Recommendations For Best Practices Research Articles

AIUM Official Statement: Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers and Equipment Between Patients as Well as Safe Handling and Use of Ultrasound Coupling Gel.

AIUM Official Statement: Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers and Equipment Between Patients as Well as Safe Handling and Use of Ultrasound Coupling Gel.

Staying Online in Uncertain Times: A Nationwide Canadian Survey of Pathology Resident Uses of and Adaptations to Online Learning During COVID-19.

Because of restrictions as a result of the COVID-19 pandemic, medical educators rapidly transitioned to an online curriculum for pathology resident education. The benefits and challenges of the shift to online learning, as well as strategies to maximize learning, are yet to be fully elucidated. To assess learner perception and satisfaction with the move to online learning. Understanding the benefits of online learning will allow future curricular changes to most effectively incorporate online learning. Understanding the common challenges will allow our current learning strategies to rapidly adapt and ideally mitigate these challenges as online learning is incorporated into medical education. This was a survey-based study distributed by email to pathology residents nationwide in Canada in anatomic pathology, general pathology, neuropathology, and hematopathology. Thirty residents participated, from anatomic pathology (n = 23; 76%), from general pathology (n = 5; 16%), and 1 participant each from hematopathology and neuropathology. All participants indicated that their program had transitioned to online learning at least in part. The majority of participants (n = 16; 53%) did not feel their pathology education was negatively affected by the transition to online learning; however, a significant minority (n = 6; 20%) felt their education had been negatively affected. Convenience and less intimidation were rated as benefits of online learning. Negative effects included technical issues and decreased engagement; we identified a number of strategies used by programs and pathology residents to mitigate these negative effects. Our survey points to a need to use adaptations and best-practice recommendations to maximize the benefits of online learning moving forward.

What Are Parents' Experiences With Their Child's Hearing Aid Use in the First 5 Years?

Parents are required to make informed choices for their children regarding the use of hearing amplification after hearing loss has been diagnosed. If parents choose a listening and spoken language approach for their child where the development of age appropriate spoken language is the parents' goal, then the early fitting and frequent use of hearing aids is crucial. Within the framework of family centered care, parents have the ultimate responsibility for supporting their child's hearing aid use. However, few studies have focused on parents' insights regarding the aspects that shape hearing aid use in the early years. Thus the aim of this study was to explore parents' firsthand experiences with their child's hearing aid use in the first 5 years. Understanding parents' insights will help improve service provision to optimize outcomes for children with hearing loss. The study utilized a prospective qualitative design to explore parents' firsthand experiences with their child's hearing aid use. Purposive sampling was used to recruit 12 parents who participated in semi-structured interviews. Parents' responses were analyzed using thematic analysis. Three overarching themes were conceptualized, namely: (a) towards hearing aids - journey into the wilderness; (b) adjusting to hearing aids - it's the journey, not the destination; and (c) support for my child's hearing aid use - it's not where you are going, it's who you have beside you. Each theme was further divided into categories and subcategories. This study identified that parents have much to contribute to service providers' understanding regarding the aspects that shape consistent hearing aid use in young children. Parents shared many insights such as the emotionally daunting nature of the first few months post hearing loss confirmation, the influence of family support, and the importance of building connections and understanding about hearing loss and hearing aid use within their social networks. Based on these insights, the authors provide recommendations for clinical best practice that draw upon key principles of family centered care. They consist of practical suggestions including strategic support to overcome less optimal hearing aid use and ways to facilitate parent support within their familial and communal networks.

Racial and ethnic differences in the use of lumbar imaging, opioid analgesics and spinal surgery for low back pain: A systematic review and meta-analysis.

There is a substantial gap between evidence and clinical care for low back pain (LBP) worldwide despite recommendations of best practice specified in clinical practice guidelines. The aim of this systematic review was to identify disparities associated with race or ethnicity in the use of lumbar imaging, opioid analgesics, and spinal surgery in people with LBP. We included observational studies which compared the use of lumbar imaging, opioid analgesics, and spinal surgery for the management of non-serious LBP between people from different racial/ethnic populations. We searched in MEDLINE, EMBASE and CINAHL from January 2000 to June 2021. Risk of bias of included studies was appraised in six domains. For each type of care, we pooled data stratified by race and ethnicity using random effects models. We identified 13 eligible studies; all conducted in the United States. Hispanic/Latino (OR 0.69, 95%CI 0.49-0.96) and Black/African American (OR 0.59, 95%CI 0.46-0.75) people with LBP were less likely to be prescribed opioid analgesics than White people. Black/African Americans were less likely to undergo or be recommended spinal surgery for LBP (OR 0.47, 95%CI 0.33-0.67) than White people. There was a lack of high certainty evidence on racial/ethnic disparities in the use of lumbar imaging. This review reveals lower rate of the use of guideline-discordant care, especially opioid prescription and spinal surgery, in racial/ethnic minority populations with LBP in the United States. Future studies in other countries evaluating care equity for LBP are warranted. PROSPERO Registration ID: CRD42021260668. This systematic review and meta-analysis revealed that people with low back pain from the minority racial/ethnic backgrounds were less likely to be prescribed opioid analgesics and undergo spinal surgery than the majority counterparts. Strategic interventions to improve the access to, and the value of, clinical care for minority populations with low back pain are warranted.

A literature review of palm leaf manuscript conservation—Part 2: historic and current conservation treatments, boxing and storage, religious and ethical issues, recommendations for best practice

The closure of the British Library during the 2020–2021 COVID-19 pandemic allowed the conservation department to undertake a treatment review of the conservation of palm leaf manuscripts in order to make better-informed decisions about the treatment of these complex objects. As part of the review a questionnaire was posted in 2020 to the Global Conservation Forum asking about the treatment of palm leaf manuscripts by others in the field. This two-part Literature Review uses the available literature and the survey results to address the wide range of issues inherent in the practical conservation of palm leaf materials. Part 1 began with an historic overview of palm leaf manuscripts and their production, leaf preparation methods, manuscript materials and media, palm leaf manuscripts at the British Library and the common types of damage found in such manuscripts. Part 2 details historic treatments and current conservation techniques as informed by our review and survey, as well as storage, religious and ethical issues. It concludes with two decision-making flowcharts, and our practical recommendations for conservators. The authors wish to share the collated information as widely as possible and help create greater continuity and consistency in palm leaf manuscript conservation by presenting recommendations for best practice for conservators who treat these amazing objects.

Numerical Simulation of Phosphine Movement in Bulk-Stored Grain

Highlights Develop a CFD model that reveals the detailed mechanisms of phosphine movement in bunkers. Evaluate factors that impact phosphine distribution in grain bunkers. Provide recommendations for best management practices for phosphine fumigation in bunkers. Abstract. Bunker storage is an inexpensive and, thus, popular method for medium- and long-term storage of wheat. To control insect infestations in bunker storage, phosphine (PH3) fumigant, released from aluminum phosphide (AlP) tablets, is commonly used, especially in Australia. For fumigation to be effective, a lethal concentration of PH3 throughout the bunker must be ensured. Because bunkers are exposed to ambient conditions, temperature gradients are created throughout the bunker, resulting in natural convection currents that move PH3 from areas around the fumigation points to the entire bunker. This research used computational fluid dynamics (CFD) simulation to investigate the effect of natural convection on fumigation in bunkers. The model was validated against published benchmarks and a field experiment with a full-scale bin with sorption and leakage. The effects of PH3 release points location, bunker shape, bunker orientation, leakage, sorption, ambient temperature fluctuation, and PH3 motion in 3D were studied. Results agreed well with the experimental data and provided various recommendations for best management practices for PH3 fumigations in bunkers. Results showed that diffusion and natural convection solely are insufficient in spreading out PH3 within bunkers. Further research is needed on the effects of tarpaulin billowing in relation to PH3 behavior. Keywords: Bin, Bunker, CFD, Fumigation, Natural convection, Phosphine, Porous media, Simulation, Sorption, Species transport, Wheat.

Avoiding cognitive bias : example of quantified assessment of muscle strength

Optimizing treatments requires the prevention of diagnostic errors. The use of shortcuts, cognitive biases, may lead to errors of judgement that can impair clinical reasoning and distort decision-making. Objective, quantifiable and comparable assessment is a safeguard against this, and for instance force quantification is used for this purpose. We will present here the use of hand-held dynamometers with recommendations for best practice as well as simple but essential tools for interpreting the results. Indeed, the use of these easy-to-use dynamometers requires rigour to ensure the quality of measurements and data analysis by/for the clinician. The use of this equipment should be widely promoted and democratized in informed clinical practice.

An objective comparison of speech intelligibility and quality of hearing aid of different companies

Abstract Purpose: This study aimed to verify the intelligibility and quality of hearing aid-processed speech across companies through objective measures. The output of hearing aids programmed to different prescriptive formulae (Company fit, NAL NL 1, NAL NL 2, and DSLv5) across companies (Company I, Company II, Company III, Company IV, and Company V) were recorded and stored in the sound level meter connected to the manikin. Materials and Methods: Offline analysis of speech quality of the recorded speech was done using the Hearing Aid Speech Quality Index (HASQI), the intelligibilty was measured using the Hearing Aid Speech Perception Index (HASPI) and Speech Intelligibility Index (SII), and Long-Term Average Speech Spectrum (LTASS) was used to measure the spectral composition of speech. Results: When the companies are compared, the hearing aid of Company V showed significantly higher SII values for all prescriptive formulae indicative of better speech intelligibility provided by Company V hearing aids. In terms of speech quality, all the hearing aids showed similar HASQI values. Conclusions: The reasons for each of these findings are highlighted and recommendations for best practices on the use of objective measures for verifying the hearing aid output in clinical setups are suggested.

An Explanation of Path Analysis and Recommendations for Best Practice

An Explanation of Path Analysis and Recommendations for Best Practice

ISP good clinical practice recommendations for gum care.

Oral health is vital for the general well-being, overall body health and the quality of life throughout our lifetime. Most of the oral diseases and conditions are largely related to the maintenance of oral hygiene, lacking that people suffer from diverse oral diseases at different times in their life. With greater life expectancy, the individuals have teeth involved with periodontal diseases that would not only require professional care but also home gum care for them to last a lifetime. Indian Society of Periodontology (ISP) has recognized the need for systematic documents to update everyday clinical practice of general dental practitioners and have provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral healthcare delivery across the country. The current set of clinical practice recommendations focused to "Gum Care for All", is aimed at emphasizing and enhancing the awareness regarding oral health promotion, maintenance, and disease prevention. Twenty-five subject matter experts from across the nation, prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three distinct sections, namely pretherapeutic, therapeutic, and post therapeutic, to provide guidance during the respective phases of patient management and may serve as a quick and concise reference to the readers. The guidelines shall provide the distinct definitions, signs and symptoms, treatment required; recall visit specifications for plausible clinical case situations, home care advice regarding maintenance of oral hygiene including information on brushing technique, care and change of brush, use of interdental aids, and mouthwashes, etc. The document should advocate and guide the combined efforts of general dentists, and the population at large toward an empowered, evidence based, integrated, and comprehensive oral health care, which shall enhance the healthful functioning and longevity of the dentition and general health of the individual.

Best-practice recommendations to inform general practice nurses in the provision of dementia care: a Delphi study.

Worldwide, responsibility for dementia diagnosis and management is shifting to primary care, in particular to the general practitioner (GP). It has been acknowledged that primary care nurses, working collaboratively with GPs, have a role in dementia care by utilising their unique knowledge and skills. However, there are no best-practice guidelines or care pathways to inform nurses in general practice on what best-practice dementia care comprises and how to implement this into their practice. This study identified the recommendations in the Australian guidelines for dementia management most relevant to the role of the nurse working in general practice. Seventeen experts active in clinical practice and/or research in primary care nursing in general practice participated in an online three-round Delphi study. All 17 participants were female with a nursing qualification and experienced in general practice clinical nursing and/or general practice nursing research. Five recommendations were identified as the most relevant to the role of the nurse in general practice. These recommendations all contained elements of person-centred care: the delivery of individualised information, ongoing support, including the carer in decision-making, and they also align with the areas where GPs want support in dementia care provision. This novel study identified best-practice dementia care recommendations specific to nurses in general practice. These recommendations will inform a model of care for nurses in the provision of dementia care that supports GPs and better meets the needs of people living with dementia and their carer(s).

INSIGHTS INTO TECHNOLOGY ADOPTION: A SYSTEMATIC REVIEW OF FRAMEWORK, VARIABLES AND ITEMS

The purpose of this study is to provide a comprehensive analysis of key variables and items in technology adoption frameworks. The study aims to identify strengths and weaknesses of different frameworks and provide recommendations for future research and best practices for implementation of technology adoption frameworks. The literature review reveals that the most commonly used technology adoption frameworks are the Technology Acceptance Model (TAM), Unified Theory of Acceptance and Use of Technology (UTAUT), Technology-Organization-Environment (TOE) Framework, Task Technology Fit (TTF), and Innovation Diffusion Theory (IDT). The study is significant as it will provide insights into factors influencing technology adoption and help researchers and practitioners better understand the adoption process. The study utilized a systematic literature review approach and identified 50 relevant articles published between 2012 and 2023. The findings revealed several key variables and items in technology adoption frameworks, including perceived usefulness, perceived ease of use, social influence, facilitating conditions, behavioral intention, organizational context, task compatibility, user skills, user involvement, communication, and innovation characteristics. The comparison of variables and items across frameworks highlighted overlaps and unique aspects of each framework, with some frameworks being more comprehensive than others. The study’s findings have practical implications for organizations considering technology adoption, and can contribute to the development of more effective technology adoption frameworks that address the complexities of adoption in various contexts.

Translation and cross-cultural adaptation of the Nordic Occupational Skin Symptoms Questionnaire to Brazilian Portuguese.

Occupational skin diseases are a frequently self-reported condition in industrialized countries. However, there are few developed and standardized self-report instruments to screen the population at risk for occupational dermatological diseases. Translation and cross-cultural adaptation of the long and short versions of The Nordic Occupational Skin Symptoms Questionnaire into Brazilian Portuguese. The process of translation and cross-cultural adaptation of the questionnaire was developed following the good practice recommendations of the International Society for Pharmacoeconomics and Outcomes Research. After translation into Brazilian Portuguese, the first reconciled version of the questionnaire was evaluated in a first round of interviews with 28 individuals, including patients with dermatological disease and healthy people. In the first meeting of the study review group, changes were made to 43 questions (75.4%) (e.g., inclusion of definition of terms, reformulation of instructions, and changes to alternative words or synonyms). In the second meeting of the study review group, there were modifications in three questions, creation of the second consensus version in Brazilian Portuguese, and then the back-translation of this version. After the second round of cognitive interviews, which took place with 10 patients, we had the third review group meeting (no modification was made) and definition of the final version of the questionnaire. The short and long versions of the Nordic Occupational Skin Symptoms Questionnaire questionnaire are available in Brazilian Portuguese.

Effects of Multimodal Therapy, Blinding, and Multi-laboratory Protocol Conduct on the Robustness of the Rat Model of Adjuvant Induced Arthritis.

The aim of this study was to investigate the effects of multimodal therapy comprising buprenorphine (BUP) and indomethacin (IND) on key translational parameters in the rat adjuvant induced arthritis (AIA) model. Furthermore, we investigated the difference between visual assessment scores and histology scores generated by blinded and non-blinded assessors and the robustness and generalizability of results by conducting a multi-laboratory study. The experiment was terminated on day 26 after 11 days (days 15-25) of voluntarily ingested buprenorphine and 7 days of gavage delivered indomethacin treatment (days 19-25). The treatment effects were assessed on the last day of the study, relying on body weight assessment, serum concentrations of α1- acid glycoprotein, and assessment of affected hind paws swelling, in-life and post mortem. Across two laboratories, the combined analgesic treatments had minimal effects on the measured model parameters indicating that multimodal treatment did not affect the translatability of the model. We found an improvement in clinical scores (a negative change in scores) in nearly all medicated animals when scored informed, whereas it was essentially 50:50 for the blinded scorings and no difference between the blinded and informed histological scoring. The present results support the use of more effective analgesic treatment regimens and the good practice recommendations advocating blinding as a mandatory practice in conduct of preclinical in vivo efficacy studies. In spite of minor differences between results obtained at the two sites, there was good agreement between them indicating robustness of the AIA model.

Developing a scale to evaluate the usability of telemedicine as a safe and useful communication channel and outpatient record

Aim: Telemedicine has been appreciated as a smart solution to bridge the gaps in healthcare delivery. Several questionnaires were developed worldwide and designed to evaluate the usability of telemedicine. However, they might be inappropriate or inadequate for all forms of telemedicine services. In this paper, we aim to report on the development and validation process of our telemedicine usability scale. Materials and Methods: The scale was part of a self-administered online questionnaire developed and content validated by a panel of physicians to evaluate the usability of telemedicine from the primary healthcare physicians’ perspective in Oman. The study employed convenient sampling of all eligible primary healthcare physicians, resulting in 143 completed questionnaires. We used the FACTOR software to run exploratory factor analysis on a polychoric matrix. The unweighted least squares extraction method was selected with promin rotation to fit the ordinal data. The psychometric properties, including the reliability measures, unidimensionality, and goodness-of-fit indices, were reported. Results: A three-factor solution satisfied the concept of simple structure and explained about 53% of the total variance. The first factor represented the usability of telemedicine as a safe and useful service; the second factor represented the usability of telemedicine as an outpatient record; the third factor represented the usability of telemedicine as a communication channel. For all factors, Cronbach’s alpha and McDonald’s omega were greater than 0.85. The goodness-of-fit indices and measures of unidimensionality were acceptable for the three-factor solution. The same three-factor solution was also evident following the run of exploratory factor analysis on the Pearson correlation matrix. Conclusion: The proposed scale is a multi-faceted scale that has been built on cumulative knowledge and developed according to the best-practice recommendations to ensure its reliability and validity for evaluating the usability of telemedicine from the physicians’ perspective.

Postoperative delirium: identifying the patient at risk and altering the course

Postoperative delirium (POD) is a common neurocognitive syndrome seen in older patients after major surgery. POD is linked to longer stays in hospital and intensive care, a greater incidence of postoperative complications, worse functional outcome, and higher mortality. Researchers have not yet fully elucidated the exact pathophysiology of POD. Several risk factors that contribute to the development of POD have been identified, such as advanced age, cardiac or hip surgery, preoperative cognitive decline or delirium, disturbances in brain levels of neurotransmitters and information processing, oxidative stress and neuro-inflammation. Identifying patients at risk for POD enables a more precise and efficient allocation of medical resources and facilitates POD prevention and management. The present review addresses how to identify patients at risk of POD and summarizes the currently available evidence and best-practice recommendations for peri-operative management and prevention of POD.

Good practice recommendations to better coordinate the management of oncological pain: a Delphi survey

Treatment of oncological pain is complex and requires a multidisciplinary management approach between oncology services and pain units. Although significant improvements have been achieved in the treatment and overall survival of cancer patients, the management of oncological pain has not followed the same directions. Many patients are not referred to pain units even though they could benefit from it. The purpose of this Delphi survey was to map the current situation in the management of cancer pain, identify barriers and propose recommendations to improve its management by emphasizing the importance of collaboration and coordination between oncology services and pain units. A survey among members with recognized experience in the management of oncology patients and oncological pain was held based on the Delphi method principles. The experts were asked to vote preselected statements on cancer pain management in two rounds and conclusions and recommendations were formulated based on the consensus reached for each statement. Barriers and areas for improvement were identified: need of multidisciplinary management approach, effective communication between oncology services and pain units, timely referral of cancer patients to pain units, training of health care professionals dealing with cancer aspects and identification of those patients that could benefit from a multidisciplinary management of their oncological disease. The experts issued recommendations targeting the identified barriers and areas for improvement by defining the service requirements of hospital and units treating cancer pain patients, establishing referral pathways necessities and adopted measures to improve the care of cancer patients.

Pneumatic tourniquet versus no tourniquet in transfemoral amputation – a study protocol for a randomized controlled trial

BackgroundLower extremity amputation patients represent a frail group with extensive comorbidity. Transfemoral amputation is a high-risk procedure with 37–50% risk of mortality in the first year. Substantial blood loss during surgery increases the risk of anemic complications and death for these already weakened patients. The use of tourniquet during surgery may reduce blood loss, the need for blood transfusions, the related complications as well as the length of the surgery. However the use of tourniquet may be related to impaired wound healing and hence the use should be investigated in a randomized controlled trial.The primary aim of this study is to investigate the total blood loss and secondary to investigate differences in complications after transfemoral amputation between patients operated with or without tourniquet.MethodsThe total blood loss is calculated using Nadlers approach. Based on data from a pilot series, the sample size was calculated to 124, allocated 1:1 in two groups of 62 participants to ensure detection of at least 200 mL difference in the total blood loss. The primary outcome is the total blood loss. Secondary outcomes are blood transfusions, duration of surgery, length of hospital stay and risk of complications within 90 days (re-admissions, re-operations and mortality). Explorative outcomes are 1 year mortality and re-operation risk. Further explorative outcomes are postoperative quality of life (questionnaire EQ-5D-5L) and evaluation of number of prosthesis users including evaluation of prosthesis-specific function measured 3, 6, and 12 months postoperatively.DiscussionThe possibility to enhance patient safety is highly relevant and this trial will provide data for evidence based recommendations of best practice in amputation surgery.Trial registrationThe trial is registered on ClinicalTrials.gov with ID: NCT05550623. Initial release: 13/09 2022.

Evaluation of taxonomic classification and profiling methods for long-read shotgun metagenomic sequencing datasets

BackgroundLong-read shotgun metagenomic sequencing is gaining in popularity and offers many advantages over short-read sequencing. The higher information content in long reads is useful for a variety of metagenomics analyses, including taxonomic classification and profiling. The development of long-read specific tools for taxonomic classification is accelerating, yet there is a lack of information regarding their relative performance. Here, we perform a critical benchmarking study using 11 methods, including five methods designed specifically for long reads. We applied these tools to several mock community datasets generated using Pacific Biosciences (PacBio) HiFi or Oxford Nanopore Technology sequencing, and evaluated their performance based on read utilization, detection metrics, and relative abundance estimates.ResultsOur results show that long-read classifiers generally performed best. Several short-read classification and profiling methods produced many false positives (particularly at lower abundances), required heavy filtering to achieve acceptable precision (at the cost of reduced recall), and produced inaccurate abundance estimates. By contrast, two long-read methods (BugSeq, MEGAN-LR & DIAMOND) and one generalized method (sourmash) displayed high precision and recall without any filtering required. Furthermore, in the PacBio HiFi datasets these methods detected all species down to the 0.1% abundance level with high precision. Some long-read methods, such as MetaMaps and MMseqs2, required moderate filtering to reduce false positives to resemble the precision and recall of the top-performing methods. We found read quality affected performance for methods relying on protein prediction or exact k-mer matching, and these methods performed better with PacBio HiFi datasets. We also found that long-read datasets with a large proportion of shorter reads (< 2 kb length) resulted in lower precision and worse abundance estimates, relative to length-filtered datasets. Finally, for classification methods, we found that the long-read datasets produced significantly better results than short-read datasets, demonstrating clear advantages for long-read metagenomic sequencing.ConclusionsOur critical assessment of available methods provides best-practice recommendations for current research using long reads and establishes a baseline for future benchmarking studies.

The Future of Higher Education: Identifying Current Educational Problems and Proposed Solutions

It is widely acknowledged that higher education is failing to meet the needs of students and employers, while educational costs and student debt are rapidly increasing. Our aim was to address these issues in an innovative fashion through a structured review combined with recommendations for best practices. Specifically, we aimed to identify and systemize failings of higher ed based on current scholarship, propose solutions, and identify institutions of higher education (IHEs) that have begun to successfully put these solutions in practice. Based on our literature review, this is the first time such a study has been conducted. We performed a structured literature review and identified four key failings in higher education: quality, relevance, access, and cost. From the reviewed literature we extracted a rubric to identify and evaluate twelve IHEs that are effectively applying new and innovative models that address these four problems. We conclude by recommending best practices for the successful redesign of IHEs. The overarching problem we identified was lack of student preparedness to succeed in a highly complex, competitive, and increasingly global, digital world—curricula lack relevance. IHEs are failing to teach the skills and tools needed for sustained success in the workplace: critical and creative thinking, problem-solving, co-operation, tolerance, and collaboration (which incidentally align with the skills and tools needed for effective citizenship) and when they do, they are not using evidence-based pedagogical strategies drawn from research on the science of learning. Additionally, IHEs are failing to provide accessible, high-quality, affordable postsecondary education. Financial and geographic inaccessibility, opaque admissions processes, attrition, poor attention to student health and well-being, lack of Indigenous inclusion, weak utilization of technology, and outmoded teaching methods and content contribute to the barriers to student success. The twelve IHEs we identified are geographically, economically, and pedagogically diverse, each serving as a model for the future of higher education. The novel contributions offered here are (i) a systematic review of higher education’s failings as they impact students and employers, (ii) identification of specific programs and initiatives that can ameliorate these failings, and (iii) identification of IHEs that are engaging in best practices with respect to (i) and (ii).