MEDICA@MUSC (Medical University of South Carolina)
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Occupational Therapy\u27s Role in Supporting Sustainable Trauma-Informed Wellness Practices in a Surfing Program for Women
Get PDFIndividuals living with trauma-related mental health conditions are often less participatory in meaningful occupations. Additionally, women are two to three times as likely as men to experience a trauma-related mental health condition or event (Olff, 2017). A local surf therapy organization was founded to provide local women who have experienced trauma an empowering community and meaningful activity to heal. The purpose of this quality improvement capstone experience was to enhance the sustainability of the skills taught within clinics through the creation and dissemination of a user-friendly resource platform. The skills specifically addressed are 1) Mindfulness, 2) Growth Mindset, 3) Comfort Zones, and 4) Personal Strengths. A needs assessment revealed the desire for creating trauma-informed resources to be utilized by the organization for sustainable results. This capstone experience was then used to develop and disseminate a desirable online resource guide that expands upon each of the aforementioned skills. The outcomes of this project revealed the need for follow-up resources and showed promising results for increased participation in home-based and community-based wellness activities. Stakeholders expressed their excitement and shared how they intend to use these activities in their weekly routines. Future research could be used to identify the benefits of using the resource guide in conjunction with clinics to enhance initial learning of skills and promote conversations about how to use the wellness activities outside of clinic time.
Olff M. (2017). Sex and gender differences in post-traumatic stress disorder: An update. European Journal of Psychotraumatology, 8, 1351204
Quantifying Trends in Hospital Administrative Costs: Examining Urban-Rural Disparities, Barriers, and Opportunities for Cost Reduction in Healthcare
No full textAdministrative and general (A&G) expenses in U.S. hospitals represent a growing financial burden, accounting for 15%–30% of healthcare expenditures. Despite this impact, A&G trends remain underexamined, particularly between rural and urban hospitals. This study used Medicare Cost Report data from over 4,400 short-term acute care hospitals from 2011 to 2022, combined with qualitative interviews with hospital executives, to assess rural-urban differences in A&G expenses. Using an explanatory sequential mixed-methods design, rural hospitals were found to consistently spend a higher proportion of total expenses on A&G salaries—18% more than urban hospitals, even after adjusting for hospital and financial characteristics. Although salary-related expenses declined, non-salary A&G costs increased across all hospitals. Interviews revealed that regulatory burdens, payer fragmentation, and staffing inefficiencies were primary cost drivers. Rural hospitals were especially affected due to limited scale and staffing capacity. Policy reforms that simplify compliance requirements and standardize payer processes could help reduce administrative burdens and improve financial sustainability, especially for rural institutions
Impact of a Case-Based Learning Module: Integrating Authentic Treatment Videos, Electronic Documentation, and Hands-on Simulation
No full textINTRODUCTION: Developing student confidence and competence is essential for effective fieldwork preparation in occupational therapy (OT) education. Educators use diverse instructional methods to foster clinical readiness, including case-based learning (CBL), video cases, documentation practice, and simulation. CBL enhances critical thinking, clinical reasoning, self-awareness, and confidence. With advancements in technology, video CBL has become more accessible, using authentic patient videos to promote higher-level clinical reasoning, documentation, and communication skills, especially when paired with complementary learning activities. CBL video cases offer a logical opportunity to incorporate structured documentation training, an area in which health professions students often report feeling underprepared. Simulation further enhances readiness for practice by fostering communication and clinical judgment. While these strategies are individually supported in the literature, research on how to successfully weave these methods together within one learning module is limited.
OBJECTIVE: This mixed methods study examined the effectiveness of a hybrid CBL activity integrating video case studies, electronic documentation, and hands-on simulation.
METHODS: Second-year OT doctoral students (n=51) participated in a CBL activity as part of a required course. Asynchronous preparatory work included video cases and documentation practice, followed by a synchronous simulation lab based on the video cases and a clinical reasoning discussion. Students completed an optional anonymous survey following the activity.
RESULTS: Students reported high agreement that the CBL activity improved their confidence (92%), reflective thinking (98%), motivation (89%), fieldwork preparation (96%), documentation (89%), and clinical judgment (98%). Students highly valued the preparatory work (100%), video cases (100%), documentation practice (100%), and simulated patient (89%). Themes revealed that students valued practicing documentation, observing authentic videos, and managing unexpected inappropriate behavior.
IMPACT: This study offers a practical, evidence-based learning activity integrating video CBL, documentation, and simulation that can be easily adapted across programs to enhance student readiness for clinical practice
Enhancing Understanding of Infant Cues and the Role of Rehabilitative Therapies in the Neonatal Intensive Care Unit
No full textResearch emphasizes the importance of early rehabilitative therapy involvement in the NICU to improve outcomes for preterm infants. The American Academy of Pediatrics (AAP) recommends the presence of occupational therapy (OT) and speech-language therapy (SLP) services in Level III NICUs to enhance neurodevelopment, promote feeding success, and support interdisciplinary collaboration (AAP, 2020). Cue-based feeding approaches have been linked to improved weight gain, reduced hospital stays, and decreased physiological stress in preterm infants compared to volume-driven approaches (Pados et al., 2020). However, limited staff understanding of infant behavioral cues and the distinct roles of OT and SLP can lead to missed therapy referrals and gaps in care delivery.
This capstone project aimed to close that gap at a level III NICU by developing and implementing educational tools for NICU staff to improve their ability to recognize infant cues and distinguish the roles of OT and SLP. Deliverables included a multidisciplinary Infant Feeding Readiness Scale, six educational handouts on infant cues and feeding readiness, a Rehabilitative Services in the NICU booklet, a step-by-step positioning guide, and in-service presentations. Educational materials were presented during a staff skills fair, followed by an anonymous post-education survey distributed through REDcap, a secure, HIPAA-compliant web-based platform designed for research data collection and management (Harris et al., 2009).
Quantitative data indicated strong support for the materials: 100% of participants agreed or strongly agreed that the content enhanced their understanding of infant cues and the roles of OT and SLP. All respondents reported increased confidence in applying this knowledge, with 96.3% stating they were “very likely” to integrate it into clinical practice. Additionally, 92.6% believed the consultation guidelines would improve therapy referral decisions. Qualitative feedback emphasized improved role clarity, greater confidence, and a desire for broader implementation. These findings support the long-term value of structured, interdisciplinary education in the NICU setting
Facilitating Student Advancement: A High School Toolkit for Developing Professional Skills
Get PDFObjective:
As students transition from high school to their next step, they are expected to demonstrate a different and often higher level of professional skills to successfully navigate their new roles. Existing research identifies these skills as highly valuable in industry and education, however there is a gap in research and resources that focus on high school students developing these essential skills. This quality improvement project focused on the development of a toolkit to fill this gap, providing an explicit, student-centered resource for professional skill development.
Methods:
The development of the Professional Skills Student Toolkit utilized established theoretical frameworks and self-assessment tools to ensure a comprehensive approach to facilitate student learning. The completed toolkit was presented to educators and students at Cherry Creek Innovation Campus (CCIC) in Centennial, CO to collect user experience data and perceptions of the toolkit\u27s potential classroom impact. Participants were asked to complete a voluntary, anonymous survey which collected User Experience Questionnaire (UEQ) data from everyone, and Acceptability of Intervention Measures (AIM), and Feasibility of Intervention Measures (FIM) from educators.
Results:
A total of 69 survey responses were collected from students (n=46) and educators (n=23) to evaluate the user experience and potential classroom use of the toolkit. Analysis of the UEQ data demonstrated positive mean values across all six categories. Both students and educators identified attractiveness and stimulation as the highest-rated aspects. However, differences emerged in the third highest-rated category: students\u27 UEQ results emphasized the toolkit\u27s perspicuity, while educators identified its dependability. Over 90% of students stated the toolkit would keep them “engaged” or “extremely engaged” in professional skills learning in the classroom. Overall educators reported high levels of acceptability (AIM mean 3.63) and feasibility (FIM mean 3.53) to implement the toolkit. These results indicate that students
Conclusion:
Initial user experience data of the Professional Skills Student Toolkit shows students report the toolkit feels motivating to engage with and easy to navigate while educators report the toolkit feels secure and predictable. Both students and educators indicate the toolkit would be easily implemented and an engaging tool in the classroom. These results indicate the toolkit has the potential to enhance students’ confidence and preparedness for their future roles outside of high school, while also equipping educators with tools to effectively facilitate professional skill building
Exploring How the Affordable Housing Market in Charleston County, South Carolina Impacts the Retention and Recruitment of Healthcare Workers
No full textThis dissertation explores the impact of the affordable housing market in Charleston County, South Carolina, on the retention and recruitment of healthcare workers. The study addresses the critical shortage of affordable housing and its implications for healthcare institutions, focusing on support staff such as medical assistants, certified nursing assistants, and other essential roles. Through a comprehensive survey of healthcare workers, the research identifies the extent of housing challenges, including financial strain, long commutes, and job dissatisfaction. The findings highlight the significant correlation between housing affordability and workforce stability, emphasizing the urgent need for targeted housing solutions. The dissertation reviews current initiatives and proposes actionable strategies, including financial incentives, regulatory changes, and public-private partnerships, to improve housing accessibility for healthcare workers. By addressing these challenges, the study aims to enhance the overall well-being of healthcare professionals and ensure the sustainability of healthcare services in Charleston County
Oncology Perceptions and Motivations Toward Adopting Artificial Intelligence
No full textWith limited research on the perceptions and motivation of oncology stakeholder’s adoption of artificial intelligence, this study was able to add more literature to the subject. The study’s aim was to survey MUSC Hollings Cancer Center employee perceptions of artificial intelligence. This study will provide organizations with results pertaining to how employees perceive the usefulness and their motivation to use new artificial intelligence tools. The study team conducted a single-site study and invited the MUSC Hollings Cancer Center employee population to participate in the study. The survey captured 47 responses from 350 invitees (13.4%). The survey explored the perceptions and motivations using the four constructs of The Unified Theory of Technology Acceptance and Use (UTAUT): performance expectancy, effort expectancy, social influence, and facilitating conditions. The survey results of this study can guide organizations on key areas of technology implementation and deployment
Development of a Novel Approach to Mitochondrial Gene Therapy: Nanoparticle Mediated Delivery of Intact, Functional Mitochondrial DNA
No full textMitochondrial dysfunction, along with widespread accumulation of mitochondrial (mt)DNA damage, contributes to the development of a range of diseases. Thus, treatments targeting one of the underlying mechanisms of mitochondrial dysfunction have the potential to be applicable to a variety of diseases, from neurodegenerative disorders to ocular pathologies to enhancing cancer treatments. While there are a variety of therapies and supplements being investigated to restore mitochondrial function, no cure for mitochondrial dysfunction/disease has been developed. Gene therapy approaches for mtDNA have thus far been limited, largely due to the heteroplasmy of mtDNA mutations observed within and between patients. Despite advancements in single gene therapy for diseases with specific mtDNA mutations and progress in mitochondrial transplantation, no method exists for restoring the entire mtDNA molecule in a clinically translatable manner. In nature, mtDNA can be restored in damaged cells via transfer of intact mtDNA within extracellular vesicles, but this method is not clinically controllable. Here, we present for the first time a strategy to deliver an exogenous, fully intact, and healthy mtDNA template into cells to provide a template for replication of undamaged mtDNA and synthesis of functional mitochondrial proteins. We tested nanoparticle formulations for: 1) their ability to deliver exogenous mtDNA to retinal pigment epithelial (RPE) cells; 2) the long-term (i.e. greater than 4 weeks) retention of the delivered mtDNA; and 3) the functionality of the retained mtDNA, that is, its ability to fulfil the central dogma and produce RNA/protein. The final prototype was created by combining a cell-penetrating peptide (CPP) with purified mtDNA, in conjunction with a mitochondrial targeting reagent. The generated nanoparticle complexes were taken up by cells and successfully localized to mitochondria. In mitochondria-depleted ARPE-19 cells, exogenously delivered mtDNA was retained for at least four weeks following a single mtDNA nanoparticle treatment, with evidence of mitochondrial RNA and protein production. These data demonstrate the feasibility of restoring mtDNA in cells, with the therapeutic potential to correct mtDNA damage independent of the number of gene mutations found within the mtDNA
The Role of Self-Reported Health Ratings in Identifying Hospitalization Risk Among Older Adults: An Integrated Review and Secondary Analyses of Medicare Claims Data
Get PDFPurpose: This study examined how Self-Reported Health (ratings), a person’s own evaluation of their overall health, relates to hospital admissions and emergency department utilization. It further assessed the extent to which demographic characteristics, Risk Adjustment Factor (RAF) scores (used to estimate healthcare expenditures based on clinical complexity), and the number of chronic conditions influence SRH rating and the likelihood of hospitalization.
Problem and Aim: The growing population of older adults places greater demands on healthcare services, leading to increased financial strain and a need for improved care strategies. Primary care teams, particularly those managing older adults, require effective assessment methods to identify and mitigate the risk of hospitalization promptly. This dissertation highlights the potential of SRH ratings as such a method, proposing that it provides critical insights into patients\u27 health that are not captured by clinical and diagnostic tests.
Design: This research included an integrated review and two non-experimental retrospective secondary data analyses. The frameworks guiding this research included Whittemore and Knafl\u27s model for the integrative review and McLeroy\u27s Social Ecological Model (SEM) for organizing the literature. Andersen’s Behavioral Model of Health Service Use guided the secondary data analyses, providing a framework to examine the factors influencing individuals’ access to and utilization of healthcare services, specifically ED visits and hospitalizations.
Results: Findings indicated that poorer SRH ratings is significantly associated with higher hospitalizations, particularly when combined with a higher number of chronic conditions and specific demographic indicators. Additionally, the relationship between SRH ratings and RAF scores varies, with a positive SRH rating potentially reducing the impact of high RAF scores on hospitalization risk and increasing medical costs.
Conclusion: The study highlights the necessity of integrating subjective SRH ratings assessments with objective health evaluations to enhance the accuracy of assessing patients for risk of ED visits, hospitalizations, and a deterioration in health status. Integrating SRH ratings into routine clinical evaluations and risk models can help healthcare teams identify at-risk individuals more effectively, allowing for targeted interventions that could reduce hospitalizations and foster a more individualized approach to health management
A Cancer Education Needs Assessment: Informing Middle-Aged Female Patients About the Relationships Between Obesity and Women’s Health Concerns in the Reproductive System, Breast, and Endometrial Health
Get PDFObesity significantly impacts women’s health, particularly among middle-aged women, by increasing the risk of hormone-sensitive cancers such as breast, endometrial, and reproductive system cancers. This study examines the educational needs of this demographic group regarding obesity-related cancer risks and explores effective intervention strategies. Obesity-induced mechanisms – hormonal imbalances, chronic inflammation, and insulin resistance – drive cancer susceptibility, emphasizing the need for targeted health education. The study employs a qualitative design, which includes interviews with subject matter experts (SMEs) and surveys of middle-aged women. The goal is to assess awareness, perceived barriers, and preferred learning methods. Findings suggest that with many of these women, there are critical deficiencies in knowledge and accessibility of preventive resources, which are compounded by psychological, cultural, and systemic obstacles. In this connection, tailored educational approaches are proposed to bridge these gaps, foster behavioral change, and reduce cancer risks. The study also provides recommendations for healthcare providers, policymakers, and future researchers aiming to improve cancer prevention and education among high-risk female populations