Traditional models for public health professional education tend to be didactic, with brief, discrete practica appended. National reports of both practitioners and academicians have called for more competency-driven, interdisciplinary-focused, community-based, service-oriented, and experientially-guided learning for students across the curriculum. East Tennessee State University began its own curricular revisioning in health professions education nearly 2 decades ago with a grant from the W.K. Kellogg Foundation, emphasizing competencies development through community-based learning in community-academic partnerships. This article describes 3 examples that grew from that initiative. In the first example, students in multiple classes delivered a longitudinal community-based employee wellness intervention for a rural county school district. BS public health students conducted needs assessments and prepared health education materials; MPH students conducted health assessments and worked with school wellness councils to deliver client-centered interventions; DrPH students supervised the project and provided feedback to the schools using participatory methods. In the second example, MPH students in a social-behavioral foundations course used experiential learning to investigate the region's elevated cancer mortality ranking. Following meetings with multiple community groups, students employed theoretical constructs to frame regional beliefs about cancer and presented findings to community leaders. One outcome was a 5-year community-based participatory research study of cancer in rural Appalachia. In the third example, MPH students in a health-consulting course assessed local African Americans' awareness of the university's health and education programs and perceptions of their community health issues. Students learned consultation methods by assisting at multiple regional African American community meetings to discover issues and interest that resulted in the organization of a regional African American health coalition, multiple community health interventions, and the region's first health disparities summit. Lessons learned are presented which identify key elements of success and factors that influence adoption of community-based teaching and learning in public health.

Objective: A collaborative campus-community partnership program provided the framework for an intervention to reduce motor vehicle accident fatalities along a rural Appalachian highway. Students from public health, nursing and medicine worked with community members to identify the problem and plan the strategy to address it. Methods: An inquiry-based learning model proved to be an appropriate approach to engage student teams with community leaders in identifying and resolving health needs. Inquiry-based strategies place students in guided learning situations where their investigations lead to working solutions. The inquiry-based model matched the curricular objectives of the Community Partnership Program (CPP) more closely than the classroom oriented problem-based learning approach. Implementation: In the spring of 1994, students, along with citizens and officials of a rural Appalachian county, initiated a community-based prevention project focused on reducing deaths from motor vehicle accidents employing the principles of an inquiry-based learning model. Discussion: This project effectively demonstrates the role that students can play in mobilizing diverse elements of the community to address identified health and safety concerns. It provides an illustration that a longitudinal, community-based, service-learning approach to health professions education is beneficial to both student learners and communities. Conclusions: Through the use of inquiry-based learning methods, students gained real life experience in applied principles of health statistics, epidemiology, community organization, health risk communication, health education planning and program implementation. Outcomes of the project included a measurable reduction in automobile-related fatalities and the initiation by the state department of transportation of a series of investigations expected to pave the way for physical improvements to the roadway.

An important question in teaching language is, what accounts for the emergence of either receptive or expressive labels when teaching only one of them? The teaching procedures in the present study were intended to reproduce the natural development of bidirectional naming in which caregivers comment on the items a child is interacting with and children echo those vocalizations they hear. Thus, the only vocalizations presented by the researcher during teaching occurred after the learner pointed to a specific stimulus, and were specific to the stimulus being targeted. These vocalizations are referred to in this study as stimulus-specific consequences. The purpose of this research was to investigate if the stimulus-specific consequences could become discriminative stimuli for receptive labels, and lead to the emergence of expressive labels. Three studies were conducted, each with four adults. Results demonstrated that using a stimulus-specific consequence during teaching led to receptive labels for all participants, but led to the emergence of expressive labels for only four participants. In other words, bidirectional naming did not occur for the majority of participants. Factors that may improve interrelations between receptive and expressive labels were analyzed, but further evaluations are needed to account for the inconsistent demonstrations of naming.

My thesis examines patients’ and caregivers’ perspectives on educating healthcare providers(HCPs). Specifically, it examined two research questions: 1) What do patients think about their involvement in the education of HCPs? and 2) What roles do patients want to have in the education of HCPs? It is important for educational leaders and HCPs to understand answers to these questions, from patients’ own perspectives, to make effective changes in current and future health professions education and ultimately, the delivery of patient-centred care. I conducted semi-structured interviews with 27 patients and caregivers for this study. Through conventional content analysis, I identified five themes for what patients think about their involvement in the education of HCPs. Namely, patient involvement in the education of HCPs: (1) is challenging because of power-differentials between themselves and HCPs; (2) requires patient training; (3) needs to start early in HCPs’ education process; (4) can improve patient-HCP partnerships; and (5) requires compensation for patients. I also identified three roles that patients want to have in the education of HCPs. Specifically, they want to: (1) teach HCPs about patients’ expectations, experiences, and perspectives through case studies, storytelling, and research; (2) provide direct feedback to HCPs; and (3) advise on curricula development and admission boards for HCPs. My research adds to the limited research on patients’ and caregivers’ perspectives on their involvement in the education of HCPs, identifies barriers to patient involvement, and provides a foundation that HCPs and educational leaders can use to improve patients’ active involvement in the education of HCPs. Further, it highlights that patients’ voices are important to the education of HCPs. It also illuminates my own perspectives on patient involvement in the education of HCPs, which I share as part of my positionality as a researcher who conducted this study.

Thesis (Doctor of Radiography)--Cape Peninsula University of Technology, 2020 / Radiation therapy has undergone significant changes with regard to new medical imaging technologies, including computerised tomography (CT) and magnetic resonance imaging (MRI). Practitioners now have access to technologies that provide anatomical information in an infinite selection of views. Earlier advances in three-dimensional conformal radiation therapy (3D-CRT) allowed for the site of treatment to be accurately located. Intensity modulated radiotherapy (IMRT) enabled practitioners to accurately focus the ionising radiation beam, while modulating the intensity of the dose being administered. Currently, using image-guided radiotherapy (IGRT) methods, radiation therapists can track the effectiveness of treatment in real-time to provide better protection for the organs and tissue that are not targeted for treatment. The changes described above have fundamentally changed radiation therapy practice, and thus have implications for the training of radiation therapists. This thesis argues that without a deep understanding of the science underpinning the advancements in radiation therapy techniques, practitioners will be unlikely to achieve the necessary level of accuracy and consistency in treatment. Radiation physics concepts, such as sources and types of ionising radiation, ionisation, the isocentre and the Inverse Square Law underpin competent and safe practice. Threshold concepts, such as those listed above, have been identified as concepts that pose difficulty to students due to its complexity and the increased levels of cognitive challenge required to master a threshold concept. In applied disciplines, such as radiation physics, threshold concepts are strongly associated with competent practice. This study focused on the first year radiation physics curriculum and addressed the overarching research question: What is the relationship between threshold concepts in the radiation physics curriculum and radiation therapy practice? The study was guided by a translation device that combined two conceptual frameworks namely the Threshold Concept Framework and Legitimation Code Theory’s (LCT) Semantics dimension. LCT is a knowledge base theory that explains the complexity of knowledge structures. The Semantics dimension provided an explanation of the difficulty of concepts and proposed five pedagogies for the cumulative learning of complex concepts. A case study research design and methodology guided the research process. Data for the study comprised curriculum documents, and semi structured focus group and individual interviews with students, academic staff and clinical educators. The data were analysed using a translation device to show the semantic profile of curriculum documents, pedagogies and participants’ different understandings of the threshold concepts in radiation physics. The study found that threshold concepts in radiation physics underpin competent and safe practice. An external language of description was developed to identify the characteristics of threshold concepts. A virtual clinical environment was proposed as one of the pedagogies to aid mastering of threshold concepts through visualisation of the unseen by facilitating students’ understanding of threshold concepts for competent and safe radiation therapy practice. The study showed that students’ mastery of threshold concepts in radiation physics is critical for practice.

East Tennessee State University Quillen College of Medicine Library (ETSUQCOML) developed a training program to enable public libraries, public health workers, and rural hospital staff to be consumer health information providers. Four NN/LM-developed classes were taught to public libraries. Regional public library directors were invaluable in obtaining the concurrence of their boards for release time for class attendance. Classes were also developed for the public health workforce and rural hospital staff. Five-hundred thirty-three students attended the classes. Fifty-two public library workers will receive the MLA's Consumer Health Information Specialist certification. Thirty-one public libraries have joined NN/LM. All ordered MedlinePlus marketing materials for their libraries from InformationRx.org.

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Safety net clinics across the country struggle with a lack of resources to tackle the needs presented. Screening programs set up for children and elderly have proven to be effective in triaging need, prioritizing care, and maximizing resources. These programs do not currently exist for working uninsured adults. Research was initiated to answer the question: Does the screening process improve patient care for the community clinic? During a 6-week pilot study a licensed dental hygienist performed 30 screenings in the community clinic setting. Findings were recorded and coded according to patient’s level of need identified. Pre- and posttest data for patient care factors were attained. Statistical tests showed a significant effect on patient care factors. While the evidence existed to support the implementation of screening, more research would quantify the specific impact on this population.

Graduating competent healthcare providers to meet increasing demands of the United States leads to interest in graduate health science student success. In this study, I explored the relationship between self-regulated learning strategies and licensing exam readiness among Doctor of Chiropractic students. Two research questions asked (1) how self-regulated learning strategies vary by gender and year of study, and (2) how self-regulated learning strategies relate to licensing exam readiness. One hundred thirty-three students from five chiropractic institutions were surveyed with questions from the Motivated Strategies for Learning Questionnaire (MSLQ) and exam readiness items. A series of t-tests, one-way analyses of variance, Kruskal-Wallis H tests, and ordinary least squares (OLS) regression addressed the research questions. Results indicated (1) self-regulated learning strategies do vary by gender and year of study, and (2) self-regulation is related to licensing exam readiness, particularly in Parts I and II of the exam. Chiropractic institutions and policymakers should focus efforts on introducing and reinforcing self-regulated learning strategies throughout the curriculum and explore licensing exam implications. Future research should continue expanding the literature on chiropractic education by considering actual licensing exam performance and determining appropriateness of the MSLQ for chiropractic students.

Maintaining dental health is vital as it contributes to the psychological well-being of an individual and the overall systemic health through preventing chronic diseases. Unfortunately, poor oral health has been identified as a common trend in individuals with Autism Spectrum Disorder (ASD). There is limited research regarding the barriers that result in rates of increased dental manifestations in patients with ASD compared to neurotypical individuals. This study strived to identify the barriers that contribute to poor oral health in individuals with ASD in order to establish interventions to break those barriers and improve overall dental health in the Autism community. A descriptive, mixed methods study design was utilized that included 10 participants: adults with ASD (n=4), parents of children with ASD (n=4) and dental professionals (n=2). The ASD population were asked to complete a questionnaire that asked about home/office dental care, dental issues and anxiety, sensitivity to external stimuli in a dental office, physical challenges and parafunctional habits. Semi-structured interviews were conducted with dental professionals regarding their experience and training in treating patients on the Autism Spectrum. Three of the four parents reported that their child had high levels of anxiety regarding dental visits. Only one adult with ASD reported flossing on a regular basis, and bruxism was reported by all adults with ASD and all but one parent as an area of concern. Interviews with the two dentists revealed that families of individuals with ASD face financial barriers and reported infrequent visits from adults with ASD. Additionally, both dentists received minimal training in working with special populations. Further research is needed to improve the frequency of dental visits in adults with ASD, which can lead to an overall increased quality of life. Additionally, more training and guidance should be provided to dental offices on working with patients with ASD.