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An Assessment of New Employee Training in a U.S. Government Agency
Full text linkThis study evaluated the utility of a newly developed employee training initiative within a U.S. government disaster recovery agency. The purpose of the professional administrative study was to examine the existing training architecture and recommend improvements aligned with the agency’s mission. A general qualitative approach was employed, using interviews and surveys with government personnel to elicit their perceptions of the training’s effectiveness. The research aimed to identify key elements to incorporate into a revised employee training program, with the goal of enhancing disaster response readiness and policy implementation. It also sought to recommend strategies for continuous improvement. The study was grounded in Kirkpatrick’s training evaluation model and organizational learning theory. Data were analyzed using inductive thematic analysis. Key findings included that interruption in skill training provision, scenario-based instruction, and the feedback process were linked to poor employee preparedness and high turnover. A new training ideal was reimagined to combine leadership development, experiential learning, and a continuous feedback loop. Recommendations included workforce resilience, enrichment activities to increase retention, and agency strategic priorities for disaster response operations. The implications for public administration include strengthening institutional capacity while enhancing organizational efficiency through an improved employee training systems that properly align the workforce development with disaster response priorities. Positive social change can be achieved when employees are retained and developed for optimal use of human and financial resources
Staff Education to Enhance Psychiatric Medication Adherence in Psychiatric Care
Full text linkMedication non-adherence affects 49% of psychiatric patients and contributes to poor outcomes and increased hospitalizations. At the project site, 40% of patients demonstrated suboptimal adherence and 12 medication-related incidents occurred. Nursing staff lacked specialized training in motivational interviewing and comprehensive adherence assessment. This project developed and implemented an evidence-based educational program to enhance nursing competencies in psychiatric medication adherence counseling. Seven nursing staff members (5 registered nurses, 2 licensed practical nurses) participated in a 90-minute session incorporating the four-domain assessment framework, motivational interviewing techniques, and psychoeducational strategies. The ADDIE framework guided program development with interactive discussions, case-based learning, and role-play activities. Participants completed 20-item knowledge tests, 15-item confidence scales, and 15-item competency assessments pre and post-intervention. Knowledge scores increased from 59% to 94% with a cohort average of 59.3% proportional gain. Confidence ratings improved from 2.8 to 4.2 out of 5.0, representing a 50% increase. Competency ratings increased from 2.5 to 4.0 out of 5.0, representing a 60% increase. Wilcoxon signed-rank test results confirmed statistical significance (W = 0, p \u3c .05). All participants rated the program excellent and intended to change practice behaviors. The intervention enhanced nursing competencies in psychiatric medication adherence support. Recommendations include ongoing training, standardized protocols in the electronic health record, and program expansion to other facilities
Improving Early Detection of Lung Cancer in Underserved Primary Care Settings
Full text linkLung cancer is the leading cause of cancer-related mortality in the United States, with underserved populations experiencing higher rates of late-stage diagnosis and preventable death. Despite established screening guidelines, adherence within primary care remains inconsistent, particularly in safety-net settings, reflecting a healthcare administration problem driven by organizational structures and care processes. The purpose of this integrative review was to identify administrative interventions that improve primary care provider adherence to lung cancer screening referral guidelines in safety-net healthcare settings. Guided by the Donabedian Quality Framework, a systematic integrative review was conducted to examine how healthcare structures and processes influence screening implementation. Study quality and relevance were appraised using the Johns Hopkins Nursing Evidence-Based Practice appraisal tools. The synthesis yielded five themes and fifteen subthemes representing evidence-based administrative strategies, including improving provider knowledge and education, strengthening health system infrastructure, reducing workforce and administrative barriers, advancing equity and positive social change, and enhancing patient access and engagement. Key subthemes included guideline-based provider education, shared decision-making support, standardized referral and follow-up workflows, electronic health record–enabled eligibility identification, defined care team roles, and reduction of access barriers related to insurance, transportation, and cost. These findings directly address the review question by demonstrating that coordinated administrative interventions are essential to improving guideline adherence, expanding screening access, and reducing lung cancer disparities in underserved primary care populations
Enhancing Medication Adherence in Home-Based Hypertension Care Through Targeted Staff Education
Full text linkSummary In this practice-based, quality improvement project, I incorporated a one-group, pre-/posttest design with the aim to evaluate a staff education intervention, reflecting on key principles in improving practice, including continuous evaluation and informing locally based change. This Doctor of Nursing Practice (DNP) project addressed the issue of inconsistent adherence to medication and the lack of staff skills in home-based hypertension management. Notably, the nurse plays an important role in medication adherence to care and in the consistent, evidence-based care with chronic diseases. The practice-focused question was: For home health staff, how does participation in an evidence-based medication adherence education program affect staff knowledge and confidence, as measured by pre- and posttest scores? In this doctoral study, I designed and tested an intervention for increasing the staff’s knowledge, confidence, and performance levels for assessing and documenting the levels of medications taken for home management of hypertension. Descriptive statistics assessed nurses\u27 knowledge. I measured pre- and post-intervention performance using mean, minimum, and maximum values. Learning gains were calculated using the normalized learning gain (NLG) method. Staff knowledge improved, with a 55.2% NLG, demonstrating the effectiveness of targeted staff education. I recommended to maintain staff education and use checklist-generated data to improve quality and evidence-based, inclusive nursing practice to close health gaps. Sound, accurate, and equitable hypertension care is an essential element vital for bringing positive social change and contributing to the reduction of health inequities among diverse populations in home based settings
Differences and Changes in Cross-Cultural Sensitivity of German and Japanese Students Before and After Short-Term Exchange Programs
No full textSince 2012, a Japanese and a German university have conducted exchange programs. This study examined the effects of a short-term exchange program in 2023, focusing on intercultural sensitivity. Nine Japanese students and nine German students completed a 24-item Intercultural Sensitivity Scale before and after the program using a 5-point Likert scale. We performed cross-tabulations and analyzed differences between countries and pre- and post-program changes using chi-square or Fisher’s exact tests. The results suggest that even a short-term exchange enhanced Japanese students’ confidence in intercultural interactions and encouraged German students to reflect on their own culture. However, Japanese students showed lower fairness in perceiving other cultures and experienced greater tension, reflecting distinctive cultural sensibilities
Educational Design Models in Transition: A Comparative Review
Full text linkA persistent gap between educational theory and classroom practice underscores the need for methodological approaches that are reflective, participatory, and context responsive. This study provides a comparative review of four major educational design models, including research and development (R&D); Analysis, Design, Development, Implementation, and Evaluation (ADDIE); design-based research (DBR); and educational design research (EDR), to examine their theoretical orientations and contemporary applications. A systematic literature synthesis and bibliometric mapping were conducted on 80 peer-reviewed journal articles indexed in Scopus between 2020 and 2025. The findings reveal that ADDIE remains the most frequently applied framework due to its procedural clarity and practical utility, whereas EDR demonstrates steady growth in studies emphasizing contextual inquiry, collaboration, and reflective design practices. Keyword co-occurrence analyses indicate a gradual methodological transition from technocratic models toward more participatory and theory-integrated paradigms. Overall, EDR emerges as a promising framework that unites theoretical advancement with practical innovation, offering a sustainable bridge between educational research and classroom implementation. These findings provide conceptual and empirical insights to inform scholars, educators, and policymakers in selecting design approaches that are both context sensitive and theoretically robust
Staff Education Project for Nursing Staff at an Adult Mental Health Clinic to Address Inconsistencies and Inadequacies in Suicide Risk Screening
Full text linkThis staff education initiative was designed for nursing personnel at an adult mental health clinic, aiming to address inconsistencies and inadequacies in suicide risk screening practices among health care providers. Despite regular patient interactions, staff frequently lack the necessary knowledge, confidence, and standardized tools to identify individuals at risk for suicide, leading to missed opportunities for early intervention. The existing gap in practice jeopardized patient safety, led to preventable harm, and highlighted the need for evidence-based screening protocols, such as the Ask Suicide-Screening Questions (ASQ) tool, to facilitate timely, equitable, and effective suicide prevention in nursing practice. The project focused on suicide risk screening by enhancing staff proficiency and standardizing the use of the ASQ tool across the clinical team. Fifteen clinical staff members participated in a 45-minute educational program designed to enhance their knowledge and skills in implementing the ASQ tool. A pretest/post-test design was used to determine any increase in knowledge and improvements in confidence across all measured areas. Results indicated an 89% increase in knowledge (pretest = 53%, posttest = 100%). Confidence in using and interpreting the ASQ tool increased from 47% on the pretest to 100% on the posttest. The project resulted in the development of training materials, reference guides, and standardized screening protocols, accompanied by recommendations for ongoing education, workflow integration, and broader initiatives aimed at promoting equity, safety, and early intervention in suicide prevention
National Survey of Physical Therapists’ Participation as Health Educators in Physical Activity Promotion Among Older Adults
Full text linkPhysical inactivity among older adults remains a major national and global public health concern linked to preventable morbidity, mortality, and rising healthcare costs. Physical therapists are uniquely positioned to promote physical activity (PA) through health education, yet their engagement in this role is not well defined. This quantitative cross-sectional study examined associations between clinical practice factors—years of experience, board certification status, and practice setting—and three domains of the theoretical domains framework (knowledge, skills, and behavioral regulation) related to PA promotion among older adults. The framework guided identification of behavioral and contextual factors influencing therapists’ delivery of PA promotion interventions. Data were collected through an online national survey of U.S. physical therapists (N = 310). Descriptive and chi-square analyses assessed relationships among variables. Significant associations were found between board certification in geriatrics and awareness of national PA guidelines (χ² = 20.73, p \u3c .001), while behavioral regulation outcomes were associated with years of experience (p = .016) and practice setting (p = .014). Only 6.5% of participants identified all guideline components, and fewer than half (44.2%) reported having a clear plan for PA discussions. Findings suggest that behavioral regulation plays a key role in promoting routine PA conversations in practice. Results support the need for targeted professional development and continuing education to enhance therapists’ competence as health educators and advance positive social change by improving older adults’ health and reducing disparities
Staff Education to Improve Diabetes Management Knowledge for Primary Healthcare Providers
Full text linkI developed this Doctor of Nursing Practice staff education project to improve primary healthcare providers’ knowledge of diabetes management. Given the vital role nurses, advanced practice providers, and physicians play in patient education, chronic illness management, and care coordination, this issue must be addressed within nursing practice. The practice-focused question guiding this project was: Among primary healthcare providers, does implementing a structured diabetes education training program, compared to the current standard practice, improve provider knowledge in diabetes management? The purpose of this project was to develop, implement, and evaluate a targeted education intervention session. As analytical strategies, I employed expert evaluation to ensure content validity, paired t-test analysis to determine the significance of change, and pre- and posttest assessments to measure participant knowledge gains. Project findings revealed that the knowledge of primary healthcare providers improved after the education session. Statistical Package for the Social Science, Version 29.0 was used to perform a sample paired t test. The participants’ average pretest score was 8.70, and their average posttest score was 14.20. Statistical analysis produced a p value \u3c .001. The project’s implications for nursing practice include decreased clinical variability, increased interdisciplinary teamwork, and better ability to provide evidence-based diabetic care. The implications for social change include fostering equitable access to diabetes care and motivating medical staff to advocate for patients who face obstacles to care due to their cultural background, financial situation, or level of health literacy
Identifying Best Practices to Decrease the High Rate of 30-Day Rehospitalization of Patients with Dementia from Skilled Nursing Facilities
Full text linkAbstract As CMS continues to prioritize quality care over quantity and positive patient outcomes, hospitals and nursing homes must ensure that their mission and goals align. The high rehospitalization rate is a current and ongoing concern among policymakers and healthcare administrators. Adverse patient outcomes and increased financial costs to both patients and Health Service Organization (HSO) administrators highlight the need to identify best practices to help reduce rehospitalization. The purpose of this integrative review is to identify best practices for reducing the high rate of 30-day rehospitalization among patients with dementia in skilled nursing facilities (SNF). The review question that guided this integrative review is: What best practices can be implemented to decrease the high rate of 30-day rehospitalization of patients with dementia from SNF? The theoretical framework used is the Donabedian framework. This framework structure encompasses the physical and organizational components of the facility, including ensuring adequate, qualified staff to care for patients. The process focuses on identifying best practices to help decrease the rehospitalization rate, while the outcome measure is a decrease in 30-day rehospitalization. The results of the thematic analysis identified four different themes. These themes include communication, risk prediction, incentives, and the specialty care unit. Skilled facilities must collaborate with hospitals and all relevant disciplines to help reduce the frequency of rehospitalizations among patients from these facilities. The implications of these findings provide best practices for decreasing the 30-day rehospitalization rate of patients with dementia from SNF, which helps promote positive social change