Medical Education Commons^™

Veteran Emergency Waiting Areas And Turned-Off Televisions: An Overlooked Variable, Randall Vanadisson

Patient Experience Journal

The significance of environmental design in emergency department (ED) waiting areas is increasingly acknowledged as a vital element affecting patient experience and stress levels, especially among veterans who may already encounter heightened psychological susceptibility. Aim: To investigate the impact of a non-operational television (TV) at a veteran's medical center emergency department waiting area on patient behavior, perceived stress, and environmental involvement. Methods: This naturalistic observation study employed non-participatory observation of 19 patients in the waiting area of a Veterans Affairs hospital. Field notes captured behavioral responses, seating patterns, and nonverbal stress cues. Observable engagement with the physical environment, …

Development And Psychometric Assessment Of The Sub-Scales Of The Ontario Perception Of Care Tool For Mental Health And Addictions (Opoc-Mha), Brian Rush, Karen Urbanoski

Patient Experience Journal

Historically, the tools designed to measure of ``patient satisfaction'' or ``perception of care'' have been developed and evolved separately for the mental health and substance use health sectors. This presents challenges for implementation and usefulness of the results for quality improvement and evaluation given recent efforts aimed at more integrated services and systems. The objective of this study was to psychometrically evaluate eight domain-specific sub-scales of a perception-of-care tool developed specifically for mental health, substance use and/or concurrent disorder services - the OPOC-MHA. The development and process for widescale implementation of the OPOC-MHA has resulted in a large provincial dataset …

Inaccessibility And Performative Inclusivity: Higher-Weight Francophone And Newcomer Adults' Experiences In A Canadian Atlantic Province, Andrea E. Bombak, Norma Chinho, Kathleen O'Keefe, Sumaiya Akhter, Lisa Thomson, Courtney Burk, Lee Turner

Patient Experience Journal

Weight stigma research is needed in diverse populations. Two populations that may experience compromised healthcare in New Brunswick, Canada's only officially bilingual province (English/French), are Francophone New Brunswickers and newcomers to Canada. As such, this study explores the experiences of higher-weight (Body Mass Index ≥ 30) adults (≥ 18 years of age) who also identify as primarily Francophone or as having moved to Canada ≤ 5 years ago in and out of healthcare contexts. Participants were interviewed according to a semi-structured interview guide face-to-face, by telephone, or video-call two times, at 2-to-3-month intervals. Interviews included questions about experiences and effects …

The Patient's Lived Experience: A Phenomenological Study On Factors Influencing Tuberculosis Treatment Outcomes In Medan, Indonesia, Erida Novriani, Urip Harahap, Khairunnisa Khairunnisa, Wiryanto Wiryanto

Patient Experience Journal

This qualitative phenomenological study was conducted to analyze the factors influencing tuberculosis (TB) treatment outcomes from the patient's perspective in Medan, North Sumatra, Indonesia. The objective was to uncover the nuanced human factors shaping the patient's treatment journey, moving beyond a sole reliance on statistics and quantitative methods. The research was conducted across all 41 Primary Health Centers (PHCs) in Medan. Through a purposive sampling strategy, data was collected from 22 TB patients via in-depth interviews until data saturation was achieved. The collected data was analyzed using thematic, narrative, and phenomenological approaches to interpret the detailed lived experiences of the …

Applying A Patient Journey Mapping Approach To Understand Maternal Care Patient Journeys: A Pilot Study, Nicole Hicks, Kristin Tully, Christopher Goodier, Sreenath Chalil Madathil, Ayaba Logan, Myrtede Alfred

Patient Experience Journal

Introduction: In the United States, giving birth is the most common cause of hospitalization. Maternal care frequently represents birthing people's first experiences of prolonged interactions with the healthcare system. However, the structure of services is often fragmented and misaligned with individuals' needs, particularly for Black birthing people. Documenting birthing people's experiences during pregnancy and postpartum allows for identification of practices working well and opportunities to improve patient-centered maternal care. Methods: The mixed-methods study was conducted in the southeastern United States and used patient journey mapping(PJM) to document experiences of patients receiving maternal care at a large academic hospital …

No One-Size-Fits-All: Patient Perspectives Of Key Factors Influencing Their Inpatient Rehabilitation Experience, Mirline Milien, Megan Bewernitz, Katherine Stallings, Mary Ellen Young

Patient Experience Journal

Although patient experience in healthcare settings has historically been an ambiguous concept, it has received increasing recognition as a measure of healthcare quality. Despite this growing recognition and efforts to define patient experience, few studies have explored patient perspectives on the key factors driving this quality indicator. This study aimed to explore the core elements patients view as influencing their experiences in the inpatient rehabilitation setting. This was a single-visit, cross-sectional qualitative interview study. Thirteen patients with diverse diagnoses who received at least one week of rehabilitation services were recruited from a single inpatient rehabilitation facility. Purposive sampling was employed …

Expanding Family Participation In Inpatient Rounds Through Remote Access: A Feasibility Study Using Automated Messaging, Praveen Meka, Susan Ayers, Jayme Wilder

Patient Experience Journal

Patient representatives (PR) often wish to be part of the care of their loved ones when hospitalized. However patients are frequently alone during morning bedside rounds. A feasibility study was conducted at a large New England Academic Center to evaluate whether short messaging service (SMS) notifications of morning round times with ability to conference-in could improve remote PR participation in inpatient rounds and assess its impact on communication, acceptability, and care experience. After IRB approval, 17 patients were recruited, resulting in 61 bedside encounters. PRs received daily SMS reminders with scheduled round times and joining instructions; care teams received daily …

The Implementation Of Family-Centered Care And Family Satisfaction In Caring For Children With Cancer, Lenny Gannika, Mulyadi Mulyadi, Jeanette Irene Christie Manoppo

Patient Experience Journal

Background: Family-Centered Care (FCC) is an approach that involves families actively in their children's care by emphasizing respect, collaboration, and support. The goal is to increase family satisfaction with the care of children with cancer. FCC covers six subscales: general satisfaction, information, family inclusion, communication, technical skills, and emotional needs. Objective: This study aims to analyze the relationship between implementing FCC and family satisfaction when caring for children with cancer. Methods: A cross-sectional quantitative study was conducted at the Estella Children's Cancer Center in Manado, Indonesia, from June to October 2024. Parents of hospitalized children with cancer were selected for …

Using Artificial Intelligence To Enhance Patient Comprehension And Risk Perception Of Pathology Reports: Findings From A Survey Of Patients And Pathologists, Jordyn Franco, Osee Koulong Leussa, Amer K. Abu Alfa, Mark K. Fung

Patient Experience Journal

Context: Electronic health records (EHRs) provide patients with direct access to their pathology reports, often before physician consultation. However, the complexity of medical terminology can lead to misinterpretation and anxiety. Artificial intelligence (AI), particularly large language models such as ChatGPT, may improve patient comprehension by simplifying medical language. Objective: This study evaluates ChatGPT's ability to enhance patient understanding and risk perception of pathology reports by generating patient-friendly explanations and assigning a numerical concern level. Pathologists assessed the accuracy of AI-generated summaries. Design: A publicly available colonoscopy pathology report was analyzed using ChatGPT, which produced a simplified summary and concern score. …

Improving Patients' Experience Through Nurturing Care For Patients Undergoing Kidney Biopsies: A Feedback Survey, Molefe Rapalai, Mahmoud Elshehawy, Johann Nicholas, Patrick Anthony Ball, Hana Morrissey

Patient Experience Journal

Background: Renal biopsies are a key tool in diagnosing kidney diseases, providing histopathological insights for personalised treatment plans. Despite their clinical value, little is explored about how patients experience this invasive procedure. Understanding these experiences is important for improving care quality, safety, and ensuring the process is as patient friendly as possible. There is also a lack of research capturing patient experience feedback on renal biopsies, making studies like this essential for guiding service improvement initiatives. Method: Observational study, May 2022 to June 2024. Eighty-six percutaneous renal biopsies performed. Fifty eligible patients invited to complete the Kidney Biopsy Patient Experience …

Capturing Patient-Centered Quality Of Life: Usability And Initial Validation Of The Pediatric Patient-Generated Index Following Esophageal Atresia Repair, Zanib Nafees, Julia Ferreira, Elena Guadagno, Nikki Ow, Nancy Mayo, Jean-Martin Laberge, Dan Poenaru

Patient Experience Journal

The Patient-Generated Index (PGI) is an individualized measure that allows patients to define the domains most important to their quality of life (QoL). This study evaluates the usability and preliminary validity of the pediatric Patient-Generated Index (pPGI) in children who previously underwent esophageal atresia (EA) repair. We conducted a mixed-methods study including the pPGI, EuroQol-5D-Youth (EQ-5D-Y), and PROMIS Life Satisfaction Short Form-8a. Children aged 7–17 years completed self-reports, while parents served as proxies for younger children. Cognitive interviews explored how children understood and completed the pPGI, and clinician interviews assessed clinical usability. Among 25 participants, the pPGI generated 104 text …

Preventing Delirium After Surgery: A Qualitative Study Of Patients, Caregivers, And Providers, Jennifer O'Brien, Maria Cruz, Heather Dyck, Hassan Yassin, Una Goncin, Lei Xia, Huma Aftab, Lilian Thorpe, Peter Hedlin

Patient Experience Journal

Post-operative delirium is the most common complication in older adults following surgery. Symptoms include agitation, difficulty focusing, sluggishness, hallucinations, slurred speech, restlessness, rapid mood swings, and uncooperative or aggressive behaviour. It can result in longer hospital stays, increased mortality, loss of functional independence, increased need for a higher level of care post-surgery, and an increased risk of readmission to hospital. We aimed to understand and describe the experiences of patients, families, and healthcare providers with postoperative delirium, and to identify targeted initiatives to support patient and family centered care for high-risk patients. We conducted a qualitative descriptive study using interviews …

Beliefs Regarding Patient Experience In The Emergency Department Among Individuals With Sickle Cell Disease, Elizabeth A. Ibiloye, Gloria N. Odonkor, Ayobami A. Aiyeolemi, Jamie C. Barner, Carolyn M. Brown, Hyeun Ah Kang, Benita A. Bamgbade

Patient Experience Journal

Individuals with sickle cell disease (SCD) frequently experience intense, unanticipated pain episodes known as vaso-occlusive events (VOEs), which often require emergency department (ED) treatment. However, they often report suboptimal experiences in the ED. Using the Theory of Planned Behavior (TPB), this study aimed to elicit salient beliefs regarding SCD patient experience in the ED. Three virtual focus group sessions were conducted with individuals with SCD recruited through a Texas SCD Association and Rare Patient Voice. Nine open-ended questions were used to elicit participants' behavioral, normative, and control beliefs regarding ED use when experiencing VOEs. Qualitative analysis was performed using a …

The Voices I Never Heard: Reflections From A Public Health Advocate On Representation, Silence, And Struggle, Araya Gautam

Patient Experience Journal

Representation of ethnic minorities among trial participants in the UK is poor. It is true that the need for diversity and inclusive language is important in research, but the practicality of making this a reality for patients from under-represented groups has not generally been the case. As a patient advocate, I have been a participant in clinical trial reviews and advisory boards during the past three years and have engaged in a national-level conversation about patient voice and equity. I draw connections between structured frameworks for patient and public involvement (PPI) in the UK and the more informal, community-based caregiving …

The Quiet End Of The Visit, Avinav Biswas

Patient Experience Journal

Reassuring language is a common and often well-intentioned feature of clinical encounters, frequently used to convey clinical confidence and bring visits to a close. This personal narrative reflects on an observed outpatient encounter during a physician shadowing experience in which reassurance appeared to function not only as comfort, but also as an implicit signal of conversational closure. From the perspective of a student observer, the piece describes a moment of patient hesitation that arose after reassurance was offered, then quietly disappeared as the visit concluded. Although the encounter was clinically appropriate and efficient, the unspoken pause highlighted how uncertainty can …

Navigating Medical Ambiguity: A Patient's Perspective On Communication, Timing, And Risk, J. Hansen

Patient Experience Journal

This essay recounts the experience of navigating re-vaccination decisions after an initial diagnosis of vaccine-associated myocarditis. A diagnosis later contested by other specialists. It is not a tale of medical error, but of diagnostic ambiguity and divergent clinical reasoning. My intent is to show how, in the absence of consensus, a patient was compelled to assume a central role in adjudicating between competing medical narratives. Recommendations are offered to make medical advice more available to patients and bridge a growing gap between medicine and the public.

Human Experience, The Boarding Crisis, And Moral Injury-A Call To Action, Thom Mayer, Wendy Dean

Patient Experience Journal

Patient experience has evolved to a broader definition of human experience, including workforce experience, and community experience. Hospital boarding is a common, pervasive problem facing healthcare, which threatens all levels of human experience, from patient experience, to workforce experience (moral injury and burnout in healthcare professionals), and community experience (delayed and denied access to care for patients, Emergency Medical Services, and even interhospital transfers. Effective system leadership across the systems and processes of healthcare, as well as stakeholder and boundary management, will be essential to deliver acceptable human experience, in addition to solutions to smooth surgical flow, improve discharge systems, …

Human Experience: A Catalyst For Global Connection, Jason A. Wolf

Patient Experience Journal

As I think about the state of play in our world today, I find we have two choices in how we react. One is with a sense of despair driven by the intentional efforts to disconnect humanity being perpetuated by some. The other, with a sense of hope, that even in the face of these forces, there are those that strive relentlessly to foster connection and opportunity. I find the path forward in holding the tension of pragmatic idealism – that we can dream, with big and noble goals, while recognizing our path forward must be grounded in practical and …

Charity Pharmacies: An Integrative Overview Of Operations: A Continuing Education Program For Pharmacists, Stella Bertram

Honors Theses

PROGRAM DESCRIPTION

The goal of this activity is to educate pharmacists about Charity Pharmacies by creating an integrative overview of their purpose, laws and regulations, processes and procedures, eligibility, and opportunities for involvement. This course will ensure pharmacists are competent in the operations involved in volunteering or working within a charitable pharmacy.

Additionally, the information provided supports pharmacists in understanding their roles as well as roles of volunteers. They will understand the importance of their role in the community and the depth of their service within Charity Pharmacies.

Handgrip Strength, Handgrip Endurance And Bmi: A Comprehensive Approach To Health Assessment Among The General Population Of Madikeri, Dr Asha S. Das, Dr Ravikiran Kisan, Dr Suhas Y. Shirur, Dr Narasimha Rai K, Dr Sanjay Bhagoji

Digital Journal of Clinical Medicine

Introduction: Being physically fit is essential for lowering the risk of illness and enhancing longevity. While Body Mass Index (BMI) is frequently used to evaluate body composition, Hand Grip Strength (HGS) and Hand Grip Endurance (HGE) are important indicators of general well-being. Goal: To assess BMI, HGS, and HGE and ascertain how they correlate in a selected group of subjects. Methods: Fifty participants between the ages of 20 and 40 years participated in a comparative cross-sectional study at the Department of Physiology, Kodagu Institute of Medical Sciences, Madikeri. Participants were divided into three BMI groups after anthropometric measurements were taken. …

An Ot Educational Program For Individuals With Upper And Lower Limb Amputations, Laurie R. Spinks Mrs, Cassandra Nelson

Spring 2026 OTD Capstone Symposium

An OT approach to reducing prosthetic abandonment with an accessible guide to promote self sufficiency and community connections for individuals with amputations.

Empowerment Of Patients Through Sexual Wellness Programming, Carly M. Busby

OTD Capstone Projects

Abstract:

This doctoral capstone project was completed in collaboration with Dr. Jenny Archer with Archer Physical Pelvic Floor Therapy. This project highlights empowerment of Dr. Archer and her team through administrative tasks and empowerment of clientele through education materials. The primary deliverable of my project is a six week ‘course,’ addressing pelvic pain through evidence-based therapy practices. Other deliverables include education materials that cover an expanse of pelvic floor and pregnancy related topics. The prominent goal of this capstone project was empowerment through education.

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

Non-Diabetic Kidney Disease In A Patient With Type 2 Diabetes Mellitus: A Diagnostic Challenge, Nikhil R, Mahabaleshwar Mamadapur , Assistant Professor, Harshwardhan S Patil

Digital Journal of Clinical Medicine

Background: Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease. However, non-diabetic kidney disease (NDKD) can coexist or mimic DKD, leading to misdiagnosis. Case Presentation: A 46-year-old female with type 2 diabetes presented with vomiting and abdominal pain. Physical examination revealed non-blanching erythematous papules on both lower limbs. Investigations showed uncontrolled diabetes, metabolic acidosis, and active urinary sediment. Absence of diabetic retinopathy prompted renal biopsy, which revealed immune-complex–mediated glomerulonephritis with small-vessel vasculitis. Diagnosis: Immune-complex–mediated glomerulonephritis with small-vessel vasculitis, not consistent with diabetic nephropathy. Management: Supportive care and immunosuppressive therapy were initiated with improvement in renal function. …

Rural Health In Pike County: A Richard & Magnolia Community Health Needs Assessment, Victoria Bracey

Honors Theses

Rural communities across the United States suffer from poor health outcomes due to lack of resources and other compounding factors that make access to quality healthcare difficult. Mississippi is a predominantly rural state, and in the southwestern region of Mississippi lies the community of Magnolia and the community of Richard within Pike County. To better understand the health needs of Pike County, a community health needs assessment was conducted. This study aimed to assess the needs of Pike County in southwest Mississippi through the use of a community health needs assessment using focus groups. Two focus groups, with a total …

Strain Gauge Analysis And Deformation Detection Of Maxillary Denture Bases Reinforced By Cad/Cam Milled Zirconia And Cobalt Chromium (Co-Cr) Frameworks: An In-Vitro Study, Maha Nagy Kamal, Marwa Ezzat Sabet, Ghada Mahmoud Elgindy, Hebatallah Tarek Mohamed

Dentistry

Background A lot of studies have demonstrated the increased hardness of the reinforced maxillary dentures. However, the amount of stress induced by different reinforcement materials under the reinforcement dentures and their effect on the underlying supporting tissues and on the deformation of the denture bases were questionable. This study was conducted to compare the stresses induced within the supporting oral tissues from maxillary denture bases reinforced with computer-aided designing/computer-aided manufacturing CAD/CAM zirconia framework or cobalt chrome (Co-Cr) framework, and to detect the deformation that occurred to these bases. Materials and methods Twenty-six maxillary complete dentures were fabricated and divided into …

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Depression Due To Combined Dexamethasone And Cyproheptadine Abuse For Weight Gain, Sanjana Sateesh, Jatin Kumar, Dhananjay Ardawatia, Kishor M, Shashidhara Kc, Srikanth Ms

Digital Journal of Clinical Medicine

Cyproheptadine, an H1 antihistamine, and Dexamethasone, a long-acting steroid, are often misused in combination for addressing self-perceived body image issues and have become a popular but dangerous ‘weight gain cocktail’, often available over the counter without any prescription. This case describes a 25-year-old man who had self-prescribed the above-mentioned drugs in combination to address his self-perceived lean physique. This resulted in a significant weight gain, followed by an abnormal increase in appetite, which affected his daily life. Upon cessation, it resulted in rebound weight changes, depressive features, along with features of corticosteroid withdrawal, which required multidisciplinary management.

This case highlights …

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …

Varicella Zoster Encephalitis In An Immunocompetent Middle-Aged Female With Benign Neurological Presentation, Kopalle Bhanu Sriram, Swathi B.S, Bernice Roberts

Digital Journal of Clinical Medicine

Varicella Zoster Virus (VZV) is a neurotropic human herpesvirus that typically presents as herpes zoster following reactivation of latent infection. Central nervous system involvement such as encephalitis is uncommon and is more frequently described in immunocompromised individuals. Increasing use of polymerase chain reaction (PCR)-based diagnostics has enabled improved recognition of VZV-related neurological disease in immunocompetent hosts.

We describe a middle-aged immunocompetent female who presented with a 15-day history of persistent headache associated with vomiting and low-grade fever. Examination revealed vesicular eruptions in the T8–T9 dermatomes, while neurological examination and neuroimaging were normal. Cerebrospinal fluid (CSF) analysis demonstrated lymphocytic pleocytosis, elevated …