Nontraditional Program Research Articles

Evaluating Neck-Strengthening Protocols to Reduce the Incidence of Traumatic Brain Injury: Traditional vs. Nontraditional Neck-Strengthening Techniques.

Schroeder, LH, McDaniel, AT, Wang, Y, Dickens, GM, Pantani, V, and Kubinak, H. Evaluating neck-strengthening protocols to reduce the incidence of traumatic brain injury: traditional vs. nontraditional neck-strengthening techniques. J Strength Cond Res 38(7): 1266-1274, 2024-A common cause of traumatic brain injuries (TBIs) is the head's kinematic response to rapid movement, which can be reduced with dynamic neck strengthening. This study aimed to determine the most effective neck-strengthening program by comparing a traditional and nontraditional program. Isometric neck strength was assessed in 32 subjects randomly assigned to one of the traditional and nontraditional neck-strengthening programs. The nontraditional program used a novel neck-strengthening device. After weeks 6 and 10 of training, isometric neck strength was reassessed. With the collected data, linear mixed models were established to compare the changes in neck strength between the 2 groups during the 10-week training period. Statistical analysis results suggest that, for both cervical extension (CE) and cervical flexion (CF), subjects in the novel neck-strengthening device group had a significantly higher gain of strength during the 10 weeks than the traditional group. With test statistics of -2.691 and -3.203 and corresponding 2-sided p -value of 0.01289 and 0.003889, respectively, we conclude that there is a statistically significant difference in the linear slopes of increase for both CE and CF between the 2 groups. As to left cervical lateral flexion and right cervical lateral flexion, the novel neck strength group had increased strength gains compared with the traditional group. However, the increase was not enough to demonstrate significant findings. Results were considered significant at p < 0.05. The results of this study show that the novel neck-strengthening device may be an effective mechanism for preventing mild TBIs.

Applying User-Centered Design and Implementation Science to the Early-Stage Development of a Telehealth-Enhanced Hybrid Cardiac Rehabilitation Program: Quality Improvement Study.

Cardiac rehabilitation (CR) is an evidence-based intervention that improves event-free survival in patients with cardiac conditions, yet <27% of all eligible patients use CR in the United States. CR is traditionally delivered in clinic-based settings where implementation barriers abound. Innovative nontraditional program designs and strategies are needed to support widespread CR uptake. This study aimed to demonstrate how user-centered design (UCD) and implementation science (IS) principles and methods can be integrated into the early-stage development of nontraditional CR interventions. As part of a NewYork-Presbyterian Hospital (NYPH) quality improvement initiative (March 2020-February 2022), we combined UCD and IS principles and methods to design a novel home- and clinic-based telehealth-enhanced hybrid CR (THCR) program. We co-designed this program with multilevel stakeholders using an iterative 3-step UCD process to identify user and contextual barriers and facilitators to CR uptake (using semistructured interviews and contextual inquiry [step 1]), design an intervention prototype that targets contextual and user factors and emulates the evidence-based practice (through design workshops and journey mapping [step 2]), and review and refine the prototype (according to real-world usability testing and feedback [step 3]). The UCD process was informed by the Theoretical Domains Framework and Consolidated Framework for Implementation Research. At step 1, we conducted semistructured interviews with 9 provider- and system-level stakeholders (female: n=6, 67%) at 3 geographically diverse academic medical centers, which revealed behavioral (eg, self-efficacy and knowledge) and contextual (eg, social distancing guidelines, physical space, staffing, and reimbursement) barriers to uptake; hybrid delivery was a key facilitator. Step 2 involved conducting 20 design workshops and 3 journey-mapping sessions with multidisciplinary NYPH stakeholders (eg, digital health team, CR clinicians, and creative director) where we identified key design elements (eg, mix of clinic- and home-based CR and synchronous remote patient monitoring), yielding an initial THCR prototype that leveraged NYPH's telehealth infrastructure. At step 3, we conducted usability testing with 2 CR clinicians (both female) administering home-based sessions to 3 CR patients (female: n=1, 33%), which revealed usability themes (eg, ease of using remote patient monitoring devices or a telehealth platform, technology disruptions, and confidence in using the telehealth platform to safely monitor patients) and design solutions (eg, onboarding sessions, safety surveys, and fully supervised remote sessions) to be included in the final THCR prototype. Combining UCD and IS methods while engaging multidisciplinary stakeholders in an iterative process yielded a theory-informed THCR program targeting user and contextual barriers to real-world CR implementation. We provide a detailed summary of the process and guidance for incorporating UCD and IS principles and methods into the early-stage development of a nontraditional CR intervention. The feasibility, acceptability, appropriateness, and usability of the final THCR prototype is being evaluated in an ongoing study.

Comparing Work Readiness for Nursing Students Enrolled in a Concept-Based Versus Medical-Based Curriculum.

Between 2015 and 2018, nurse faculty replaced a medical-based curriculum with a concept-based curriculum. NCLEX®-RN pass rates and a nontraditional program quality indicator assessed the association of different curricula on four dimensions of work readiness. Three cohorts of senior baccalaureate nursing students ( N = 199), who enrolled in either the medical-based curriculum or the concept-based curriculum, completed the Walker et al. Work Readiness Survey for Graduate Nurses. Survey results revealed significant differences between the curriculum types but no differences in NCLEX-RN pass rates. Using nontraditional quality indicators may identify best practices that foster student readiness for practice.

Students Transitioning to a Non-traditional Doctoral Program: Identifying Success Factors Promoting Doctoral-level Academic Success

Students Transitioning to a Non-traditional Doctoral Program: Identifying Success Factors Promoting Doctoral-level Academic Success

Assessing the Efficacy of a Character Development Program in Non-Traditional Undergraduate Students

The purpose of this quantitative ex post facto study was to examine if there is a significant difference in mean moral judgment levels of first year undergraduate students after participating in a character development program at a non-traditional program in a university in the southwestern United States. This study included new non-traditional students matriculating between October 2019 and June 2020. The measurement instrument for the study was the Defining Issues Test-2 (DIT-2). Pre- and post-test DIT-2 archival data was retrieved from the study site for the two assessments. The independent variable was the character education program of study, and the dependent variables were the difference in the mean scores from the DIT-2. Paired t-tests were used to determine if a statistical difference existed after character training. The positive mean change in post-conventional thinking scores, P (M = 2.24), N2 (M = 1.70), were not significantly different than zero (P score p = .203, N2 score p = 0.203). The positive mean change in scores for the lowest level of moral reasoning, PI, (M = 0.15) was not significantly different from zero (p = 0.912). The predominant moral schema used by the students, maintaining norms (MN) demonstrated a negative mean change (M = -1.35) but it was not significantly different from zero (p = 0.348). Therefore, the character program of study at the site did not increase moral reasoning levels. The results are significant, as they help to define what works and what does not in non-traditional student ethical development.

Impact of a Nontraditional Ambulatory Clinic Nurse Residency Program.

This study sought to answer how implementing a nontraditional ambulatory registered nurse (RN) residency program impacted confidence, role transition, and retention rates of nursing staff in the outpatient clinical setting. Results demonstrated that the program improved RNs' confidence in communication and perceived preparedness to complete individual professional responsibilities. As a result of this study, implementing a nontraditional RN ambulatory residency program should be considered to support RNs new to the ambulatory setting.

Development and perception of a multiple-site nontraditional postgraduate year 1 residency program.

To describe the development and perception of a multiple-site nontraditional postgraduate year 1 (PGY1) residency program from the resident and preceptor perspectives. A multiple-site nontraditional residency program was developed within a Florida health system to increase the education level and clinical responsibilities of hospital staff pharmacists. The program provided pharmacists interested in residency training an opportunity to pursue postgraduate credentials while maintaining their current position. The nontraditional residency program was implemented at 1 site and subsequently expanded across multiple affiliated hospital sites due to its success. Pharmacists currently working in the health system's network of hospitals for at least 2 years were eligible to enter into the 24-month program after successfully completing the application, interview, and matching process. The number of nontraditional resident positions available has varied by residency year and site. Offering this opportunity has increased the clinical knowledge of pharmacists, exposed them to a variety of practice areas, and increased their departmental contributions. In response to a request for feedback regarding the multiple-site nontraditional program, both residents and preceptors have reported benefits and challenges. Adequate resources are needed and a number of factors must be considered in developing a multiple-site nontraditional PGY1 residency program. Although there are potential challenges, it is perceived that the benefits justify continuation of the program.

Elusive expectations for a novel program design: Contrast between program intentions and student recruitment and retention

AbstractBackgroundStudent recruitment and retention are essential to the vitality of any program, but are often difficult to achieve, particularly for new and/or alternative programs.AimsThis qualitative study explores the factors that influence students' enrollment in, and subsequent decision to continue in or leave a pilot on‐campus program within a large traditional university. The program design integrated nontraditional components that likely have not previously been combined in this form.MethodsStudents (N = 33) were surveyed and interviewed throughout the year to explore their reasons for enrolling the program and reasons why they decided to continue with the program or leave. Constant comparative method for naturalistic inquiry was used to identify themes.ResultsResults showed that many of the factors influencing students' decisions to join, stay, or leave, such as university reputation and perception of program fit, were similar to those for traditional programs. However, program novelty and unique program design elements also contributed to students' decision to join, stay, or leave the program. Students' uncertainty about transfer of credit, grading, and how to succeed in the program also contributed to these decisions. The very traits some students found most attractive were unattractive to others. We contend that new, nontraditional programs need to ensure institutional alignment, provide scaffolding to support new students in acclimating to nontraditional program aspects, and align recruitment materials with program aspects to attract diverse students for whom the program is a good fit. Implications, limitations, and future research are discussed.

Access to the School Breakfast Program Is Associated with Higher Attendance and Test Scores among Elementary School Students

The School Breakfast Program (SBP) has grown and evolved substantially since its inception, yet relatively little is known about its impact on school engagement and academic outcomes. The purpose of this study is to estimate the impact of the SBP on school attendance and standardized test scores, as well as how impacts differ among student subpopulations and between traditional and nontraditional program models. The study uses administrative data from ∼1000 Wisconsin elementary schools during 2009-2014, including almost all public elementary schools in the state except those in Milwaukee Public School District. Over the 5-y period, 168 schools in our sample introduced a new SBP and/or changed the location of breakfast (classroom or cafeteria) or the payment structure. The impact of breakfast availability and type was evaluated using multivariable regression models with school fixed effects and extensive demographic controls, leveraging within-school changes in SBP availability and type. Implementing the SBP was associated with a 3.5-percentage-point reduction in the percentage of students with low attendance and an increase of 0.08 SD in normalized reading scores among likely-participant boys (P=0.015), with no impact among girls. When breakfast was offered free to all students, the probability of low attendance was 3.5 percentage points lower than with traditional SBP for a broad cross-section of students (P<0.001), and math and reading scores were 0.07 and 0.04 SD higher among the higher-income sample, respectively (P=0.001 and P=0.035, respectively). When breakfast was offered in the classroom, neither attendance nor reading scores differed relative to cafeteria-based SBP, whereas math scores among likely-participant boys were 0.05 SD lower (P=0.045). Offering breakfast at school can modestly improve educational engagement and performance, but benefits differ across children and by program structure. Universally free breakfast appears particularly beneficial to both attendance and test scores.

Rethinking medical school curriculum: An exploratory study of medical student mental health in a nontraditional program

Context: Medical student mental health has been studied extensively, yet little is known about students in nontraditional medical school programs. Aims: The goal of this study was to assess the frequency of symptoms of mental illness in the first, second, and third class at a new, nontraditional medical school. Settings and Design: An exploratory self-reported study was conducted in students enrolled at recently opened University of Texas at Austin Dell Medical School (n = 147) in April 2019. Methods: The Patient Health Questionnaire-9 was selected as the outcome measure for the study which includes subscales for depression, thoughts of suicidal ideation or self-harm, anxiety, and posttraumatic stress disorder (PTSD). Qualitative interview data were collected to better understand perceived barriers to engaging with university mental health services. Statistical Analysis Used: Descriptive statistics was used for the univariate analysis with Chi-square, and logistic regression models were used for the bivariate analysis. Results: One hundred and twenty of the 187 students responded to the survey, and the response rate was 81.6%. Overall, 16 (13.3%) of medical students were screened positive for depression, 14 (11.7%) for anxiety, and 4 (3.4%) for PTSD. There were 7 (5.8%) of students who reported suicidal ideation or thoughts of self-harm. The second year students reported higher rates of mental health illnesses when compared to other classes. Common barriers to using mental health services were lack of time (n = 52, 63.4%) and stigma (n = 13, 15.9%). The response rate for the quantitative and qualitative data was 120 (81.6%) and 82 (68.3%), respectively. Conclusions: Attending a nontraditional medical school program may contribute to a low prevalence of anxiety (11.7%). Since the 2nd year clinical medical students had the highest rates of mental illness and reported lack of time as the largest barrier, interventions should focus on providing flexible timing of mental health services.

Surrendering to Gender in Education? Complacency and the Woman Leader

The purpose of our study was to better understand the role of gender performance for aspiring school leaders through a reflection of their journey through the administrative pipeline. The transformation of professional aspirations throughout and following the certification process and during employment was also analyzed. Also, the appealing factors of a nontraditional administrative preparation program were evaluated. Using heuristic qualitative methods, women graduates of and expedited certification for educational leadership program participated in focus groups and a select group returned for individual interviews. Coding was employed to analyze the data. Our participants entered into school leadership as a result of an external catalyst, a mentor, which inspired a process of self-empowerment that led to their pursuit of administrative certifications and positions. This process was cyclical. The nontraditional program and its appealing characteristics added to the realization of their current leadership positions. The recommendations we make in the areas of policy, research, and practice, each speak to a need for enhanced encouragement, by diverse means, of women school leaders at the national, state, and district levels.

A New Mentorship Model: The Perceptions of Educational Futures for Native American Youth at a Rural Tribal School

A case study utilizing a mixed methods design concluded that a nontraditional-style mentorship intervention model for at-risk, Native American youth at a tribal school in South Dakota has positively impacted the youths’ perspectives of their educational futures. The mentorship intervention model was social work-rooted, theory-driven, and culturally-sensitive. The literature review discussed the lack of research for this oppressed group with mentorship programming and provided comprehension to advance mentorship program in rural reservation settings. Research knowledge of this at-risk group's social problems, historical trauma experience, and mentorship programs advanced the success of this intervention. By focusing on the strengths and needs of the tribal school, a partnership between a tribal school and two universities formed to establish a non-traditional mentorship program that positively impacted the youth and benefited the school’s strategic goals. Comparing the mixed method data of the Native American tribal rural school target youth group to a non-Native American, non-tribal, rural school youth group, findings justified the need for this intervention as well as supported the positive impact that the intervention has had on the Native American youths' educational perspectives.

The Learning Environment Counts: Longitudinal Qualitative Analysis of Study Strategies Adopted by First-Year Medical Students in a Competency-Based Educational Program.

The move toward competency-based education will require medical schools and postgraduate training programs to restructure learning environments to motivate trainees to take personal ownership for learning. This qualitative study explores how medical students select and implement study strategies while enrolled in a unique, nontraditional program that emphasizes reflection on performance and competence rather than relying on high-stakes examinations or grades to motivate students to learn and excel. Fourteen first-year medical students volunteered to participate in three, 45-minute interviews (42 overall) scheduled three months apart during 2013-2014. Two medical educators used structured interview guides to solicit students' previous assessment experiences, preferred learning strategies, and performance monitoring processes. Interviews were digitally recorded and transcribed verbatim. Participants confirmed accuracy of transcripts. Researchers independently read transcripts and met regularly to discuss transcripts and judge when themes achieved saturation. Medical students can adopt an assessment for learning mind-set with faculty guidance and implement appropriate study strategies for mastery-learning demands. Though students developed new strategies at different rates during the year, they all eventually identified study and performance monitoring strategies to meet learning needs. Students who had diverse learning experiences in college embraced mastery-based study strategies sooner than peers after recognizing that the learning environment did not reward performance-based strategies. Medical students can take ownership for their learning and implement specific strategies to regulate behavior when learning environments contain building blocks emphasized in self-determination theory. Findings should generalize to educational programs seeking strategies to design learning environments that promote self-regulated learning.

The NORTH CLINIC Experience: Patient Experiences of Participating in a Novel and Non-traditional Cardiac Rehabilitation Program

The NORTH CLINIC Experience: Patient Experiences of Participating in a Novel and Non-traditional Cardiac Rehabilitation Program

Exploring the perceptions of male nursing students enrolled in an accelerated baccalaureate degree nursing program

Objective: To gain understanding about the factors that drew men to an accelerated baccalaureate degree nursing program, the challenges they faced, and the support they need to complete the program. Methods: This qualitative descriptive study explored the perceptions of male nursing students enrolled in an accelerated baccalaureate degree nursing program. The study design used semi-structured questions in a focus group format comprised of a sample of male nursing students currently enrolled in the ABSN program of a southeastern academic health sciences center. Relatively few studies have examined male nursing students, and those enrolled in a non-traditional program typically have unique circumstances. The significance of this study to nursing science is that the results will add to the growing body of knowledge regarding the recruitment and retention of males into nursing schools. Results: Following data analysis, four themes emerged from the participant responses related to sacrifice, knowledge gain, organization for survival, and opportunities for men in nursing. Conclusions: The results of this study highlight the attraction of accelerated BSN programs since many men opt for nursing as a second career choice. Results of this study may be used to improve recruitment and retention of male nursing students.

Teacher Candidate Dispositions: Perspectives of Professional Expectations

This study describes a programmatic effort to examine dispositions perceptions of teacher candidates entering the profession. Study participants included 114 master's level teaching candidates in their first semester of a nontraditional teacher education program. Teacher candidates scored themselves on a department disposition rubric designed to evaluate their professional behaviors and wrote reflective rationales to support their scoring. Results indicated that candidates positioned themselves as no fault, accepts fault, and assigns fault in writing their rationales. These positions were used as lenses to analyze candidates' positioning in relation to the program and faculty expectations. Candidates' disposition performance rationales relied on their novice status, the demands of work and family, and an admitted minimalist approach to some course demands. Insights gained from the study may allow teacher education faculty to better understand and support candidates' dispositional growth and development.

Implementation of a nontraditional postgraduate year 1 pharmacy residency program

The development and implementation of a nontraditional pharmacy residency program at a Veterans Affairs medical center (VAMC) are described. The nontraditional pharmacy residency program at Lebanon VAMC was designed in accordance with the ASHP accreditation standard. The residency program was structured to meet staff needs without compromising patient care or significantly affecting the pharmacy services provided. The purpose statement, intended outcomes, and learning goals and objectives of the nontraditional pharmacy residency program were formulated to be equivalent to those of a traditional one-year pharmacy residency program, enabling practicing pharmacists to obtain similar overall learning experiences. The nontraditional residency program at Lebanon VAMC spans two years. The non-traditional program structure is based on a four- to six-week residency learning experience that alternates with a comparable time in the work schedule. Each required or elective learning experience ranges from four to six weeks. Longitudinal learning experiences may extend up to two years. One pharmacist was matched and began the residency in July 2012 as the inaugural nontraditional postgraduate year 1 (PGY1) pharmacy resident at Lebanon VAMC, the second institution to implement the nontraditional program within the Veterans Health Administration. The resident is expected to complete the program in June 2014 and remain committed to the Lebanon VAMC pharmacy service for a minimum of two years thereafter. A nontraditional PGY1 pharmacy residency program was successfully developed and implemented for pharmacists who aspire to complete residency training and improve their clinical, leadership, and preceptorship skills.

Pharmacists see positives in nontraditional residency programs

Hospital pharmacy departments that have successfully launched non-traditional residency programs for staff pharmacists say that the programs are a win for everyone involved. “I’m surprised more sites aren’t doing this,” said Melanie K. Kuester, residency programs coordinator at the Richard L. Roudebush Veterans Affairs Medical Center (VAMC) in Indianapolis. The Roudebush VAMC launched its nontraditional pharmacy postgraduate year 1 (PGY1) residency in 2009. Participants spend two years alternating between month-long rotations as residents and month-long stints at their regular job. Kuester said in March that two pharmacists have completed the nontraditional program and four are currently enrolled, with two scheduled to complete their final rotation this summer. Two more staff members are expected to begin the training in July. “Ideally, we would love all our pharmacy staff to do a residency,” Kuester said. She explained that residency training enhances pharmacists’ critical thinking skills and boosts their confidence as hands-on practitioners.

The impact of teacher preparation on student achievement in algebra in a “hard-to-staff” urban PreK-12-university partnership

Debate about teacher supply, demand, retention, and attrition has been renewed in recent years by an increased concern about the reduced numbers of prospective teachers entering teacher education programs, the high attrition rate of beginning teachers, and the resulting teacher shortages. U.S. schools are experiencing teacher shortages, especially in low-income urban areas, because of increased school enrollment, teacher retirement, reduction in class size, teacher attrition, and turnover related to low salaries, job dissatisfaction, and lack of administrative support and influence over decision-making. Recently, the increased interest in teacher quality has been the topic of debate for policy-makers, the public, and the educational community. The purpose of this study was to determine if a nontraditional teacher preparation program, the Transition To Teaching program, was a viable way to ease the teacher shortages in a high poverty, urban U.S. school district, and at the same time, to evaluate the impact of teacher training on students' academic achievement. The results of this study afford evidence that the students taught by 1st-year, alternatively prepared teachers achieved as well as or better than their peers taught by traditionally certified 1st-year teachers, according to student achievement in mathematics, specifically Algebra I.

Preparing First-Time Leaders for an Urban Public School District: An Action Research Study of a Collaborative District–University Partnership

This article reports the results for the first cycle of an action research study about a district–university partnership. Two district facilitators and two university facilitators co-constructed a principal preparation program for an inner-city school district to help prepare the next generation of building leaders. Twenty-two students participated in the 15-month nontraditional program. The study found that in preparing first-time school leaders, the most helpful experiences were those that developed self-understanding and readiness for the role change. New instructional techniques and the full-time residency facilitated this earning. It also found that the partnership, though providing new and exciting opportunities to deviate from the traditional preparation model, needed further development.