Loyola Nursing Magazine 2023 by Loyola University Chicago Marcella Niehoff School of Nursing

LOYOLA UNIVERSITY CHICAGO MARCELLA NIEHOFF SCHOOL OF NURSING • 2023

LOYOLA NURSING

RESEARCH WITH A MISSION

ALSO INSIDE:

CUTTING-EDGE SCIENCE FUELS EXCEPTIONAL COLLABORATION

SCIENCE FACULTY’S INNOVATIVE METHODS

CHARTING A PATH FOR A DIVERSE WORKFORCE

VITAL PARTNERSHIPS WITH COMMUNITY GROUPS

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LOYOLA NURSING

FROM THE DEAN Lorna Finnegan, PhD, RN, FNP, FAAN Dean and Professor, Marcella Niehoff School of Nursing

LOYOLA NURSING MAGAZINE is published annually for alumni and friends of Loyola University Chicago Marcella Niehoff School of Nursing

EDITORS

Tim Bannon Ashley Rowland

DEAR FRIENDS, As supporters and alumni of the Marcella Niehoff School of Nursing, you understand the power of nursing to drive change within health care and positively impact patients’ lives. I am proud of the accomplishments of our outstanding students, faculty, and staff in the past year and the leadership they show in advancing health care for all—and particularly their determination to address the social determinants of health that hinder wellness for the most vulnerable. Our donors are an integral part of these efforts, and their partnership inspires us as we strive toward achieving the central goal outlined in our “why” statement about our commitment to our students, patients, and community: “To build relationships so lives are positively transformed.” The last year has been a time of growth and renewal within the School of Nursing, and the sense of energy and momentum at both our Lake Shore and Health Science campuses is palpable. Consider the following:

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Kate O’Neil

faculty in the past two years alone. Leading our research team is Associate Dean for Research and Scholarly Innovation Karen Saban, who received a $3.3 million National Institutes of Health research grant in 2023 to study an initiative to reduce race-based stress in Black women at risk for cardiovascular disease. Her work is a testament to the very real, life-changing impact we seek to have on the communities we serve at home in Chicago and nationally. • Growing our research program is a key strategic priority for the School of Nursing as we seek to increase our national standing and attract the brightest students to our graduate programs, and I could not be prouder of the work our talented nurse scientists are doing.

PHOTOGRAPHERS

Erik Unger Lukas Keapproth CO P Y E D I T O R

Evan Eckerstrom CO N T R I B U T O R S

I invite you to read more in the following pages about the impact of our groundbreaking research and commitment to academic and clinical excellence. I am grateful to the students who inspire me with their passion for learning and for creating a healthier, more equitable world; to our faculty and staff and their dedication to our students; to our community partners who play an essential role in preparing our students for nursing practice; and to our donors who support our transformational work. As friends of the School of Nursing, you understand the power of nursing to change lives—including those of our students, who will enter a rapidly changing profession and become frontline health care providers while navigating an increasingly complex health care system. So many of you have stepped up to provide scholarships that enable young talent to seek a university education, and your investment in their future encourages them to be the best they can be. I appreciate your generosity in investing in scholarships, research, and other programs that support our students and our overall mission. Many thanks to all of you who are a part of our exceptional School of Nursing community. Warm regards,

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• The School of Nursing was recently ranked by U.S. News & World Report among the top 5 percent of undergraduate nursing programs nationally for the third year in a row. Rankings are critical to our reputation and success, and our high national standing speaks to the strength of our Bachelor of Science in Nursing program. • Our Inclusive Excellence program is expanding and attracting national attention under the leadership of Associate Dean for Inclusive Excellence Dian Squire. This fall we received the Higher Education Excellence in Diversity (HEED) Award for Health Professions Schools in recognition of our commitment to diversity and inclusion. We held our first Inclusive Excellence Day conference in September, drawing student, faculty, and staff participants from across Loyola and other institutions. • Associate Dean for Innovative Partnerships and Faculty Practice Mary McNamara is strengthening long-standing community partnerships such as our School-Based Health Center at Proviso East High School, while establishing new ones with organizations like BEDS Plus, which works to prevent homelessness. Meanwhile, innovative models offer expanded opportunities for faculty practice. • We continue to deeply invest in research, hiring five tenure-track

DESIGNER

Emily Ayshford Diane Dungey Ted Gregory Sarah Richards

RESEARCH FOCUS THE SCHOOL EXPANDS AND DEEPENS ITS COMMITMENT TO NIH RESEARCH IN AN ENVIRONMENT THAT EMPHASIZES COLLABORATION, SUPPORT, AND LOYOLA’S COMMITMENT TO SOCIAL JUSTICE AND EQUITY.

CARE PATHWAY AN UNDERGRADUATE NURSING PROGRAM CHARTS A COURSE FOR WORKFORCE DIVERSITY AND EQUITY IN HEALTH CARE.

VALUABLE ALLIANCES THE CONNECTION WITH BEDS PLUS, WHICH WORKS TO PREVENT HOMELESSNESS, IS ONE OF MANY PARTNERSHIPS BETWEEN THE NURSING SCHOOL AND COMMUNITY ORGANIZATIONS.

O N T H E CO V E R

From left to right: Assistant Professor Ginger Schroers, postdoctoral researcher Sueyeon Lee, Assistant Professor Lindsey Garfield, Professor and Associate Dean for Research and Scholarly Innovation Karen Saban (center), Assistant Professor Katherine Breen, Assistant Professor Meghan Garland, Assistant Professor Alexandra Nowak, Assistant Professor Thao Griffith, and Associate Professor Monique Ridosh. Cover Photo: Erik Unger

MEANINGFUL GIFTS THE STORIES BEHIND THREE GENEROUS GIFTS TO THE SCHOOL OF NURSING.

STATE-OF-THE-ART TEACHING NURSING SCIENCE FACULTY MEMBERS FIND INNOVATIVE WAYS TO TEACH FIRST-YEAR STUDENTS.

CO N TA C T U S QUESTIONS, ADDRESS CHANGES, O R C O M M E N T S M AY B E E - M A I L E D T O :

LOYOL A NURSING MAGA ZINE

schoolofnursing@LUC.edu

MISSIONS OF CARE TREATING PATIENTS IN A RURAL, UNDER-RESOURCED ENVIRONMENT, AND FINDING SPIRITUAL HEALING IN LOURDES.

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RESEARCH

“ It’s about

who we are” Cutting-edge research and collaboration drive an exceptional atmosphere at Loyola Nursing, an incubator of talent S TO R Y B Y T E D G R E G O R Y • P H OTO S B Y E R I K U N G E R

Thao Griffith (left), assistant professor, is researching how early life stress compromises oral feeding skill development in preterm infants. 4

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n early 2023, Marcella Niehoff School of Nursing Professor Karen Saban earned a prestigious fiveyear, $3.3 million National Institutes of Health R01 grant. The funding will allow her to expand her promising research on reducing race-based stress in Black women at risk for cardiovascular disease. R01 funding is also a marker of national recognition as an independent scientist, which Saban has earned through her distinguished record of publications and research funding. Saban says she is grateful for mentors who have guided her along the way. Now she is passing on that generosity, mentoring others as associate dean for research and scholarly innovation. “Advancing NIH-funded research speaks to our mission to advance the science of nursing within the context of providing care for the whole person and promoting social justice and health for all,” School of Nursing Dean Lorna Finnegan says. “We want our school and our research to be known for changing the lives of the communities and patients we serve.” Saban worked closely with three faculty members to submit NIH Research Career Development (K) Awards, which provide support and protected time for junior researchers to enhance their research training and conduct preliminary studies prior to submitting R01 grant applications: • Lindsey Garfield, assistant professor, received an NIH K23 Mentored Patient-Oriented Research Career

Development Award in 2021 to support her research training and a clinical trial on mindfulness as a stress reduction tool for Black mothers who have an infant in the neonatal intensive care unit. • Monique Ridosh, associate professor, received an NIH K1 Mentored Research Scientist Development Award in 2021 to advance her research with adolescents and young adults living with spina bifida. • In 2022, Thao Griffith, assistant professor, received an NIH K23 Mentored Patient-Oriented Research Career Development Award to determine the extent to which early life stress compromises oral feeding skill development in preterm infants. These grants are perhaps the most tangible signs that an exceptional atmosphere is taking shape in the School of Nursing. The school is expanding and deepening its commitment to NIH-funded research in an environment that emphasizes collaboration, support, and Loyola University Chicago’s focus on social justice and equity. At the same time, the School of Nursing is enhancing its reputation as a talent incubator. “The School of Nursing, under the leadership of Dean Lorna Finnegan, has been making great strides in recruiting talented researchers and growing its portfolio of societally impactful research,” says Meharvan Singh, Loyola’s vice provost for research. “There has been a 23 percent growth in School of

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RESEARCH The Marcella Niehoff School of Nursing is on a path to reach the top 20 in NIH research funding for U.S. nursing schools.” — D E A N LO R N A F I N N E G A N

Karen Saban earned a $3.3 million grant that will allow her to expand her research on reducing race-based stress in Black women at risk for cardiovascular disease.

Nursing research expenditures over the past four years, and noting the tough climate for external funding, this trajectory of success is a testament to the competitive programs of research being established by the faculty and their research teams.” “The fact that we currently have three NIH-funded K awards at once is pretty amazing for a school our size,” Saban says. “But we worked really closely with these faculty and helped polish their applications, which have to be stellar to earn NIH support.” In addition to Saban’s work with these three faculty, other senior faculty research mentors are providing support. Linda Janusek, Loyola nursing professor emerita, who has extensive research expertise examining the impact of chronic stress on well-being, mentors Griffith and Garfield. Ridosh is mentored by Grayson Holmbeck, a Loyola psychology professor who has followed families with spina bifida for more than 20 years. Janusek was on the nursing school faculty for 42 years until she retired in 2020. During that time, she was continuously funded by NIH for 18 years. Now she is serving as a grant reviewer for faculty who submit NIH and other major research grant proposals. In June, the School of Nursing moved another step closer to acquiring additional NIH funding when

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Alexandra Nowak, assistant professor, submitted a proposal for K funding to continue her research on stress and preterm birth in Black women. She worked closely with Saban and Janusak on her proposal. “Both Karen and Linda were very helpful in reviewing the proposal and making suggestions for improvement,” Nowak recalls. “Linda’s vast experience in reviewing grant proposals and her work in genomics was instrumental in the organization and clarity of my proposal.” Beyond those projects, Assistant Professor Ginger Schroers received grants from the National League for Nursing and Illinois Nurses Foundation to advance her work developing ways to manage medication interruptions and errors. These grants fund preliminary work to support a future R01 grant. The collaborative environment in the School of Nursing, all key players agreed, has been crucial. Nowak, who chose Loyola after postdoctoral research at Columbia University, says she felt that support during her 2022 interview. “Then, once I got here, everybody kind of rallied around me, like, ‘What do you need? What can I do for you?” “I’m so grateful to be part of this environment,” she adds. “I think that’s why people come here, and I think that’s why people stay.”

Ridosh, the associate professor researching ways to improve the lives of those with spina bifida, personifies the Loyola ethic. Starting in 1996 as a pediatric intensive care nurse, she has worked at the School of Nursing since 2007. Back then, Ridosh saw Loyola as a premier, Catholic higher education institution where she could develop her career. She went elsewhere to earn her PhD, but Loyola faculty in and outside the School of Nursing continued mentoring her. She says that support was crucial to her returning to become a nurse scientist at Loyola. “It’s the Jesuit values of this university that distinguish us from other institutions,” she says. “I share those values. They attracted and retained me. I’ve grown up in Loyola. I always say, ‘This is my home. This is where I want to stay.’” Several faculty members say Saban personifies that. “Whenever I want to run an idea past Karen, she’s willing to jump on a call,” Schroers says, adding that Saban meets at least monthly with her. “She gives me very constructive, helpful feedback, and very quickly. It’s just really nice.” That atmosphere starts with Finnegan, Saban says. Arriving at Loyola in 2019 from the University of Illinois Chicago College of Nursing, Finnegan had experience obtaining her own NIH R01 funding, and in mentoring other faculty to obtain NIH funding. As dean, Finnegan is committed to assuring that faculty have adequate support on their paths to NIH funding. One “huge change” Finnegan made early was reducing the teaching load for tenure track faculty, allowing more time for research, Saban says. “It’s an investment that you don’t see a return on right away,” she says, “but you do over time.” In the last two years, the School of Nursing has hired five tenure-track faculty. In addition to Nowak and Schroers, who were hired in 2022, Lisa Wesolowski, Katherine Breen, and Meghan Garland began their assistant professor positions in August 2023. When Wesolowski was interviewing for the position, she asked about the school’s approach to mentoring new faculty—an important topic for her. The

answer she received, in her words, “was just stellar.” Wesolowski accepted the job. A full month before joining the faculty, she was assigned a mentor. “The school has a warmth that I haven’t experienced at prior institutions—warmth among the faculty, real enthusiasm for their students, their research, their mission,” says Breen, whose research focuses on using artificial intelligence to measure multimorbidity (living with two or more chronic illnesses) in patients with acute coronary syndrome. “That’s so inviting to new investigators and new faculty members. It feels like a home environment.”

Lindsey Garfield received an award to support her research on mindfulness as a stress reduction tool for Black mothers who have an infant in the neonatal intensive care unit.

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RESEARCH

Meet the new faculty

In the last two years, Loyola’s School of Nursing has hired five tenure track assistant professors and a postdoctoral researcher

Assistant Professor Katherine Breen

Started August 2023 Education: University of Illinois Chicago (PhD), Benedictine University (MSN), St. John’s College of Nursing (BSN), Southern Illinois University (BS Healthcare Management). Research focus/goal: “Acute coronary syndrome (ACS) threatens the lives of millions of people per year. People with ACS frequently have multiple chronic conditions, or multimorbidity, and are at greater risk for worse outcomes than those without multimorbidity. Unfortunately, multimorbidity is higher and occurs earlier among minority and lower socioeconomic communities. Therefore, developing multimorbidity risk profiles that include social determinants of health may be useful in developing interventions that reduce disparities and improve post-ACS care. As a next step in my research, I plan to develop an NIH Mentored Research Career Development grant focused on using electronic health records and artificial intelligence to develop these risk profiles.” Why Loyola: “The support from everyone, the opportunity for career development, and the warmth and enthusiasm that permeate the school make it feel like home.”

Assistant Professor Meghan Garland

Started August 2023 Education: Rush University (PhD), Case Western Reserve University (MSN), Western Michigan University (BA Anthropology). Research focus/goal: “Black people are three times more likely to die from pregnancy-related complications than white people. Physical activity during pregnancy has been shown to reduce pregnancy-related complications. My research goal is to develop a physical activity

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intervention for Black pregnant people. I am beginning to work on an NIH Mentored Research Career Development grant to identify social and environmental factors that are related to physical activity among Black pregnant people so that I can develop a physical activity intervention that addresses these factors.” Why Loyola: “I was so impressed with the welcoming and the warmth and the care that were expressed to me during the interview process. It really made me feel like this would be a great home.”

Postdoctoral researcher Sueyeon Lee

Started Fall 2023 Education: University of Illinois Chicago (PhD), Ewha Womans University in South Korea (MS, BS Nursing). Research focus/goal: “My program of research focuses on promoting healthy behavior to prevent and address cardiovascular disease. During my doctoral program, I studied physical activity and sleep in patients who underwent cardiac surgery. I have broadened my research interest to explore how physical activity and sleep impact inflammation in underrepresented populations. Recently, I submitted an American Heart Association (AHA) postdoctoral fellowship application to examine the effects of a race-based stress reduction program on sleep, dim-light melatonin onset, and inflammation in Black women at risk for cardiometabolic disease. My research plan includes the measurement of salivary melatonin samples and the collection of activity tracker sleep data. This research aligns with my commitment to reducing health disparities and improving the well-being of underserved populations.” Why Loyola: “I chose Loyola to be mentored by Karen Saban. Her research is aligned with my work, and I have the opportunity to participate in the study team of a newly funded NIH randomized clinical trial. I’m also impressed by the school’s commitment to diversity, equity, and inclusion as well as community service.”

Assistant Professor Alexandra Nowak

Started August 2022 Education: Ohio State University (PhD), Wayne State University (JD), Oakland University (BSN), Madonna University (BS Legal Assistant/Paralegal). Research focus/goal: “My research focuses on biopsychosocial measures of preterm birth in Black women—specifically aspects of the neighborhood environment as measures of structural racism and their effects on biological mechanisms. I recently submitted a grant proposal for an NIH Mentored Patient-Oriented Research Career Development Award to study the relationships among neighborhood disadvantage, psychological stress, changes in gene expression (using integrated single-nucleotide polymorphism and DNA methylation data), and preterm birth in pregnant Black women. I would like to identify a biomarker that could be used in clinical trials to identify women who are at risk for preterm birth. The ultimate goal is to prevent preterm birth by intervening early in pregnancy.” Why Loyola: “Once I started interviewing, I could really feel the support. Then, once I got here, everybody kind of rallies around you.”

Assistant Professor Ginger Schroers

Started August 2022 Education: Villanova University (PhD), North Park University (MS Nursing Education), University of Illinois Chicago (BSN). Research focus/goal: “My program of research focuses on key quality and safety issues in health care: interruptions during medication administration and nursing handoff reports. I am currently funded by the National League for Nursing and the Illinois Nurses Foundation to conduct a multi-site

study with nursing students to determine the effects of deliberately practicing medication administration and interruption management on medication administration error rates and several other outcomes. The results of this study and other pilot studies will provide support for a major federal grant application.” Why Loyola: “It’s the faculty, leadership, and students. The faculty are just so supportive. Leadership, too. There’s no ego here. On top of that, the students are wonderful to work with. They want to be here, and they want to make a difference.”

Assistant Professor Lisa Wesolowski

Started August 2023 Education: University of Pittsburgh (PhD), St. Xavier University (BSN). Research focus/goal: “Pregnant women who undergo induced labor have nearly double the risk of having a cesarean delivery. A better understanding of the variation in natural labor progression could lead to more precise care of laboring women and decreased risk for unnecessary interventions. In my dissertation research with 401 women, I found three patterns, or trajectories of labor: precipitously progressing, average, and slow progressing. The slow progressing trajectory was associated with greater length of pregnancy. My next step is to begin working on an NIH Research Career Development Award to continue my work with identifying demographic, clinical, and genomic predictors of labor trajectories. My long-term goal is to develop interventions that are more precisely tailored to different trajectories of laboring women.” Why Loyola: “It’s just a really supportive environment, especially with Karen Saban introducing all of us to all the resources Loyola has to offer, and it has a great reputation for research and academics. Also, I was born and raised in the Chicago area. I have that Chicago pride in Loyola.”

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Overcoming barriers Innovative Loyola Nursing program charts path for a diverse workforce and equity in health care S TO R Y B Y D I A N E D U N G E Y

fure Ogedegbe hopes to be a pediatric nurse, a dream accelerated by an innovative program at the Marcella Niehoff School of Nursing that provided her with a scholarship—and a mission. She discovered the CARE (Collaboration, Access, Resources, and Equity) Pathway to the Bachelor of Science in Nursing, created at Loyola to meet the broad goals of building a more diverse nursing workforce and addressing health disparities for under-resourced communities. Recruiting and supporting Black and Latinx student nurses is at the core of the CARE Pathway. The initiative connected Ogedegbe to other students of color and their discussions enhanced what she was learning about health care inequities. “This really opened my eyes to see how my community is struggling to get quality care,” says Ogedegbe, a senior from Des Plaines, Illinois. “Now, I specifically want to work with underrepresented communities. The CARE Pathway has been the best part of the nursing program for me.” The CARE Pathway arose from Loyola’s recognition that nursing is a pillar in reducing disparities and improving health outcomes for all. That vision is consistent with the national blueprint outlined in “The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity,” a consensus study from the National Academy of Medicine that charges the nation’s nearly 4 million nurses with achieving 10 outcomes that position the profession to contribute meaningfully to achieving health equity. One major goal is building a nursing workforce that reflects the community. Patients benefit when nurses deeply under-

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stand the cultural, economic, and social factors that can be barriers to optimal care. “We know that a more diverse nursing workforce, reflecting the racial and ethnic diversity of communities served, is a tangible and essential step toward achieving health equity,” says Lorna Finnegan, dean and project director of the CARE Pathway. Reaching that goal will not be easy. Across Illinois, 6 percent of registered nurses identified as Latinx and 8.4 percent as Black, a 2022 survey by the state’s Department of Financial and Professional Regulation showed. That compares to a Latinx population of 18.3 percent in Illinois and 28.7 percent in Chicago, and a Black population of 14.7 percent in Illinois and 29.2 percent in Chicago. Increasing diversity among nursing students is the first step forward. That’s the goal of the CARE Pathway, which goes far beyond recruitment to support and mentor students who might face financial, educational, and social barriers to getting a nursing degree. The CARE Pathway approach to easing these obstacles is envisioned as a model for nursing schools nationwide. “It’s about more than recruiting diverse students and faculty—it’s about changing structures and creating a sense of belonging,” Finnegan says. The CARE Pathway was created in 2021 with a $2.2 million grant from the Health Resources and Services Administration. It grew out of an initiative to transition students into the School of Nursing from Arrupe College, Loyola’s two-year associate’s degree program. The CARE Pathway has since received additional funding from the Illinois Board

Juniors and seniors who are part of the first CARE Pathway cohort celebrate the start of the 2023 –2024 academic year on Loyola’s Lake Shore Campus. In May 2024, seniors in the group will become the first CARE Pathway participants to graduate.

of Higher Education, the Chicago Community Trust, and private donors. Financial support for students is a crucial starting point. A CARE Pathway scholarship “has lifted a weight off my shoulders and my parents’ shoulders,” says Loyola junior Alejandra Castellanos of East Chicago, Indiana, an aspiring labor and delivery nurse who says her goal is to help reduce mortality rates for women of color giving birth. The program focuses on building relationships and a welcoming culture through many facets: peer, alumni, and faculty mentoring; a CARE Pathway lounge where students can mingle and study; financial support; student success seminars; and holistic admissions. In a recent seminar, CARE Pathway students practiced how to approach professors to ask for academic help. Another session reminded students to focus on the future triumph of graduation to help them through the rigors of nursing school. The seminars are among the ways big and small that the CARE Pathway meets the needs of students, many of whom are the first in their family to go to college. “It gives them a pathway with the barriers removed,” says Regina Conway-Phillips, associate professor and School of Nursing department chair. “It allows them the ability to hope and trust that they have an

The CARE Pathway to the BSN team received Loyola’s inaugural READI (Racial Justice, Equity, Anti-racism, Diversity, and Inclusion) Catalyst Award from the Office of Institutional Diversity, Equity, and Inclusion in May 2023. opportunity to fulfill their dreams, when the system or the world is telling them that they can’t.” Jorgia Connor, associate professor and assistant dean of the BSN program, recalls one student who had good grades but rarely spoke in class. In a written reflection, “the student wrote that it was hard to be the only Black person in the classroom. I thought, ‘Oh my gosh, I’ve been there,’” says Connor, a Philippines native who has experienced being singled out and feeling like an outsider. With the CARE Pathway, Connor says, “we want to make sure these students have a feeling of belonging.” The program is growing, with 62 students enrolled during the 2023–24 academic

year, up from 22 in its first cohort. A “transformational” $4 million gift from Chicago’s Sisters of the Resurrection will provide financial aid for CARE Pathway students for several years, Finnegan says. Finnegan dreams of building on the program’s initial success and expanding it to the school’s graduate and Accelerated BSN students. She also has ambitious plans to create a CARE Center for Student Success and Well-being that would translate the program’s evidence-based strategies into a framework other universities could replicate. “Nursing schools recognize more than ever the importance of creating a more diverse nursing pipeline and supporting the unique needs of these students,” Finnegan says. “We believe the strategies we’re using to recruit and retain under-represented students can be a game changer for schools nationwide.” A CARE Pathway student, meanwhile, hopes her example as a Latinx nurse will attract others to the profession. “Growing up, I didn’t have a lot of nurses that I was able to see as role models,” says Sofia Rodriguez, a junior from Elgin, Illinois. “I would like to inspire other minorities such as myself and show them that they are capable of going into any career they want.”

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Power of

Alliances show students the value of nursing careers

partnerships S TO R Y B Y DIANE DUNGEY P H OTO S B Y ERIK UNGER

ursing student Samantha Rosales chatted with residents at the BEDS Plus Summit Service Center as she helped prepare their lunch—a way to get to know them and learn about the circumstances that led them to the medical respite facility. The connection with BEDS Plus, which gives recently hospitalized people without housing a safe place to recover while accessing medical care and other sup-

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portive services, is one of many partnerships between the Loyola University Chicago Marcella Niehoff School of Nursing and community organizations that provide health care to people who need it. The partnerships provide broad experiences to nursing students while exposing them to the realworld impacts of housing instability, food insecurity, inadequate access to health care, and other social determinants on health.

“It’s a symbiotic relationship between academia and our health care partners,” says Mary McNamara, Loyola’s inaugural associate dean for innovative partnerships and faculty practice. “It results in better prepared students, innovative models of care, excellent opportunities for research, and better patient care outcomes.” Named to that role in 2022, McNamara is charged with building new strategies for faculty practice and creating partnerships with communities and health care systems. That includes the BEDS Plus partnership, where Rosales had come to a momentous conclusion. She intended to devote her career to working with people who are underserved—like those she met at BEDS Plus. “Being able to talk to the residents helped me solidify my decision to go into community health,” says Rosales, who is enrolled in the Accelerated Bachelor of Science in Nursing (ABSN) program. Open since March 2023, BEDS Plus can house 18 people who need help stabilizing their health and securing housing. For Iraq War veteran Dartagnan Landing, that help includes coordinating with Edward Hines, Jr. VA Hospital on his medical care and providing a quiet place to rest. Mark, who did not give his last name, says BEDS Plus helped with his application for Social Security disability benefits. “They give us hope,” says William Chiarappa, who came to BEDS Plus after living on the street in Tinley Park, Illinois. The student nurses focus on preventative programs and learn a team approach to caring for BEDS Plus residents and others who drop in at the Summit center. “Listening to everyone’s stories, in and of itself, can change the students,” says Kate Myczek, Loyola clinical assistant professor and co-director of the family nurse practitioner track. Luz Cruz, of Chicago Ridge, Illinois, also an ABSN student, formerly was a COVID-19 case manager for Cook County. Working in the community was nothing new to her, but being at BEDS Plus gave her a different perspective. “We get the experience of working with people who are homeless,” Cruz says. “As nurses, even if you don’t work in community health, you may have a patient on your medical surgical floor who is homeless or is at risk for being homeless. You can help connect them to resources.” The alliance with BEDS Plus is just one of the partnerships aimed at preparing Loyola students for an array of nursing roles. The School of Nursing operates a longstanding School-Based Health Center (SBHC) at Proviso East High School in Maywood, Illinois, offering a range of services: primary and urgent care, immunizations, behavioral health services, and more. SBHC staffing includes Loyola nurse practitioners,

a physician, social workers, and a dietitian. For many students and families in the underresourced community, the SBHC is their main health care resource. “We can offer them care in a safe and convenient location, so that all students have access to health care, and it keeps them in school,” says McNamara. The School of Nursing also runs the Loyola Community Nursing Center, which serves Chicago’s Rogers Park, Uptown, and Edgewater neighborhoods. Meanwhile, partnerships with health care systems including Loyola Medicine, Northwestern Medicine, Near North Health, and Cook County Health offer faculty and students clinical practice opportunities. The collaboration with Loyola Medicine, for example, now includes an academic practice council, where School of Nursing faculty and health system nursing leaders meet regularly to create joint practice and teaching opportunities. These partnerships offer faculty and students the opportunity to explore new paths within the profession and deepen their understanding of the factors that contribute to health equity. Until taking part in the community nursing rotation at Loyola, “I didn’t realize how many options we have as nurses,” says Rosales, who is considering joining the Commissioned Corps of the U.S. Public Health Service. That’s the point of partnerships like the one at BEDS Plus, McNamara says. “It’s a very different experience for the students than if they’re in a hospital,” she says. “This is a firsthand way to meet someone in their current situation and be completely empathetic to their way of living and to partner with them to use community resources to get to a better situation. “It’s the focus on social determinants of health that gives the nurse an enormous window into the power of nursing.”

It’s a symbiotic relationship between academia and our health care partners. It results in better-prepared students, innovative models of care, excellent opportunities for research, and better patient care outcomes.” — MARY MCNAMARA

Opposite page: Loyola Nursing students Aaronee Bereal (left) and Luz Cruz (right), along with Dr. Jennifer Swoyer from Pillars Community Health, interview a client of the BEDS Plus Summit Service Center. This page: Loyola Nursing students Darius Caesar (center) and Samantha Rosales (right) prepare lunch at the BEDS Plus Summit Service Center.

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Investing in the

next generation Three generous gifts, three remarkable stories S TO R I E S B Y A S H L E Y R O W L A N D

ROCCO AND ROXANNE MARTINO

$2.5 million gift will help build a more diverse pipeline of nurses A $2.5 million gift from Rocco and Roxanne Martino in 2023 will provide additional funding for graduates of Loyola’s Arrupe College who pursue Bachelor of Science in Nursing degrees at the Marcella Niehoff School of Nursing. Those students will be known as Martino Scholars. Arrupe is a two-year program that provides a path to an associate’s degree for students who face hurdles paying for and succeeding in college. Many are first-generation students, are academically unprepared for college, and are from under-represented communities. “Roxanne and I believe deeply in the power of education to improve lives. We’re first-generation college graduates who received a lot of help along the way,” says Rocco Martino (MBA ’78), a Loyola trustee since 2015. “We’re grateful that we can help these students receive an education and training, achieve a degree, and fulfill their aspirations. And—we hope—go on to improve Chicago.” The Martinos’ philanthropy will help fund financial aid and support services for Arrupe-to-BSN students, helping Loyola Nursing move closer toward its goal of building a more diverse pipeline of nurses. Having nurses of color treat patients of color has been shown to improve health outcomes.

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The couple’s gift has the power to expand and improve the futures of the Martino Scholars and strengthen the Chicagoland communities where many are likely to live and work after completing their degrees. Dean Lorna Finnegan says the Martinos have made an important commitment to students who could one day help reduce health inequities in Chicago. “This generous gift from the Martinos will help create educational access for our talented students of high need,” she says. “The gift will have profound impacts on our students, their families, and communities for generations to come, and we are deeply grateful for the opportunity to support students to reach their full potential.”

BARBARA BRODIE

Nursing pioneer’s gift reflects her commitment to teaching In her commencement address to the Marcella Niehoff School of Nursing Class of 2010, alumna Barbara Brodie—already regarded as a “living legend” within the nursing profession—delivered a compelling message: Treat your patients with dignity, no matter their background. “Dignity…signifies the human worth of an individual in the eyes of others and in their own estimation of who they are,” said Brodie, a 1957 graduate of Loyola’s baccalaureate program. “Dignity is essential to our very being and enables us to face the world and maintain our place within it.” That emphasis on the inherent worth of each person—instilled as Brodie cared for the poorest of Chicago’s poor during her clinicals—guided her throughout her career as a leading nurse practitioner, historian, and educator.

While Brodie spent decades at the University of Virginia, she maintained close ties to her alma mater until her death in February 2023. She left a large gift to Loyola Nursing—one colleagues say reflects her commitment to teaching the next generation, and to the school’s guiding principle of service to others. “Barbara valued her undergraduate education at Loyola and always spoke enthusiastically about Loyola whenever she had the opportunity,” says Karen Egenes, Loyola Nursing associate professor emerita. “She said it was important for undergraduates to absolutely love their school and stay attached to it, because it gave them their foundation in nursing.” Brodie was a pioneer in the nurse practitioner movement, a mission inspired by her work with underresourced patients—particularly children—at Cook County Hospital during her clinicals and early career. “She was one of the first people who saw pediatric nurse practitioners as a way to bring health care access to lower-income groups,” Egenes says. But Brodie, who was named a “Living Legend” by the American Academy of Nursing in 2009 and received Loyola Nursing's Damen Award in 2014 for leadership and service to others, is best known for her work in nursing history. She founded the American Association for the History of Nursing and urged schools to make the profession’s history a standard part of nursing school curricula. “She said that the same issues in health care keep reemerging, and we have to learn from approaches used in the past if we want to move forward,” Egenes says. “She believed that the issues nurses identify and deal with over time are the ones that end up shaping health care policy.”

HELEN (SUNDALL) GOYER

Scholarship honors tenacity and grit of ‘health care hero’ One of 11 children born to impoverished Norwegian immigrants, Helen Sundall moved to Chicago as a teenager to escape a bleak future on her family’s Wisconsin farm. Bright and hardworking, she graduated in 1923 from nursing school and launched her career at the Chicago Municipal Tuberculosis Sanitarium—putting her life on the line to care for contagious patients with an often deadly lung disease. “She was a health care hero,” says her granddaughter, Carol Sullivan, a registered nurse who holds an MBA

from the Quinlan School of Business. “She put herself at risk to help others and she knew what the consequences could be.” Later married and adopting the last name of Goyer, the TB nurse’s family is honoring her legacy as a frontline health care provider with the establishment of the Helen (Sundall) Goyer RN Memorial Scholarship to support first-generation nursing students. The fund also marks the 100th anniversary of her graduation from St. Anne’s School of Nursing, one of several hospital nursing schools that merged with Loyola in 1935 to become the first collegiate nursing proLoyola made a huge gram in Illinois. The scholarship was made difference in my family’s possible thanks to Goyer’s late trajectory. We know what daughter and son-in-law, Mary Esther and George Baskys, a difference obtaining an who had no children but beeducation...can make to queathed an inheritance to their many nieces and nephews. future generations.” A number of Goyer’s descendants have contributed to the — J I M R U D O L P H , HELEN (SUNDALL) GOYER’S GRANDSON fund, which the family sees as a tribute to her compassion and resiliency. Several family members likened Goyer’s courageous decision to treat TB patients to the work of nurses nearly 100 years later in COVID wards. Helen Goyer and her husband, Leo Goyer, a TB patient who lost a lung to the disease, paid a steep price for that choice: She eventually developed full-blown TB and spent two years in a treatment facility. Her confinement splintered her young family, forcing the Goyers to send their five children—including one with Down syndrome who required full-time care—to live with relatives or in institutions for several years. “It was tough,” says her daughter, Leona Rudolph. She remembered her mother, who died in the 1980s, as someone who personified the best of nursing: “She was compassionate, patient, and understanding. We were so proud of her.” The scholarship honors Goyer’s tenacity and grit as a first-generation student. It also recognizes Loyola’s impact on generations of the Goyer clan, several of whom attended the university. “Loyola made a huge difference in my family’s trajectory,” says the Goyers’ grandson, Jim Rudolph, a Stritch School of Medicine graduate. He said Helen Goyer likely received financial assistance to attend nursing school, and her family wants to extend a helping hand to other aspiring nurses who lack the resources to attend college. “We know what a difference obtaining an education and having a stable career can make to future generations,” he says. “That’s the motivation behind this scholarship—to augment someone’s journey.”

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Scientific School of Nursing science faculty find innovative ways to teach first-year students

S TO R Y B Y SARAH RICHARDS

method

ngela Mahaffey wants her chemistry and physiology students to have the same power she has: the ability to see science in everything. It’s a key skill for nurses, she says, who are often the last line of defense against medical errors. “I’ve seen nurses spot things that other individuals did not,” says Mahaffey, an assistant professor at the Marcella Niehoff School of Nursing. “Once you understand the science behind it, you can catch, ‘Hey, the physiology, the biochemistry in this patient’s body does not match the pharmacology, the organic chemistry in the medicine.’” To do that, Mahaffey and other School of Nursing science faculty are finding innovative ways to teach first-year students the scientific expertise, skills, and principles they’ll need, not to mention the importance of cura personalis—the Jesuit value of caring for the mind, spirit, and body—to their work as nurses. It’s all part of Loyola University Chicago’s commitment to training the next generation of nurses using state-of-the-art teaching tools and foundational science classes structured on nursing. After joining the School of Nursing in 2017, Mahaffey created one of the first virtual chemistry lab programs in the country for undergraduate nursing students, publishing numerous research papers on the topic. Within her program, she incorporates tangible examples that highlight science in everyday places, like having students role-play as baristas in a coffee shop to learn about the specific heat capacity of beverages. “Chemistry in a cup of coffee explains the heat energy transfer,” says Mahaffey. “From there, I bridge to health care questions on where we see such heat transfers from chemical to thermochemical reactions, such as when patients receive chemotherapy or in the biomedical lab equipment sterilization process.” Mahaffey frequently works with students on her research projects. Most recently, a joint effort with

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Loyola’s School of Environmental Sustainability focused on developing a sanitizer that can be used on both electronic devices and hands, without leaving a residue. “I want students to be not simply practitioners, but investigators,” says Mahaffey. That’s because today’s nurses face a complex health care environment. On a daily basis, they’re challenged with juggling care for multiple patients and maintaining the highest standards of patient and workplace safety, all while staying abreast of the latest treatments and medications.

I want students to be not simply practioners, but investigators.” —A N G E L A M A H A F F E Y

“The Loyola model in which students start their four-year BSN right away is a great model because it helps students form their identities as nurses very early,” says School of Nursing Dean Lorna Finnegan. Matt Bruder is another faculty member helping anchor those nurse identities in the foundational sciences. On the first day of his anatomy class, Bruder draws a pyramid on his whiteboard and writes “anatomy” at the bottom. Moving up the pyramid’s levels, he writes in other disciplines pertinent to nursing, such as pathophysiology and pharmacology. It’s a simple message for his nursing students: anatomy is the foundation of success in medicine. “Everything is based on anatomy,” says Bruder, an assistant professor. “All of their future coursework is based upon that of the relationship of structure—that of anatomy.” Bruder is an expert at packing essential knowledge into his lessons, but he’s also well aware that most of

School of Nursing Assistant Professors (clockwise from upper left) Kevin Mazor, Matt Bruder, and Angela Mahaffey are finding innovative ways to teach first-year students the scientific expertise, skills, and principles they’ll need for their work as nurses.

his students were sitting in high school classrooms three months before first walking into his. Supplemental instructors—former students who excelled in his class and now tutor new students for free—and study groups provide his students with added support. Bruder’s students benefit from computer-generated anatomy labs in which they come to class and perform virtual dissections of human cadavers using specialized software. Not only are these virtual labs safer (no finger nicks with the scalpel), but Bruder says they’re also as effective as traditional wet labs at the undergraduate level. “In a traditional lab, you spend a lot of time cutting through the skin and fat of your specimen to expose the muscles,” says Bruder. “All of that tedious, mundane work is accomplished with a click of a button and students can spend their time appreciating anatomical relationships rather than digging through fat.” Capitalizing on those moments often means the difference between rote learning and active scholarship—something Assistant Professor Kevin Mazor knows all about. His love of science came from two very different influences: the critical thinking of his favorite detective when reading Sherlock Holmes novels and the quirky experiments of the Good Eats cooking show. “With Sherlock Holmes, it was all about deductive reasoning,” says Mazor. “With Good Eats, it was all about the science of cooking, understanding the fun-

damentals, how and why things work.” Today, Mazor taps similar skills and techniques when teaching microbiology and nutrition to secondyear nursing students. His challenge, he says, is creating novel lessons that maximize knowledge, foster learning, and minimize stress. Mazor strives to tailor his classes to his nursing audience, often focusing on disease and patient interactions. In nutrition, that means a more robust examination of obesity and the impact bias has on long-term health outcomes; in microbiology, it means scrutinizing the overprescription of antibiotics, which students do in part by tapping into training materials from the Centers for Disease Control and Prevention. At the end of every semester, one of his favorite things to do is to express pride in his students by showing them all of the material they’ve learned. “It’s that connection you make having those a-ha moments of knowledge and education that are always really, really fun and rewarding,” Mazor says. It’s a feeling echoed by Bruder and Mahaffey. “The most satisfying thing to me is when I reach the end of the semester and a student comes to me and says, ‘Dr. Mahaffey, I was reading about this medical case study on my own and this is what I think is happening,’ ” says Mahaffey. “They proceed to go over what we’ve learned in chemistry and physiology to come up with an educated critique or deduction—and I love it.”

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Loyola Nursing by the

numbers US News & World Report ranked Loyola’s BSN program:

Top

#31

5% of undergrad nursing programs nationally

93.5%

of 656

schools nationally

among BSN programs in Illinois

National Council Licensure Examination (NCLEX) pass rate for first-time test takers in 2023

2023 fall enrollment BSN

959

MSN

DNP

149

Certificate

PhD

Students attend Loyola Nursing from , the District of Columbia, and several countries.

35 states Nearly

52% of our BSN students are students of color.

Research grant activity (fiscal year 2023) 23 new and ongoing grants totaling

$3,323,401

Donor gifts (fiscal year 2023)

$904,982

THANK YOU to our generous donors!

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Missions of

Two service immersion programs extend Loyola Nursing’s reach S TO R I E S B Y E M I LY AYS H F O R D

Care

Finding spiritual healing in Lourdes

n 1858 in Lourdes, France, a young girl had visions of the Virgin Mary, who told her to dig and drink from an underground spring. The site quickly became a destination for those seeking cures. Today, millions of religious pilgrims visit the site each year, where they wash themselves in stone baths and drink the water, hoping to find spiritual healing. For a week in May, Loyola Nursing students volunteer in the baths, assisting the visitors and reflecting on what spiritual care means. This year was the 11th Lourdes Service Immersion. The school did not take students during the pandemic. “It’s very important for our students to engage with sick people from around the world,” says Ann Solari-Twadell, the associate professor who leads Loyola Nursing’s Lourdes Service Immersion program. “At Loyola, care for the whole person includes physical, emotional, and spiritual wellbeing. For our students to have this experience is transformational for them and for their future nursing practice. For some patients, spiritual care is the most important care that you can provide for them.” This year, Jorgia Connor, assistant dean of the BSN program, wondered if the trip could include a more personal connection. She suggested that her cousin Maureen Sevandal come along. Sevandal, a 44-year-old pediatric dentist with two young children, had just finished chemotherapy after her third recurrence of breast cancer in eight years and was searching for both physical and spiritual healing. Sevandal agreed and met with the nursing students before the trip to share her

Faculty, students, and the chaplain at Loyola Nursing's 11th Lourdes Service Immersion program. Millions of religious pilgrims visit the site in France each year hoping to find spiritual healing.

story—something the normally reserved Sevandal struggled with. “I basically talked for the longest I’ve ever talked in my life,” she says. She told them of her struggles with the diagnoses, the treatments, and keeping up her roles as a dentist and a mother throughout. “I wanted to be more spiritual, and I told them this trip would help me do that,” she says. The group joined her in a healing mass, and when they traveled to France and visited the baths, Connor assisted Sevandal as she washed herself in the waters, which Sevandal says felt like “a baptism and renewal of my spirit.” “Having Jorgia and the nursing students there was very comforting,” Sevandal says.

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“I felt overwhelming love from the power of prayer and being in such a miraculous place. I wanted to show the nursing students the power of spiritual care, that even though this was not my plan, God has a purpose. And even in my struggles, I do have a lot of blessings in life.” For Connor and the students, Sevandal’s story made their immersion experience that much more powerful. “The students are also seeking spiritual healing themselves, and they all said how special it was to have her with us,” says Connor. “That real personal connection shows them the power of spiritual healing, and that’s something they can take back with them and use as they become nurses.”

Treating patients in the rural, under-resourced environment of the Pine Ridge Reservation

n the Pine Ridge Reservation in the grasslands of South Dakota, the Oglala Lakota tribe lives and celebrates its heritage among its unique institutions, including within the Our Lady of the Sioux parish. But the reservation is among the poorest in the country, and many residents struggle with alcohol and drug addiction. Its rural location also means its residents are underserved medically. In 2018, Loyola Nursing students and faculty first traveled to the reservation for a week-long service immersion trip. They repeated the trip in 2019 but were unable to go in 2020 and 2021 due to COVID-19. Loyola Nursing returned to Pine Ridge in 2022 and this year. There, they help however they can— cleaning, delivering food to residents, or painting buildings—while learning about Lakota culture and history, and what it means to provide care when resources are restricted. “We meet with people from the community to hear about what life at Pine Ridge is like, then we provide service to the community,” says Ann Solari-Twadell, the associate professor who leads the Pine Ridge Reservation immersion programs. “The students develop realtionships within the community and get a perspective on what it's like for people trying to survive in this challenging geographic terrain.” For nursing student Elizabeth Castillo, that meant meeting with parishioners at Our Lady of the Sioux. “The people were very open with their struggles,” she says. “Their community was important to them, but they didn’t want their children exposed to these issues. It made me realize how different it is from my own experience and made me want to be the kind of nurse who advocates for policy changes to help this.” This year, thanks to a Health Resources and Services Administration (HRSA) grant, the students also had an opportunity to practice telehealth visits—a high-demand skill since the pandemic. The Interprofessional Rural Telehealth Certificate Program paired Loyola nursing students

Assistant Professor Nancy Raschke Deichstetter (center) leads a distance telehealth simulation during the summer 2023 Pine Ridge Reservation immersion program. The simulation allows all students and faculty in Pine Ridge and Chicago to engage in patient care.

with social work students and medical students to simulate a telehealth visit on the reservation. The telehealth simulation was designed to bring students together using equipment received during the pandemic from the federal CARES Act. This allowed all students and faculty to engage whether they went to Pine Ridge or not. “Usually, nurses conduct physical assessment using all our senses, but if the patient is on the screen, we can’t touch them,” says Carol Kostovich, assistant dean of innovative educational strategies and simulation and project director of the HRSA grant. For telehealth visits, nurses need to be trained in interviewing skills and to guide patients to move their bodies so nurses can examine them thoroughly. The telehealth visit at Pine Ridge involved a simulated patient with diabetes who developed a foot ulcer. The students connected with Loyola University Medical

Center in Maywood, Illinois and worked with the wound care team—as well as nursing students who did not go on the trip—to diagnose and create a care plan for the patient. “The feedback was very positive,” Kostovich says. “Chances are, after students graduate, they will be exposed in some format to telehealth, even if they don’t serve in rural communities.” Though Loyola Nursing has developed relationships with the Indian Health Service and the nearby hospital, the goal is to create a clinical practicum experience for Loyola students to also treat patients on the reservation. “Students learn about the culture, socioeconomic issues, and health issues, and the goal is to come into this new situation and be of service,” Solari-Twadell says. “But now that we have been there for five years, we want our students to experience even more and help residents in a new way.”

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Challenging the

status quo

Our 2023–2028

Strategic Plan TWO YEARS AGO, THE LOYOLA UNIVERSITY CHICAGO MARCELLA NIEHOFF SCHOOL OF NURSING FACULTY AND STAFF EMBARKED on a strategic visioning process intended to strengthen our long-standing

Inaugural Inclusive Excellence Day focuses on how the nursing profession can promote health equity among historically oppressed populations

history of excellence, describe a clear vision for the next five years, and identify strategic directions to drive our growth. Through an approach

the 2023–2028 Marcella Niehoff School of Nursing Strategic Plan—11 ambitious strategies with measurable goals, initiatives, and key performance

ow can nurses best treat patients from marginalized groups—Black, Brown, LGBTQIA+, and those with disabilities? And how can educators better prepare the next generation of nurses to do so? Those were among the topics discussed at the Marcella Niehoff School of Nursing’s inaugural Inclusive Excellence Day, held

September 26, 2023, at the Lake Shore Campus Damen Center. Attended by faculty, staff, and students, the event focused on how the nursing profession can promote health equity among historically oppressed populations. It also sought to give nurses tools to address social determinants of health— the non-medical factors such as poverty and education that impact well-being—

and be advocates for their patients’ health, dignity, and access to care. “Nursing education provides a unique opportunity to challenge and change the status quo,” says Dian Squire, founding associate dean of inclusive excellence at the School of Nursing, which will hold Inclusive Excellence Day annually. Keynote speaker Felesia Bowen, associate dean for diversity, equity, and inclusion at the University of Alabama at Birmingham, spoke on the strong connection between racism and toxic stress in children. Other sessions addressed equity at the intersection of Jesuit values and inclusive excellence, bystander intervention training, and providing affirming care to the LGBTQIA+ community. A nurse researcher performed spoken word poetry to demonstrate how nontraditional learning tools can humanize the experience of those who face discrimination. “Nurses have a powerful voice within health care systems,” Squire says, “and it is crucial that they use it to address systemic injustices that perpetuate health disparities.”

grounded in Loyola’s mission and enduring values, we engaged dozens of participants, including students, alumni, and practice partners. All were dedicated to fulfilling the call of our school’s “why” statement: to build relationships that positively transform lives. This effort resulted in indicators linked to them that build on successes, address opportunities for growth, and prepare Loyola Nursing for the future.

Scan the QR code below to view the strategic plan report and visit LUC.edu/nursing to watch our progress.

LOYOLA NURSING EARNS HEED AWARD The Marcella Niehoff School of Nursing earned the 2023 Higher Education Excellence in Diversity (HEED) Award in recognition of its expanding efforts to promote diversity, equity, and inclusion. It marks the first time the School of Nursing has received the prestigious national honor, given annually by INSIGHT Into Diversity, the largest-circulation magazine for diversity in higher education and a leader in identifying best DEI practices in universities across the United States.

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“Being named a HEED Award winner alongside other excellent nursing and health professions schools throughout the country places our inclusive excellence efforts among the best,” says Dian Squire, associate dean for inclusive excellence. “We could not be prouder of this honor, and we aspire to lead by example as we develop new ways to incorporate DEI into nursing education.”

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