Papers by David A U G U S T I N E Bull
This study examined the predictive and operational value of bottleneck analysis for optimizing he... more This study examined the predictive and operational value of bottleneck analysis for optimizing healthcare staff utilization through the integration of the Theory of Constraints (TOC) and predictive analytics. Using a quantitative, explanatory research design, data was collected from departmental workflows, performance metrics, and staff schedules in a mid-sized urban hospital over a 12-month period. Bottlenecks were identified and categorized into human, procedural, and technological constraints. To address the first research question, predictive models, including multiple linear regression and random forest algorithms were developed to assess the relationship between bottlenecks and staff utilization. The random forest model demonstrated higher predictive accuracy, indicating that identified constraints can meaningfully forecast staffing efficiency. To answer the second research question, descriptive statistics revealed that procedural and human bottlenecks were the most frequent and disruptive. One-way ANOVA showed significant differences in staff efficiency across departments based on constraint type and severity, while chi-square tests confirmed associations between bottleneck types and inefficiencies. For the third research question, TOC-informed interventions were implemented in departments with high constraint levels. Pre-and post-intervention analyses using paired t-tests showed significant improvements in staff efficiency, reduced idle time, and increased patient throughput, with effect sizes indicating meaningful practical changes. The study's findings have several implications. For practice, healthcare leaders should adopt TOC-driven bottleneck analysis combined with machine learning models to anticipate and alleviate staffing inefficiencies. Regular audits of workflow constraints can help in deploying staff more effectively and improving patient flow. For research, this study lays the groundwork for longitudinal and multi-site investigations to generalize findings across various healthcare settings. Future studies should explore real-time constraint detection using artificial intelligence tools. Theoretically, this study supports and extends the Theory of Constraints by demonstrating its compatibility with predictive modeling, contributing to a more data-driven approach to operational decision-making in healthcare. Recommendations include training healthcare managers in constraint identification and predictive analytics to enhance systemic responsiveness and sustainability in workforce management.
This study examined the impact of data-driven curriculum optimization on student outcomes in an o... more This study examined the impact of data-driven curriculum optimization on student outcomes in an online undergraduate healthcare management program, with a sample of N=200 students. Using a quasi-experimental design, the research analyzed course performance metrics, course completion rates, and student engagement before and after the implementation of analytics-informed curriculum revisions. The first research question assessed whether the optimization improved final course grades. A one-way ANOVA revealed a statistically significant improvement in final grades [F(1, 198) = 5.72, p = 0.018)], indicating that students performed better following curriculum optimization. The second research question focused on the impact of optimization on course completion rates. A Chi-square test showed a significant increase in completion rates post-optimization [(χ²(1) = 8.45, p = 0.004)], suggesting that more students completed the course after curriculum revisions. The third research question examined the relationship between student engagement with optimized course components and academic performance. Correlation and regression analyses revealed a strong, positive relationship [(r = 0.62, p < 0.001)], with student engagement significantly predicting higher academic performance. These findings underscore the value of leveraging learning analytics and adaptive course design in supporting academic success and persistence among online learners. The study contributes to growing evidence advocating for intentional, data-informed curriculum strategies to enhance student outcomes in health education.
This study investigated reductions in perceived academic stress among undergraduate students, foc... more This study investigated reductions in perceived academic stress among undergraduate students, focusing on how stress levels vary across subgroups defined by enrollment status (full-time vs. part-time), parenting status (single parents vs. non-parents), work obligations, and GPA. Guided by three research questions, the study examined (1) to what extent is there a relationship between reductions in perceived academic stress and improvements in student academic performance (2) to what extent does a reduction in perceived academic stress predict changes in undergraduate students’ academic performance and (3) whether significant differences in stress levels exist among key student subgroups. A total of 200 undergraduate students, male and female, participated in this cross-sectional study. Data was collected using the Perceived Stress Scale–Academic (PSS-A), a validated instrument designed to assess stress related to academic responsibilities and self-reported Grade Point Averages (GPAs). Using SPSS 28 software for analysis, descriptive statistics indicated that students experienced moderate levels of perceived academic stress overall. Independent samples t-tests revealed significant subgroup differences. Full-time students reported significantly higher stress (M = 3.5, SD = 0.6) than part-time students (M = 3.3, SD = 0.6), [t(185) = 2.47, p = .015], Cohen’s d = 0.33. Single parents exhibited higher stress levels (M = 3.7, SD = 0.6) compared to non-parents (M = 3.4, SD = 0.6), [t(185) = 3.21, p = .002], d = 0.50. Students with work obligations also reported significantly higher stress (M = 3.6, SD = 0.6) than those without (M = 3.3, SD = 0.6), [t(185) = 2.87, p = .005, d = 0.42]. Boxplot visualizations highlighted elevated median stress levels and wider interquartile ranges among full-time students, single parents, and those with work commitments. While GPA range appeared to show minor differences in stress distribution, students with GPAs in the 3.5–4.0 range reported the lowest median stress levels, suggesting a potential link between academic performance and stress management. These findings have important implications for institutional policies and student support services. Undergraduate programs should consider developing targeted interventions, such as flexible scheduling, mental health resources, and family/work-life balance support, especially for full-time students, single parents, and working students. By addressing these disparities, institutions can enhance student well-being, academic persistence, and overall program success.
Keywords: academic stress, undergraduate students, academic performance, Cognitive Appraisal Theory, Self-Determination Theory.
International Journal of Life Sciences Research, 2025
The impact of logotherapy intervention on student's perceived academic performance and stress lev... more The impact of logotherapy intervention on student's perceived academic performance and stress levels was investigated using quantitative methodology, among students in Texas, ages 18 to 60 with particular attention to subgroups facing unique challenges, including work-study and single-parenthood. A total of (N = 200) participants were randomly assigned to either an intervention group (n = 100) receiving logotherapy-based support or a control group (n = 100) receiving no intervention for three, five-weeks sessions from December 2024 to March 2025. Academic performance was measured using self-reported GPA, while stress levels were evaluated using a Modified Preferred Stress Scale (PSS-10) before and after the intervention. The results demonstrated a statistically significant improvement in academic performance for the intervention group (M = 3.5, SD = 0.4) compared to the control group (M = 2.8, SD = 0.5), [t(198) = 8.52, p < 0.001], with a large effect size (Cohen's d = 1.54). Similarly, stress levels were significantly lower among students who received the intervention (M = 4.2, SD = 1.3) than those who did not (M = 7.8, SD = 1.6), [t(198) =-13.21, p < 0.001], with a large effect (Cohen's d = 1.86). Two-way ANOVA analyses further revealed that work-study and single-parent students experienced amplified benefits, with significant interaction effects indicating that the intervention was especially effective for these subgroups. These findings suggested that logotherapy not only enhances academic outcomes but also provides critical emotional resilience, particularly for students managing complex life responsibilities. The study supports the integration of logotherapybased interventions into academic support services to improve educational persistence and psychological well-being among diverse student populations.
This study investigates the impact of curriculum concept mapping on students' perceived academic ... more This study investigates the impact of curriculum concept mapping on students' perceived academic performance, course material retention, overall perception of curriculum mapping, and self-efficacy and motivation in higher education. Curriculum concept mapping, a structured visual tool for representing and organizing course content, aims to enhance comprehension, retention, and engagement. Despite its increasing adoption, limited research explores its influence on these interconnected variables and their role in fostering academic success. The study employed a quantitative pre-test/post-test design with a sample of (N=100) undergraduate students. Participants engaged in structured concept mapping activities within a healthcare management course to organize and connect learning objectives, topics, and outcomes. Paired t-tests and linear regression analyses were conducted to evaluate changes in students' perceived academic performance and related variables. Pre-test results indicated moderate significance across all variables, while post-intervention results demonstrated statistically significant positive improvements in perceived academic performance, course material retention, overall perception of curriculum mapping, self-efficacy, and motivation. The findings reveal that curriculum concept mapping fosters enhanced comprehension of course content, a deeper connection to learning objectives, and increased confidence in academic capabilities. Students also reported improved motivation and a heightened appreciation for the curriculum's organization and relevance. These results underscore the efficacy of curriculum concept mapping as a pedagogical strategy for promoting engagement, retention, and self-efficacy in higher education. This study contributes to the growing body of literature on innovative teaching methods, offering actionable insights for educators seeking to align instructional strategies with students' academic needs and holistic development.
Published, 2024
This study explores the role of suffering within Viktor Frankl's logotherapy framework and examin... more This study explores the role of suffering within Viktor Frankl's logotherapy framework and examines its application to modern mental health care and daily life. Logotherapy, which emphasizes finding meaning through
suffering, contrasts with other therapeutic approaches that focus primarily on symptom relief or cognitive restructuring. By highlighting the central tenet that individuals can choose their attitude toward suffering and find
purpose in adversity, this study delves into how logotherapy aids patients in clinical settings, particularly those experiencing existential crises, chronic illness, or trauma. It also addresses criticisms of the approach, including its focus on individual responsibility and the limited empirical support for its efficacy in treating severe mental health disorders. Furthermore, the research integrates a spiritual dimension, considering how logotherapy's principles align with broader philosophical and religious concepts of suffering and redemption. Ultimately, this study contributes to understanding how meaning-making can serve as a valuable psychological tool, offering insights for both clinical practice and personal coping strategies. Implications for research, practice, and theory are discussed, critically evaluating logotherapy's role in contemporary therapeutic interventions.
Keywords: logotherapy, suffering, existential therapy, mental health, tragic optimism, psychological resilience.
International Journal of Social Science and Humanities Research, 2018
The relationship between Supervisor Dominant Leadership Style and job satisfaction was investigat... more The relationship between Supervisor Dominant Leadership Style and job satisfaction was investigated among 240 randomly selected non-managerial hospital personnel, between the ages of 20-65 years of age working in hospitals within the southern region of the United States. The Hersey's perspective of the Situational Leadership® Model and Spector's (1997) Job Satisfaction Scale were used in this investigation to obtain data for analysis. Results of the investigation revealed that the selling leadership style (S2-40%) and delegating leadership styles (S4-33.3%) were the dominant styles practiced by supervisors. However, multimodal leadership styles were also identified (S1S2S3, S2S3, and S2S4). Participants considered contingent reward the most important component of job satisfaction, while communications was considered the least. Sixty percent of the participants indicated their leader had a low level of adaptability (LAS < 24). Conversely, 10 percent reported that their leader had a high level of adaptability (LAS > 30); and 30 percent reported their leader had moderate adaptability (LAS ≥24≤30).
International Journal of Healthcare Sciences, 2018
The relationship between employee readiness and turnover intentions was investigated among (N = 4... more The relationship between employee readiness and turnover intentions was investigated among (N = 48) supervisors and (N = 192) subordinates, men and women between the ages 18 to 65, randomly selected from four randomly selected hospitals within the southern region of the United States. Instrumentation for the study included the Blanchard, Hersey and Hambleton (1977) Readiness Scale, the Jackofsky and Slocum's (1987) Turnover Intent Scale, and Demographic questionnaire. Statistical analysis using SPSS 24 software included Pearson correlation, Paired t-test, Independent t-test, and Descriptive statistics. Results of the paired t-test failed to show any significant differences between Staff Rated Total Readiness (SRTR) and Supervisor Rated Total Readiness (SRTR). However, an independent sample t-test revealed a statistically significant difference between the mean scores in Total Readiness (TR) for clinical and nonclinical staff. A Pearson correlation matrix for Staff Rated Job Readiness (SRJR), Staff Rated Psychological Readiness (SRPR), and Staff Rated Total readiness (SRTR); and Supervisor Rated Staff Job Readiness (SSRJR), Supervisor Rated Psychological Readiness (SSRPR), and Supervisor Rated Total Readiness (SSRTR), and Turnover Intentions (TI) revealed sufficient evidence of a significant positive correlation between Staff Self-Rated Job Readiness (SRJR) and Staff Self-Rated Psychological Readiness (SRPR) (r = .837, p = .000; Supervisor Rated Staff Job Readiness (SRSJR) and Supervisor Rated Psychological Readiness (SRPR) r = .843, p = .000; Staff Self-Rated Job Readiness (SRJR) and Supervisor Rated Staff Psychological Readiness (SRPR) r = .832, p = .000. In terms of turnover intent, there was significant negative correlation between Job Readiness, Psychological Readiness, Total Readiness and Turnover Intent [TI-SRJR (r =-.143, p = .026), TI-SRPR (r =-.133, p = .040), TI-SSRJR (r =-.140, p = .030), TI-SSRPR (r =-.137, p = .034)] among employees.
International Journal of Commerce Innovations, 2018
The relationship between leadership style and turnover intentions was investigated among 48 super... more The relationship between leadership style and turnover intentions was investigated among 48 supervisors and 192 subordinates, men and women between ages 18 to 65, randomly selected from four randomly selected hospitals with the southern region of the United States. A descriptive correlational research methodology guided by a positivist paradigm was deployed in this investigation. Instrumentation for the study included the Leadership Effectiveness Adaptability Descriptors (LEAD-Self and LEAD-Other), Jackofsky and Slocum's 1987 Turnover Intent scale, and demographic questionnaire. Statistical analysis using SPSS 24 software included Pearson correlation, and descriptive statistics. Results indicated that the most frequently used leadership style was selling/coaching, followed by participating as perceived by both staff and supervisors. In addition, both supervisors and staff had similar perceptions in relation to supervisors' leadership adaptability. The Pearson correlation matrix revealed significant negative relationship between leadership styles L, SL, PL, and turnover intentions (TI), and significant positive relationship between TL, and DL, and TI. Results of the linear regression revealed that DL and TL significantly positively predicted TI, while L, SL, and PL significantly negatively predicted TI.
International Journal of Research and innovations, 2018
The purpose of the study was to examine differences in leadership styles among hospital superviso... more The purpose of the study was to examine differences in leadership styles among hospital supervisors based on their demographic characteristics of age, gender, educational level, and years of experience. A total of (N = 240) randomly selected supervisors, ages 20-70 years, from four randomly selected hospitals in the southern region of the United States voluntarily participated in the study. Hersey's perspective of Situational Leadership® was used as a conceptual framework for this study. The Leadership Effectiveness Adaptability Descriptor (LEAD) was used to collect data on leadership styles, while demographic data was collected using demographic survey designed by the researcher. The results of the one-way analysis of variance (ANOVA) failed to reveal any significant differences in leadership styles among supervisors based on demographic characteristics of age, gender, educational level, and experience in years.
International Journal of Interdisciplinary Research and Innovations, 2020
The association between demographic characteristics and Job Satisfaction Scores (JSS) was examine... more The association between demographic characteristics and Job Satisfaction Scores (JSS) was examined among 240 hospital staff. The population sample consisted of men and women, between the ages of 18 to 60 randomly selected from four different hospitals within the Southern region of the United States. The study was a descriptive correlational study guided by a positivist paradigm. Data was collected using the Spector (1997) Job Satisfaction Scale and a demographic survey designed by the researcher. Data analysis was enabled by SPSS 25 to identify any association Total Job Satisfaction and demographic characteristics among hospital staff. Differences among staff in relation to job satisfaction facets based on demographic characteristics was also examined. Results of the Spearman Rank-Order Correlation revealed a significant negative correlation between age and Total Job satisfaction (TS); and generational categories and (TS) [1 – tailed]. However, a similar [2 – tailed] test failed to reveal any significant relationship among the variables. A post-hoc Kruskal-Wallis (KW) test of independent samples failed to reveal a significant difference between demographic characteristics and (TS), and individual JSS facets. Further investigation into clinical and nonclinical staff yielded similar results.
Keywords: Staff, Job Satisfaction, Demographic Characteristics, Clinical, Nonclinical, Generational Categories
Thesis Chapters by David A U G U S T I N E Bull
RESEARCH PUBLISH, 2022
A descriptive qualitative case study methodology was deployed to explore baking as a method of co... more A descriptive qualitative case study methodology was deployed to explore baking as a method of cooking and dry heat ovens in Sierra Leonean. The study was a project to partially fulfill the requirements for the award of an associate degree in food science at Njala University College, University of Sierra Leone. The study focused on baking using low-cost, dry heat, efficient ovens as an income-generating enterprise, highlighting the challenges faced by local bakers, and alleviation strategies to help bring about social change in Sierra Leone. Data collection and analysis included content analysis of articles, interviews with community members, observations, and hands-on participation. The Social Enterprise Theory, Appropriate Technology, and Heat Transfer concepts were the conceptual frameworks that guided the study. Meta-analysis of articles and interviews of participants yielded themes or phrases such as food, economic benefit, land, labor, prices, ingredients, satisfaction, and career. These themes were part of the coding and analysis that facilitated discussions regarding baking as a social enterprise, its health and economic benefits, challenges faced by local bakers within the community, and an in-depth understanding of the phenomenon. Results indicated that the use of dry heat oven for baking were easy to prepare with low-cost materials and are capable of functioning efficiently. Furthermore, results indicated that many bakers would prefer baking as a career but are hindered by financing options and would need help as they could not meet microfinancing requirements. Baking has a great potential for communities in Sierra Leone for social entrepreneurship and illuminates appropriate technology in contributing to social change in Sierra Leone. The current global economic crisis was also a critical factor impacting bakers as the prices of supplies and cost of production have doubled.
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Papers by David A U G U S T I N E Bull
Keywords: academic stress, undergraduate students, academic performance, Cognitive Appraisal Theory, Self-Determination Theory.
suffering, contrasts with other therapeutic approaches that focus primarily on symptom relief or cognitive restructuring. By highlighting the central tenet that individuals can choose their attitude toward suffering and find
purpose in adversity, this study delves into how logotherapy aids patients in clinical settings, particularly those experiencing existential crises, chronic illness, or trauma. It also addresses criticisms of the approach, including its focus on individual responsibility and the limited empirical support for its efficacy in treating severe mental health disorders. Furthermore, the research integrates a spiritual dimension, considering how logotherapy's principles align with broader philosophical and religious concepts of suffering and redemption. Ultimately, this study contributes to understanding how meaning-making can serve as a valuable psychological tool, offering insights for both clinical practice and personal coping strategies. Implications for research, practice, and theory are discussed, critically evaluating logotherapy's role in contemporary therapeutic interventions.
Keywords: logotherapy, suffering, existential therapy, mental health, tragic optimism, psychological resilience.
Keywords: Staff, Job Satisfaction, Demographic Characteristics, Clinical, Nonclinical, Generational Categories
Thesis Chapters by David A U G U S T I N E Bull