Kathleen Monahan

Background: The COVID-19 pandemic led to the rapid integration of telemedicine into health care delivery. As a result, the ability to effectively collaborate in interprofessional virtual teams became a necessity, as did the development of educational opportunities designed to equip health care students with these skills. Currently, there is a lack of dedicated tools to assess learners’ ability and readiness to function as a well-coordinated virtual medical team. Objective: The primary objective of this study was to conduct a psychometric assessment and validation of measures evaluating graduate-level health professions learners’ experience and familiarity within virtual interprofessional settings. The secondary objective was to integrate these 2 validated subscales into a comprehensive survey tool for use in interprofessional education course evaluation, spanning domains including demographics, telehealth knowledge and skills, understanding interprofessional roles, communication, and teamwork. Methods: An interprofessional expert panel reviewed an initial item pool of 126 questions compiled from adaptations of previously validated instruments and newly developed items. Five experts with experience in interprofessional education and telehealth competencies independently rated each item, and the highest-ranked items were selected for distribution to graduate health professions students at Stony Brook University. The survey was administered during mandatory in-class instruction across the School of Medicine, School of Nursing, School of Health Professions, and School of Social Welfare between November 2023 and June 2024. Participation was voluntary, and responses were anonymous. Item reduction focused on the 33 experience items and 8 familiarity items using interitem correlations, the Cronbach α, item-to-total correlations, and exploratory factor analysis (EFA); confirmatory factor analysis was not conducted. Results: A total of 520 responses were obtained. After excluding records without any response to questions 9 or 10 and duplicate submissions, 393 records were included in the analysis. The final survey was reduced from 51 to 32 items, including 5 demographic items, 3 telehealth knowledge items, 17 retained experience items, and 5 retained familiarity items. For the experience domain, EFA identified 17 items loading onto 3 factors, accounting for 69.81%, 13.00%, and 9.58% of the variance. Internal consistency remained high, with the Cronbach α decreasing from 0.94 to 0.90. For the familiarity domain, EFA supported a refined 5-item structure, with the Cronbach α decreasing from 0.94 to 0.91. Conclusions: This EFA-based validation study provides preliminary psychometric support for 2 subscales assessing graduate health professions learners’ experience and familiarity within virtual interprofessional settings. Additional validation work is needed before broader claims can be made regarding the full survey’s ability to evaluate educational outcomes or clinical impact.

Background: The rapid expansion of telehealth has outpaced formal training in virtual interprofessional collaboration across health professions education. Although telehealth and interprofessional education (IPE) competency frameworks exist, limited evidence informs how longitudinal, virtual IPE curricula prepare learners for team-based telehealth practice. Objective: This study evaluated a longitudinal virtual interprofessional telehealth course to examine its impact on learners’ perceived telehealth competencies, understanding of interprofessional roles, and readiness for virtual team-based care. Methods: We conducted a mixed methods evaluation of a 4-week virtual IPE course involving graduate students from medicine, nursing, physical and occupational therapy, and social work. Learners participated in longitudinal standardized patient telehealth encounters, interprofessional debriefing sessions, and asynchronous learning activities. Quantitative outcomes were assessed using a validated postcourse survey. Qualitative data were obtained from open-ended survey responses and analyzed using thematic analysis. Results: Twenty-eight students completed the course and postcourse evaluation. Quantitative findings demonstrated high self-reported confidence in telehealth communication, ethical practice, interprofessional collaboration, and role clarity, with mean scores ranging from 4.4 (0.7) to 4.8 (0.6) on a 5-point Likert scale. Qualitative analysis identified three core themes: (1) development of interprofessional collaboration skills in virtual settings, (2) growth in telehealth-specific clinical and communication competencies, and (3) perceived value of longitudinal standardized patient encounters with iterative feedback. Conclusions: A longitudinal, standardized patient–based virtual IPE curriculum was associated with strong self-reported preparedness for interprofessional telehealth practice among health professions students. These findings support the use of structured, longitudinal virtual IPE models to address evolving educational needs in telehealth training.

Open access peer-reviewed chapter

This paper examines the coping strategy of humor presented by eight adult women aged 26 through 61 in a small clinical practice setting. Each woman had been sexually abused by a variety of family members during childhood. They were seeking therapy for life-phase issues (e.g., divorce, retirement, marital problems, parent/child issues). The reemergence of sexual violence memories and the ways in which these women used humor as a coping strategy to alleviate the effects of childhood sexual abuse (CSA) are presented.

Trauma experiences and symptomatology may be overlooked by clinicians as a significant impediment to aging in place. This paper presents the types of traumas and the impact of culture and racism on older adults. Additionally, age-related stressors may influence the reemergence of trauma memories and reactions and therefore, impact aging in place. Assessment, case examples, and best practice issues are presented.

Background Primary bone diffuse large B cell lymphoma (DLBCL) is a variant of extranodal non-Hodgkin lymphoma (NHL) that is relatively rare, accounting for 3-15% of extranodal NHL and less than 1% of all NHL. Patients often present with pain and swelling or pathologic fracture of the affected area of the skeleton, and B symptoms are often less prevalent. Many cases are limited stage at presentation. Patients are usually treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or similar induction therapy. Based on older studies showing improved outcomes associated with the addition of radiation (many completed prior to the rituximab era), patients often still receive combined-modality therapy today. However, it remains unknown whether consolidative radiation therapy (RT) confers additional benefit following rituximab-based chemoimmunotherapy (CIT) induction. We sought to address this question in a multicenter retrospective study. Methods We conducted a retrospective analysis of outcomes in a modern cohort of patients who underwent treatment for primary bone DLBCL using chemotherapy regimens in the rituximab era either with or without consolidative RT. Data was collected from 13 academic medical centers in the U.S., with patients treated between 2005 and 2019. Patients were identified using each institution's hematologic malignancy registries. Analysis was limited to patients with primary bone DLBCL, with stage I-II disease (primary site +/- locoregional lymph nodes) that could be encompassed in a radiation field. Patients who received CIT alone or CIT followed by RT were included. Treatment selection was at the treating physician's discretion. Electronic medical records were reviewed for: demographics, chemotherapy regimens, radiation treatments, and PET scan data. Local IRB approval was obtained at sites. All data was distributed in a de-identified fashion. The primary outcomes were overall survival (OS), and relapse-free survival (RFS). Secondary outcomes included: response after induction CIT induction and the need for additional therapies. Chi-square test analysis was used to compare categorical variables and the Wilcoxon rank-sum test was used for continuous and ordinal measures. Survival curves were estimated using the Kaplan-Meier method and compared between groups via the log-rank test. Multi-variable analysis (MVA) for OS and RFS was performed using RT vs no RT, PET status post CIT (negative vs positive) and rituximab in induction (Y/N) as variables. Results A total of 127 patients were included: 91 who received CIT and radiation (RT group), and 36 who received CIT alone (no RT group). The median age of patients at diagnosis in the RT group and no RT group was 58.5 and 57.0, respectively. For CIT, the majority of patients received R-CHOP (84%). Despite focusing on 2005-2019, a small percentage of patients (5 - 14%) in each group (RT and no RT) did not receive rituximab with their induction therapy. The OS at 10 years was 74.5% in the RT group and 86.5% in the no RT group (p = 0.29). The RFS at 10 years was 70.9% in the RT group and 78.2% in the no RT group (p = 0.85). Among the 91 patients who received RT, 67 (77.0%) received a dose of 36 Gy or higher. There was no difference in OS (p = 0.63) or RFS (p = 0.90) in patients who received > 36 Gy vs < 36 Gy of radiation. On MVA for OS, RT was not associated with improved OS, although rituximab as part of induction was (p = 0.048). On MVA for RFS, neither RT nor rituximab were associated with improved RFS. For rituximab the trend was in the direction of rituximab benefit (p = 0.11). Conclusion Our results demonstrate that, in the rituximab era, patients with limited stage primary bone DLBCL have excellent outcomes overall. In this study, neither RFS or OS appeared to be improved with the addition of consolidative RT. Rituximab, however, was associated with improved OS on MVA. Outcomes do not appear to differ based on the dose of RT (> 36 Gy vs < 36 Gy). Our data suggests that RT may have less benefit for primary bone DLBCL in the rituximab era, although it is possible that a subset of patients may benefit from consolidative radiation therapy. A larger data set would likely be needed to evaluate this. We plan to present data regarding PET responses at the meeting.

Intimate Partner Violence (IPV) remains at epidemic proportions in the United States. Traumatic Brain Injury (TBI) as an outcome of IPV is now being investigated by researchers, particularly long-term sequelae. This review addresses underreporting and lack of treatment, and the physical and psychological impact for victims of IPV who have received a TBI. Recent research has begun to investigate professional sports players who experience repeated concussions and their at-risk status for Chronic Traumatic Encephalopathy (CTE). Women who are in abusive relationships for long periods of time may also incur repeated blows to the head. Researching the at-risk status for CTE is a much needed line of inquiry for this underserved population.

During the past 30 years, the social work profession has explored the issue of intimate partner violence (IPV) and abuse by an intimate partner. Through research, policy, and practice data we have addressed safety issues and the psychological, physical, sexual, and economic harm done to women in these situations (Black et al., 2011; Campbell et al., 2002).