Doctoral Scholarly Project: Education & Leadership in Healthcare: 2021

KRUSE, Faith. (2021). An essential function of a healthcare curriculum is to help develop critical thinking skills in students. This paper introduces how a medical laboratory science course increased students’ perception of their ability to critically think using teaching tools discovered through evidence-based research literature. Virtual case studies of Hematological disorders were created in conjunction with using CellaVision® technology. This technology allowed for virtual images and cell differentials to be created of real patient blood smears. Virtual cases and CellaVision® files were distributed to medical lab science students who were in their final semester of study; an anonymous survey was distributed with the intervention. Participants indicated that solving the virtual cases and virtual differentials did boost their perceived ability to critically think through complex hematology cases; participants indicated the cases were well put together and easy to follow, and participants indicated they did not prefer virtual differentials over hands-on microscope differentials. The virtual cases have been stored in a library and have the potential to be shared and used among multiple hematology courses for continued student learning.

OSTROSKI, Michelle Lynn. (2021). The conducted retrospective analysis investigated a preventative approach in addressing mental health concerns in medical students through the incorporation of the Interactive Screening Program (ISP) guided by the American Foundation for Suicide Prevention (AFSP). The proposed outcome measured the engagement rates of medical students with the intended outcome of 10% or more. Three levels of engagement included participation in the survey, participation with messaging the counselor, and finally, participating with Student Health Services as a referral from ISP. Surveying demographic factors can identify if there are various influences that may increase the risk of mental health concerns in medical students. The findings suggest that a preventative approach is effective in engaging medical students to seek help for mental health concerns by decreasing the barriers which may influence help-seeking behaviors.

WOLFF, Benita D. (2021). Health systems across the United States are charged with providing equitable care for all the patients they serve. However, too often, gaps or disparities exist between racial and ethnic groups. Though health disparities are not new, the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) crisis that began in March 2020 has renewed attention to the inequities that exist for minority and underserved communities in the United States. Also, the proliferation of chronic disease (e.g., diabetes) within minority communities highlights the need to identify and serve patients from racial and ethnic groups more equitably. This project used de-identified data from a new health system’s electronic medical records, human resources information systems, and descriptive statistics to create a baseline demographic profile of the health system’s patients and workforce. The project team then used the profile data and inferential statistics to stratify the rate of diabetes across racial and ethnic groups to determine if gaps exist. Demographic profile data suggests that the health system serves a diverse patient population. Only 46% of patients self-identify as White, and 22% indicate a primary language other than English. The diabetes data, stratified by race and ethnicity, shows patients who self-identify as African American or Black are 1.236 times more likely to have diabetes than White patients. The findings were used to propose actions the health system can take to serve its diverse patient population more effectively.

ZAPFE, Adrienne Davis (2021). Emotional intelligence, the knowledge and ability to manage social and emotional behaviors in an intrapersonal and interpersonal manner, is a critical trait in healthcare professionals. Undergraduate medical laboratory science (MLS) programs prepare students with the technical skills and knowledge to work as laboratory professional, but these students may lack the professional skills and knowledge, such as emotional intelligence, necessary to be an effective member of the healthcare team. The purpose of this project was to increase clinical year MLS students' perceived emotional intelligence through designing and implementing an effective brief, instructor-led training module on emotional intelligence. The study was conducted within an MLS program at public research university and study participants were undergraduate MLS students enrolled in the final, clinical year of the program. The intervention included a 30-minute, online emotional intelligence training module and pre- and post-assessment using the Trait Emotional Intelligence Questionnaire – Short Form to measure perceived emotional intelligence. In total, 13 students completed the study and a control group was not employed to allow all student equal opportunity to participate in the education module. The study group did not have a significant effect on increasing the study group’s emotional intelligence score before and after the educational intervention. This finding differs from previous research on brief emotional intelligence education and might be explained by relatively small sample size, response set bias, and limited time for applying the acquired knowledge and techniques from the training in order to detect a significant change. Future studies will be needed and should include an increase in the participant sample size, more robust educational content, and post-assessment after the students have had time to process and apply their newly acquired emotional intelligence knowledge and skills.

BANDONG, Wilma Evangeline A. (2021). The purpose of this quality improvement evidence-based capstone project was to determine
whether a stress management pilot program could reduce and or eliminate stress for special education teachers in Southern Maryland. The capstone project consisted of a pre-intervention survey, an intervention, and a post-intervention survey. The participants targeted for this evidencebased project were middle school special education teachers in Southern Maryland public schools. The stress management pilot program was implemented during a two-week period in which participants were provided with resources to reduce and or eliminate symptoms of stress. The implementation of the stress management pilot program capstone project had a positive impact of 75%, while 25% had no positive impact after the intervention. Investigator's analysis found strong support for mindfulness as an effective tool. In addition, the results from post-intervention on the feasibility of an online mode for mindfulness-based intervention were promising on stress level, anxiety, and personal growth of special education teachers. As such, teachers may benefit from opportunities to develop effective coping resources. These initial findings highlight the need for further research on mindfulness-based teacher training and course participant outcomes with larger participant samples

BOSAN, Keisha M. (2021). From athletics to the classroom, the categories of feedback are the same. Some students eagerly accept feedback and apply the suggestions made, while others dismiss the advice. This study evaluated the effects that video recording has on effective feedback. The intended outcomes were to decrease student's insecurities about clinical, allow students to analyze their own work, and enhance students' overall growth and learning. Participants were first-year radiography students who determined whether video-based feedback was more effective than verbal feedback. Pre and post-surveys were given to 24 participants, with 23 participating. The analysis showed a correlation between video recordings and intended outcomes. The study concludes that self-evaluation from video recording and faculty input allows for more accurate feedback. A recommendation for further implementation would include more than one video recording, so participants can compare their videos and see their growth over time.

COX, Betsy. (2021). Problem: Human trafficking is quickly becoming a global concern, with an estimated thirty to forty
million people impacted worldwide. Recent studies have shown that many trafficking victims are seen in healthcare settings and yet many providers feel they lack the skills to be able to identify and treat victims. This study examined the impact of an online human trafficking educational module on BSN students’ knowledge of human trafficking and confidence levels in identifying and treating potential victims. Intervention: Participants were asked to partake in an online educational module that examined basic human trafficking information including the definition, prevalence, and common myths, along with information more relevant to healthcare providers on how to identify and treat potential victims. Measures: Pre-test and post-test surveys evaluated the effectiveness of the intervention in three domains: basic human trafficking knowledge, confidence in identifying a potential victim, and confidence in treating a potential victim. Results: Analysis showed that there was significant increases in students’ (n = 5) knowledge of human trafficking pre-test (M = 6.45, SD = 1.04) and post-test (M = 8.4, SD = 1.14), t(7.2) = 3.3, p = 0.01; confidence in identifying a potential victim pre-test (M =7.27, SD = 1.19) and post-test (M = 9.8, SD =1.30), t(3.7) = 3.7, p = 0.007; and confidence in treating a potential victim pre-test (M = 7.73, SD = 1.19) and post-test (M = 10.2, SD = 1.64), t(6.0) = 3.0, p = 0.02. Conclusions: There is a gap in healthcare providers’, including nursing students, knowledge in human trafficking and confidence in identifying and caring for trafficking victims. Education is key to addressing these gaps and making an impact on the lives of this vulnerable population.

CYR, Gabrielle. (2021). Suicide is the 10th leading cause of death in the state of focus and in the top 12 causes nationally. Research shows that church leaders are in a unique position to take part in suicide prevention efforts. This project investigated the effectiveness of Question, Persuade, Refer (QPR) Gatekeeper Training on clergy, church staff, and church volunteers’ perception of
knowledge and confidence in identifying and preventing suicide, and in referring individuals to mental health promotion resources. Two measures were utilized and compared for this project: intervention pre-test and an intervention post-test. Both tests were created by the QPR Institute. The intervention was held socially distanced, in person. Seventeen people completed the pre-test, 16 people attended the training, and 14 completed the post-test. The surveys were constructed in Google Form and disseminated via email. Project results suggest that Question, Persuade, Refer (QPR) Gatekeeper Training had a significant impact on identified outcomes. This supports the ask to continue training more church staff and volunteers in the future.

DIESING, Katie. (2021). Paternal postpartum depression is a topic that has been under-explored and is just recently becoming more recognized as something fathers also can experience. The purpose of this project was to improve paternal knowledge about the signs and symptoms of paternal postpartum depression during their postpartum hospital stay. Participants were recruited for this project upon arrival to the postpartum unit at the Midwestern hospital where this project took place. For the intervention, fathers were provided with a pre-intervention survey to determine their current knowledge about paternal postpartum depression. They were then provided with education about paternal postpartum depression. After they received this education, fathers were asked to fill out a post-intervention survey. Paired sample t-tests were used to determine if the education provided to fathers during the postpartum period helped to improve paternal knowledge about the signs and symptoms of paternal postpartum depression, when paternal postpartum depression is most likely to occur, and when to seek help. This project showed that there is a need to provide education about paternal postpartum depression to fathers during prenatal visits and during their hospital stay after the baby is born. Providing this education showed significant findings towards achieving the project goals.

DUNAVANT, Laura Elizabeth. (2021). The problem addressed in this research is virtual education. Virtual education is classified as an online method of learning where teachers hold synchronous class meetings with students, and the students are allowed to complete coursework in their own time by a set due date. Virtual education has been at the back of the line in the field of education as an option for learning, but with the onset of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, it has been pushed to the forefront as the option of choice. The intervention that was implemented in this study was using several different techniques of online learning that have been tested separately, and having them put together in one systematic approach to allow for a successful learning experience for high schoolers in the virtual classroom. The implementation of using discussion boards graded based on the Pecka grading rubric, shortened assignments of incremental difficulty, and using the inverted classroom method of teaching were all measured. Participants were given a post-intervention survey that measured their feelings of how well the different aspects of the intervention served them in their learning, and if they felt as if they had a successful learning experience as a result of the intervention. Thirty-one students, consisting of 90% 11th graders and 10% 12th graders, participated in the post-intervention survey. The survey consisted of eight statements that the students rated using a Likert scale. The results of the study are substantial in finding students can effectively learn in the virtual classroom, and the different aspects of the intervention are effective tools and strategies in aiding in the students having a successful learning experience.

DUNN, Roderick. (2021). Vaccines have proven to be the most effective preventative tool against vaccine preventable diseases; however, the success is contingent on high rates of coverage. Vaccines have successfully eradicated several infectious diseases from the United States including smallpox, polio, and measles. Recently there has been an outbreak of preventable disease believed to be the result of intentional vaccination hesitancy and refusal. College campuses are considered high-risk environments for preventable disease outbreaks. The state of Texas has a mandatory vaccination requirement for meningitis for incoming college freshman students to register for classes. Additional immunizations are not a state requirement and are left up to the institutions. Without an immunization mandate, college campuses potentially have a large student body with variable immunization status. This intervention was introduced to improve students’ perception of vaccines to increase vaccination uptake by identifying barriers to compliance, correcting misinformation and providing evidence-based facts about preventable diseases and vaccinations. The intervention consisted of a pre-intervention survey, a presentation covering influenza and the influenza vaccine, and a post-intervention survey. Preintervention survey results revealed that participants did not realize the severity of the disease, and perceived adverse events from the vaccine to be riskier than the disease. Results also indicated deficiencies in knowledge and beliefs in misinformation. There were 35 participants that completed the survey, which mostly focused on risk perception, perceived behavioral control, attitude, knowledge, and intention. The results of the survey (t = 2.48, df = 34, p = 0.018) indicated a significant mean difference between the pre-intervention and post-intervention scores. This lends support for the effectiveness of the treatment.

ESPADA, Jose. (2021). As the Hispanic population grows in the United States, they must receive appropriate nutrition and budgeting education to better care for their children and create awareness on their following generations. Problem: Hispanic population tends to have poor nutrition behaviors that put their children and their health at risk. Intervention: How can a short nutrition and budgeting intervention help improve knowledge. Measure: The Boston Medical Center Nutrition Knowledge Test (BMCNKT) and an assessment tool from the Practical Money Skills® were used to assess nutrition and budgeting knowledge, respectively. Results: A short intervention for budgeting did not have any knowledge gains on the participant. The brief nutrition education is evidenced to improve significant knowledge. Conclusion: Further study should be conducted with a more substantial number of participants to have robust evidence of the outcomes of the interventions.

HARRIS, Josey. (2021). Problem: Research indicates that healthcare professionals and nursing students exhibit high levels of stigmatization and bias when working with pregnant and postpartum women with substance use disorder (SUD), which can compromise maternal and fetal outcomes. Intervention: A World Café event designed using the Empathy Continuum model was implemented with senior-level undergraduate nursing students with the aim of fostering empathy for pregnant and postpartum women with SUD. Measures: The Medical Condition Regard Scale (MCRS) was used in a pre-test post-test format to evaluate for an increase in empathy. A short demographic questionnaire collected sample characteristics including age, gender, ethnicity, and enrolled degree track. The demographic categories were also analyzed as possible predictors for the participants’ pre-intervention empathy scores. Results: After completion of the World Café event, a paired samples t-test revealed a statistically significant improvement (p < .05) in participants’ empathy scores from pre-intervention to post-intervention. Multiple linear regression and individual predictor analysis was not able to identify any demographic categories as predictors for participants’ pre-intervention empathy scores. Conclusions: The World Café methodology is an effective teaching strategy that can be used with undergraduate nursing students to mitigate stigma and increase empathy for pregnant and postpartum women with SUD.

JONES, Ronald B. (2021). Low self-concept, depression, and lack of belonging are all contributing factors to suicidal ideation and studies show that positive affirmations can boost these factors and create a higher sense of belonging. This capstone project was aimed at improving self-concept among school-aged children using the General Self-Concept Model as a framework. Signage with positive affirmation slogans were placed around a middle school, scattered about the school grounds. The signs were also posted in high traffic areas inside the school such as hallways and bathrooms. Pre and post sign deployment surveys were issued using the Academic Self-Description Questionnaire II (ASDQ II) . The entire capstone project ran for thirty days, and statistical analysis were completed utilizing means, standard deviations, and independent t-tests. Although data analysis indicated results to be statistically insignificant, insight was gained to areas of student self-concept struggle. This project opened the door for future projects that can expand to a broader application of positive affirmation up to and including a longer study period.

LUDWIG, Barbara. (2021). With the continued growth of nursing education programs, a corresponding development of student stress-related challenges are on the rise. According to the American College Health Association (2018), stress and low stress management skills are a significant impediment to student academic success. A shift in campus culture from traditional to nontraditional, online structure, and remote learning introduces new stressors that must be addressed. The perceived stress scale survey was used in the pilot project to measure the effect of an online stress management workshop on nursing students' perceived stress levels. The stress management workshop was developed from Georgia Southern and implemented entirely online and self-paced format. The study's findings showed that the workshop had a statistically significant effect on post-Perceived Stress Survey (PSS) scores compared to pre- PSS scores.

MANDY, Michelle R. (2021). Background: Workplace violence, including disruptive behaviors in healthcare, is an occupational hazard that is complex and is on the rise. Workplace violence includes bullying, lateral violence, and incivility, as they all have been thoroughly defined in the literature and pose harmful effects on healthcare professionals' wellbeing. The interest in healthcare professionals' wellbeing has caught the attention of accreditation bodies, labor unions, national healthcare organizations, and Congress. Purpose: This project aimed to explore the effects of implementing an interactive, interprofessional training program to improve workplace violence for healthcare professionals within a medical clinic. Methods: Staff from an outpatient medical clinic, including providers and medical assistants, participated in an interactive workplace violence training. Quantitative pre and post-survey data were analyzed using Excel t-test and means. Pre and post-interviews conducted with the Medical Director examined the number of workplace violence incidents reported. Intervention: A 45-minute program consisted of an interactive audience response system using clickers to answer a 29-item survey and role-playing exercises using escalating workplace violence scenarios. Results: After the training intervention, participants perceived knowledge of workplace violence and identification of workplace violence behaviors significantly increased. The majority of participants (87.5%) reported that the interactive, interprofessional training was very useful. Understanding what behaviors constitute workplace violence decreased the frequency of workplace violence incidences within two weeks after the training. Conclusion: The study provided insight into an interactive, interprofessional training intervention that could positively combat rising incidences and adverse effects of workplace violence among healthcare professionals in an outpatient clinic.

MANIBUSEN, Jocelyn. (2021). Background: This study examined the effectiveness of digital citizenship curriculum in increasing students’ awareness of online privacy guidelines and online safety behaviors. Methods: The intervention consisted of introducing participants to a digital citizenship curriculum to measure the effect of the program on students’ awareness of online privacy guidelines and online safety behaviors. Participants were fourth-grade students. A pre-test and post-test was administered to measure the effectiveness of the intervention. Results: A total of 19 students participated in the intervention study. There was an increase in mean scores before the intervention and after the invention. Descriptive statistical data analysis was conducted to determine the mean score for both the pre-test and post-test. There was a significant difference in the pre-test (M = 10.74, SD = 2.58) and post-test (M = 12.95, SD = 2.42) mean score; t(18) = -5.95, p < .001. Conclusion: The findings of this project suggests that digital citizenship education is beneficial in increasing students’ awareness of online privacy guidelines and online safety behaviors.

O'ROURKE, Ashley. (2021). A consistent training program for nursing students to increase knowledge and awareness of Autism Spectrum Disorders may result in greater quality of life for patients and caregivers and less room for error (Havercamp et al., 2016). As patients diagnosed with ASD will continue to face lifelong limitations, current and future healthcare providers must receive adequate training to support individual needs. This paper will explore the rationale behind implementing such a training protocol at two small private colleges for students enrolled in a family nurse practitioner (FNP) graduate-level program.

PATTON, Megan. (2021). The purpose of this project was to determine the affect an interactive lecture compared to a voiceover PowerPoint had on retention of information in nontraditional adult learners in a Health Information Management program. The intervention was centered around a Human Resource module in a Health Information Management online program. The program had traditionally used a voiceover PowerPoint which had been used for the last 14 years. Students did not have the opportunity to interact with the lecture material. The multimedia format allowed students to watch a portion of a lecture and then answer questions about the material. The multimedia also allowed students to complete interactive components such as flashcards, labeled graphics, sorting, clickable images, and lists. The measure for the project was a comparison of quiz scores between the Fall 2020 and Spring 2021 Human resource students in module 2 of the online course. Each set of students received the same 15 questions on the quiz. The Fall 2020 students received the normal voiceover PowerPoint, while the Spring 2021 students received the interactive multimedia lecture. The mean of the scores was 12% higher in the Spring 2021 students; however, the multimedia lecture did not have a significant impact on student retention of information. Future studies should be conducted over an entire course to determine if there is a greater increase overall. The option for the multimedia lecture should be explored across more modules to look at the average increase in scores versus one module in one course. Time and budget constraints could be an issue for widespread implementation.

STOLTENBERG, Amber. (2021). Baccalaureate nursing students experience a significant amount of stress during their nursing education that carries over into their nursing careers. The purpose of this project was to determine if an educational intervention on self-care would impact the utilization of self-care activities for baccalaureate nursing students. Participants attended an educational intervention that was implemented to identify what self-care is, why it is important and examples of self-care activities. A distinct definition of self-care was identified as follows: completing an activity that optimizes a person’s health, incorporating the mind, body, and/or spirit. Following the educational intervention participants were instructed on weekly self-care activities for three weeks. Participants completed a Self-Care Assessment Worksheet as a pre-survey. At the completion of the intervention participants completed a post-survey. Data was gathered over four-weeks. Following data gathering, descriptive statistics were calculated including mean, median, and mode. Comparing the pre- and post-survey frequency rating results there was an increase in the utilization of self-care activities. While the intervention did indicate improvement in pre- and post-scores for the one participant, further research is needed to support effectiveness of the educational intervention with more participants.

WOOD, M. (2021). The staggering increase in mental health disorders among college students has thrust the area of student mental health to the forefront of the national agenda. During the past several decades, the number of students enrolled in higher education institutions who have presented with depression and suicidal tendencies has tripled. In addition to an increase in the number of college students who experience mental health concerns, the illnesses with which they present tend to be more serious and complex as compared to years past. It is imperative that colleges have a plan to address this influx of students with mental health concerns. Addressing the mental health crisis must not fall only to counseling centers. Other stakeholders, including students, should be trained to recognize individuals who may be having a mental health crisis. This project was to designed to address mental health concerns that have overwhelmed college campuses, by utilizing a mental health training program to increase awareness regarding mental health. The project was not implemented due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic and time restrictions. Upon future implementation, participants may benefit from increased knowledge of mental health and intervention behaviors, which are crucial steps to addressing the collegiate mental health crisis.