Multi-campus DPT Programmatic Development in a Public University: Leadership Considerations

Background/Purpose: Institutional pressure for expanded revenue streams, coupled with workforce development needs to insure patient access of health resources both drive programmatic expansion of healthcare education programs across multiple campus sites. Such expansion is predicated on deliberate planning and resource acquisition for effective course delivery and successful programmatic outcomes. The University of Nebraska Medical Center’s College of Allied Health Professions opened a second campus site in 2016, located 185 miles from the main campus and the urban corridor of the state. The Doctor of Physical Therapy (DPT) program (and four additional allied health professions) modified traditional course delivery to create a synchronous learning environment, with core and adjunct faculty members actively engaged on both campuses. This administrative case report describes areas of critical consideration for faculty and administrators when expanding DPT programs across multiple sites. Strategies associated with successful implementation are addressed. Case Description. The process of program expansion and implementation are outlined, including challenges, subsequent actions, and successful strategies. Critical elements of program planning and implementation are categorized in the context of: Essential Infrastructure, Essential Functions, and identification of Essential Outcomes to provide evidence that the distance-based curriculum effectively addresses student learning needs. Outcomes: Key considerations related to “essential infrastructure: include resources such as: Administrative/leadership support; community engagement and relationships; qualified personnel; space; equipment; and basic technology (including deployment of a “STAT” team of student technology assistants). “Essential functions” include: Changes associated with the admission process and messaging; curriculum modifications; instructional design assistance; reformulated interprofessional education and practice experiences; faculty development and scholarship, and the serious need to empanel a bi-campus faculty “response team” for vigilance in pragmatic detail and parity of learning experiences. “Essential Outcomes” address the critical focus of protecting a singular program concept from shifting to an asynchronous, satellite format, as well as describing assessment strategies at various levels within the institution. Discussion: The ability to maintain quality brand reputation during multi-campus expansion of a DPT program requires the leverage of resources and talent from multiple and varied stakeholders. This administrative case report describes essential factors that must be deliberately addressed by campus administrators and faculty for successful implementation and outcomes

The Self-Perceived Leadership Characteristics of Female Producers

Through the implementation of the transformational leadership theory and selfconstructed metaphors this study seeks to understand the self-perceived leadership characteristics of female producers. By means of qualitative analysis, the leadership characteristics of twelve female producers have been subjectively and objectively analyzed. A survey constructed using the transformational leadership characteristics found by Bemard Bass, the characteristics of groundbreaking women found by Barbara Polnick et al., as well as the emotional intelligence leadership characteristics presented by David Goleman et al., was electronically distributed to twelve women from six different television news and entertainment stations in the United States, Canada, and England. The findings of this study show the twelve women to perceive themselves as charismatic-inspirational leaders with supporting characteristics from the groundbreaking and emotional intelligence categories, within their roles as producers in the medium of television news and entertainment

Student Builders of Online Curriculum Content. What Are Their Perceptions and Motivations?

Objective/Purpose: 1. Describe the benefits and challenges of establishing a campus-wide student-centered program to create online curricular content. 2. Gain insight about student perceptions and motivations for becoming curriculum content developers. Need for Innovation: Faculty receive constant encouragement to discover methods for transforming health science instructional materials using active learning. Faculty identify lack of time as the most significant barrier to developing blended and online materials. In 2014, our academic medical center issued a student-centered call for proposals to create online materials for the Interactive E-Learning Program as a means to include students in the curricular change process. By pairing student creators, many of whom are fluent consumers of technology and digital education, with content expert faculty, the program uniquely capitalized on the students desire to contribute with the identified need of faculty for production time. Instructional Methods/Materials Used: The first call for student proposals was conducted in the fall of 2014, with the second in the fall of 2015. The competitive application required the following information: project members, faculty advisors, learning objectives, budget worksheet, description of the proposed module, and implementation plans for the curriculum. Awardees received $1000 per project for project expenses or student stipends. Students developed modules in six months with guidance from faculty advisors using resources available in the campus e-learning studio. Program completion was recognized by a letter of commendation. During the summer of 2016, students from both cohorts took part in a survey to assess their motivations and perceived benefits of participating in the Interactive E-Learning Program. Educational Outcomes: The two calls for proposals resulted in 30 funded student projects covering curricular topics for medicine, nursing, pharmacy, dentistry, allied health, and public health. A total of 58 students were involved and worked solo or in groups of 2-4 people. Survey results indicated students were motivated to participate by the desire to contribute to or enhance the curriculum and to develop their own e-learning skills. Students perceived an enhanced relationship with their faculty advisors and increased e-learning skills to be benefits of the program. Students also perceived participation in the program as a positive addition to their CV. Strengths/Areas for Improvement: The energy and creativity with which students approached the modules they designed resulted in many novel projects. The centralized e-learning studio and instructional design staff are strengths of the program, ensuring the modules meet instructional design principles, university branding requirements, copyright guidelines, and accessibility rules. An internal rubric and project checklist provided a guide for development and served as a tool for evaluation and feedback. Areas for improvement include the development of more interprofessional student teams that can lead to content applicable in more than one curriculum (eg professionalism skills, vital signs, medical history, etc). Approaches for identifying opportunities to implement the student-developed materials into courses on campus is also under consideration. Feasibility of Program Maintenance/Transferability: Many health sciences programs are facing curriculum redesign to meet the learning needs of current and future students or are seeking ways to engage students in the learning process. Based on our findings, extending the opportunity to students to become creators in partnership with faculty content experts was highly successful. Students are now more than just learners, but are also demonstrating altruistic behaviors to contribute and enhance curriculum for future students. After initial expenditures are made to acquire the proper software and hardware needed to support a formal e-learning program, the cost of maintaining such equipment is of small consequence when considering the impact of this program for the student developers, their faculty mentors, and the entire campus community

Does Implementation of a Lifestyle Medicine Curriculum Affect Student Wellness During Doctor of Physical Therapy Education?

Background Current healthcare environments amplify the need for educational systems to forge healthy workforces to withstand stressors. Our study examines the effects of embedding a lifestyle medicine curriculum on student wellness in a Doctor of Physical Therapy (DPT) Program, simultaneously preparing students to implement lifestyle medicine with future patients and communities. Methods In a DPT program, we implemented a lifestyle medicine curriculum grounded within the Social-Ecological Model. This framework emphasizes student success in the program’s pre-clinical phases, creates a purposeful “ripple effect” threading wellness strategies among peers, patients, and communities, and emphasizes wellness as a clinician over the 32-month curriculum. The Five Factor Wellness (FFW) Inventory and Psychological Capital (PC) Questionnaire measured student wellness at matriculation, mid-program, and graduation. We used Social Network Analysis (SNA) to examine the strength and types of peer connections. Results The response rate for two cohorts across the four-year study for the FFW was 100% and 80% (n=100/125) for PC and SNA. Race composition was White (84.0%, n=105), Asian (9.6%, n=12), Native Hawaiian or Pacific Islander (2.4%, n=3), Hispanic or Latino (2.4%, n=3), other-not described (.8%, n=1), and preferred not to answer (.8%, n=1); and 61.6% (n=77) were female. SNA: The average number of close classmate connections increased from 4.7 (0-28) to 12.9 (0-39) at mid-program and to 19.7 (3-43) at graduation. A repeated-measures ANOVA (Bonferroni correction) revealed significant increases in scores: matriculation-mid-program - FFW-coping (1.6, .2-3.0, p=.024), FFW-leisure (3.2, .8-5.5, p=.004), FFW-self-care (2.3, .7-3.9, p=.002), PC-efficacy (2.1, 1.3-2.9, p\u3c.001), PC-optimism (1.6, .5-2.6, p=.002); mid-program-graduation - PC-efficacy (2.3, 1.5-3.0, p\u3c.001), PC-hope (2.4, 1.4-3.4, p\u3c.001), PC-resilience (1.7, .7-2.7, p\u3c.001); matriculation-graduation - FFW-leisure (3.5, .6-6.4, p=.013), PC-efficacy (4.4, 3.3-5.4, p\u3c.001), PC-hope (3.4, 2.4-4.3, p=\u3c.001), PC-resilience (2.2, 1.3-3.1, p\u3c.001), PC-optimism (2.0, 1.0-3.0, p\u3c.001). Conclusion Implementing a lifestyle medicine curriculum contributed to DPT graduates developing close connections among peers for support and friendship, being empowered with coping strategies to regulate responses and manage negative effects of life events, taking responsibility for self-care measures, and improving psychological capital to persevere confidently toward goals. Funding Funding was provided by the College of Allied Health Professions Interprofessional Education Grant and the Physical Therapy Program of the University of Nebraska Medical Center

“Dermal Dendritic Cells” Comprise Two Distinct Populations: CD1+ Dendritic Cells and CD209+ Macrophages

A key cell type of the resident skin immune system is the dendritic cell (DC), which in normal skin is located in two distinct microanatomical compartments: Langerhans cells (LCs), mainly in the epidermis, and dermal DCs (DDCs), in the dermis. Here, the lineage of DDCs was investigated using monoclonal antibodies and immunohistology. We provide evidence that “DDC” comprise at least two major phenotypic populations of dendritic-appearing cells, immature DC expressing CD1, CD11c and CD208; and macrophages expressing CD209, CD206, CD163, and CD68. These data suggest that dermal dendritic-appearing macrophages comprise a novel part of the innate immune response in the resident skin immune system

La dieta en las enfermedades alérgicas caninas

Las dermatitis alérgicas son, con diferencia, las principales enfermedades dermatológicas observadas en perros (Gagné, 2021). Las alergias alimentarias son un tipo de reacción adversa a los alimentos (RAA). Esta se caracteriza por ser inmunomediada; en el caso en que no lo sea, hablamos entonces de intolerancia alimentaria. Los perros que sufren RAA presentan mayoritariamente cuadros cutáneos. El signo clínico que más se observa es el prurito. Cuando un paciente acude a consulta con sintomatología pruriginosa, hay que proceder a un trabajo de descarte ya que existen muchas patologías causantes de prurito. Una vez eliminadas las otras causas, pensamos en una alergia: RAA, dermatitis atópica o hipersensibilidad a la picadura de pulgas. Existen diferentes métodos para poder diagnosticar las RAA, sin embargo, a través de varios estudios y, en nuestro caso, del análisis de 10 casos clínicos en la consulta de Dermatología, se pone de manifiesto que el único método efectivo es el de valorar la respuesta a una dieta de eliminación. Se observa gran confusión en cuanto a cómo determinar qué tipo de dieta se debe administrar a un paciente alérgico y como establer si un perro es alérgico al alimento. Por otra parte, se observa que, dietas presentadas como hipoalergénicas, inducen reacciones cutáneas anómalas en algunos pacientes, para los cuales no funcionan como dietas de eliminación.Los propietarios tienen un papel esencial en el buen desarrollo del diagnóstico de RAA mediante el método de la dieta de eliminación. Para que esta sea lo más efectiva posible, es muy importante que los veterinarios comuniquen bien con los tutores de sus pacientes, que entiendan sus dudas y que tengan las mejores herramientas posibles como un buen conocimiento de los tipos de productos que podrían servir en las dietas de eliminación (Tiffany et al., 2019)<br /

Student wellness during curriculum implementation of a lifestyle medicine approach within the Social-Ecological Model: a longitudinal study

Purpose The student-life experience is an ideal time to implement lifelong wellness behaviors needed for the professional role. The ongoing effects of the COVID pandemic have amplified the need for Doctor of Physical Therapy (DPT) educational programs to train an emerging workforce that can, through personal wellness, withstand the stressors of personal and professional lives. The study purpose is to: a) evaluate the change in student wellness from matriculation to mid-program to completion after implementation of a curriculum based on a lifestyle medicine approach within the Social-Ecological Model, and b) compare student wellness between cohorts that matriculated before and during the COVID pandemic. Methods/Description We implemented curricular interventions to promote student wellness and professional formation in the fall of 2019. Students first study healthy behaviors for themselves, followed by learning experiences around the professional formation as a healthy clinician, and finally health promotion for patients and communities. We also modified program policies (e.g., holistic admissions, attendance, tutoring, faculty advising) to be student-centered. Three student cohorts in the DPT program at a Midwest academic medical center agreed to participate. Cohort19 (C19, n = 66) matriculated in 2019, Cohort20 (C20, n=66) in 2020, and Cohort21 (C21, n=64) in 2021. Participants completed the Five Factor Wellness Inventory (FFW) at matriculation into the 32-month program. C19 and C20 completed the FFW midway through the program as planned. Remaining assessments will occur as scheduled at program midpoint and completion. The FFW inventory is the gold standard for identifying central factors for healthy living. The wellness score is composed of 5 “Selfs” (Essential, Social, Creative, Physical, and Coping) made up of 17 domains where the acceptance of personal responsibility and choice have positive effects on well-being. A one-way ANOVA was used to compare FFW scores of all 3 cohorts at matriculation. Paired sample t-tests were used to compare results of C19 and C20 at mid-program and over time (matriculation and mid-program). Results/Outcomes The curriculum revisions and policy modifications were implemented in fall 2019. There were unexpected COVID-directed health measures beginning in March 2020 resulting in a move to more virtual activities that were not planned in our curriculum and new pressures related to student wellness. Three cohorts of DPT students (C19, C20, C21) completed the FFW at matriculation. Additionally, C19 and C20 completed the FFW at mid-program. The response rate for the FFW across all cohorts and time points was 100%. Comparison across cohorts: At matriculation, one of 17 FFW domain scores was found to be significantly different across cohorts. The score for the exercise domain (physical self) was significantly higher (p=.046) for C19 (pre-COVID) compared to C21. However, at mid-program for C19 and C20 (both during COVID), scores were significantly lower in C19 compared to C20 in five domains: culture (p=.004) and gender identification (p=.005) (essential self), nutrition (p=.037) (physical self), leisure (p=.020) and self-worth (p=.035) (coping self). Comparison over time: A comparison of FFW scores between matriculation and mid-program for C19 showed a significant increase in self-care scores (p\u3c.001 ) (essential self). For C20 scores significantly increased at mid-program in the coping self domains of leisure (p=.001) and stress management (p=.025), friendship (p=.018) (social self), and nutrition (p=.001) (physical self) leading to a significant improvement in overall FFW score (p=.037). Conclusions To optimally train a health workforce, faculty are studying methods to promote student wellness as part of student professional formation along with the curriculum for the PT of the future. Our study shows higher wellness scores in several domains in cohorts matriculating after COVID compared to before. This finding is interesting as it could indicate students entering professional school were potentially more prepared in terms of healthy behaviors due to the public health news surrounding COVID . Our study shows that components of student wellness may be improving due, in part , to the curriculum interventions and policies supporting wellness. These are important findings especially given the intended curriculum delivery was interrupted by directed health measures beginning in March 2020. The future direction is to continue to assess outcome measures through the end-of-program. In addition, we are analyzing additional measures of wellness such as psychological capital of hope, confidence, resilience and optimism, and social capital measuring connections with others for a sense of belonging. Our curriculum and supportive policies could be a model to demonstrate how student wellness can be aligned with a lifestyle medicine approach within the individual, relationship, community and society components of the Social-Ecological Model. REFERENCES Bezner JR. Promoting Health and Wellness: Implications for Physical Therapist Practice. Phys Ther. 2015; 95(10):1433-1444. Brooke, T., Brown, M., Orr, R., & Gough, S. (2020). Stress and burnout: exploring postgraduate physiotherapy students’ experiences and coping strategies. BMC Medical Education, 20(1), 1-11. Centers for Disease Control.Social Ecological Model. https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html; Materials developed by Dahlberg LL, Krug EG. Violence: a global public health problem. In: Krug E, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, eds. World Report on Violence and Health.Geneva, Switzerland: World Health Organization; 2002:1-21. Coffey DS, Eliot K, Goldblatt E, et al. A multifaceted systems approach to addressing stress within health professions education and beyond [discussion paper]. National Academy of Medicine website. https://nam.edu/wp-content/uploads/2017/01/Multifacted-Systems-Approach-to-Addressing-Stress-Within-Health-Professions-Education-and-Beyond.pdf Published January 30, 2017. Dean D. (2009) Physical therapy in the 21st century (Part II): Evidence-based practice within the context of evidence-informed practice, Physiotherapy Theory and Practice, 25:5-6, 354-368. Douris, P. C., D\u27Agostino, N. A., Mathew, S. K., Anderson, R. P., Bauman, K. M., Tiangtham, S. A., ... & Hall, C. A. (2020). The physiological and psychological effects of the first year of an entry-level physical therapist education program on students. Journal of Physical Therapy Education, 34(3), 186-191. Myers JE, Sweeny TJ. Five Factor Wellness Inventory. Mindgarden https://www.mindgarden.com/99-five-factor-wellness-inventory. Accessed 3.15.202

Actinomyces israelii May Produce Vulvar Lesions Suspicious for Malignancy

Background. We present a case of Actinomyces israelii causing vulvar mass suspicious for malignancy in a postmenopausal woman. Case. A 60 year-old woman presented due to a firm, nonmobile, 10 cm vulvar mass, which had been rapidly enlarging for 5 months. The mass was painful, with localized pruritus and sinus tracts oozing of serosanguinous fluid. Biopsy and cultures revealed a ruptured epidermal inclusion cyst containing granulation tissue and Actinomyces israelii. Conclusion. Actinomyces israelii may produce vulvar lesions that are suspicious for malignancy. Thus, biopsies and cultures are both mandatory while evaluating vulvar masses suspicious for malignancy