Problem-based learning (PBL) was developed for use in medical education to incorporate more active, learner-centered instruction. Central to problem-based learning is the problem, which in medical education is usually case a case presentation, revealed in stages to allow learners to form and research learning objectives. The purpose of this study was to identify themes present across the PBL cases, including the patient-centeredness of the cases. Content analysis was used to examine 62 PBL cases that comprised the first and second years' core curriculum at a public medical school. The cases included a patient population similar to the local population, but care was more hospital-centric than would be expected from the actual patterns of medical utilization in the United States. Analyzing along two axes of patient-centeredness, the PBL cases demonstrated a good understanding of the patient (knowing the patient), but other qualities such as shared decision making was not as exemplified. Medical educators can use the results to understand elements that contribute to patient-centeredness and apply the analysis framework to evaluate future cases.

The goal of this study was to establish empirical benchmarks for Cohen's d in child counseling research. After initial review of over 1,200 child intervention research studies published from 1990 to 2016, 41 randomized clinical trials were identified in which intervention and control groups were compared with children 3-12 years old (N = 3,586). Upon identification or calculation of a Cohen's d for each study, I calculated a weighted mean d by multiplying the effect size of each study by the number of participants in that study then dividing by total number of effect sizes. The weighted mean accounted for study sample size and served as the suggested medium effect size benchmark. Results indicated effect size is impacted in large part by type of reporter, with parents apparently most sensitive to improvement and yielding higher effect sizes overall; teachers relatively less sensitive, perhaps due to difficulty observing change in a classroom setting; and children self-reporting lowest levels of improvement, perhaps reflecting a lack of sufficient measures of child development. Suggested medium benchmarks for Cohen's d in child counseling literature are .70. for parent report, .50 for teacher report, and .36 for child self-report. Small and large benchmarks are suggested based …

Utilizing the theory of planned behavior, I examined the variables that affect Chinese individuals' help-seeking intention. A total of 251 Chinese individuals participated in this study. Results showed that the variables in the theory of planned behavior accounted for 16% of the variance in help-seeking intention. Specifically, attitude (r = .22, p < .001) and perceived behavioral control (r = .22, p < .001) were found to be significant predictors of help-seeking intention. Based on these results, mental health professionals can design outreach interventions, such as psychoeducational programs, to improve Chinese individuals' help-seeking attitude and perceived behavioral control in an attempt to increase mental health service utilization. Additionally, counselors can discuss with clients' their attitude and perceived behavioral control regarding seeking counseling in an attempt to assist clients in being committed to the counseling process.

An estimated 15 million people in the US have had a near‐death experience (NDE), an experience of usually lucid consciousness during a close brush with death. Following an NDE, experiencers (NDErs) sometimes feel challenged and seek counseling to integrate the experience into their subsequent lives. They have reported psychologically harmful experiences disclosing their NDEs to healthcare professionals, including counselors. Counselors' knowledge and attitude about NDEs appear to be critical variables in their ability to uphold the ethical imperative to do no harm to clients. The recent development of a psychometrically sound instrument to assess these variables, coupled with online availability of a three-part NDE educational program for health professionals, made possible for the first time a large‐scale pre‐post study of the effect of the program on counselors' knowledge and attitude about NDEs. Participants were 212 licensed professional counselors (LPCs) aged 23 to 71 years old (M = 44.93, SD = 12.69); sex self-identified as 12.3% male, 87.3% female, and .5% other; racially/ethnically self-identified as 84% White and 17% non-White and as 6.6% Latino-Hispanic and 92.5% non-Latino/Hispanic; and representing four regions of the US. Results revealed that, compared to control group, composed of LPCs who completed topically unrelated online programs (n …

The problem this study addressed is the relationship between Clery Act crime data and student recruitment at private colleges and universities. For this quantitative study, I used secondary data from the Department of Education and the Delta Cost Project (2013) to conduct ordinary least squares regression analyses to determine the predictive ability of institutional characteristics, specifically the total number of crime incidents reported in compliance with the Clery Act, on the variance in number of applications and applicant yield rate at private four-year institutions in the United States. Findings showed that the total number of reported incidents was a significant positive predictor of the total number of applications. Conversely, findings also showed that the total number of incidents had a significant negative impact on institutional yield rates. An implication of this study is that although crime statistics required by the Clery Act may not serve as variables used in the student application process, they are part of numerous variables used in the student's decision to enroll at a particular school. The findings highlight the importance of prioritizing and investing in safety and security measures designed to reduce rates of crime; especially for private, enrollment-driven institutions of higher education.

Developmental education courses are typically defined as courses offered at postsecondary institutions below college level instruction. More than 60% of community college students are deemed non-college ready and required to enroll in non-credit bearing developmental education courses. Research shows that developmental education can be either a bridge or barrier to degree attainment for racial/ethnic minority students, particularly African Americans, who require developmental education more than any other racial/ethnic groups. The purpose of this study was to explore the lived experiences of African American community college achievers who were required to enroll in two or more developmental education courses. Achievers were defined as students who passed all developmental education courses and were enrolled in their final college gateway course at the time of the interviews. Utilizing a phenomenological approach and anti-deficit framework, 15 semi-structured interviews were conducted to capture the essence of how African American achievers described, interpreted, and understood their journeys from developmental education to becoming college ready to completing college level courses. Twelve participants were female and three were male, ranging from 20 to 52 years old. Results revealed seven major themes. The first research question addressed how achievers described their developmental education experience from pre-collegiate years through inside …

Traditionally, medical residency positions have been primarily funded by the federal government. However, due to declining governmental funding support over time, medical schools have resorted to fund these programs through other means such as clinical fees and payments for services. This change has affected the number and types of residencies available to medical school graduates. The purpose of this study was to measure how the availability of fiscal resources shape mission-related outputs, particularly medical residency positions at medical schools. Using academic capitalism as the theoretical framework provided a lens through which to examine how federal policies have shaped the availability and funding of medical residencies today at the institutional level. This concept has been studied in traditional colleges and universities and how they balance mission and money, but less so in the context of medical schools. This study used a fixed effect panel analysis to study the impact of selected variables over a 10-year period on financing of medical residencies. Findings included that tuition revenues, paid for by undergraduate medical students, are increasingly funding medical residency positions. There was little to no effect from hospital revenues and federal research monies on increasing the number of medical residency positions. The funding …

Professional counselors may choose to increase self-awareness and/or engage in self-care through the use of personal therapy. In particular, counselors may feel reluctant to pursue personal therapy due to stigma related to their professional identity. To date, researchers have paid limited attention to the unique concerns of counselors in personal therapy. The purpose of this phenomenological study was to explore counselors' experiences and decision-making in seeking personal therapy. I addressed the following questions: What contributes to counselors' decision to seek personal therapy? How do counselors make meaning of their experiences in utilizing personal therapy? Participants included 13 licensed professional counselors who had attended personal therapy with a licensed mental health professional in the past three years. I identified six emergent themes through adapted classic phenomenological analysis: presenting concerns, therapist attributes, intrapersonal growth, interpersonal growth, therapeutic factors, and challenges. Participants reported positive changes in personality and relationships, as well as several barriers specifically related to their counselor identity. Findings inform mental health professionals and the field of counselor education and supervision about the personal and professional needs of counselors. Limitations and future research directions are discussed.

Despite recent scholarly interest in college students' spirituality and spiritual development, as well as research indicating that students are interested in spirituality and have a strong desire to integrate spirituality into their lives, few researchers have addressed the spiritual experiences of gay and lesbian college students. Utilizing a phenomenological qualitative approach, I explored the spiritual experiences of nine gay and lesbian college students at two religiously affiliated universities in the southwest region of the United States. The ages of the participants ranged from 19 to 23, with a mean of 21. There were five female, three male, and one gender queer participants. Seven participants identified as white, while the other two participants identified as Hispanic. I identified three major themes related to their lived experience of spirituality: (1) spiritual quest characterized by struggle and pain, (2) finding reconciliation and acceptance, and (3) the importance of support from the university, student groups, friends, and family. Implications for practice included the importance of establishing an official recognized student organization to support gay and lesbian students, creating spaces for personal reflection, meditation, prayer, and solitude as well as safe spaces, the need for educational and outreach programs for faculty, staff, and students, and …

Gendered organizational conditions create the context for persisting differences between men and women in the workplace. Within, higher education, this manifests as a salary gap between male and female faculty members. The academic capitalistic policy environment creates the conditions for increasing competition for external funding, especially in the areas of research and science and engineering. The change in the academic climate may sustain or intensify the gendering of universities as organizations. Universities with the highest level of research activity were chosen for this study and formed the 130 public institution sample. This study used fixed effects panel regression analysis to explore the relationship between the faculty gender salary gap and institutional emphasis on research as well as science and engineering. In addition, the relationship between institutional emphasis and the faculty gender salary gap was explored over time with the inclusion of a time trend and temporal interaction terms. Results showed that the higher the percentage of female faculty members, the greater the faculty gender salary gap for assistant professors. In addition, science and engineering emphasis over time had a significant impact on the professor salary gap with a decreasing effect both at the mean and one standard deviation above the …

This study offers insight into students' use and desire to use mobile devices for educational purposes. I examined college students' mobile device usage on the basis of demographic factors including sex, age, ethnicity, class standing, mode of delivery, and socioeconomic status. This study also investigated factors that affect students' likelihood to use mobile devices for academic pursuits. I utilized data from the EDUCAUSE Center for Analysis and Research's (ECAR) 2015 Student Technology Survey. Of the 10,000 undergraduate respondents, 56% were female, 70% were between the ages of 18-24, 73% attended college full time and the breakdown of ethnicity included 59% Caucasian, 16% Hispanic, 13% African American, 8% Asian and 1% Native American. The results indicated that traditional aged students reportedly used smartphones more frequently, whereas non-traditional aged students reportedly used tablets more. Students most frequently reported using their devices in class to connect to the learning material. Institutional technology infrastructure and support were strong factors impacting students' use of smartphones. Results of this research can assist higher education faculty and administrators in devising comprehensive training and technology plans to support and encourage students' use of mobile devices for educational purposes.

The focus of this case study was a study abroad program for student-athletes at a high academically achieving, small liberal arts college in the mid-west region of the United States. The program is designed to maintain a culture of internationalism and multiculturalism by exposing as many student-athletes as possible to study abroad. I reviewed literature to extract an appropriate theoretical framework along with variables that aligned with the purpose of the study; structural and organizational characteristics of the institution, student's background and pre-college traits, interaction with agents of socialization and institutional environment, and quality of effort. I used the semi-structured interview process to interview 9 senior student-athletes (3 female, 6 male; 7 White, 1 African American/White, 1 Chilean/White) who participated in study abroad during the 2015-2016 academic school year at the researched institution and to interview 5 administrators who facilitate the athletic department at the institution. I found that certain critical elements emerged as necessary to create and maintain a study abroad program geared specifically to the needs of the student-athlete population. I also found strong implications for adaptable elements that could generate opportunities for student-athletes to study abroad at a higher rate. These elements serve as a recommended framework …

Trends in tuition and financial aid policy have increased the number of students who borrow for higher education and the aggregate debt students acquire. Most research on student borrowing over the years has analyzed the effects of borrowing and the prospects of indebtedness on individual students' choices and persistence. However, dynamics at the institutional level such as the need to ensure a stable flow of resources may accelerate or slow down student borrowing. Drawing on resource dependence theory, this study examined changes in student borrowing at private not for profit four year institutions in the US to identify trends and implications. A fixed effects regression analysis was applied to panel data from the Delta Cost project and the National Association of College and University Business Officers. Analytical focus was on the financial and enrollment characteristics of private not for profit four-year institutions, the relationship between these characteristics and student borrowing, and whether these relationships are stable or change over time. Findings revealed that the financial and enrollment characteristics of private not for profit institutions during the study period were characterized by gradual variation. The results also revealed that most of the financial characteristics were predictive of student borrowing and that …

Although the recent annual growth rate in the US paramedic field has been 4%, Latino and African American men have been significantly underrepresented in the field compared to their proportion in the US population at large. This problem threatens both the quality and quantity of available emergency health care. The purpose of this study was to describe how men of color (MOC) in community college paramedical programs experienced their awareness, interest, and proactive choice of paramedicine as a course of study. Using a qualitative phenomenological approach and social cognitive career theory as a theoretical framework, I interviewed 23 MOC enrolled during one semester across three community college paramedical programs in the southwestern US: 9 Latino and 14 African American, aged 18-29 with mean age 22 years. The focus of the interviews was the participants' lived experiences at various career points, as well as the enablers and disablers they had encountered. I identified three primary themes for possible use in enhancing recruitment of MOC to the paramedic field: strategic use of new digital media, promotion of the vocation's quasi-familial characteristics, and augmentation of neighborhood-based outreach. Identified areas for further research included recruitment dynamics of female paramedics, MOC persistence issues, and MOC …

The purpose of this quantitative secondary data analysis was to examine the effect of family, school, and community context on high schools whose students participate in financial aid preparation services. Data from the High School Longitudinal Study of 2009 were analyzed to answer the two research questions using Perna's conceptual model of college enrollment behaviors that explores how students gain and utilize information about financial aid and college prices. Descriptive statistics were used to determine the extent of high school participation in financial aid services. The results indicated a varying degree of these interventions being offered at high schools ranging from 22% to 52%. Schools sending students reminders of FAFSA deadlines (52%) and disseminating flyers/pamphlets on financial aid (50%) were the only two interventions that had a slight majority of schools participating. Multiple regression was used to determine if a relationship existed between the outcome variable (participation in financial aid preparation services) and several family context and school context predictor variables for eight financial aid interventions. Results revealed school context variables as the best predictors of the outcome variable. Counselor caseload and school control were the most effective in predicting high school participation in the eight financial aid preparation services, …

The growing commercialism within Division I big-time athletics has raised the financial stakes for universities, as successful athletic programs benefit from increased opportunities for financial gain. This has contributed to a pervasive "win culture" that drives institutions to seek competitive advantages, and as a side effect, NCAA rule violations have become incentivized. Programs whose infractions go unnoticed may benefit from the competitive advantage gained, but for programs investigated by the NCAA, the financial penalties incurred may far outweigh the potential revenues from undetected violations. The purpose of this study was to address institutional self-sanctions as an organizational behavior in response to NCAA major infractions and the impact of self-sanctioning on alumni charitable giving. Through the use of neo-institutional and resource dependence theories, this study aimed to further examine the role of institutional self-sanctions as a crisis management strategy in containing financial fallout of athletic scandal. While researchers have addressed scandal and alumni charitable giving in relation to athletics and institutional self-sanctions, respectively, no research exists linking the two bodies of literature. This study employed a two-way fixed effects analysis of 10 years of panel data to address the effect of key variables on alumni charitable giving. Analysis results indicated no …

The purpose of the study was two-fold. First, the study explored how self-identified Afrocentrist professors in higher education utilized Afrocentric pedagogy and andragogy to address the learning needs of students, specifically Black women students. Second, the study explored the ways in which Black women students experienced that learning in the higher education classroom. The purpose was advanced through an in-depth analysis of Afrocentric teaching and learning in the higher education. A sample of five self-identified Afrocentric faculty members - three females and two males - and five Black women students who studied with those professors was identified. Participants were interviewed individually in-person and by telephone. Data analysis resulted in the themes of the importance of living an Afrocentric life in which the African body is centered and elevated, rejection of European dominance and universalism, re-routing history, and introducing Afrocentricity as a methodology from which to analyze human life. These themes presented core values, approaches, practices and characteristics utilized in Afrocentric teaching. Findings also showed that the Black women student participants received multiple benefits from receiving an Afrocentric education that assisted them in their journeys through higher education. Study findings provided a foundation for the guidebook "Teach Me, Toward Me Kuongoza, …

This study explores where African American college students find mental health support and why those supports are chosen. Greater knowledge of the sources of mental health support sought by African American college students can assist higher education institutions in adapting current services to meet the needs of this specific student population. A qualitative phenomenological approach was utilized, and the study's sample included twelve participants, 6 female and 6 male, from a large public four-year university in Texas. These participants, undergraduate students with ages ranging from 18 to 24, were given a survey and completed two semi-structured interviews throughout one semester. Results indicated that study participants were more likely to utilize informal than formal support for their mental health and many had no source of support. Family stigma, peer attitudes, as well as internal and external pressures all influenced participant's choices to seek support. Based on findings from the study, recommendations for two distinct groups, counseling center directors and higher education administrators, are also discussed.

Although trans* students often face greater levels of discrimination, harassment, and hostility on college campuses than their cisgender peers, research indicated that they can succeed by developing and honing survival strategies, such as resilience and being part of a trans* kinship network that resists trans* oppression. Having the support of family, and by taking the risk to cultivate relationships while in college also improves the likelihood of persistence through college. The term trans* is used in this study as an inclusionary term for transgender persons and other gender nonbinary identities. The purpose of this research study was to explore the experiences that trans* students have while being in college. Utilizing a phenomenological approach and the theoretical lens of feminist and queer theories, semi-structured interviews were conducted to better understand the lived experiences of trans* college students. Four Caucasian trans* undergraduate students, ranging in age from 19 to 25 were each interviewed five times. Twenty total interviews over a period of three months provided in-depth data. Five primary themes emerged that were common among the participants: exploration, experimentation, and self-discovery; living as a trans* person in college: developing survival strategies; cultivating relationships and seeking acceptance; race and gender privilege/power; and generational …

Depression in childhood is a significant mental health concern, impacting cognitive, affective, social, behavioral, and physical domains. Children who experience depressive symptoms are at an increased risk for physical and mental health, social, and behavioral problems throughout adulthood. Children who are marginalized due to their socioeconomic status, racial and ethnic identities are at an increased risk to experience depression and limited access to mental health care. Further, previous research has demonstrated limited efficacy of depression treatments for young children. In this study, I examined the efficacy of child-centered play therapy [CCPT], a culturally and developmentally responsive treatment, on depression among young children. Participants were 71 children from five Title 1 elementary schools in the southwestern U.S. referred by school personnel for depressive symptoms (49 males, 22 females; ages 5-9, mean age M = 6.21). The sample consisted of 14 (19.7%) African American, 3 (4.2%) Asian American, 15 (21.1%) biracial, 19 (26.8%) Caucasian, and 20 (28.2%) Latino children. Participants were randomly assigned to eight weeks of twice-weekly CCPT treatment group (n = 34) or a waitlist control group (n = 37). Results of doubly multivariate repeated-measures MANOVA revealed statistically significant improvement in depressive symptoms for children who participated in CCPT on …

The purpose of this transcendental phenomenological inquiry was to explore college-aged women's experiences of body positivity and self-acceptance. I applied a conceptual framework that blended feminist identity development model (FIDM) and relational cultural theory (RCT) to answer the following questions: (a) what are the lived experiences of college-aged women who identify as having a positive and accepting body image? and (b) how do college-aged women's intersecting identities contribute to the development of positive and accepting body image? Ten college-age women participated in the current study. The participants provided detailed accounts of their experiences of body image throughout their life. Five overarching themes were identified through data analysis of the interview transcripts: (a) advocating for self and others, (b) beauty expectations and societal definitions, (c) intersecting identities, (d) journey of acceptance, and (e) relationships and community. Participants offered insight into the development of their current position of body positivity and self-acceptance that serve as implications for other relevant contexts. Implications and recommendations drawn from the participants' experiences can inform preventative and treatment care in educational settings, family environments, clinical practice, and integrated care.

Virginia Axline developed a new field of child psychotherapy by applying a nondirective approach to the burgeoning experimentation of utilizing play in therapeutic work with children. While much biographical information is available regarding other leaders in the fields of counseling and psychology, historical research into Axline and her development of child-centered play therapy represent a gap in the literature. The purpose of the current study was to: 1) examine the professional contributions of Virginia Axline; 2) gather personal information regarding Axline that contributes to deeper understanding of her theory; and 3) identify life circumstances or events that influenced Axline's professional contributions. Historical methodology was utilized to locate and examine artifacts and materials necessary to create an interpretive biography of Axline's life and work, with a focus on her professional influences, experiences, and contributions. Historical methods utilized include historiography, oral history, and interpretive biography, with an emphasis on established and accepted source criticism and data synthesis processes. The research yielded a number of historically significant and previously unknown documents valuable to the field of CCPT including personal correspondence, academic writings, and interviews, as well as academic and government records. The research also established new information about and understandings of several of …

Childhood poverty is a prevalent concern in the United States and is associated with poor psychological and academic outcomes. Psychosocial stressors associated with life in poverty may interrupt the development of a positive self-concept, ultimately hampering the academic achievement of children in poverty. As the therapeutic objectives of child-centered play therapy (CCPT) support the development of an increasingly positive self-concept, I explored the impact of CCPT on the academic achievement of children in poverty. Participants were composed of 55 students between the ages of 4-7 years old from seven Title 1 elementary schools in the southern United States. Of the 55 study participants, 12 (22%) were female and 43 (78%) were male. Regarding participant ethnicity, 7 (13%) were African American, 1 (2%) was Asian American, 5 (9%) were multi-racial, 35 (64%) were Latino, 6 (11%) were Caucasian, and 1 (2%) did not report ethnicity. Participants were randomly assigned to either a 16 session CCPT treatment group (n = 25) or a waitlist control group (n = 30). A mixed between-within ANOVA was conducted to evaluate improvement in academic achievement scores between treatment and control groups across time. Results indicated a statistically significant interaction effect on the Early Achievement Composite Score …

Multicultural (MC) counseling and social justice (SJ) are foundational parts of counselors' professional identity, and they are fostered through a developmental process that counselor educators facilitate. The purpose of this study was to explore the relationship between counselor educators' ethnic/racial identity development (ERI), their social justice orientation (SJO) and their multicultural teaching competence (MCTC). MCTC was examined using the constructs of knowledge and sensitivity. Data was collected from a nationally distributed online survey. Data were analyzed using four hierarchical regression models in order to control for socially desirable responding. Results indicated that ERI was a significant predictor of MCTC-Knowledge (p < .001) and that SJO was a significant predictor of MCTC-Sensitivity (p < .001). Socially desirable responding was not significantly related to MCTC. Results suggest the importance of attending to ERI and SJO as separate processes in training future counselor educators.