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BACKGROUND: Involving clinician end users in the development process of clinical dashboards is important to ensure that user needs are adequately met prior to releasing the dashboard for use. The challenge with following this approach is that clinician end users can undergo periodic turnover, meaning, the clinicians that played a role in the initial development process may not be the same individuals that use the dashboard in future. OBJECTIVES: Here, we summarize our Plan, Do, Study, Act (PDSA)-guided clinical dashboard development process for the VA Geriatric Scholars Program (GSP) and the value of continuous, iterative development. We summarize dashboard adaptations that resulted from two PDSA cycles of improvement for the potentially inappropriate medication dashboard (PIMD), one of many Geriatric Scholars clinical dashboards. We also present the evaluative performance of the PIMD. METHODS: Evaluation of the PIMD was performed using the system usability scale (SUS) and through review of user interaction logs. Routine end users that were Geriatric Scholars and had evidence of 5 or more dashboard views were invited to complete an electronic form that contained the 10-item SUS. RESULTS: The proportion of Geriatric Scholars that utilized the PIMD increased for each iterative dashboard version that was produced as a byproduct from feedback (31.0% in 2017 to 60.2% in 2019). The overall usability of the PIMD among routine users was found to be above average (SUS score: 75.2 [95% CI 70.5-79.8]) in comparison to the recommended standard of acceptability (SUS score: 68) CONCLUSION:  The solicitation of feedback during dashboard orientations led to iterative adaptations of the PIMD that broadened its intended use. The presented PDSA-guided process to clinical dashboard development for the VA GSP can serve as a valuable framework for development teams seeking to produce well-adopted and usable health information technology (IT) innovations.

Building upon the work of Ladson-Billings, Lind and McKoy, and Shaw, our proposed framework takes into consideration the depth and breadth of musical experiences and contexts, musical content, and the diversity of musical cultures. The proposed framework includes four quadrants: (a) teacher competencies, (b) informed choices, (c) authenticity, and (d) holistic and comparative lessons. The framework provides K-16 teachers with tangible, accessible, and actionable methods for implementing a teaching pedagogy that has often been misunderstood or implemented without fidelity, and therefore ineffective. Each quadrant's description and detail provide educators with guidance, supporting their individual musical growth, facilitating authentic relationships with students, authentic performances, and careful idea development for lesson planning that is inclusive of multiple musical perspectives and origins. Muñiz and Richards et al. acknowledged that community support and teacher capacity are essential for culturally relevant pedagogy to be implemented effectively, thus increasing students' academic growth.

AbstractUsing diffusion tensor imaging (DTI), we assessed the extent to which fractional anisotropy values in the dorsal (i.e., arcuate fasciculus; AF) versus ventral (i.e., inferior fronto-occipital fasciculus; IFOF) distinction of structural white matter pathways associated with selected reading processes, could be replicated in skilled adult readers (N = 17) and extended to adults with reading impairments (N = 13). In addition to the AF and IFOF, motor-based tracts (i.e., posterior limb of the internal capsule (PLIC) and the frontal aslant tract (FAT)) were isolated to explore their role in reading performance. Several interesting relationships with reading performance emerged. First, orthographic awareness was related to the left IFOF in skilled readers, whereas orthographic awareness was related to left PLIC for impaired readers. Morphological awareness was related to left FAT for skilled readers, whereas morphological awareness was related to right AF, right IFOF and left PLIC for impaired readers. Overall, these findings support the notion that adult reading performance (both skilled and impaired) is related to the structural properties of the ventral white matter pathways. More consideration should be paid to motor pathways, particularly the PLIC, and their role in compensatory reading strategies in individuals with reading impairments. [ABSTRACT FROM AUTHOR]