This study explores professional practice and examines an approach to research that could be useful for the practitioner in developing and extending their practice. The existence of artistry is recognised within professional practice (Schon 1983), and is important in making professional judgements (Fish and Coles 1998, pp. 28-53, de Cossart and Fish 2005). Therefore, as in the methodology proposed by Fish (1998), the artistic/holistic paradigm was adopted because this specifically enables the exploration of professional artistry and is suited to insider practitioner research. The study critically appraised the use of the proposed artistic/holistic paradigm. A case study approach was used in which the researcher was the case. A portrait of an episode in clinical practice was produced, followed by a critical appraisal of this portrait. These then became the portrait of research practice, which was equally appraised. This mirrors the process seen within the arts in which critical appreciation is a reflective process, deriving its rigour from the discipline and connoisseurship of the critic. The results demonstrate that the artistic/holistic paradigm is well suited to continuing professional development, both individually and corporately. The proposed paradigm does enable the recognition and exploration of professional artistry, both within clinical and research practice. Professional practice has a moral foundation and it was shown that this must be openly recognised if meaningful professional development is to occur. Evidencebased medicine, which is founded on the technical-rational view of practice, was shown to be insufficient for the professional's ongoing development. This, and similar work, will impact and contribute to the ongoing evolution of the traditions of the profession.

The thesis in part describes a research journey of a psychotherapy practitioner engaging in research development. It details, narrates and values the synchronistic events that enabled the ‘story’ to emerge. The central enquiry draws on embodied phenomenological research methods and poetic experiencing to explore the experiences of psychotherapists who have an understanding of nonduality and the perceived impact of this on their psychotherapeutic work. Nondual experiencing is also studied following a synchronistic research visit to Pakistan. Here, embodied spirituality is explored, using video and the concept of ‘Therao’ is studied and utilised as an aspect of skilful practice. These are drawn together and compiled as a summary of skilful means in psychotherapeutic practice. Additionally, as a Doctorate in Professional Practice two studies are presented as part of the practice development component. Both used creative video and performance as part of research presentation. The first, a project based on the Mandala with people living with HIV. The second ‘Beyond Statistics’ is an enquiry into the lifeworld experiences of gay men living with the co-infection of HIV and HCV. The thesis strongly articulates the significance of practice based research as a basis for humanising practice and the development of tacit and pathic knowledge. It identifies 10 key qualities present in practitioners who have a spiritual understanding of nonduality and the positive impact of these on depth connection with client work. The thesis also acknowledges, in line with current developments, the importance of including the cultivation of these depth relational qualities within a psychotherapy training curriculum.

The aim of this research was to explore the experiences of Chronic Fatigue Syndrome among a small group of adolescents, through three research questions: What are the personal experiences of young people with CFS – how does the condition affect their daily lives – including educational, social and psychological perspectives. Secondly, how does CFS impact family life – how does the condition influence not only the lives of sufferers but also those closest to them? Finally, can the knowledge base be deepened to help guide practice for those caring for the needs of adolescent CFS sufferers and their families? The study used a narrative approach in an attempt to capture young people‘s stories, and to provide a window of insight into the personal impacts of CFS on the lives of individuals. Open-ended interviews with eight young CFS sufferers (11 to 18 year olds) were employed that explored personal experiences of CFS. In addition four email interviews were conducted with primary caregivers to explore the impacts of CFS from a carers perspective. Five themes arose from a generic qualitative analysis of data - adolescent CFS is experienced as: (1) having to adapt to debilitating physical symptoms; (2) living with changes in family relationships and loved one‟s life experiences; (3) living with isolation and a disruption to a full and satisfying teenage life; and (4) feeling misunderstood and judged. Also a fifth and universal overarching theme, that CFS in adolescents is experienced as having to put life on hold. This is a major life adjustment, not only for the individual sufferers but for their family members also, who have to adapt to a new way of life accommodating for the limitations of one member. The implications for clinical practice and further research are discussed.

Many academic medical programs present students with the chance to experience scenario based learning. This is often achieved through the use of clinical simulation laboratories which utilize computer-based scenarios that realistically imitate the human body and how it responds to various situations. This interactive style of learning has proven to be successful at integrating theories taught in textbooks and practice gained through clinical experience without posing any harm to human patients. Literature has shown documentation of the effectiveness of using clinical simulation laboratories in both the academic and clinical setting; however, some clinical facilities have been slow to adapt the use of this technology. The purpose of this study was to determine what factors are deterring the use of clinical simulation labs for the purpose of continuing education in the hospital setting. The study was limited to the field of respiratory therapy. The study was conducted by sending surveys to respiratory therapists and administrators working in acute care facilities in the Northeast region of Tennessee and the Southwest region of Virginia. The surveys included various questions concerning knowledge and perceptions of clinical simulation labs. The surveys were coded using a modified Likert scale, and the data was input into SPSS Version 18.0. Sample t-tests were then run where appropriate. Therapists indicated a preference for learning through the use of clinical simulation labs as opposed to learning through textbooks alone. Administrators indicated a knowledge of the benefits of clinical simulation labs even though the majority are not currently using the technology in their facilities.

Despite the vast amount of research regarding type II diabetes, little is known about the relationship between fatalistic beliefs and self-efficacy in individual self-care among adult Appalachians with type II diabetes. As a result of multiple predisposing risk factors that include high rates of obesity and poverty, as well as a lack of access to preventative care services, the prevalence of diabetes is very high in this region and has become a major health issue. In addition, a history of exploitation and lack of diverse economic development has profoundly influenced the cultural beliefs of those living within the region, which has resulted in Appalachians being collectively described as fatalistic. The purpose of this study was to determine if a correlation between fatalistic beliefs and self-efficacy in self-care among adult Appalachians with type II diabetes exists. A survey was created that assessed three concept areas pertaining to both fatalism and self-efficacy in self-care: emotional distress, religious/spiritual coping, and perceived self-efficacy. The survey was administered to participants being treated for type II diabetes at a rural clinic in northeast Tennessee. Expected correlations were found when comparing both emotional distress and perceived self-efficacy with religious and spiritual coping. However, an unexpected positive correlation was found when comparing emotional distress with perceived self-efficacy. In conclusion, this study did not demonstrate the hypothesized negative correlation between fatalism and self-efficacy, and the results found are not attributable to a larger population due to the small sample size obtained.

Due to the increase in the aging population older adults are looking for ways to stay fit and active in their later years. Such activities need to be fun, easy to operate, and encourage socialization. The Nintendo Wii© Bowling provides these features for the aging population. Participants in this quantitative pilot study had the opportunity to play the Nintendo Wii© Bowling Game twice a week for six weeks to see if their balance and mobility would improve when compared with the pre and post scores from the Performance Oriented Mobility Assessment (POMA). The participant’s scores on the Performance Oriented Mobility Assessment showed an average increase in both gait and mobility from 24 to 27.5 on the post-test. These participants’s were also asked to provide qualitative feedback on their experience in the study. One participant stated that she “gained confidence.” As a whole, the participants really enjoyed playing the Nintendo Wii© Bowling. This study demonstrates that Nintendo Wii© Bowling game can be an enjoyable, easy activity to motivate elders to become more active and social while incorporating exercise into their routine. It also provides the chance for future research to be conducted on older adults to examine the benefits of exercising with the Nintendo Wii© Bowling game.

There is an increase in uncivil student behaviors in the classroom setting including inattention, lying, cheating, and plagiarism. The purpose of this quantitative descriptive study was to determine behaviors that undergraduate nursing students perceived as uncivil in the classroom. The research question was, “How do undergraduate nursing students perceive uncivil behavior in the classroom?” A convenience sample using cluster sample method of all five undergraduate baccalaureate nursing student cohorts from a College of Nursing in Appalachia were invited to complete the researcher’s edited version of the Incivility in Nursing Education (INE) survey. There were 526 undergraduate nursing students enrolled in the program. Power analysis estimate of sample size was 222 with a 95% confidence interval; 372 students completed the survey which demonstrated an adequate sample. The sample consisted of 276 females (74.2%) and 84 males (22.6%). Participant ages ranged from 19 to 53 years. The majority of students, 333 (89.5%) were Caucasian. The primary behavior that students perceived as uncivil was holding distracting conversations, 285 (76.6%). The most common uncivil behavior experienced by students was acting bored or apathetic, 318 (85.5%). Challenging faculty, 232 (62.4%) was the most common uncivil behavior reported by students. Students perceived academic incivility as a problem, 260 (69.9%). Data from this study support previous findings that incivility in the nursing academic environment is a serious and growing problem. These findings are important because the instructor is responsible for providing a classroom environment that is conducive to learning. Classroom interventions are suggested to provide a healthier learning environment.

As the United States population becomes more culturally diverse, it has become a priority for health care professionals to competently provide culturally sensitive care. Cultural competency is required in baccalaureate (BSN) programs, mandated by collegiate nursing accrediting agencies. Although BSN programs have integrated cultural competency education into their core curricula, little data has been collected evaluating outcomes and effectiveness. Using a 36 question survey, students in all levels of a selected BSN program were asked questions regarding cultural competency and attitudes towards cultural care. The ANOVA and a Tukey Kramer analyses were performed with an alpha coefficient of 0.05 and a confidence interval of 95%. The results revealed some statistically significant differences between several cohorts. Additionally, Cohort 5 (students in the last semester of the nursing program) did not differ significantly to Cohorts 2,3, and 4, indicating that current cultural competency education may not be adequate or effectively taught as students progress through the BSN program.

Two types of patient-centered care in the radiology profession are service and safety. Service relates to the technologist being a patient advocate by effectively communicating, building relationships and providing care. Two types of safety in the radiologic sciences profession relate to contrast media and radiation safety. The focus of this study was on radiation safety. The project was designed to evaluate exposure indicator values from radiographic procedures performed by junior and senior radiography students during the month of March 2013. The mean exposure indicator values for radiographic procedures were evaluated by all students and then by student rank (juniors and seniors). The type of procedure and student rank (juniors and seniors) had an impact on exposure indicator values. The results revealed that dose creep occurred during radiographic procedures performed by student radiographers. It was determined that there is a need for additional education for student radiographers regarding selection of appropriate exposure factors to minimize dose creep.

The purpose of this study was to examine how past experiences with nursing homes influence perceptions and attitudes of college students toward nursing homes in the United States. A review of the current research literature indicates that nursing homes are publicly scrutinized in a negative manner. Variables examined included students’ college of study, experience with nursing homes either from personal experience, from a well-known relative or friend, or the media, and different attitudes and perceptions including good or bad views of nursing homes. Results indicate that students’ perceive nursing homes more negatively than positively even when their experience came from personal knowledge. Students enrolled in health services do not perceive nursing homes more positively than negatively or any better than students enrolled in other courses of study. Moreover, there was no significant relationship between the students’ perceptions of nursing homes and their field of study.