Rehabilitation and Therapy Commons^™

Flexible Coordinator And Switcher Hubs For Adaptive Task Control, Carrisa V. Cocuzza, Takuya Ito, Douglas H. Schultz, Dabielle D. Bassett, Michael W. Cole

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Functional connectivity (FC) studies have identified at least two large-scale neural systems that constitute cognitive control networks, the frontoparietal network (FPN) and cingulo-opercular network (CON). Control networks are thought to support goal-directed cognition and behavior. It was previously shown that the FPN flexibly shifts its global connectivity pattern according to task goal, consistent with a “flexible hub” mechanism for cognitive control. Our aim was to build on this finding to develop a functional cartography (a multimetric profile) of control networks in terms of dynamic network properties. We quantified network properties in (male and female) humans using a high-control-demand cognitive paradigm …

Validating Tackle Mechanics In American Football: Improving Safety And Performance, Arthur C. Maerlender, Caitlin J. Masterson, Rex Norris, Adam Hinthorne

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Research has helped to understand the risks of injuries of tackling in American football and rugby; however, approaches to teaching and analysis are not well-documented. Shoulder-led tackling has been proposed as a safer approach to tackling even though data on the effectiveness for safety and defensive performance is limited. Additionally, some have argued that safety and effectiveness are incompatible. The purpose of the study was to validate a specific sequence of tackling actions as a tool for teaching safer and more effective tackling skills. Results suggested tackle scores help predict presence of head contact, and that higher tackle scores were …

Effectiveness Of Aerobic Exercise For Adults With Leukemia, Jalin Davis, Summer Hood, Alex Miller, Sam Stein, Kaylee Stem

Master of Occupational Therapy Student Critically Appraised Topics

We wanted to look at the most effective interventions for increasing strength and endurance in clients with Leukemia experiencing functional decline.

Language, Motor, And Cognitive Outcomes Of Toddlers Who Were Born Preterm, Diane Frome Loeb, Caitlin M. Imgrund, Jaehoon Lee, Steven Barlow

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Purpose: The purpose of this study was to examine the language, motor, and cognitive abilities of children born preterm in four categories: (a) healthy preterm infants, (b) infants of diabetic mothers, (c) infants with respiratory distress syndrome, and (d) infants with chronic lung disease when the children were 30 months, uncorrected age. Comorbidity of language, motor, and cognitive skills was examined, along with predictor variables.

Method: A total of 148 children who were born preterm participated and were assessed using bivariate tests and logistic regression on standardized assessment scores.

Results: Controlling for the children’s gestational age (GA), overall language ability …

Alexithymia Symptoms Are Not Associated With Childhood Trauma Or Crhr1 Rs110402 Genotype, Emily Wiatr, Grace Sullivan, Scott Stoltenberg

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Alexithymia is associated with difficulties in emotional self-regulation, and alexithymia is specifically associated with an absence of emotional experience and cognition of emotion. Past research has indicated a potential association between alexithymia and the CRHR1 gene . Situational factors may also impact the expression of the CRHR1 gene within an individual. Berenbaum (1996) found associations between PTSD/childhood trauma and alexithymia. This study examined these associations using the Online Alexithymia Questionnaire-G2 (OAQ-G2) as well as DNA samples gathered from 657 participants at the University of Nebraska-Lincoln (72% women; 78.6% white; mean age= 20.34; standard deviation of 2.6). It was hypothesized that …

Sleep And Stress In The Acute Phase Of Concussion In Youth, Arthur C. Maerlender, Caitlin Masterson, Jessica L. Calvi, Todd Caze, Ross Mathiasen, Dennis Molfese

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

This study sought to address the complex interplay between both biological and psychological perceptions of stress and sleep in the acute stages following a mild traumatic brain injury. A secondary goal was to identify potential targets for intervention. Eleven acutely injured youth (mean age 12 years) were studied at home with overnight actigraphy, salivary cortisol and melatonin assays, and subjective ratings of stress and fatigue (injured group). Nine matched control youth also were assessed (control group). Results suggested longer sleep latencies (time to fall asleep) and higher levels of fatigue in the injured group exist (p ¼ 0.025 and p …

Psychometric Properties Of The Standardized Assessment Of Concussion In Youth Football: Validity, Reliability, And Demographic Factors, Arthur C. Maerlender, Eric Smith, P. Gunnar Brolinson, Jillian Urban, Steven Rowson, Amaris Ajamil, Eamon T. Campolettano, Ryan A. Gellner, Srinidhi Bellamkonda, Mireille E. Kelley, Derek Jones, Alex Powers, Jonathan Beckwith, Joseph J. Crisco, Joel Stitzel, Stefan Duma, Richard M. Greenwald

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The objective of this study was to determine the psychometrics (reliability, validity) of the original Standardized Assessment of Concussion (SAC) in a youth sample (ages 11 to 13). Demographic factors of race, level of vocabulary knowledge, mother’s level of education were also considered. Over 150 youth football athletes completed the SAC and a brief battery of NIH Toolbox cognitive tests as part of a larger study on biomechanical factors in youth sport concussion. This was a within-subjects design (pre-season, post-season assessments), and correlational analysis of convergent and discriminant validity. Between groups analysis based on demographic differences was also employed. The …

The Global Assessment Of School Functioning (Gasf): Criterion Validity And Interrater Reliability, Arthur C. Maerlender, Joseph Palamara, Jonathan Lichtenstein

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The Global Assessment of School Functioning (GASF) provides a robust estimate of a student's overall level of functioning within the school environment. It is intended to capture a global metric reflecting academic, social and general behavioral functioning within the school. It is a modification of the Global Assessment of Functioning and reflects functioning across academics, interpersonal relationships, school behavior, and school participation. It was developed to allow school personnel a means to communicate the general level of student functioning without re- verting to specific issues or immediate concerns. This paper reports on the scale's criterion validity and interrater reliability. Confirmations …

Males With Chronic Ankle Instability Demonstrate Deficits In Neurocognitive Function Compared To Control And Copers, Adam B. Rosen, Melanie L. Mcgrath, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The purpose of this study was to determine if there were neurocognitive deficits among controls, copers and those with chronic ankle instability (CAI). Participants included those without history of ankle injury (n = 14), ankle sprain copers (n = 13) and patients with self-reported CAI (n = 14). They completed a battery of valid and reliable computer-based neurocognitive tests. The differences between neurocognitive domain scores were compared across the Control, Coper and CAI groups. Patients with CAI had lower composite memory, visual memory and simple attention compared to controls. In males with CAI, large differences in memory and attention were …

Neuropsychological Change After A Single Season Of Head Impact Exposure In Youth Football, Arthur C. Maerlender, Eric Smith, P. Gunnar Brolinson, Joseph J. Crisco, Jillian Urban, Amaris Ajamil, Steven Rowson, Eamon T. Campolettano, Ryan A. Gellner, Srinidhi Bellamkonda, Emily Kieffer, Mireille E. Kelley, Derek Jones, Alex Powers, Jonathan Beckwith, Joel Stitzel, Richard M. Greenwald, Stefan Duma

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Objectives: Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes.

Method: Over 200 participants (ages 9–13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre- and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes.

Results: For the full …

The Effect Of In-Service Methodology On Learning Transfer For School Personnel Managing Students Following Concussion, Jennifer Parent-Nichols, Angela Desilva Mousseau, Joshua Cleland, Jonathan D. Lichtenstein, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background: It is essential to increase the knowledge base of teachers involved in facilitating return to learning in middle school students following a concussion. However, the best method to enhance the transfer of learning for teachers remains to be elucidated. Application of Adult Learning Theory (ALT) is a plausible solution to this problem. Purpose: The purpose of this randomized post-test study was to examine the effects of ALTon the transfer of learning in teachers who work with individuals with concussion. Methods: A convenience sample of 169 teachers at four middle schools were randomized to receive an in-service regarding concussion management …

Modeling Interactions Between Brain Function, Diet Adherence Behaviors, And Weight Loss Success, Amanda N. Szabo-Reed, Laura E. Martin, Jinxiang Hu, Hung-Wen Yeh, Joshua Powell, Rebecca J. Lepping, Trisha M. Patrician, Florance J. Breslin, Joseph E. Donnelly, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Summary

Introduction: Obesity is linked to altered activation in reward and control brain cir-cuitry; however, the associated brain activity related to successful or unsuccessful weight loss (WL) is unclear.

Methods: Adults with obesity (N = 75) completed a baseline functional magnetic res-onance imaging (fMRI) scan before entering a WL intervention (ie,3-month diet and physical activity [PA] program). We conducted an exploratory analysis to identify the contributions of baseline brain activation, adherence behavior patterns, and the asso-ciated connections to WL at the conclusion of a 3-month WL intervention. Food cue-reactivity brain regions were functionally identified using fMRI to index brain activation …

Neural Bases Of Phonological And Semantic Processing In Early Childhood, Avantika Mathur, Douglas H. Schultz, Yingying Wang Dr.

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

During the early period of reading development, children gain phonological (letter-to-sound mapping) and semantic knowledge (storage and retrieval of word meaning). Their reading ability changes rapidly, accompanied by learning-induced brain plasticity as they learn to read. This study aims at identifying the neural bases of phonological and semantic processing in early childhood by using a combination of univariate and multivariate pattern analysis. Nineteen typically developing children between the age of five and seven performed visual word-level phonological (rhyming) and semantic (related meaning) judgment tasks during functional magnetic resonance imaging scans. Our multivariate analysis showed that young children with good reading …

Genetic Taster Status As A Mediator Of Neural Activity And Swallowing Mechanics In Healthy Adults, Angela M. Dietsch, Ross M. Westemeyer, William G. Pearson Jr., Douglas H. Schultz

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

As part of a larger study examining relationships between taste properties and swallowing, we assessed the influence of genetic taster status (GTS) on measures of brain activity and swallowing physiology during taste stimulation in healthy men and women. Twenty-one participants underwent videofluoroscopic swallowing study (VFSS) and functional magnetic resonance imaging (fMRI) during trials of high-intensity taste stimuli. The precisely formulated mixtures included sour, sweet-sour, lemon, and orange taste profiles and unflavored controls. Swallowing physiology was characterized via computational analysis of swallowing mechanics plus other kinematic and temporal measures, all extracted from VFSS recordings. Whole-brain analysis of fMRI data assessed blood …

Wavelet-Based Analysis Of Physical Activity And Sleep Movement Data From Wearable Sensors Among Obese Adults, Rahul Soangra, Vennila Krishnan

Physical Therapy Faculty Articles and Research

Decreased physical activity in obese individuals is associated with a prevalence of cardiovascular and metabolic disorders. Physicians usually recommend that obese individuals change their lifestyle, specifically changes in diet, exercise, and other physical activities for obesity management. Therefore, understanding physical activity and sleep behavior is an essential aspect of obesity management. With innovations in mobile and electronic health care technologies, wearable inertial sensors have been used extensively over the past decade for monitoring human activities. Despite significant progress with the wearable inertial sensing technology, there is a knowledge gap among researchers regarding how to analyze longitudinal multi-day inertial sensor data …

The Relationship Between Socioeconomic Status And White Matter Microstructure In Pre-Reading Children: A Longitudinal Investigation, Ola Ozernov-Palchik, Elizabeth S. Norton, Yingying Wang, Sara D. Beach, Jennifer Zuk, Maryanne Wolf, John D.E. Gabrieli, Nadine Gaab

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Reading is a learned skill crucial for educational attainment. Children from families of lower socioeconomic status (SES) tend to have poorer reading performance and this gap widens across years of schooling. Reading relies on the orchestration of multiple neural systems integrated via specific white-matter pathways, but there is limited understanding about whether these pathways relate differentially to reading performance depending on SES background. Kindergarten white-matter FA and second-grade reading outcomes were investigated in an SES-diverse sample of 125 children. The three left-hemisphere white-matter tracts most associated with reading, and their right-hemisphere homologs, were examined: arcuate fasciculus (AF), superior longitudinal fasciculus …

Alterations In Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control, Adam B. Rosen, Jennifer M. Yentes, Melanie L. Mcgrath, Arthur C. Maerlender, Sara A. Myers, Mukul Mukherjee

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Context: Chronic ankle instability (CAI) is characterized by repetitive ankle sprains and perceived instability. Whereas the underlying cause of CAI is disputed, alterations in cortical motor functioning may contribute to the perceived dysfunction.

Objective: To assess differences in cortical activity during single-limb stance among control, coper, and CAI groups.

Design: Cross-sectional study.

Setting: Biomechanics laboratory.

Patients or Other Participants: A total of 31 individuals (10 men, 21 women; age = 22.3 ± 2.4 years, height = 169.6 ± 9.7 cm, mass = 70.6 ± 11.6 kg), who were classified into control (n = 13), coper (n = 7), and CAI …

The Relationship Between Biological And Psychosocial Risk Factors And Resting‐State Functional Connectivity In 2‐Monthold Bangladeshi Infants: A Feasibility And Pilot Study, Ted K. Turesky, Sarah K.G. Jensen, Xi Yu, Swapna Kumar, Yingying Wang, Danielle D. Sliva, Borjan Gagoski, Joseph Sanfilippo, Lilla Zöllei, Emma Boyd, Rashidul Haque, Shahria Hafiz Kakon, Nazrul Islam, William A. Petri Jr., Charles A. Nelson, Nadine Gaab

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Childhood poverty has been associated with structural and functional alterations in the developing brain. However, poverty does not alter brain development directly, but acts through associated biological or psychosocial risk factors (e.g. malnutrition, family conflict). Yet few studies have investigated risk factors in the context of infant neurodevelopment, and none have done so in low‐resource settings such as Bangladesh, where children are exposed to multiple, severe biological and psychosocial hazards. In this feasibility and pilot study, usable resting‐state fMRI data were acquired in infants from extremely poor (n = 16) and (relatively) more affluent (n = 16) families in Dhaka, …

Dynamic Effects Of Habituation And Novelty Detection On Newborn Event Related Potentials, Cathryn S. Cortesa, Caitlin M Hudac, Dennis Molfese

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Newborns habituate to repeated auditory stimuli, and discriminate syllables, generating opportunities for early language learning. This study investigated trial-by-trial changes in newborn electrophysiological responses to auditory speech syllables as an index of habituation and novelty detection. Auditory event-related potentials (ERPs) were recorded from 16 term newborn infants, aged 1–3 days, in response to monosyllabic speech syllables presented during habituation and novelty detection tasks. Multilevel models demonstrated that newborns habituated to repeated auditory syllables, as ERP amplitude attenuated for a late-latency component over successive trials. Subsequently, during the novelty detection task, earlyand late-latency component amplitudes decreased over successive trials for novel …

Functional Source Separation For Eeg-Fmri Fusion: Application To Steady-State Visual Evoked Potentials, Hong Ji, Badong Chen, Nathan M. Petro, Zejian Yuan, Nanning Zheng, Andreas Keil

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Neurorobotics is one of the most ambitious fields in robotics, driving integration of interdisciplinary data and knowledge. One of the most productive areas of interdisciplinary research in this area has been the implementation of biologically-inspired mechanisms in the development of autonomous systems. Specifically, enabling such systems to display adaptive behavior such as learning from good and bad outcomes, has been achieved by quantifying and understanding the neural mechanisms of the brain networks mediating adaptive behaviors in humans and animals. For example, associative learning from aversive or dangerous outcomes is crucial for an autonomous system, to avoid dangerous situations in the …

Confirmatory Factor Analysis Of Two Computerized Neuropsychological Test Batteries: Immediate Post-Concussion Assessment And Cognitive Test (Impact) And C3 Logix, Caitlin Masterson, Julie Tuttle, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Introduction: Tests of memory and speed of cognitive and motor responses have been the primary foci in sports-related concussion assessment. This study sought to assess the construct validity of neuropsychological tests within C3 Logix.

Method: Results of both baseline C3 Logix and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) computerized tests from 86 Division I collegiate athletes were submitted to a two-factor confirmatory analysis using structural equation modeling. The two factors of Speed and Memory have been confirmed in previous studies of ImPACT.

Results: Results confirmed the two-factor model of ImPACT, whereas C3 Logix did not …

Concussion Competencies: A Training Model For School-Based Concussion Management, Arthur C. Maerlender, Jonathan D. Lichtenstein, Jennifer Parent-Nichols, Kate Higgins, Peggy Reisher

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

This study reports on the use of ten knowledge competencies related to the behavioral management of concussion in schools. Trainings using these competencies as learning objectives were delivered to school personnel. This aims of the use of competencies in this way are to streamline the education of key stakeholders, to establish clear roles and responsibilities for constituents and equip individuals working with students following a concussion with the relevant knowledge to optimize outcomes. The majority of participants, primarily speech language pathologists working as related service providers in the schoolswhere the trainings occurred, judged the use of the competencies to be …

Assistive Utensil: A Spork For Hand Tremors And Spatial Awareness, Ana Font Hernandez, Jacob Kabariti, Troy Taylor

Publications and Research

In this poster, we present a 3D printed solution for hand tremors and special awareness. Our spork is an assistive device designed and 3D printed for patients suffering from scleroderma, systemic sclerosis, Parkinson's, multiple sclerosis, drug withdrawal, etc. The scale-based handle will act as a counterweight to offset the contents on the other end and reduce shakiness. The larger grip allows an easy and comfortable hold. The product will be 3D printed for a customizable fit and at an affordable price. Lastly, the product will include a haptic feedback sensor to assist the visually impaired in locating food contents on …

Concussion Competencies: A Framework For School-Based Concussion Management (Flyer), Arthur C. Maerlender, Jonathan Lichtenstein, Jennifer Parent-Nichols

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

This volume grew out of many years of clinical practice, research, and program projects. It is the culmination of more than 50 years of work with kids, brains, and schools. While there is research behind the Competencies and the underlying content, the intent was to create a user-friendly manual that cut across levels of responsibility and care. Concussion Competencies was not intended to be a textbook in the traditional manner; however, the Competencies have been shown to be a useful approach to teaching this material.

This volume is organized around a set of Competencies that have been shown to be …

Mesotocin Influences Pinyon Jay Prosociality, J. F. Duque, W. Leichner, H. Ahmann, Jeffrey R. Stevens

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Many species exhibit prosocial behavior , in which one individual’s actions benefit another individual, often without an immediate benefit to itself. The neuropeptide oxytocin is an important hormonal mechanism influencing prosociality in mammals, but it is unclear whether the avian homologue mesotocin plays a similar functional role in birds. Here, we experimentally tested prosociality in pinyon jays (Gymnorhinus cyanocephalus), a highly social corvid species that spontaneously shares food with others. First, we measured prosocial preferences in a prosocial choice task with two different pay-off distributions: Prosocial trials delivered food to both the subject and either an empty cage …

Factor Structure And Gender Invariance Testing For The Sport Anxiety Scale-2 (Sas-2), Leilani Madrigal, Vincenzo Roma, Todd Caze, Arthur C. Maerlender, Debra Hope

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

This study aimed to provide further psychometric validation of the Sport Anxiety Scale-2 (SAS-2) by assessing the factor structure, invariance across gender, and convergent and divergent validity of the SAS-2 by correlating both related (i.e., anxiety sensitivity, brief fear of negative evaluation, intolerance of uncertainty, and negative affect) and unrelated constructs (i.e., positive affect, self-confidence). A total of 542 current and former competitive athletes completed a questionnaire through Amazon’s Mechanical Turk system. All data were collected via online survey. Participants were randomly assigned to an exploratory factor analysis (n = 271) and confirmatory factor analysis group (n = 271). Results …

Accumulating Data To Optimally Predict Obesity Treatment (Adopt): Recommendations From The Biological Domain, Michael Rosenbaum, Tanya Agurs-Collins, Molly S. Bray, Kevin D. Hall, Mark Hopkins, Maren Laughlin, Paul S. Maclean, Padma Maruvada, Cary R. Savage, Dana M. Small, Luke Stoeckel

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background: The responses to behavioral, pharmacological, or surgical obesity treatments are highly individualized. The Accumulating Data to Optimally Predict obesity Treatment (ADOPT) project provides a framework for how obesity researchers, working collectively, can generate the evidence base needed to guide the development of tailored, and potentially more effective, strategies for obesity treatment. Objectives: The objective of the ADOPT biological domain subgroup is to create a list of high-priority biological measures for weight-loss studies that will advance the understanding of individual variability in response to adult obesity treatments. This list includes measures of body composition, energy homeostasis (energy intake and output), …

Novel Biomarkers Of Physical Activity Maintenance In Midlife Women: Preliminary Investigation, Kelly A. Bosak, Vlad B. Papa, Morgan G. Brucks, Cary R. Savage, Joseph E. Donnelly, Laura E. Martin

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

The precision health initiative is leading the discovery of novel biomarkers as important indicators of biological processes or responses to behavior, such as physical activity. Neural biomarkers identified by magnetic resonance imaging (MRI) hold promise to inform future research, and ultimately, for transfer to the clinical setting to optimize health outcomes. This study investigated resting-state and functional brain biomarkers between midlife women who were maintaining physical activity in accordance with the current national guidelines and previously acquired age-matched sedentary controls. Approval was obtained from the Human Subjects Committee. Participants included nondiabetic, healthy weight to overweight (body mass index 19–29.9 kg/m …

Left Lateralized Cerebral Glucose Metabolism Declines In Amyloid-Β Positive Persons With Mild Cognitive Impairment, Christopher M. Weise, Kewei Chen, Yinghua Chen, Xiaoying Kuang, Cary R. Savage, Eric M. Reiman

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background: Previous publications indicate that Alzheimer's Disease (AD) related cortical atrophy may develop in asymmetric patterns, with accentuation of the left hemisphere. Since fluorodeoxyglucose positron emission tomography (FDG PET) measurements of the regional cerebral metabolic rate of glucose (rCMRgl) provide a sensitive and specific marker of neurodegenerative disease progression, we sought to investigate the longitudinal pattern of rCMRgl in amyloid-positive persons with mild cognitive impairment (MCI) and dementia, hypothesizing asymmetric declines of cerebral glucose metabolism. Methods: Using florbetapir PET and cerebrospinal fluid (CSF) measures to define amyloid-β (Aβ) positivity, 40 Aβ negative (Aβ-) cognitively unimpaired controls (CU; 76 ± 5y), …

The Pathway To The Use Of A Structured And Supported Approach To Debriefing, Anne H. Zachry, S. B. Lancaster

Faculty Presentations

Debriefing plays a critical role in the transfer of knowledge in simulation education. Various methods are used in the debriefing process based on a variety of factors; this presentation sheds light on the pathway to the use of a structured and supported approach as traversed in the Department of Occupational Therapy at the University of Tennessee Healthcare Center as well as reflections and lessons learned along the way. Engagement in this session will allow learners to further develop their debriefing skills through exposure to information about strategies to use in the debriefing process that can be used as part of …