<p> Biomedical PhD education is a large and increasingly interdisciplinary segment of higher education. The primarily laboratory-based research training is commonly distributed to a range of administrative units within and outside the research-intensive universities. This organizational fragmentation represents a significant challenge to coordination, oversight, and quality development. The University of Pennsylvania was one of the first institutions to establish a centralized, umbrella-type biomedical graduate program to address these organizational challenges. The thirty-year-old program has been highly successful and is regarded as a model for other institutions. In order to learn from the program's path to success, this research investigated the inner dynamics and leadership actions related to the development of Biomedical Graduate Studies (BGS) at the University of Pennsylvania. The retrospective instrumental case study explored the process from the period prior to the establishment of the program in 1984 until its current configuration in 2014. Data were collected through semi-structured interviews with 18 people representing different time periods and leadership positions in the history of the program, as well as archival material. The data were analyzed to establish the chronology of events and to identify the main themes and leadership actions of the change process. The presented case was subsequently analyzed in light of established theory on organizational change and leadership orientations in higher education. This analysis demonstrated that the change was a multi-dimensional process and could be explained by several theoretical frameworks. There were elements of planning and decisive management, organizational learning, political bargaining, adaptation to environmental factors, and attention to culture and symbolism. The process involved a transformation that empowered the junior faculty, promoted collegiality, and improved the quality of recruitment, student satisfaction, and scientific outcomes. Centralization of student recruitment and funding, detaching the graduate education from the department structure, and collaborative leadership stood out as primary factors for success. This case study may serve as a guideline for other institutions that aim to develop centralized biomedical graduate programs. It also represents a reference for further research in the field of biomedical education management.</p>

<p> <b>Background.</b> Nurse educators are challenged with a new generation of students referred to as the Millennial generation. These millennial students, who have different learning style preferences, are testing the traditional pedagogical methods of nurse educators such as lecture. The social nature of millennial students coincides with the social constructivism theory that students learn in groups. </p><p> <b>Purpose.</b> The purpose of this quasi-experimental study was to examine if there was an improved retention of knowledge in millennial students who were taught by collaborative learning strategies rather than the traditional lecture method in an associate degree nursing program. Additionally, the study examined if learning by the students' preferred learning style resulted in a higher level of achievement on a comprehensive standardized examination versus learning by a nonpreferred style. </p><p> <b>Theoretical Framework.</b> The theoretical framework for this study was founded on the social constructivism theory suggesting students build knowledge through social group interactions. </p><p> <b>Methods.</b> The quasi-experimental study was conducted at an associate degree program in the Midwest. The nonprobability purposive sampling was utilized to examine the means of a comprehensive standardized examination and a learning styles preference assessment. </p><p> <b>Results.</b> The statistical analysis utilizing the analysis of covariance did not produce statistically significant findings in the differences in the comprehensive standardized examination score means between the students taught by the lecture method and students taught by the collaborative method when controlled for the cumulative grade point average. Additionally, the study did not find statistically significant differences in mean comprehensive standardized examination scores when taught by the students' preferred learning style versus being taught by their nonpreferred style. </p><p> <b>Conclusions.</b> Although not significant, the study did find students who were taught by the collaborative method had higher scores than those who were taught by the lecture method. In addition, learning styles preferences were not significant in determining academic success. The implications of the study are significant to nursing education by highlighting the importance of using collaborative activities and multiple teaching modalities.</p>

<p> <b>Background:</b> Implementation of evidence-based knowledge in healthcare is challenging with success rates less than optimal at times. This is particularly true in the area of pressure ulcer prevention. Attention to use of the affective domain in educational interventions to implement best practices may be part of the solution. </p><p> <b>Purpose:</b> The ultimate purpose of this study was to compare the use of two different educational interventions on medical-surgical nurses' behavioral intent to use evidence-based practice in preventing pressure ulcers. </p><p> <b>Theoretical Framework:</b> The theoretical framework for this study was the theory of planned behavior. </p><p> <b>Methods:</b> This study proceeded in three phases and collected both qualitative and quantitative data for instrument development and instrument testing. The resultant instrument was used to collect data for hypothesis testing in a cluster randomized experiment. </p><p> <b>Results:</b> The theory of planned behavior was not fully supported in this study. Attitudes toward pressure ulcers were predictive of behavioral intent. Nurses who experienced the affective domain educational intervention showed significant improvements over the control group on attitude and perceived behavioral control. Behavioral intent and subjective norm were not impacted. </p><p> <b>Conclusions:</b> A reliable and valid theory of planned behavior derived instrument was created. The theory of planned behavior was partially supported. An affective domain intervention has the potential to favorably impact nurses in valuing pressure ulcer prevention, despite any barriers.</p>

<p> The purpose of this project was to develop a curriculum related to the safety and effectiveness of dietary supplement use in athletes, including both recreational and competitive athletes. A review of literature was conducted to investigate current research and scientific evidence regarding dietary supplements and athletic performance. Using this evidence-based foundation, the curriculum was then designed as a series of three interactive sessions for athletes. The sessions incorporate lectures, case studies, discussion questions, and group activities to facilitate group learning. The project was reviewed by an expert panel and adjustments were made based upon their recommendations. This curriculum was designed for implementation at the community level and is adaptable based upon the needs of a particular community. An evaluation tool was developed for future program review and adjustment. The curriculum was not pilot tested.</p>

<p> The purpose of this quantitative study was to examine, from a constructivist career development perspective, the factors of well-being and vocational identity that emerged among a diverse sample of upper-division undergraduate students. This study also examined which factors of vocational identity predicted well-being and which factors of well-being predicted vocational identity. Participants included 411 diverse, upper-division health science students from a public university in Southern California. The first two research questions that guided this study were designed to explore emergent factors of well-being and vocational identity using items from the PERMA Well-Being Profiler (PERMA) and the Vocational Identity Status Assessment. The final two research questions were designed to examine the best predictors of well-being among the factors of vocational identity and the best predictors of vocational identity among the factors of well-being. To address the research questions, data obtained from surveys was analyzed using exploratory factor analysis and multiple linear regression analysis.</p><p> The findings of this study demonstrated that PERMA theory and Vocational Identity Status theory explained the constructs of well-being and vocational identity among the diverse sample with few exceptions. Further, the PERMA and VISA instruments proved valid and reliable among the diverse sample. In-depth career exploration, identification with career commitment, and career self-doubt were the vocational identity factors that best predicted well-being. Meaning, accomplishment, and engagement were the well-being factors that best predicted vocational identity.</p><p> Recommendations based on the findings of this study included revisiting performance based funding policies to incorporate the measurement of well-being and vocational identity as metrics of student success alongside more objective measures like retention, GPA, and time to graduation. Further, recommendations were offered for integrating well-being and vocational identity enhancing activities and interventions into current practices in classroom, counseling, and advising settings. Recommendations for qualitative, experimental, and longitudinal research designs were offered based on the findings of this study.</p>

<p> The purpose of this quantitative ex-post facto study was to determine if the level of satisfaction is increased over hospitals that do not incorporate PCC services. The study involved the use of archival data from HCAHPS (n.d.) satisfaction surveys analyzed during the first quarter of 2013. The respondents of the study included using archival patient satisfaction survey data from 113 hospitals within the State of Michigan. Fifty-two of these hospitals were identified as providing some level of PCC services to patients, and 61 of the hospitals were identified as not providing PCC services to patients. For each of the research questions, a two-sample t-test was used to compare the mean percentages between hospitals that have implemented PCC services and hospitals that have not implemented PCC services. The use of a two-sample test with all of the research variables did not reject any of the hypotheses for this study. This outcome could indicate that HCAHPS (n.d.) patient satisfactions scores may not be directly linked to PCC services. Although the results for this study did not demonstrate a favorable outcome regarding HCAHPS (n.d.) satisfaction scores and PCC services, the literature review for this study validates the importance for leaders within the health care community who have established PCC services to find other measurements to assess the effectiveness of PCC services, and those who do not to consider the implementation of Patient-Centered Care (PCC) services within their hospitals.</p>

<p> The purpose of this project is to create fun and educational lesson plans for before and after school childcare providers of children in kindergarten through fifth grade. The lesson plan will incorporate aspects of physical activity and nutrition into the basic curriculum for this age group. The nutrition and physical activity curriculum contains four themed weekly lessons. Each lesson incorporates a nutrition discussion, an activity related to the discussion, and one group game. The lessons and activities were designed to incorporate minimal materials so that any facility could easily incorporate them. A committee of nutrition professionals and educators reviewed the curriculum and improvements were made based on their recommendations.</p>

<p> Childhood obesity is a disease that affects 17% of children aged 2-19. This disease, best described by a social ecological perspective, is multifactorial in nature and includes individual, familial, community, and societal contributors. As the causes are multifactorial, so too should be prevention and treatment. Healthcare providers, specifically physicians, can play an important role in the diagnosis, prevention, and treatment of childhood obesity, especially if they appropriately utilize nutrition behavior change counseling to facilitate lifestyle changes. Behavior change falls within the realm of the social and behavioral sciences, disciplines that will receive greater emphasis on the newly designed MCAT 2015^&reg;; therefore, premedical and medical programs may need to alter their approaches to disseminating this discipline-specific knowledge. Nutrition education is currently limited in medical education; and thus, just as premedical programs seek to increase the social and behavioral sciences, so too should they increase nutrition education. In light of these recommended curricular changes, researchers sought to investigate the current state of premedical and medical students. views of childhood obesity. This dissertation describes three studies conducted for that purpose. In study 1, researchers investigated 30 pre-healthcare undergraduate seniors. views of childhood obesity and their sources of knowledge through in-depth qualitative interviews. Investigators found that students with specialized coursework and significant volunteer and/or internship experience had a deeper understanding of childhood obesity; however, as a whole, students failed to see the role of healthcare providers in prevention and treatment. These findings provide justification for premedical programs to guide students to see their role in prevention and treatment through educating them on the social ecological model and providing them with relevant service-learning opportunities and guided reflection. In study 2, researchers conducted a similar nationwide qualitative investigation in 78 third and fourth year medical students. These students described student-, patient- and healthcare system-centered barriers, including their lack of knowledge, patients. lack of access, and their lack of time in practice. Students also requested more applicable information and counseling training in order to equip them to prevent and treat childhood obesity. Much like the pre-healthcare seniors, these medical students failed to discuss their role in prevention and treatment. Therefore, medical schools need to help their students overcome barriers by providing them knowledge and skills and helping them understand their role in prevention and treatment. In study 3, researchers built on the knowledge gained from study 1 and study 2 and developed a valid and reliable computerized tool, the Childhood Obesity Prevention Self-efficacy (COP-SE) survey. Factor analysis of 444 completed surveys from students at 53 medical schools revealed a two factor structure with a correlation of 0.637 between factors. Factor 1 assesses self-efficacy in nutrition counseling while Factor 2 measures self-efficacy to assess readiness to change and initiate nutrition lifestyle changes. There was high reliability within factors (Factor 1 = 0.946; Factor 2 = 0.927), and the correlation (0.648) between the COP-SE survey and a general self-efficacy survey confirmed that the COP-SE measures domain-specific self-efficacy. This valid and reliable survey can be used by medical schools as a formative or summative assessment of students. self-efficacy in childhood obesity prevention and treatment. Further research should include confirming the factor structure and exploring the significance of response trends seen in this sample. The findings of all three studies can be used by premedical and medical programs to maximize the effectiveness of their preparatory programs to provide students with the necessary skills for prevention and treatment of childhood obesity. With the appropriate preparation, future healthcare providers can build their self-efficacy in disease prevention and treatment, hopefully resulting in improved patient outcomes.</p>

<p> Low health literacy impacts an individual's ability to comprehend communication from healthcare providers, reduces access to healthcare, and contributes to increased mortality. The purpose of this study was to evaluate the impact of learning style on adult health literacy education. The health belief model, protection motivation theory, the transtheoretical model, and social cognitive theory were used to analyze the data in this study, and to further develop effective health literacy education. The research questions addressed the effectiveness of educational intervention adjusted to their appropriate learning style in comparison to a standardized health literacy intervention and potential difference, according to type of learning style, in the amount of changed performance between pretest and posttest. A sample of 80 adults in an urban community was recruited through organizations serving low-income individuals. The participants were assessed for baseline health literacy level, followed by identification of learning style, educational intervention, and posttest assessment, which led to determination by <i>t</i> test that changes between pretest and posttest scores were statistically significant between the control group and the study groups. This finding suggests that health education should be delivered to patients according to individual learning style in order for patients to comprehend and retain information provided. Social change implications include healthcare professionals appropriately addressing health literacy so that patients may participate more actively in their personal healthcare decisions to improve healthcare quality outcomes, decrease long-term costs of delivering healthcare services, and improve the general health of the community.</p>

<p> Intercultural competence through study abroad is widely recognized as a preferred teaching approach for the development of globally competent health care practitioners. Colleges and universities are looking for multiple ways to encourage students to study abroad because of the noteworthy effects that these experiential opportunities have on students. Sparse research has been conducted to determine if short-term study abroad trips of less than two weeks are achieving these same outcomes. </p><p> The purpose of this basic interpretative qualitative study was to describe the nature and meanings of a short-term international cultural experience for nursing students, and whether or how their understanding of the role of the professional nurse was changed. A group of baccalaureate nursing students traveled to Tanzania and took part in professional and social opportunities over an 8-day period. All participants were required to complete a nursing course with global objectives prior to the trip and pre-immersion seminars. Data were collected from reflective journals during the study abroad experience, focus group discussions one month after returning home, and personal interviews 6 months later. The results indicated that the participants experienced culture shock, but they also gained in self-awareness, cultural empathy, leadership skills, a desire to learn more, and a new perspective of the role of the professional nurse. Langer's theory of Mindfulness, Bennett's Developmental Model of Sensitivity and Campinha-Bacote's Process of Cultural Competence provided the theoretical framework for this study.</p>