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Developing a Curriculum Audit Tool for Justice, Equity, Diversity, and Inclusion in Occupational Therapy Education
Full text linkBackground: The OT profession is calling for intentional pedagogy that builds future practitioners’ capacity for embodying justice, diversity, equity, and inclusion (JEDI) values; however, the interpretation and application of this mission remain subjective and nebulous. Developing a theory-driven audit tool may help standardize and clarify JEDI pedagogy needs to enhance OT preparation and practice.
Objective: Using a culturally responsive, justice-based theoretical lens, this paper describes the development of a JEDI Curriculum Audit Tool for a Post-Professional Doctor of Occupational Therapy (PP-OTD) program.
Design: Quantitative systematic evaluation of curricular alignment with JEDI principles, including a 3-prong retroactive self-evaluation approach.
Setting: Curriculum audit and data analysis occurred via the institutional online learning platforms and Microsoft Excel.
Participants: Thirteen courses in a single PP-OTD program.
Discussion: Applying the JEDI Curriculum Audit Tool 1) yielded valuable program-level and course-specific insights into if and how JEDI-infused learning was occurring and 2) informed specific recommendations to enhance JEDI-informed pedagogy.
Conclusion: Overall, this quality improvement self-audit project serves as an example of how theory-driven approaches can support standardized evaluation and ongoing refinement of JEDI-infused OT education.
Plain Language Summary: This brief report outlines an example of developing and applying a curricula audit tool to objectively evaluate the pervasiveness of JEDI-informed pedagogy for a doctor-level OT curriculum. Using a theory-driven approach informed by current JEDI frameworks, the audit tool provided valuable program-level and course-specific insights regarding how effectively this program was embedding JEDI themes into its curriculum. It also informed specific recommendations for improving observable gaps in pedagogy. The development of objective measures to evaluate and improve OT education, such as the one presented in this paper, can support standardized evaluation, sustainable implementation, and ongoing refinement of JEDI-informed OT preparation
Cross-Cultural Care in Perinatal Nursing
Full text linkPersistent racial and ethnic disparities in perinatal outcomes in the United States demand attention to the relational dynamics that shape cross-cultural care experiences. This dissertation examined patient-clinician interactions for Black birthing people in perinatal care, examined the concept of nurse cultural humility, and explored OB nurses’ experiences delivering cross-cultural care. This was first accomplished by conducting an integrative review of the literature that reported on patient-clinician interactions during the perinatal period for Black birthing people. Next, a concept analysis was completed on nurse cultural humility using descriptive statements from the literature. Finally, a hermeneutic phenomenological study was completed exploring the lived experience of OB nurses delivering care to diverse patient populations. Major findings of the integrative review reveal a patient-clinician relationship characterized by mistrust, ineffective communication, lack of established relationship, and unequal power dynamics. The concept analysis provided a conceptual definition of nurse cultural humility that included the attributes of a lifelong process of reflexivity, engaging in active listening to learn from patients, an understanding and appreciation that the cultural background of both nurse and patient influences health care encounters, and a commitment to redress and mitigate power imbalances in the patient-clinician relationship. Major findings of the hermeneutic phenomenological study revealed five interrelated patterns: (1) Relational Openness: Attending to the Other with Curiosity and Care; (2) Moving Beyond the Tasks: The Art of Nursing; (3) Navigating Ethical Crossroads: When Values Collide in Care; (4) Reframing Cultural Knowing: From Preconception to Patient Presence; and (5) Becoming Aware: The Clinician as a Work in Progress. This dissertation study further illuminates how cultural humility can be enacted in practice and developed through relational experience and reflection. Together, this work offers a foundation for reimagining perinatal nursing through the lens of cultural humility, with the goal of honoring the full humanity of every birthing person
Improving Resident Orientation to Anesthesiology Subspecialties Using a Structured “Passport”
No full textBackground. On an initial pediatric, cardiothoracic, or obstetric anesthesiology rotation, a resident faces new knowledge and procedural expectations. Lack of guidance to direct learning may lead residents to feel unprepared. The optimal way to prepare residents is unknown. This initiative included the introduction of a structured “passport” for each subspecialty specifying the knowledge and procedural goals of an introductory rotation. This intervention aimed to improve resident and attending perceptions of resident readiness on these anesthesiology subspecialty rotations, as measured using pre- and post-initiative surveys of residents and attendings.
Methods. This initiative occurred at a large anesthesiology residency with 53 residents in 2022-2023. “Passports containing checklists of concepts and skills for each resident to review with attending anesthesiologists over the first 4-week period in each of these subspecialty rotations were provided. Perceptions of clinical readiness were assessed using pre-intervention and post-intervention surveys sent to residents and attending anesthesiologists.
Results. The obstetric anesthesiology passport was associated with improvements in resident and attending assessments of clinical readiness, while the use of the pediatric anesthesiology passport was associated with improvements in attending assessments primarily. The use of the cardiothoracic anesthesiology passport was associated with improvements in resident assessments primarily. Effect sizes for most categories were moderate to large. No barriers to implementation were noted.
Conclusion. The introduction of a structured passport during residents’ initial subspecialty rotations resulted in moderate to large improvements in resident and attending perceptions of clinical readiness across multiple domains. This initiative can easily be applied to other anesthesiology residencies
Building Community-Engaged Capacity to Advance Telerehabilitation Services for Patients with Chronic Disease and/or Disability
Full text linkPurpose:
This report was developed to capture insights from clinicians, patients, and families who have experienced or delivered telehealth services over the past four years. The rapid rise of telehealth during the COVID-19 pandemic presented both challenges and opportunities, but as the initial surge subsided, its continued application in physical therapy has become less clear. This report explores what has worked well in telerehabilitation, identifies ongoing challenges, and provides actionable recommendations to bridge gaps in service delivery. By reflecting on these experiences, this work aims to inform the development of sustainable models that will advance clinical practice, improve patient outcomes, and support policy development moving forward.
Description:
This project aimed to build capacity and understanding across clinical teams, patients, and caregivers around the use of telerehabilitation as a sustainable, patient-centered model of care. Recognizing that patients are the ultimate recipients of care, the initiative prioritized patient engagement, experience, equity, and outcomes as key components of value in telerehabilitation delivery.
Summary of Use:
Over a 12-month period, we convened a multidisciplinary team of clinical stakeholders and patient partners to identify evidence-based telerehabilitation practices in a remote service delivery model and how these are implemented. The project included retrospective patient demographic review, stakeholder discussion settings, and quarterly reflection meetings. This initiative fostered shared learning between patients and providers and emphasized care strategies tailored to the unique needs of individuals in underserved communities. Key themes to emerge were primarily in regards to education—educating and equipping providers to more effectively and confidently deliver care via telehealth, educating clinics on the benefits of giving their patients a choice between in person or hybrid care, and educating patient populations/communities on the availability of telehealth services.
Importance to Members:
Healthcare providers are increasingly using digital health technologies to expand and modify care delivery. In the right applications, these tools can advance quality of care, provide clinician support, speed access to services, increase patient engagement, and reduce overall spending. The stakeholder group discussions has created an opportunity to pursue patient-centered comparative effectiveness research (CER) to evaluate traditional versus telerehabilitation service delivery models—ultimately aiming to improve access, quality, and outcomes for underserved populations.
References and Narrative:
See download document for references and narrative
Eating the Fat of the Land: The Work of Coxiella burnetii To Traverse Intracellular Lipid Landscapes
No full textCoxiella burnetii is an obligate intracellular pathogen and the causative agent of Q fever in humans. With primary hosts in livestock ruminants, C. burnetii is endemic globally, presenting significant health risks to agricultural workers and herd health at large. Numerous wild animal reservoirs exist, increasingly threatened by expanding livestock ranges. Furthermore, with a low infectious dose through aerosol transmission, the CDC considers C. burnetii a potential bioweapon, though in humans a large amount of infections persist subclinically, occasionally progressing to pneumonia and hepatitis with chronic infections leading to endocarditis.
The parasitic life cycle of C. burnetii is biphasic, a small cell variant gains entry into the host cell, assembling a parasitic vacuole by fusing with vesicles along the endosome/lysosome continuum, with the bacterium expanding into a large cell variant for replication and manipulation of the host environment. The vacuole assembled by C. burnetii is uniquely acidic, utilizing a Type IVb secretion system (T4BSS) for its parasitic goals. A protein secreted by the T4BSS is CbEPF1, singled out for its FFAT motif, implicating it in membrane contact sites through interaction with endogenous VAP-family proteins. HeLa cells transfected with CbEPF1 feature an increased number of lipid droplets of larger diameter. On a subcellular level, CbEPF1 localizes to budding lipid droplets, continuing to stay associated with LDs entering their cytosolic stage. These EPF1 studded lipid droplets form membrane contact sites with the endoplasmic reticulum, hinting at mechanisms in manipulating host lipid metabolism
Focus Group Study of Racial Disparities and the Effects of Parental Marijuana Use on Youth Marijuana Use
Full text linkMarijuana has become one of the most used drugs in the United States. There has been an increase in use among both adults and youth during the past several years. Public health interventions are needed to address marijuana use because of its detrimental effects on youth well-being. Research shows that marijuana can lead to problems with memory, learning, attention, and even depression among youth. Furthermore, marijuana exposure in-utero can lead to developmental issues and problems with other organs such as the lungs. Youth are influenced to start using drugs, like marijuana, for numerous reasons, and parents are one of those influences. The goal of this qualitative study was to understand parents’ opinions on marijuana use among their children, how they would feel if their child/children use the drug, and their own marijuana use. Eight focus groups (4 with African American parents and 4 with Hispanic parents) were conducted via zoom in November of 2024. Thematic analysis was used for data interpretation. The African American participants mainly started using marijuana due to peer pressure, curiosity, and personal relief. Hispanic participants started using marijuana due to peer influence and personal relief, and they also believed in punishing their child for using marijuana. Many similarities were observed. Both groups used marijuana for personal relief mostly within some home environment, but they did not use it in front of their children. Most participants had a no smoking policy for their children in their homes, but also hoped their children would not start using marijuana. Both groups also thought it was best to have open conversations with their children on marijuana and supported full marijuana legalization. The findings in this study can be used to tailor marijuana prevention programs for youth
Improving Oral Hygiene Practices in a Long-Term Care Setting for Individuals with Advanced Dementia: A Quality Improvement Initiative
Full text linkThis quality improvement project utilized the Plan-Do-Study-Act framework to enhance oral hygiene practices in a long-term care setting for individuals with advanced dementia. Advanced dementia often leads to significant oral health challenges due to the individuals’ inability to communicate needs or independently manage oral care. Poor oral hygiene results in pain, systemic infections, and reduced quality of life. The project aimed to identify and address barriers to effective oral care delivery by focusing on organizational factors such as leadership, training, and caregiver support. This capstone paper provides insights into the quality improvement initiative’s aims, background, and methodology, while emphasizing its alignment with Healthcare Administration competencies
Preferences and Feasibility of Long-Acting Technologies for the Treatment of Hepatitis C Virus: A Survey of Patients in Diverse Low- and Middle-Income Countries
Full text linkDespite available curative treatments, global rates of hepatitis C virus (HCV) infection persist with significant burden in low- and middle-income countries (LMICs). Long-acting (LA) antiviral products are in development. This study explored the challenges and opportunities in LA-HCV treatment across three LMICs: Egypt, Ethiopia and India. The survey focused on understanding barriers and facilitators to treatment, with emphasis on LA treatment preferences. Four-hundred respondents completed a survey including demographics, HCV treatment history and preferences for injections, implants and microarray patches (MAPs) compared to pills. Overall, 78% of respondents were willing to receive injections, 43% were willing to receive implants and 55% were willing to receive MAPs. Marked heterogeneity in acceptability of non-oral treatments was observed. Among respondents who had not previously received HCV treatment, 94%, 43%, and 75% were willing to receive injections, implants, or MAPs, respectively. In contrast, among those already cured by oral HCV treatment, 61%, 40% and 43% were willing to receive injections, implants or MAPs. Other characteristics associated with willingness to receive an injection included urban residence, younger age, male sex, higher education level and taking pills for any reason (all results p \u3c 0.001). The most common concern for all LA modalities was lack of effectiveness. Prior experience with injection or implant increased willingness to receive any LA modality (p \u3c 0.001). Coupled with a point-of-care HCV diagnostic test, availability of and willingness to receive HCV treatment delivered by a LA formulation could simplify and expand treatment access in LMICs and contribute towards global HCV elimination goals
Enhancing Safety in Healthcare Construction: A Comprehensive Training Program on Managing Construction Dust
Full text linkIn healthcare settings, construction activity poses significant risks due to the formation and release of construction dust containing allergens, pathogens, and toxic substances. This culminating project will develop a comprehensive training course for contractors to mitigate these risks while ensuring the safety of patients, employees, and construction workers. The training programs will raise awareness of the health risks associated with construction dust and educate contractors on proper dust handling techniques and ensure compliance with relevant regulations. Key elements such as containment, ventilation, and proper personal protective equipment (PPE) use will be emphasized. The program will also underscore the potential for collaboration among contractors, clinical staff, and infection control personnel to ensure the optimal dust solutions for each project. Working together can enhance patient safety, deliver high-quality care, and reduce healthcare-associated infections (HAIs) associated with construction dust. Ultimately, the goal is to foster a culture of continuous improvement in dust management, thereby enhancing the overall quality and safety of healthcare settings
