

Aims: To identify and assess nutrition educators and practitioners perceived motivations, self-efficacy, and attitudes in using D&I science to inform the educational design and strategies of a nutrition-specific D&I curriculum for nutrition educators. Then to test feasibility of the nutrition-specific curriculum in increasing knowledge, self-efficacy, and attitudes by a case study approach, pre/post intervention design.

Methods: First, scoping review methodology involved the …

Towards The Growing Edge: Integrating Simulation In A Genetic Counseling Graduate Program, Cassandra Pisieczko

Human Genetics Theses

Simulation is a well-established learning practice in medical education; however, it is not well studied in genetic counseling. The current study utilizes action research to document and describe the implementation of a simulated patient (SP) program into the Joan H. Marks Graduate Program in Human Genetics curriculum. With the standards of genetic counseling training now including simulated patient encounters as participatory cases (ACGC 2019 and 2020), the utilization of SP methodology can be expected to grow. The goal of the study was to explore specific considerations of simulation in genetic counseling while meeting the standards of best practice laid out …

Investigating Barriers Experienced By Underrepresented Minorities In Becoming A Competitive Genetic Counseling Applicant, Katie Huang

Dissertations & Theses (Open Access)

Representation for both racial/ethnic and gender identity minorities in genetic counseling (GC) remains the lowest among similar healthcare professions. Barriers that underrepresented minority (URM) individuals face in becoming a competitive GC applicant have not yet been described. Academic capital (AC) is a theoretical framework describing the social processes necessary for individuals to navigate and succeed in higher education. This study aimed to characterize barriers experienced by applicants who self-identify as underrepresented and to explore how AC could identify areas for intervention. Prospective GC applicants for the 2021/2022 cycles were recruited to complete an anonymous online survey in Qualtrics through a …

Racial Disparities In Liver Disease In The Us: Addressing The High Prevalence Of Hepatitis B Infection In The Apia Community, Lindsey L. Trinh, Lindsey Trinh

Scripps Senior Theses

Chronic liver disease and hepatocellular carcinoma are some of the leading causes of death in the United States, resulting in a number of annual deaths that has only increased over the past several decades. A vast proportion of these liver-related deaths is due to chronic hepatitis B infection, which currently affects approximately 1.2 million people in the US. However, the hepatitis B virus does not affect every racial group in the United States equally: Asian Americans experience a disproportionately high prevalence of HBV infection. In fact, even though the APIA community comprises only 4% of the US population, they account …

Physician Knowledge, Attitudes, And Behaviors Towards Registered Dietitian Nutritionists, Amy Motley Jones

UNF Graduate Theses and Dissertations

Diet is increasingly linked with overall quality of life, and a healthy diet is now being considered one of the cornerstones of preventative care. Physicians rely on Registered Dietitian Nutritionists (RDNs) as most doctors lack the nutrition knowledge to properly treat their patients, especially during their residency. Little published information exists on the specific collaboration of RDNs and resident physicians. This study aimed to determine whether mentoring with an RDN increased physician nutrition knowledge, increased consults to RDNs, and whether physician attitudes improved regarding their understanding of the role of the RDN in healthcare. Knowledge or attitude alone are not …

Reconsidering The Obstetrical Dilemma: Correlations Between Head And Pelvic Size, Kelsey Catrice Fox

LSU Master's Theses

The Obstetrical Dilemma (OD) theory has become canon in biological anthropology. The OD posits that i] dystocia results from bipedal mothers and encephalized infants, ii] contrasting selection for bipedality and obstetrics hinders locomotive efficiency, and iii] the contradicting requirement of the fetus being small enough to pass through the birth canal yet being cognitively advanced enough to cling to its mother after birth. Females, theoretically, exhibit deficient gait efficiency for the sake of successful childbirth. An obstetric advantage theory has been posited where taller individuals with a larger head size have larger pelves. If the distance between the acetabulae increases …

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

DNP Projects

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

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

Learning Science: Physical And Life Sciences In Curricula Across U.S. Schools Of Nursing, Valerie C. Sauda

Electronic Theses and Dissertations

Nursing educators are being challenged to provide curriculum that meets the changing healthcare environment and demand for creative, innovative nurses to assist in transforming healthcare into the future (Benner, Sutphen, Leonard, & Day, 2010; Institute Of Medicine, 2011). The liberal education provided within a baccalaureate of science in nursing (BSN) degree program provides a diversity of courses within the curriculum, including courses in the natural, physical, mathematical, and social sciences (American Association of Colleges of Nursing [AACN], 2008). Although nursing programs have included science courses in curriculum since the early 1900s (Nutting & Dock, 1907), there is lack of nursing …

Physical Therapist Views And Experiences With Patient Use Of Marijuana, Arturo De La O Basurto Jr.

Cal Poly Humboldt theses and projects

Conditions seen within physical therapy settings overlap with reasons that patients seek marijuana. For this reason, information about these professionals’ outlooks on patients’ marijuana use in prime. Purpose: Gain current views and experiences of physical therapists (PTs)/physical therapist assistants (PTAs) on their patients’ use of marijuana in the physical therapy field. Methods: PTs/PTAs were invited to complete an anonymous survey asking relative PT/PTA views, experiences, and understanding of patients’ marijuana use. Results: PTs/PTAs who have had experience (did not have experience) with patients who use marijuana received information about marijuana from news media - 61% (60%), patients …

Learn First, Practice Second Approach To Increase Health Professionals’ Nutrition-Related Knowledge, Attitudes, And Self-Efficacy., Madison E. Santella

Graduate Theses, Dissertations, and Problem Reports

The aim of this study was to assess the effectiveness of a “learn first, practice second” intervention on the nutrition-related knowledge, attitudes, and self-efficacy of multidisciplinary health professionals in West Virginia, specifically highlighting the Mediterranean Diet. Data was captured via online surveys at four time points (Baseline, Post-education, Post-immersion, Follow Up). All information was self-reported. This approach consisted of 16 weeks of online education, 2 weeks of cultural immersion in Tuscany, Italy, and a 7 month return to practice period. Data were analyzed using JMP Version Pro 12.2 and SAS Version 9.3 for Windows. Repeated measures ANOVA with irregular spacing …

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim …

Success Rates Of Second Semester Anatomy Students In Online And On-Ground Classes At A Community College In East Tennessee, William Sproat

Electronic Theses and Dissertations

Educators expect the number of institutions offering online courses and the number of students enrolling in these courses to increase as many students, particularly nontraditional students, discover the advantages of online content delivery. Online courses require new methods of communication between students and faculty as well as discovering new ways to build relationships, earn student trust, conduct appropriate assessment, and deliver useful course content. Many institutions—public, private, and for-profit—offer a wide variety of online coursework but faculty, employers, and the public have expressed concerns about the quality of online course content. In particular, online delivery of coursework in the natural …

Genetic Testing Practices Of Genetic Counselors, Geneticists, And Pediatric Neurologists With Regard To Childhood-Onset Neurogenetic Conditions, Sara Wofford

Dissertations & Theses (Open Access)

Identifying genetic diagnoses for neurological conditions with a considerable hereditary component, such as autism spectrum disorder (ASD), intellectual disability, and epilepsy, is critical to providing proper medical management for these patients and their families. However, many patients with these conditions are not tested appropriately or receive no genetic testing at all. The current study was designed to characterize the genetic testing practices of the providers most likely to evaluate or order genetic testing for these patients: pediatric neurologists, geneticists, and genetic counselors. The study noted significant variance between the testing strategies selected by pediatric neurologists compared to those of geneticists …

Entry-Level Physical Therapy Students' Knowledge And Attitudes Of Nutrition, Jordan D. Day

Electronic Theses and Dissertations

Like other allied health fields, physical therapy has incorporated health promotion as a part of their practice. A large and important component of health promotion is nutrition. Little research has been conducted on the knowledge and attitudes of nutrition in physical therapists and has only included small sample sizes. Therefore, the purpose of the present study was to expand upon the knowledge and attitudes of nutrition in physical therapy students. Subjects included doctoral physical therapy students from across the United States, ranging from first year to senior level. The present research was conducted online via a Qualtrics survey. Surveys, included …