Medical Education Commons^™

Pulmonary Hemosiderosis In A Young Child Presenting With Recurrent Respiratory Illness And Refractory Anemia: A Case Report, Praveen Das, Ratnapriya Chowdhry, Neha Bhongale, Poonam Wade

Digital Journal of Clinical Medicine

Pulmonary hemosiderosis (PH) is a rare cause of diffuse alveolar hemorrhage in children and often presents with nonspecific respiratory symptoms and refractory iron‑deficiency anemia. We report a 2.5‑year‑old girl with recurrent lower respiratory tract infections, severe transfusion‑dependent anemia, failure to thrive, and persistent bilateral pulmonary infiltrates since infancy. Bronchoalveolar lavage demonstrated hemosiderin‑laden macrophages, confirming pulmonary hemosiderosis. Further evaluation revealed C‑ANCA positivity and PR3‑ANCA negativity, raising suspicion for an ANCA‑associated vasculitis; however, there was no renal, ear‑nose‑throat, or other systemic involvement, and a lung biopsy could not be performed. The child was managed with systemic corticosteroids with clinical improvement. This case …

State Social Benefit Schemes For Women In Continuity Of Psychiatric Care: A Case Report, Mathumitha A, Kishor M. Manohar Rao Professor

Digital Journal of Clinical Medicine

Mental health disorders are a major global public health challenge. The disorders affect over a billion people worldwide, while depressive and bipolar spectrum disorders also contribute substantially to disability and reduced quality of life. According to the World Health Organization, major depression alone affects more than 300 million people globally and is considered a leading cause of years lived with disability. Beyond clinical morbidity, mental illnesses exert a profound economic impact, with depression and anxiety accounting for an estimated USD 1 trillion annually in lost productivity worldwide, while the overall global economic burden of mental disorders is projected to reach …

The Impact Of Medicaid Policy Limitations On Access To Eating Disorder Treatment: Uncovering The Consequences Of A System Built To Fail, Meghan Frost

DSW Capstone Projects

Individuals who rely on Medicaid face major barriers when trying to access eating disorder (ED) treatment, reflecting broader patterns of structural disadvantage in publicly funded health care. Research shows delayed diagnosis, limited access to ED specialists, and frequent denials for recommended services. These gaps occur because Medicaid policies do not match the needs of evidence based ED care, resulting in delayed or incomplete care for many individuals with eating disorders.

This issue is highly relevant to social work practice because the policies shaping these barriers are complex and difficult for clients and ED providers to navigate. Social workers across clinics, …

Contextualizing The Aspe Standards Of Best Practice: Reflecting On The Past, Present, And Future Of Sp Methodology, Amelia M. Wallace, Cory Krebsbach, Janice Radway, Lou Clark

EVMS School of Health Professions Faculty Publications

As we celebrate the publication of the Association of SP Educators Standards of Best Practice (ASPE SOBP) for Physical Exam Teaching Associates (PETAs) and corresponding literature review, we, elected leaders of ASPE, offer reflections on SP methodology history, current practices, and future opportunities. Our aim is to contextualize this addition to what is now the third SOBP publication [1, 2] that guides the global simulation community on best practices of simulated participant (SP) methodology.

Thank you to the ASPE members and SP Educators who made time to share their expertise as authors on these new standards- in addition to their …

Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

Work-Related Musculoskeletal Disorders: Epidemiology, Risk Factors, Socioeconomic Impact And Prevention - A Narrative Review, Swarna Radhakrishnan, Harini Ramendran, Priyanga Thirunavukkarasu

Digital Journal of Clinical Medicine

Abstract

Work-related musculoskeletal disorders (WMSDs) represent one of the most pervasive and costly occupational health challenges worldwide. Affecting muscles, tendons, ligaments, nerves, joints, and supporting blood vessels, these conditions arise from a complex interplay of physical, psychosocial, organizational, and individual risk factors present across diverse work environments. From factory floors and construction sites to offices and healthcare settings, WMSDs contribute substantially to pain, disability, reduced productivity, absenteeism, and diminished quality of life. This narrative review synthesizes existing literature on the epidemiology, pathophysiology, risk factors, and socioeconomic impact of WMSDs, with particular attention to high-risk occupational sectors. It further discusses prevention …

Advancing Skin Cancer Diagnostics: A Comparative Analysis Of Convolutional Neural Network Models For Skin Lesion Classification, Jesse Osuji, Tania Malik

SURE Journal: Science Undergraduate Research Experience Journal

For many years, skin cancer diagnosis and cancer research have been major focal points in the healthcare sector. Accurate classification of different types of skin lesions, including cancerous ones, is essential for proper diagnostics. Many machine learning (ML) techniques and models are used to solve various problems across various domains. One of such techniques is called neural networks. Convolutional Neural Networks (CNNs) are primarily used in computer vision-based problems, allowing computer systems to process and understand images. CNNs offer a potential tool for diagnosing skin lesions from images, occasionally demonstrating superior accuracy compared to trained dermatologists. This project explores various …

Developing A Tool To Measure Resistance To Sustainable Food Choices: A Pilot Study In Ireland And The Netherlands, Kate Flanagan, Bart Sinteur, Patricia J. Bulsing, John M. Kearney

SURE Journal: Science Undergraduate Research Experience Journal

Consumer uptake of a sustainable diet is critical for addressing environmental challenges and promoting public health. Understanding why consumers resist adopting sustainable eating habits can inform targeted interventions and policies. This pilot study examines whether a newly developed scale can effectively detect consumer resistance to a sustainable diet. Currently, there is a lack of research on a tool to measure consumer resistance to a sustainable diet, highlighting the need for a reliable instrument.

The aim of this study is to develop a scale, based on existing literature, to measure consumer resistance to a sustainable diet. Additionally, the study aims to …

Editorial-Sure Journal Volume 7, Issue 2, Geraldine M. Dowling, Eva Campion, Sinead Loughran, Ariane Perez-Gavilan, Josephine Treacy

SURE Journal: Science Undergraduate Research Experience Journal

No abstract provided.

Global Prevalence Of Hyperhomocysteinemia Among Adults With Hypertension: A Narrative Review, Wangkheimayum Ashalata Devi Phd Scholar, Dr. Melita Sheilini Associate Professor, Dr. Rinchen Doma Bhutia Assistant Professor, Corresponding Author: Dr.Melita Sheilini, Associate Professor,Department Of Medical-Surgical Nursing, Manipal College Of Nursing, Manipal Academy Of Higher Education, Manipal, Udupi District, Karnataka, India.Contact Number- 8095976561. Email Id: [email protected]

Manipal Journal of Nursing and Health Sciences

Background: Elevated blood homocysteine (Hcy) levels are a hallmark of hyperhomocysteinemia (HHcy), a metabolic disorder that is known to be a risk factor for cardiovascular illnesses. It greatly raises the risk of vascular problems when combined with hypertension (HTN). However, there are few statistics on the prevalence of HHcy in individuals with HTN. Objective: The present review aims to estimate the global prevalence of HHcy among adults with HTN and to highlight regional disparities, associated risk factors, and implications for clinical practice. Method: The comprehensive literature search was conducted using the PubMed and Google Scholar search engines. Studies published in …

Public Perception About Covid-19 Vaccine Hesitancy In South Central Nebraska, Rita Nnenne Oparaocha

Biology Theses, Dissertations, and Student Creative Activity

The COVID-19 pandemic created a shift in the trajectory of vaccination hesitancy, altering risk perceptions and vaccination attitudes among individuals in rural communities. The 5C framework highlights confidence, complacency, constraints, calculation, and collective responsibility as influencing factors of vaccine hesitancy. This study assessed the proportion of adults who refused COVID-19 vaccination and identified the individual reasons for hesitancy among those who refused the COVID -19 vaccines in South Central Nebraska. Data was analyzed from a local cross-sectional public health survey administered to 2,034 adult participants over a six-month period (March-August 2024), including 91 respondents who were from outside the seven-county …

Assessing Education And Training Of Developmental Screening Tools Among Residents In A Southern Academic Medical Center, Paige Seabrook, Dustin E. Sarver, Susan Buttross

Journal of Public Health in the Deep South

Background: Developmental disabilities are highly common. Early identification of developmental disabilities is critical, but many practitioners, including those in Southern U.S. states like Mississippi, do not utilize developmental screening tools.

Purpose: We aimed to identify modifiable targets within resident training experiences and their correlates using a quality improvement approach to serve as a baseline for intervention efforts.

Methods: Medical residents (N = 57) in pediatrics (n = 26), combined medicine-pediatrics (n = 12), and family medicine (n = 19) completed a survey assessing training, attitudes, practices, and perceived barriers regarding using screening tools. Perceived barriers were …

Pxj Volume 12 – Key Theme Summary And Article Index, Patient Experience Journal

Patient Experience Journal

Volume 12 of the Patient Experience Journal showcases a global dedication to advancing human experience in healthcare, illuminating both existing challenges and crucial emerging practices. The content, spanning three issues, emphasizes that improving the human experience is not a temporary initiative but rather the essential foundation for building trust, ensuring safety, facilitating healing, and sustaining organizational resilience. The overarching message of Volume 12 is that human experience is the heart of healthcare. It is actively shaped through shared purpose, design, empathy, communication, and partnership. The journal calls for a future where every voice is heard, every story matters, every …

Best Practice Recommendations For Anesthesia Providers In Preventing Postoperative Delirium In The Geriatric Population Undergoing Non-Cardiac Surgery, Ana Primeaux, Ashanti Reed

Doctoral Projects

Postoperative delirium (POD) is a significant and preventable complication in geriatric patients undergoing non-cardiac surgery. Such complication is associated with foreseeable consequences, such as prolonged hospitalization, long-term cognitive decline, increased morbidity and mortality, and increased costs. Despite the emerging awareness of evidence-based nonpharmacologic and pharmacologic interventional strategies, POD still represents a clinical challenge for anesthesia providers.

Currently, there is a lack of clinical guidelines to guide formalized education and evidence-based interventions on POD prevention across anesthesia practice settings. Consequently, there is a critical need to raise awareness that the lack of clinical guidelines and the high incidence of POD may …

Enhancing Crna's Knowledge Of Radiation Safety Through Online Education, Angela Iledan, Madeline Pousson

Doctoral Projects

Although ionizing radiation is frequently used in anesthesia-related procedures, many CRNAs receive minimal training in radiation safety principles and protective measures. This knowledge gap increases the risk of cumulative radiation exposure for providers and patients. To address the issue, this doctoral project developed and implemented an online educational intervention designed to enhance CRNAs’ understanding of radiation safety, ultimately promoting safer practices in radiation-prone environments.

The doctoral project follows a QI and EBP approach that incorporated diverse adult learning styles to enhance engagement and knowledge retention of CRNAs. The online educational module was designed and delivered to CRNAs that currently practice …

Impact In Action: Your Michigan Dental Association Foundation, Anne Berquist

The Journal of the Michigan Dental Association

The Michigan Dental Association (MDA) Foundation, a 501(c)3 non-profit, works to promote better dental health and support the future dental workforce through educational scholarships. The Foundation’s impact is increasing yearly, evidenced by a 42% increase in scholarship awards in 2024, providing $44,000 to 15 recipients. It also provides grants to statewide organizations delivering dental care to uninsured, impoverished, and underserved populations, awarding $141,500 in 2025. A high-profile program is the biannual Michigan Mission of Mercy (MOM), which provided over $1.1 million in donated care in Flint in 2024. Support is generated through various fundraisers, including the Year-End Fundraising Campaign.

Co-Designing A Patient-Facing Version Of A Mental Healthcare Pathway For People Receiving Dialysis, Alexandra Albers, Charlotte Berendonk, Julie Robison, Richard Sawatzky, Loretta Lee, Monika Bolin, Jeff Costley, Sandy Johnstone, Kevin Kemp, Justin Leroux, May Tourangeau, Sabiha Zaman, Kara Schick-Makaroff

Patient Experience Journal

A Community Advisory Committee comprised of nine members with lived experience of kidney failure, identified the need for a patient-facing version of a mental healthcare pathway for people receiving dialysis in Alberta, Canada. Recognizing that healthcare tools to support person-centred care practices should be available in lay language, our team (comprised of Community Advisors and healthcare clinicians and researchers) co-designed a patient-facing pathway: “Your Journey: Coping with and Adjusting to Dialysis.” The Provincial Pathways Unit provided a template for the pathway, and the content was adapted through multiple online and in-person meetings with the Community Advisors. Adaptations were informed by …

Leading Through Partnership: Development Of A Hospital-Wide Family-Centered Care Collaborative, Jessica T. Fry, Naomi Shapiro, Barbara Lawlor Burke, Kalee Ryan, Kerri Z. Machut

Patient Experience Journal

Though it has been widely recognized that systematic patient and family engagement plays a critical role in strengthening the provision of family-centered pediatric healthcare, significant gaps in knowledge remain regarding how to develop and build a successful model of engagement. As a group of pediatric health care professionals invested in improving the patient and family-centered care provided by our children’s medical center, we saw the opportunity for family and organizational collaboration as a needed “first step” in model development. In this case study, we describe our institutional journey to build connections and resources though the development of a Family Centered …

Virtual Nurse Discharge: Improving Patient And Nurse Experience, Dina Flihan, Christine Odell, Stacey Davis, Carolyn Oates, Fay Wright

Patient Experience Journal

This case study reviews the virtual discharge nurse (VDN) process and its impact on patient experience and nursing workflow as an exemplar of an effective telehealth innovation at a community hospital 23-bed Short Stay Unit (SSU). At the SSU, the daily turnover rate of more than 50% of the unit census challenged the nurses’ ability to provide comprehensive individualized discharge education. SSU patient experience scores measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) reflected opportunities to improve the discharge process. Therefore, the direct care nurses on SSU suggested a trial innovation of a VDN to improve …

Empowering Frontline Staff In Service Recovery, Sarah E. Duncan, Brianna Camera, Iva Ervin-Stanberry, Heather L. Pezzullo

Patient Experience Journal

Objective: This study aimed to develop and implement a standardized service recovery training program within the VA healthcare system to enhance patient experiences and address grievances effectively. The purpose of the training was to equip VA employees with the necessary skills and knowledge to resolve service issues promptly and empathetically, adhering to the principles of the VA’s SALUTE model for service recovery. Method: The training program was designed based on feedback from anonymous pre-surveys to identify knowledge gaps and incorporate industry best practices. The VA’s SALUTE model, which emphasizes six key actions—saying hello, apologizing, listening, understanding, taking action, …

A Case Report On Meeting The Spiritual Need Of Intubated Conscious Patient, Mahuya Karmakar, Santhna Letchmi Panduragan, Faridah Mohd Said

Patient Experience Journal

Nurses are showing more interest in including spiritual health to prevent and treat illnesses. For patients who can speak may ask for their spiritual need to the health care provider. But for intubated patients it.s difficult to express such needs. Most of the time caregivers focus on the physical parameters only for intubated patients. Apart from physical symptoms these patients also experience a variety of bio-psycho-socio-spiritual sensations. Research has shown that spiritual therapies can reduce distress, assist in preparing the patient for end-of life care, and enhance overall wellbeing along with improving their quality of life. The purpose of this …

A Systematic Review Of The Literature On The Validity, Reliability, And Utility Of The Nhs Friends And Family Test As A Method For Gathering Feedback On And Improving The Experiences Of Patients, Miss Jenny King, Catherine Davidson, Miss Hannah Wade, Chris Graham

Patient Experience Journal

The NHS Friends and Family Test (FFT) is widely used across the National Health Service to collect patient feedback on care experiences. Given its scale and cost, there is strong public and organisational interest in the validity, reliability, and utility of the FFT. This study aimed to systematically review the literature on the validity, reliability, and utility of the FFT as a method for gathering feedback on and improving patient experiences. PubMed and ProQuest databases were searched in September 2024. Studies were included if they met the inclusion criteria. Information extracted included study information (e.g., title, authors, publication year, research …

Reliability And Validity Of A Modified Version Of The Consumer Assessment Of Healthcare Providers And Systems (Cahps®) Clinician And Group Visit Survey 4.0 (Beta) For Ambulatory Behavioral Health Care, Jessica K. Jeffrey, Ron D. Hays, Randi Hissom, Mark Grossman, Samuel A. Skootsky

Patient Experience Journal

Patient experience is a fundamental indicator of healthcare quality. A patient experience survey that assesses telemedicine and in-person ambulatory behavioral health care is needed. This study aims to adapt the CAHPS Clinician and Group Visit Survey 4.0 (beta) to assess adult patient experience with ambulatory behavioral health services and its reliability and validity. Seven behavioral health subject matter experts (psychiatrists, therapists with master’s degrees, and primary care physicians) at an integrated delivery system aligned with an academic institution provided input to select a subset of items and make minor wording adjustments to the CAHPS survey. The adapted survey was administered …

Assessing Patient Satisfaction With The Services Provided Under The National Health Insurance Scheme At The Outpatient Department Of The Levy Mwanawasa University Teaching Hospital In Lusaka, Zambia, Wesley Kapaya Mwambazi, Mubanga Mpundu

Patient Experience Journal

The National Health Insurance Scheme (NHIS), introduced in Zambia in 2019 to enhance healthcare financing and service delivery, still faces challenges impacting patient satisfaction. This study assesses and investigates the factors influencing patient satisfaction with NHIS-provided services at a third-level tertiary public hospital. The study was conducted at the outpatient department (OPD) of Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia, deliberately chosen as one of the largest publicly financed tertiary referral hospitals and among the first NHIS-accredited facilities. A cross-sectional survey was conducted with 270 respondents using a modified SERVQUAL 5-point Likert scale questionnaire, whose reliability was assessed …

Using Patient Experience Data With Impact: A Framework For Healthcare Improvement, Corey Adams, Ramesh Walpola, Reema Harrison

Patient Experience Journal

Background: Despite major investment in patient experience measurement, healthcare organizations often struggle to translate patient feedback into lasting improvements. Existing knowledge translation frameworks provide useful concepts, but often lack the practical detail or contextual relevance needed to improve patient experiences. Objective: To develop and present the IMPACT Framework, an evidence-informed approach designed to bridge the gap between patient experience measurement and meaningful improvement in healthcare. Methods: This framework was informed by a systematic review of patient experience measurement and analysis of barriers to feedback use. Findings from contemporary patient experience research were combined with key principles of knowledge translation, change …

Enhancing System-Level Quality Improvement Through Patient-Inclusive Teamwork: A Review, Shaik Mohiuddin

Patient Experience Journal

Engaging patients in quality improvement (QI) initiatives offers significant advantages, including increased patient satisfaction, improved outcomes, and the integration of creative insights from patient perspectives. This review synthesizes findings from 14 peer-reviewed articles retrieved from PubMed and Google Scholar, focusing on patient-inclusive teamwork in healthcare settings. Despite the recognized benefits, patient involvement remains limited due to cultural and professional barriers, logistical challenges, and the need for structured training programs. The review contrasts conventional provider-centered approaches with patient-centered models, emphasizing the importance of policy reform, organizational culture change, and supportive training to enhance patient engagement. Traditional QI strategies often overlook patient …

Understanding Patient Experience Through Narrative Complaint Analysis: A Mixed Methods Study In A Rural Academic Health System, Htun Ja Mai, Jabeen Ahmad, Brant Oliver

Patient Experience Journal

Patient Experience (PX) is recognized as an independent dimension in assessing healthcare quality and is associated with the quality domain of patient-centeredness. A better understanding of PX can help clinical providers enhance care, guide further research, and inform quality improvement and policies. Our study aims to identify, classify, and prioritize patients’ complaints and grievances at a rural health care system to inform strategic improvement planning. We conducted standard inductive qualitative thematic analysis and quantitative Pareto analyses of narrative comments received from patients and families via phone calls, emails, or standard letters at the four settings under study (one major academic …

Patient Experience Second Opinion: Expanded Telemed Simulation Broadens Inquiry Of Health Care Provider Verbal And Nonverbal Communication Issues, Mike C. Porter, Xiaowen Guan, Paul G. Omodt

Patient Experience Journal

In the quest to improve patient experience and health outcomes, the impact of provider consultation generally earns serious consideration. This study recruited a richly diverse pool of participants to examine how patient demographics and psychographics during a telemedicine consultation simulation impact the perceptions of the provider that contribute to patient satisfaction. Further, this study relies on a between-subject experimental design to investigate how “provider” verbal and nonverbal communication and demographics in addition to patient demographics and psychographics impact patient perceptions and outcomes of the simulated telemedicine experience. Results inform how healthcare provider verbal and nonverbal communication might be improved through …

The Patient Experience Of The #Hellomynameis... Campaign And The Value Of Personalised Embroidered Student Uniforms, Julie Derbyshire, Gemma Bradley, Sasha Ban, Lianne Horscroft, Joanne Woodhead

Patient Experience Journal

Background: The #hellomynameis... campaign was an international initiative implemented to improve Person Centred Practice by increasing the number of health professionals who introduce themselves to every patient and place them at the centre of each interaction. To add to this campaign, the idea of personalised uniforms for undergraduate health care students was introduced at one University in the UK, embroidered with the #hellomynameis...logo and their name. This paper will present findings from a study that explored this initiative from the patient perspective. Methods: A case study research design was used, with semi-structured questionnaires consisting of open and closed questions to …

Communicating Effectively When Engaging People With Lived Experience In Mental Health And Substance Use Health Research: A Qualitative Descriptive Study, Lisa D. Hawke, Wuraola Dada-Phillips, Charlotte Munro, Shoshana Hauer, Claudia Sendanyoye, Yona Lunsky, Gillian Strudwick, Tanya Halsall, Natasha Y. Sheikhan

Patient Experience Journal

Background. People with lived experience of mental health and/or substance use challenges and families (PWLE/F) are increasingly engaged in research, providing positive impacts. However, effective engagement can be challenging, including ensuring effective communication. This qualitative study sought to understand the communication preferences of PWLE/F who are engaged in mental health and substance use health research. Method. A total of 18 participants (aged 19 to 79) took part in one of four focus group discussions. A semi-structured interview guide was used to facilitate the discussions. Focus group transcripts were analyzed using codebook thematic analysis. PWLE/F were engaged in all stages of …