The University of Texas at Tyler
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EVALUATING HEALTHCARE STUDENT LEARNING PERFORMANCE DURING THE INITIAL YEAR OF THE COVID-19 PANDEMIC: A CASE STUDY
Get PDFThe COVID-19 pandemic caused a mass interruption to daily life lasting almost an entire academic year. Return to normalcy was hard won and phased over the following academic year. Neither time-period offered “traditional” learning experiences in academic institutions. The extent to which the operational shut-down affected academic institutions and their learners is just now beginning to be elucidated. Human resource development (HRD) is uniquely positioned to apply established and newly developed theories and applications to the study of this phenomenon. One particular case lends itself to observation. A major academic medical center launched a technology-driven state-of-the-art simulation education center mere months before the shut-down. Subsequently, campus leadership invested heavily in technologies to offer first-of-the-kind online learning platforms for students in the healthcare professions including medical, nursing, health professions, and graduate school of biomedical sciences. This study tracked their grades across years to provide a snapshot of academic performance trends for the institutional leadership. The study took advantage of the institutionally created student survey and tailored questions to address COVID-19 effects and challenges on students. These data were publicly available and accessed for this study, as the university published deidentified responses to the survey online. The institution also shared the published licensure exam pass rates that were used for this study. In this case study with a mixed-methods research design, I analyzed these data to shed light on the effects of the pandemic on the student population of the case institution. Triangulation of the data revealed a multi-faceted challenge resulting from the many hardships caused by the pandemic. Students suffered direct effects including the loss of loved ones, financial troubles, as well as difficulty in engaging online in their new learning environment. However, the data showed that though the statistical impact of the pandemic was considered significant, it had a minimal effect size. The mitigation of the negative effects on the student population was partially attributed to the leveraging of virtual reality and simulation activities used to substitute for in-person clinicals. Reviewing these datasets for correlations provided valuable insight into the timeless application of HRD principles relevant to interrupted training and education as a result of increasing campus disruptions caused by political unrest, natural disasters, and climate change. Of paramount importance, are the contributions provided to the study population by Virtual HRD (VHRD) tools and resources. As the world continues to experience an increase in the frequency with which we see these disruptions happening, the tenets of both HRD and VHRD will help stabilize the training environment for learners as they cope with the events of their particular disaster
Body Dysmorphia Screening Tool for Aesthetic Treatments
Get PDFThis evidence-based project includes a discussion of Body Dysmorphic Disorder (BDD) or body image disturbance as part of pre-treatment screening in medical facilities providing appearance-altering procedures and aesthetic treatments to adult patients. The information provided serves as the foundation for endorsing the adoption of a BDD screening tool into clinical practice to increase the identification of body dysmorphia, thereby facilitating proper referral, diagnosis, and treatment to aid in patient safety and satisfaction and limit medico-legal imputations. The discussion presented here is supported by evidence-based research. It focuses on BDD prevalence and significance amongst adult patients and highlights validated screening tools used to identify BDD. It also identifies the process for a change project that supports the proposed implementation of a validated BDD screening tool. The milestones for this project include developing an administrative team for the execution of this project, formulating policies and procedures, designing a plan and execution pilot, and identifying the best suitable screening tool for practice use. This project will follow a strategic timeline for integration and will be executed over 12 weeks. The change project will include various stakeholders and personnel working collaboratively to develop and implement this change. The effectiveness of implementing this evidence-based change in healthcare relies heavily on the support and active involvement of all stakeholders. This includes the administrative members, direct patient-care staff, IT specialists, and the appointed leaders to oversee the tool\u27s proper use and efficacy. The chief officers are critical in promoting safety, making executive decisions, and allocating resources to support this goal. The patients also play an essential role by participating in the change, understanding its purpose and goal, and actively completing the screening tool
The Effects of Non-pharmacological Interventions for Behavior and Psychological Symptoms of Dementia: A Benchmark Study
Get PDFThe management of behavioral and psychological symptoms of dementia (BPSD) in patients who reside in nursing homes can be challenging. These neuropsychiatric behaviors can include but are not limited to aggression, agitation, delirium, depression, and psychosis (Cloak & Al Khalili, 2022). Patients with BPSD often have difficulty expressing their needs due to the disease process, resulting in further complexity when managing behaviors. There are no psychotropic medications to treat BPSD specifically, but many are often prescribed to treat the symptoms or behaviors exhibited by patients. The use of psychotropics, especially long-term can cause a myriad of adverse effects and should be used with caution. Implementing alternative non-pharmacological patient-centered interventions as first-line treatment can assist in decreasing the over-use of many psychotropic medications, ultimately providing safer patient outcomes.
The purpose of this benchmark project is to incorporate non-pharmacological interventions as first-line treatment of BPSD with the aim of decreasing the use of psychotropic medications. A PICOT question was formulated which helped guide a systematic search of the literature to determine how the reduction of psychotropic medications and use of non-pharmacological interventions as first-line treatment affect those with BPSD. The non-pharmacological interventions to be utilized in this benchmark project are baby dolls and a stocked aquarium in a nursing home with patients diagnosed with BPSD. This benchmark project will be conducted over a three-month period. To evaluate the effectiveness of these non-pharmacological interventions a team of designated members in the nursing home, known as a Quality Assurance (QA) team, under the direction of myself as the project coordinator, will monitor behavioral charting, incident reporting, and narrative documentation found in the electronic health records (EHR) which will include what interventions were used along with their outcomes
Pre-shift Mindfulness: An Evidence Based Practice Benchmark Project
Get PDFAlthough a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.
The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, disengagement, and reduced professional efficacy (Reith, 2018). Burnout in nurses may be influenced by stress, resilience, and overall well-being, and impacts job performance, patient care and outcomes, and the well-being of healthcare systems.
This paper will explore an evidence-based wellness intervention designed to prevent, alleviate, or mitigate the effects of stress and burnout in the nursing workforce. A brief mindfulness-based stress reduction (MBSR) activity will be provided to staff at morning shift huddles for two weeks, including guided meditations and deep breathing exercises. Effectiveness will be measured using questionnaires containing the Copenhagen Burnout Inventory (CBI) and the Perceived Stress Scale (PSS), as well as qualitative questions. This project will be fully implemented in ten weeks.
The costs of nursing turnover and agency staffing are well documented and can have millions of dollars in impact yearly to the operations of health systems. Implementation of brief MBSR on one unit is estimate
Animal-Assisted Therapy in Mental Illness
Get PDFMental health disorders are a significant global health concern, with a growing need for alternative therapeutic approaches. Animal-assisted therapy has gained recognition for its potential to improve the emotional and psychological well-being of individuals struggling with these disorders.
This Capstone Benchmark proposed project explores the potential positive impact of animal-assisted therapy (AAT) on patients with mental health disorders during inpatient hospitalization. The project outlines a 4-week intervention program involving 45-60 minutes sessions with dogs, which patients receive 2-3 times per week. For this Capstone Benchmark project, the selected PICOT question is: In patients with mental health disorder (P) how does the use of animal-assisted therapy (I) affect the mental health symptoms as measured by the Child and Adolescent Behavioral Assessment-Youth/Informant, and the Behavior and Symptom Identification Scale BASIS-32” (C) compared to those who don’t receive animal-assisted therapy over 4 weeks (T)?
Specifically, this project implements a structured AAT intervention, involving trained therapy dogs, for patients in inpatient hospitalization. This intervention aims to assess the impact of regular AAT sessions on patients’ mental health and overall well-being. The data and results collected are based on the Child & Adolescent Behavior Assessment- Youth/or Informant (CABA-Y/I) for adolescents and the Behavior and Symptom Identification Scale (BASIS-32, McClean Hospital & Eisen, S. V, 19) for adults. Patients who participated in the AAT program exhibited significant reductions in symptoms of anxiety, depression, and stress
Commentary on Ultrasound Instruction in Undergraduate Medical Education: Perspective from Two Students
Get PDFBackground: Ultrasound integration in undergraduate medical education (UME) has been a focused endeavor in recent years. According to the American Institute of Ultrasound in Medicine, more than a third of all US medical schools have adopted a focused ultrasound training program for medical students. Medical student perspectives on best practices in ultrasound education are lacking in the literature. Curricula Experiences: Two students\u27 reflections are presented regarding two different didactic approaches, flipped classroom and self-study learning models, to teaching ultrasound in the pre-clinical medical education curriculum. Students present reflections on these didactic approaches to facilitate further improvement in ultrasound education curricula. Discussion: The self-directed learning model enabled students to learn foundational ultrasound exam techniques efficiently in a lowstress environment and subsequently optimized the efficiency of later faculty-led learning events. However, we noted that in both the flipped classroom and self-study learning models of education, the training on basic physical properties of ultrasound, tissue characteristics, and probe manipulation was limited. Conclusion: A self-study learning model ultrasound curricula improves perceived learning efficiency and student confidence, especially when followed by faculty-guided didactics and scanning opportunities. We suggest a framework for ultrasound education curricula that includes components of both formats of ultrasound education alongside faculty-led sessions as an ideal model of ultrasound education. Further, we propose the added benefit of inanimate object scanning to optimize students\u27 knowledge of waveform physics (image acquisition and physical properties of materials) early in the ultrasound education process
THE ART AND MYSTERY OF PRAGMATIC HISTORY
Get PDFThis thesis considers how we make meaning in our individual lives and in practice as historians. From an initializing question —Why do people believe things that have either been proven false or shown improbable?— born out of historical discourse in the liminal space between mythology and history, this thesis embarks on a inquiry into meaning that is both deeply philosophical and practical. The work develops a historical method that falls within the tradition of Pragmatism, and then turns this method toward two case studies (Pedro Huízar and Señora Candelaria) from San Antonio, Texas. The aim is to explore two myths of local history, retaining respect for belief while examining its historicity. The argument that emerges is that meaning is always made with present factors in mind and by implication is always shifting and adjusting to the present moment. Finally, the thesis argues for a pragmatic approach to historical method due to its view of the world as plastic, its focus on human action, the necessity of a community of inquirers, its view that extremes are only far ends of a continuity, its openness to pluralistic beliefs, and that it is belief that leads to action
Plasma Drug Testing for D and L Isomers of Amphetamine and Methamphetamine by Liquid Chromatography Mass Spectrometry with a Range of 2.5 to 1000 ng/mL
Get PDFDevelopment and validation of a quantitative plasma assay for measuring D and L amphetamine and methamphetamine in human K2 EDTA samples to determine prescription versus illicit sources of the analytes. The assay was developed using liquid-liquid extraction followed by a dry down step and reconstitution with D and L mobile phase. The samples were separated on a chiral column and measured using an API 4000™ LC/MS/MS system. Methods: The assay was validated according to US FDA, CLIA and CAP guidelines including assessment of the following parameters in plasma validation samples: linear range, limit of detection, lower limit of quantitation, matrix effects, inter- and intra-day assay precision and accuracy, carry over, linearity of dilution, matrix effects and stability. Detection was done by using an The assay was validated according to US FDA, CLIA and CAP guidelines including assessment of the following parameters in plasma validation samples: linear range, limit of detection, lower limit of quantitation, matrix effects, inter- and intra-day assay precision and accuracy, carry over, linearity of dilution, matrix effects and stability. Detection was done by using an API 4000™ LC/MS/MS system. The chiral separation was performed using isocratic separation with a Supelco Astec CHIROBIOTIC® V2 (25 cm x 2.1 mm, 5μm) column
Impact of Social Emotional Learning on Exclusionary Discipline
Get PDFA middle school campus in a Southeast urban community used a Plan-Do-Study-Act (PDSA) Cycle, an inquiry method in improvement science, to address high exclusionary discipline rates by implementing Social Emotional Learning (SEL) strategies and Restorative Practices (RP) to transform school culture. A reform to a comprehensive discipline program was developed to minimize the amount of exclusionary discipline outcomes (in-school suspension [ISS], out-of- school suspension [OSS], and expulsion) among students while increasing student attendance rates, student achievement, and teacher retention. Three distinct cycles will be examined, each concentrating on a different problem of practice and intervention. These methods were introduced, practiced, and applied throughout the school to establish a safe, academically challenging, and emotionally supportive environment. The campus established a School Culture Design Team, which served as a Network Improvement Community, to improve student performance in academic and non-academic areas. As evaluated by district and state data, the campus has achieved significant reductions in discipline referrals and suspensions as a result of the implementation of Social Emotional Learning and Restorative Practices, as well as the continuing application of improvement cycles. This has had a favorable impact on school culture as assessed by attendance, academic proficiency, student-teacher interactions, and retaining teachers using quantitative and qualitative methods. The Network Improvement Committee would place “priority on solving a problem together rather than pursuing a theoretical predilection, methodological orientation or personal belief” (Bryk et al., 2017, p. 17)
Automated Sensing Methods in Soft Stretchable Sensors for Soft Robotic Gripper
Get PDFA soft robot is made from deformable and flexible materials such as silicone, rubber, polymers, etc. Soft robotics is a rapidly evolving field where the human-robot-interaction and bio-inspired design align. The physical characteristics such as highly deformable material and dexterity make soft robots widely applicable. A soft robotic gripper is a robotic hand that acts like a human hand and grasps any object. The most common applications of soft robotics grippers are gripping and locomotion in sensitive applications where high dynamic and sensitivity are essential. Nowadays, soft robotics grippers are used without any sensing method and feedback as it is crucial to make the output feedback from the gripper. The major drawback of soft robotic grippers is their need for more precision sensing. In traditional robots, we can integrate any sensor to detect the force and orientation of objects. Still, soft robotic grippers rely on the deformation sensing method, where the sensor must be highly flexible and deformable. With a precise sensing method, it is easier to determine the exact position or orientation of the object being gripped, and it limits the application of the soft robotic gripper. Sometimes, soft robots are employed in harsh environments to solve problems. With the sensing feedback, automation may become more reliable and succeed altogether. So, in this research, we have designed and fabricated a soft sensor to integrate with the gripper and to observe the feedback of the gripper. We propose integrated multimodal sensing that incorporates applied pressure and resistance change. The sensor provides feedback when the grippers hold any object, and the output response is the resistance change of the sensor. The liquid metal is susceptible and can respond to low force levels. We presented the 3D design, FEM simulation, fabrication, and integration of the gripper and sensor, and by showing both simulation and experimental results, the gripper is validated for real-time application. FEM simulation simulates behavior, optimizing design and predicting performance. We have designed and fabricated a soft sensor that yields microfluidic channel arrays embedded with liquid metal Galinstan alloy and a soft robotic gripper hand. Different printing processes and characterization results are presented for the sensor and actuator. The fabrication process of the gripper and sensor is adequately described. The gripper output characteristics are tested for bending angle, load test, elongation, and object holding under various applied pressure. Additionally, the sensor was tested for stretchability, linearity and durability, and human gesture integration with the finger, and this sensor can be easily reused/ reproduced. Furthermore, the sensor exhibits good sensitivity concerning different pressure and grasping various objects. Finally, we collected data using this sensor-integrated gripper and trained the dataset using machine learning models for automation. With more data, this can be an autonomous gripper with intelligent sensing methodologies. Moreover, this proposed stretchable sensor can be integrated into any existing gripper for innovative real-time applications