Interprofessional Education Commons^™

A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis

Undergraduate Honors Theses

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …

Development Of A Nurse Practitioner Driven Program For Cardiology Providers To Increase Knowledge And Awareness Of Neurodevelopmental Assessment Needs In Children With Congenital Heart Defects, Michele Readman

Doctor of Nursing Practice Final Manuscripts

Children diagnosed with congenital heart defects are at increased risk for neurodevelopmental delays. Timely referral of patients to a neurodevelopmental clinic for initial evaluation and referrals to support services can improve learning outcomes, provide early intervention for neurodevelopmental disorders, and mediate factors affecting low quality of life. Nationally, a substantial proportion of pediatric cardiologists are not referring children for neurodevelopmental evaluation. A review of patient referrals to a Cardiac Neurodevelopmental Clinic within an urban children’s hospital demonstrated an opportunity to improve provider awareness and knowledge of referral recommendations. Using the Iowa Model of Evidence-Based Practice to Promote Quality Care, an …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Assessing The Impact Of Camp Phever On Blood Phenylalanine Levels, Michelle Zelnick

Dissertations and Theses (Open Access)

Phenylketonuria (PKU) is a metabolic disorder that results in accumulation of the amino acid, phenylalanine, throughout the body. This can result in neurocognitive complications if individuals with this disease do not follow a low-protein diet. Camp PHEver is a weeklong summer camp that gives children with PKU an opportunity to obtain skills related to diet compliance, but also enhance their confidence, relationship development, and independence. Through learned skills and the strict diet regimen at camp, campers were found to have a statistically significant drop in phenylalanine (PHE) levels within a single attendance (mean decrease per year range = 2.1 to …

Internal Medicine Residents' Perceptions Of Virtual Morning Report: A Multicenter Survey, Tyler J Albert, Joel Bradley, Helene Starks, Jeff Redinger, Cherinne Arundel, Albertine Beard, Laura Caputo, Jonathan Chun, Craig G Gunderson, Dan Heppe, Anand Jagannath, Kyle Kent, Michael Krug, James Laudate, Vignesh Palaniappan, Amanda Pensiero, Zaven Sargsyan, Emily Sladek, Matthew Tuck, Paul B Cornia

Faculty, Staff and Students Publications

IMPORTANCE: The COVID-19 pandemic disrupted graduate medical education, compelling training programs to abruptly transition to virtual educational formats despite minimal experience or proficiency. We surveyed residents from a national sample of internal medicine (IM) residency programs to describe their experiences with the transition to virtual morning report (MR), a highly valued core educational conference.

OBJECTIVE: Assess resident views about virtual MR content and teaching strategies during the COVID-19 pandemic.

DESIGN: Anonymous, web-based survey.

PARTICIPANTS: Residents from 14 academically affiliated IM residency programs.

MAIN MEASURES: The 25-item survey on virtual MR included questions on demographics; frequency and reason for attending; opinions …

Understanding Both Sides Of The Blood Draw: The Experience Of The Pediatric Patient And The Phlebotomist, Julie R. Piazza, Sandra Merkel, Brooke Rothberg, Joan Gargaro, Kristin Kullgren

Patient Experience Journal

A phlebotomist’s words and actions play a crucial role in success of a blood draw and in providing a supportive patient experience. This study examined use of comfort measures during a pediatric blood draw. The phlebotomist’s use of soft words, positioning, distraction, coaching/support were observed with sixty children between 3-14 years of age during a blood draw. The level of fear /anxiety before and during the blood draw was recorded by an RA. The child’s level of fear/anxiety was observed and reported by the parent/caregiver after the procedure. Comfort measures provided by phlebotomists, the parent/caregiver’s report of their child’s usual …

Psycho-Emotional Education For Occupational Therapists Supporting Individuals Assuming The Role Of Family-Caregiver For People With A Traumatic Brain Injury (Tbi), Laura Dawn Lippman, Caitlyn E. Baird, Natalie L. Billharz

2022 Celebration of Scholarly Works

The purpose of this research was to identify the psycho-emotional needs of family-caregivers of individuals who sustained a traumatic brain injury (TBI), and measure if there was a change in knowledge among occupational therapists, and occupational therapy students following a two-hour seminar covering topics identified in the literature. The topics covered in the seminar included the concept of ambiguous loss, the importance of validating emotions, the caregiver grieving process, and the importance of providing caregiver resources. To measure the change in knowledge, researchers utilized primarily a quantitative research design using pre- and post-test questionnaires with Likert- scale questions. The questionnaire …

Design, Usability, And Acceptability Of A Needs-Based, Automated Dashboard To Provide Individualized Patient-Care Data To Pediatric Residents, Julia K W Yarahuan, Huay-Ying Lo, Lanessa Bass, Jeff Wright, Lauren M Hess

Faculty, Staff and Students Publications

BACKGROUND AND OBJECTIVES: Pediatric residency programs are required by the Accreditation Council for Graduate Medical Education to provide residents with patient-care and quality metrics to facilitate self-identification of knowledge gaps to prioritize improvement efforts. Trainees are interested in receiving this data, but this is a largely unmet need. Our objectives were to (1) design and implement an automated dashboard providing individualized data to residents, and (2) examine the usability and acceptability of the dashboard among pediatric residents.

METHODS: We developed a dashboard containing individualized patient-care data for pediatric residents with emphasis on needs identified by residents and residency leadership. To …

Virtual Deliberate Practice Module For Tracheostomy Change Training: An Application Of Educational Design Research, Jennifer Christina Benjamin, Saul Flores, Parag Jain, Shelley Kumar, Satid Thammasitboon

Faculty, Staff and Students Publications

BACKGROUND: The pandemic poses challenges for in-person procedural skills training. We developed a virtual module for teaching hands-on tracheostomy skills.

OBJECTIVE: To develop and evaluate a virtual module prototype grounded in deliberate practice using tracheostomy change as an example.

METHODS: After identifying desirable features of a virtual module by surveying stakeholders, we designed a prototype using VoiceThread, a multimedia-based collaborative learning platform. We created an asynchronous module accessible to learners for repeated skill practice and for video upload of individual performance on a tracheostomy task trainer using personal devices. This virtual module provided a four-step coaching (demonstration, deconstruction, formulation, and …

Emergency Medicine Journal Club, David Gibbs, Dylan Norton, Kyle Barbour

Advances in Clinical Medical Research and Healthcare Delivery

In this column, we provide a brief review of important papers recently published that relate to the field of Emergency Medicine. The goal is to provide the busy clinician a bullet-like summary of the study, focusing on the research question, methods, results, limitations and bottom line interpretation.

Physician And Patient Moves In The Hospital Do Not Move Patient Satisfaction: A Single-Center Retrospective Analysis, Basil George Verghese, Nagesh Jadhav, Walter A. Polashenski, Carl H. Reynolds

Advances in Clinical Medical Research and Healthcare Delivery

Background. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey for measuring patient's experiences at US hospitals. There is a shift towards geographically assigning patients and physicians. However, its impact on patient satisfaction scores has not been studied.

Objective: Examine the correlation between patient experience and overall hospital rating with the number of physicians seen and the number of times the patient was moved during a hospitalization.

Methods: A retrospective observational study was performed using select HCAHPS & Press Ganey survey questions to assess physician satisfaction scores and overall hospital rating and recommendation scores.

Results: There …

Implementation Of A Drive-Through Covid-19 Mass Vaccination Site: Experiences From Louvax–Broadbent In Louisville, Kentucky, Ruth Carrico, Sarah Beth Hartlage, Valenchia Brown Msn, Aprn, Fnp-C, Sarah M. Bishop, Luanne Didelot, William Hayden, Beverly Williams Coleman, Sarah Tan, Delanor Manson, Kellie Kane, Dawn Balcom, Paul Kern

The University of Louisville Journal of Respiratory Infections

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination.

Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked …

Senior Academic Ranks In Us Anesthesiology Programs: Differences Between Women And Men And Examination Of Independent Factors For Success, Brenda Lee, Farhad Zahedi, Ina Zaimi, Roman Schumann

Journal of Maine Medical Center

Introduction: Gender equality among faculty is a challenge in academic medicine, including anesthesiology. We investigated the likelihood that several factors were associated with academic success in the United States (US), defined as having achieved a senior academic rank (SAR) in a US anesthesiology training program.

Methods: We collected data available on the Internet on 131 anesthesiology programs, including faculty academic rank, gender, number of faculty, graduate status from an American medical school, fellowship training status, number of residents, number of program fellowships, and geographic location. SAR was defined as either associate professor or professor. Data were analyzed with logistic regression. …

Comparison Of Maintenance Gains From Two Treatment Approaches For Patients Diagnosed With Apraxia Of Speech And Broca’S Aphasia: A Critically Appraised Topic, Kalli B. Whiting

The Graduate Review

Three peer-reviewed research articles demonstrated benefits in using the articulatory-kinematic approaches of sound production treatment (SPT) and speech motor learning (SML) for intervention of patients diagnoses with apraxia of speech (AOS) concomitant with aphasia over the age of 50. This CAT was intended to review and compare the treatment maintenance between the two approaches using a specific search question; however, there was limited evidence for the specified population in that question. Although both approaches warranted positive outcomes, the SML approach may demonstrate a stronger linkage to the underlying features of apraxia of speech based on the method’s rationale. Through the …

Non-Pharmacological Management Of Idiopathic/Persistent Dyspareunia, Iveshia Ford

Capstone Showcase

Painful sexual intercourse, or dyspareunia, is a condition numerous women experience. An unknown, but still important, number of those affected find no relief with medication or surgery. Yet, it can be difficult for patients to discuss concerns with their provider. In addition, many providers do not have an adequate comfort level to discuss such topics. This paper aims to equip providers with non-pharmacological treatment options which include pelvic floor physical therapy, sex therapy and lifestyle changes. With the cultural shifts and changing ideas of sexuality in today’s age, it is important that clinicians remain versed in sexual health and patient …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

Eagle Syndrome: Efficacies Of Medical And Surgical Treatments, Kirklin Mitchell

Capstone Showcase

Eagle Syndrome is a rare syndrome caused by elongation of the styloid process of the temporal bone or calcification of the stylohyoid ligament occurring in a very small percentage of the population that can cause a wide range of common symptoms, leading to it being often misdiagnosed. While there are no set standards for treating Eagle Syndrome, both pharmaceutical and surgical options exist. Pharmaceutical options are often ineffective in long term treatment so surgery is usually required for full symptom resolution. Transoral and Transcervical surgeries have similar efficacies but each come with important drawbacks when considering which type of surgery …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Evaluation Of A Comprehensive Diabetes Mellitus Protocol At A Rural, Federally Qualified Health Center In Southern West Virginia, Hannah D. Davis

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Diabetes mellitus is a chronic disease that affects nearly 34 million Americans. In rural Appalachia, the population is affected disproportionately at a rate of 14% compared to the national average of 10%. Diabetes is a lifelong, chronic condition managed best by a multidisciplinary team-based approach to achieve optimal disease control. Best practices in the care of diabetes support the use of evidenced based care protocols and leveraging technology to decrease the burden of disease. Type 2 diabetes mellitus (T2DM) is the most common type, making it the focal population for evaluation.

Purpose: The purpose of this project was to …

Inpatient Coding System And Opportunities For Documentation Optimization: An Interactive Session For Internal Medicine Residents, Lindsey Jordan Gay, Doris Lin, Ziba Colah, Glynda Raynaldo

Faculty, Staff and Students Publications

INTRODUCTION: The Inpatient Prospective Payment System, the framework for categorization of admissions, is based upon physician documentation leading to International Classification of Diseases, Tenth Revision code generation and Medical Severity Diagnosis-Related Group (MS-DRG) assignment. In this curriculum, we introduced internal medicine residents to this inpatient coding framework and its effects on hospital quality metrics and reimbursement. We focused on educating learners about the importance of physicians being proficient in providing thorough and specific clinical documentation to produce appropriate DRG assignment.

METHODS: Internal medicine residents participated in a 90-minute session that introduced the basic framework of inpatient coding, discussed effects of …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

Bridging Mental Healthcare, Kristin L. White

MSN Capstone Projects

Nurses have an important role in the care given to mental health patients presenting to the emergency department (ED). Without expectations or encouragement toward growth or continued education, the quality of care and the therapeutic ability for care are crippled, as evidenced by nurses' knowledge/competency deficits and negative attitudes. Through ongoing/continued education, the cultivation of a therapeutic culture toward patients that present to the ED for mental health complaints could result. Additionally, these improvements in care, in turn, could promote not only the closure of gaps that exist for quality mental healthcare but may also lead to an increase in …

Partnering With Hospital Providers To Facilitate Handoff For Persons With Dementia In The Acute Care Setting, Vanessa Jeune

Student Scholarly Projects

Practice Problem: Individuals with Alzheimer's disease and related dementias cannot verbalize their care needs during transitions of care (TOC) and rely on their home caregivers (HCs) for advocacy. The lack of communication between clinicians in one setting and HCs can lead to detrimental health outcomes for the length of stay.

PICOT: The PICOT question that guided this project was: With the assistance of family nurse consultants (P), how does the implementation of standardized care needs communication tool for support persons of persons with dementia (I) vs. no standardized process (C) enhance the ability for the support person to …

The Emergence Of A Texas Collaboration To Improve Well-Being In Learning Health Systems, Toi B Harris, Anil Nanda, Lilit A Sargsyan, Wei-Jung A Chen, Jennifer G Christner

Faculty, Staff and Students Publications

Prior models of well-being have focused on resolving issues at different levels within a single institution. Changes over time in medicine have resulted in massive turnover and reduced clinical hours that portray a deficit-oriented system. As developments to improve purpose and professional satisfaction emerge, the Texas Medical Association Committee on Physician Health and Wellness (PHW) is committed to providing the vehicle for a statewide collaboration and illuminating the path forward.To describe the existing health and wellness resources in Texas academic medical centers and understand the gaps in resources and strategies for addressing the health and wellness needs in the medical …

Variations In Medical Students' Educational Preferences, Attitudes And Volunteerism During The Covid-19 Global Pandemic, Nital P Appelbaum, Sanghamitra M Misra, Jennifer Welch, M Harrison Humphries, Sunthosh Sivam, Nadia Ismail

Faculty, Staff and Students Publications

Public health crises require individuals, often volunteers, to help minimize disasters. The COVID-19 pandemic required such activation of individuals, but little is known about medical students’ preferences of such engagement. We investigated potential variations in medical students’ educational preferences, attitudes, and volunteerism during the COVID-19 pandemic based on socio-demographics to better prepare for future activation scenarios. A web-based, anonymous survey of U.S. medical students at a single institution was conducted in May 2020. Across four training year, 518 (68% response rate) students completed the survey. During the pandemic, 42.3% (n = 215) wanted to discontinue in-person clinical experiences, 32.3% (n …

Resident-Led Physical Wellness Initiative Linked To Less Burnout For Emergency Physicians During Covid-19 Pandemic, Camila A. Calderón, Adeola A. Kosoko, Salil K. Bhandari, Jason A. Lesnick, Derek R. Herkes, Ryan M. Huebinger

Journal of Wellness

Introduction: The COVID-19 pandemic has taken a significant toll on societal, physical, and psychological health. Emergency physicians (EPs) are susceptible to burnout under ordinary circumstances and may be particularly vulnerable during the pandemic. To reduce pandemic-related burnout, we implemented a residency-led physical wellness initiative and evaluated the effect on burnout among EPs.

Methods: In the spring of 2020, we invited all resident and attending EPs in our department to participate in a four-week physical wellness initiative as part of a prospective study. After completing or opting out of this wellness initiative, EPs responded to an online survey comprised …

An Integrated Multispecialty Curriculum For Point-Of-Care Ultrasound, Carina M. Brown, Karl Fields, Duncan Vincent, Alison Rumball, Joshua Zavitz, Shane Hudnall, Caroline Iskander, Alexander Raines

Advances in Clinical Medical Research and Healthcare Delivery

Point-of-care ultrasound is increasingly recognized as a valuable tool for physicians practicing in a variety of specialties. Currently there is no standard curricula or assessment model for training primary care specialty residents in the use of ultrasound. This article presents a multispecialty experience in developing a list of 11 core Pediatric, 13 core Family Medicine and 22 core Internal Medicine ultrasound scans based on best available evidence for their clinical use.

Pharmacy Students As Volunteer Medical Staff For American Diabetes Association Summer Camp, Emily Harvath

Purdue Journal of Service-Learning and International Engagement

For children living with a diagnosis of diabetes, com-munity support and education about proper disease management are critical for the mental and physical health of the child and their family. The experiences offered at summer camps hosted by the American Diabetes Association address both of these needs for the pediatric diabetes community. These camps provide children with the opportunity to participate in a traditional camp experience—swimming, rock climbing, tubing, and more—while giving parents peace of mind in the knowledge that their child’s diabetes will be closely monitored by a team of health care professionals. During my time as volunteer medical …

Communication Skills Training: A Means To Promote Time-Efficient Patient-Centered Communication In Clinical Practice, Else Dalsgaard Iversen, Maiken Wolderslund, Poul-Erik Kofoed, Pål Gulbrandsen, Helle Poulsen, Søren Cold, Jette Ammentorp

Journal of Patient-Centered Research and Reviews

Purpose: We hypothesized that health care providers would behave in a more patient-centered manner after the implementation of communication skills training, without causing the consultation to last longer.

Methods: This study was part of the large-scale implementation of a communication skills training program called "Clear-Cut Communication With Patients" at Lillebaelt Hospital in Denmark. Audio recordings from real-life consultations were collected in a pre-post design, with health care providers' participation in communication skills training as the intervention. The training was based on the Calgary-Cambridge Guide, and audio recordings were rated using the Observation Scheme-12.

Results: Health care providers improved their communication …

Secondary Stroke Prevention Education Project, Lauren Collie, Rn, Bsn, Pccn, Alyssa Brown, Rn, Bsn

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.