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 Comfort Cart Initiative: A Quality Improvement Intervention To Improve Patient Satisfaction In The Emergency Department, Heidy Cladimir Ayala

Doctor of Nursing Practice Final Project Abstract

The Comfort Cart Initiative: A Quality Improvement Intervention to Improve Patient Satisfaction in the Emergency Department

Purpose

The Comfort Cart QI project aimed to improve Emergency Department patient, parent, and guardian satisfaction by 10% over an 8-week implementation period.

Background

In healthcare, patient satisfaction is an important indicator of the quality of care provided, and many literature reviews suggest it is closely associated with patient-centered care.

 Methodology

The Comfort Cart intervention is an evidence-based quality improvement project employing a pre- and post-intervention design, conducted over an 8-week period, in the Emergency Department. The project was guided by Kolcaba's Comfort Theory …

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 …

A Qualitative Case Study Of Leadership Development In A Graduate Medical Laboratory Science Program, Demetra Castillo

EVMS School of Health Professions Theses & Dissertations

Leadership development is increasingly recognized as an essential component of healthcare education, particularly as medical laboratory professionals assume expanded responsibilities involving collaboration, decision-making, systems thinking, and organizational leadership. Despite this need, limited research has explored how leadership develops within graduate medical laboratory science (MLS) programs. This qualitative case study examined leadership development through the lens of Experiential Learning Theory (ELT). Two research questions explored how the program fostered leadership development through students’ professional biographies, leadership questionnaires, final reflection papers, and leadership credos and how leadership reflections demonstrated growth over time. Secondary data from five student cases were analyzed using deductive …

The Primary Care Brief Intervention Competency Assessment Tool (Bi-Cat): Examining Reliability And Validity, Arielle Guillod

Dissertations

Within primary care, the Primary Care Behavioral Health (PCBH) model integrates behavioral health services into medical settings through brief, population‑based interventions delivered by behavioral health consultants (BHCs). Although effective performance in this role requires competencies distinct from traditional mental health practice, few psychometrically sound tools exist to assess clinical skills in primary care. The Brief Intervention Competency Assessment Tool (BICAT) is commonly used for this purpose but lacks published evidence supporting its reliability and validity. This dissertation examined the psychometric properties of the BICAT across two studies. Study 1 evaluated factor structure, internal consistency, and construct validity in a heterogeneous …

Exploring Primary Care Providers’ Compassionate Care And Their Evidence-Based Practice With Death, Grief, And Loss: Patient Experience And Perspective, Kathryn Krzykala

Dissertations

Research on primary care providers’ (PCPs) education regarding Death, Grief, and Loss (DGL) remains limited. Specifically, data is lacking regarding patients' perceptions and opinions on what they need and expect from their PCPs regarding grief and loss. This exploratory mixed-method study comprised 146 participants who had experienced death and non-death loss. It examined participants' perceptions of 1) PCP compassion, 2) PCP utilization of evidence-based grief and loss practices, 3) their own level of comfort discussing DGL with their PCPs during medical visits, and 4) their personal grief and loss experiences. The findings revealed that PCPs' grief-informed evidence-based treatment, as reflected …

Does The Availability Of An Additional Set Of Bunker Gear Impact Firefighter Health, Safety, And Operational Readiness?, Ryan Riley

Certified Public Manager® Applied Research

Firefighting is a complex and inherently dangerous profession. Firefighters today face a growing array of occupational hazards, not just from the effects of being exposed to fire and smoke, but also from the personal protective gear they wear, commonly referred to as “bunker” or “turnout” gear. While this gear is designed to protect firefighters in dangerous environments, prolonged use and repeated exposure to smoke, chemicals, and products of combustion can compromise the gear. Research has shown that bunker gear contains and can also retain cancer-causing chemicals. To this end, this paper examines whether the availability of an additional set of …

Real-World Clinical Outcomes Of Robotic-Assisted Total Knee Arthroplasty: A Propensity-Matched Comparative Study, Hassan Yassine, Amir Ghafarian, Jawad Saad, Abdel Kareem Hilo, Muaaz Wajahath, Khaled Saleh

Medical Student Research Symposium

Background:

Robotic-assisted total knee arthroplasty (RA-TKA) is increasingly utilized to improve component alignment and soft-tissue balance, yet its impact on clinically meaningful outcomes in large real-world populations remains uncertain. Although prior studies demonstrate improved radiographic accuracy, whether robotic assistance reduces postoperative complications, opioid utilization, or midterm mechanical failure has not been established at scale.

Methods:

We conducted a retrospective, propensity-matched cohort study using the TriNetX US Collaborative Network to identify adults undergoing primary TKA from 2018–2023. Robotic-assisted procedures were defined by CPT 27447 with concurrent robotic navigation codes. Propensity score matching (1:1) was performed to balance demographics and comorbidities, yielding …

A Survey Of Health Professions Learners’ Attitudes Towards Social Media In Medical Education: A Substance Use Disorders Education Case Study, Gregory A. Jaffe, Sarah Lawson, William Leach, Mallika Kodavatiganti, Erin Avanzato, Katherine Fesperman, Heather Klusaritz

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Social media is a ubiquitous part of the modern world and plays a key role in the dissemination of information. While utilizing social media for educational purposes has been repeatedly demonstrated as feasible, it has been underutilized in medical education and remains a critical opportunity to integrate microlearning and stigma reduction curricula.

METHODS: A cross-sectional survey on social media usage, attitudes, and beliefs was sent to medical and nursing students at two large academic institutions within Philadelphia. Descriptive statistics are reported, and non-parametric tests were utilized for exploratory analyses.

RESULTS: Health learners were low consumers of social media, reporting …

Preparing A Qualified Workforce To Support The Disability Community Through The Lend Interprofessional Learning Experience, Megan K. Roberts, Beth W. Degrace, Mark J. Fisher, Sandra H. Arnold

Developmental Disabilities Network Journal

Leadership and workforce preparation are vital roles of the nation’s academic institutions to advance health care services for the members of our communities. Leadership Education in Neurodevelopmental and other Related Disabilities (LEND) programs aim to prepare leaders in health care services and advocacy to improve systems and the quality of care and supports for the disability community, specifically children with developmental disabilities. LEND programs enhance standard health care pre-service training by providing interdisciplinary learning experiences for student trainees from a minimum of ten disciplines in 300 hours of learning activities over one academic year. An innovative feature of LEND programs …

More Than A Rod: Reconceptualizing Medical Student Development Through The Lens Of Social Determinants Of Learning, Dejour Young

Electronic Theses and Dissertations

Medical education traditionally follows a biomedical paradigm that emphasizes academic rigor but often overlooks non-academic factors that fundamentally influence student success. The aim of this study was to reconceptualize medical student development by shifting focus from traditional academic metrics to the systemic, non-academic factors that affect learning and well-being.

This study employs a systemic analysis of structural barriers, defined as institutional policies, practices, and environments that create and perpetuate inequity in medical education. This investigation was grounded in the Integrated Social-Ecological Framework for Learning (ISEF-L), a three-tiered conceptual framework developed for this study. The ISEF-L includes Social Determinants of Learning …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

Medical Journals As Complex Adaptive System (Cas) Reports: Reframing Journals As Structured Detection, Interpretation, And Feedback Systems In Healthcare, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background Healthcare operates as a complex adaptive system (CAS) characterized by distributed agents, nonlinear interactions, and emergent behavior. Effective adaptation depends on mechanisms capable of detecting and redistributing signals from across the system.

Objective To conceptualize the medical journal as a structured CAS report and to examine its role in supporting system awareness among clinicians.

Conceptual Model Recurring journal sections—including original research, reviews, editorials, clinical cases, perspectives, humanities, and letters—function as distinct sensing and signaling channels. Together, they provide a multi-dimensional representation of system activity.

Implications Journals serve not only as repositories of knowledge but as adaptive communication nodes that …

In The Era Of The Smartphone: The Case For The Continued Role Of Mnemonics As Cognitive Scaffolds That Support Encoding, Working Memory Efficiency, And Rapid Cue-Dependent Retrieval, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: The ubiquity of smartphones and point-of-care digital references has prompted questions regarding the continued relevance of mnemonic devices in medical education. If information can be instantly retrieved, is memorization—and by extension mnemonic structure—still necessary? Objective: To reframe mnemonics not as relics of pre-digital pedagogy, but as cognitive scaffolds that support encoding, working memory efficiency, and rapid cue-dependent retrieval in time-pressured clinical environments. Discussion: Cognitive science demonstrates that working memory remains inherently limited regardless of technological access. Mnemonics function as structured chunks that reduce cognitive load, support pattern recognition, and facilitate transition from novice encoding to expert automaticity. In emergency …

Helping Waldo (The Poster) Be Found: Teaching Search Literacy, Discoverability And Search Engine Optimization As Core Scholarly Skills In Graduate Medical Education, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: In modern academic medicine, trainees are taught how to search the biomedical literature but rarely taught how to structure their own scholarly work so that it can be discovered. This creates a diffusion gap in which high‑quality educational innovations, case reports, and operational insights remain difficult to locate despite being presented or archived.

Objective: To propose a concise educational module that teaches residents the principles of search literacy and scholarly discoverability.

Methods: A conceptual curriculum framework was developed drawing on literature from information science, medical education, and diffusion theory. The module introduces the paired competencies of 'Finding Waldo' (literature …

Changes In The Dental & Oral Health Information Landscape, Alisun Dekock, Melissa Ernst, Jimmy Gonzalez Vicker, Kelly O'Brien

Individual Scholarship

As we navigate rapid changes to information access and utilization, dental and oral health care professionals are finding new ways to meet the needs of their users. Practitioners locating, evaluating, and applying research continues to encounter new obstacles, including significant changes to institutions that share health data and make recommendations. This poster discusses effective strategies dentistry librarians have used for information retrieval, method analysis, and patient education.

Background  

This poster provides an overview of how four dentistry librarians are responding to trends and changes in the dental and oral health information landscape at their various institutions and organizations.

Description   

Within …

Gme As A Healthcare And Economic Driver In Southern Nevada, Tripp Umbach

Policy Briefs and Reports

In early 2025, the Nevada Health and Bioscience Corporation (NHBC) commissioned Tripp Umbach to conduct a comprehensive study examining the current state and future expansion of physician training and retention in Southern Nevada. The approach recommended in this report is rooted in strategic partnerships among medical institutions, proven funding approaches, and needed policy changes. Tripp Umbach, a nationally renowned private consultancy specializing in medical education expansion strategies, reviewed data, conducted interviews, and developed recommendations to expand GME, highlighting its profound economic impact in Southern Nevada.

A Scalable Model For Resident And Faculty Well-Being: Applying Self-Determination Theory And The Job Demands-Resources Framework In Graduate Medical Education, Gregory Guldner, Adam Neufeld

HCA Healthcare Journal of Medicine

Despite growing attention to burnout in graduate medical education (GME), many institutional efforts remain fragmented and lack theoretical coherence. In response, HCA Healthcare developed a system-wide initiative grounded in Self-Determination Theory (SDT) and the Job Demands-Resources (JD-R) framework to guide leadership development, learning climate improvement, and resident and faculty well-being. What began as a single-program effort evolved into a multi-year, system-wide initiative involving more than 5800 residents across 366 programs at 85 hospitals. In collaboration with workplace psychologists from Claremont Graduate University and Immersyve Health, the initiative integrated theory-informed leadership workshops, validated assessment platforms, and continuous quality-improvement processes to help …

Facilitating Freirean Pedagogy And Asset-Based Learning In An Asynchronous Environment In A Doctoral Public Health Course, Manoj Sharma, Liliana Davlos, Sharmistha Roy

UNLV Best Teaching Practices Expo

The Department of Social and Behavioral Health offers an asynchronous course, Advanced Applications of Social and Behavioral Theories (HED 762), to doctoral students in public health. In this course, commonly used behavior and social change theories are taught. One such theory is the Freirean theory of adult education, which emphasizes dialogue, critical conscientization, praxis, transformation, and critical consciousness. The instructor of this course uses a variety of methods to imbibe this pedagogy that comprise (a) the use of the fourth-generation multi-theory model (MTM) of health behavior change to motivate students, (b) Freirean dialogue in the Canvas discussion forum with students …

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 …