20Q: A Leader in Ergonomics

Karen Jacobs, A Leader in Ergonomics

I am pleased to interview Dr. Karen Jacobs, one of the leaders and pioneers in occupational therapy. I have known Karen since 1977 when I was a professor of Occupational Therapy at Boston University and Karen was a young student. Karen is a very productive leader in occupational therapy, notably as a past president of AOTA, founding editor of the journal, WORK: A Journal of Prevention, Assessment & Rehabilitation, and a researcher in ergonomics.

 

 

 

 

Franklin Stein, PhD, OTR/L, FAOTA

Guest Editor

Salute to OT Leaders Series

20Q: A Leader in Ergonomics

EdD, CPE, OTR/L, FAOTA

History

1.  Where did you grow up?

In 1951, I was born in Brooklyn, New York, and shortly afterward we moved to Long Island, New York. When I was eight years old, our family sailed on the US Constitution, and we moved to Bologna, Italy where my father started medical school. We lived in Italy for less than a year and then moved back to Brooklyn. I went to elementary school at Public School (P.S.) 139 and 7th grade at Ditmas Junior High. In 1964, when I was 13 years old, we moved to Juneau, Alaska. We arrived during the week of the great Alaskan earthquake. We stayed in Alaska for that year and moved back to New York. My family then moved to Stony Brook, Long Island while I stayed in Brooklyn with my grandma (Nanie) so I could finish 8th grade. I moved to Stony Brook with my parents and siblings from 9th-12th grade and graduated from Ward Melville High School in Setauket, LI, NY in 1969. In high school, I was active in school politics and had a leadership position.

2. Where did you attend undergraduate and graduate school?

I received a BA degree in psychology and pre-school/primary education from Washington University in St. Louis. I also attended for a short time Ripon College in Ripon, Wisconsin, St. Louis University, St. Louis, MO, and Stony Brook University in Stony Brook, Long Island, New York. I received my Master of Science in Occupational Therapy from Boston University in 1979 and an EdD in educational leadership in 1993 from the University of Massachusetts.

Career

3. How did you become interested in occupational therapy?

When I was 20 years old, I married and a year later, my beautiful daughter Laela was born. During my undergraduate education at Washington University, I started a leathercraft business. My handmade products of belts and game boards sold at local arts and crafts shows. During one of these arts and crafts shows, I met a potter named Michelle Manning (Isserman) who was in the occupational therapy program at Washington University. She introduced me to occupational therapy. After graduating from Washington University, my family moved to Boston in 1976. In Boston, I took prerequisite courses and applied to the Boston University’s entry-level Master of Science in Occupational Therapy program and started in the summer of 1977. I graduated from the program in 1979 and passed the certification examination to practice as an occupational therapist. While a graduate student, I set three professional goals:

• To write a book
• To be awarded a FAOTA
• To be elected the President of the American Occupational Therapy Association (AOTA).

I believe perseverance and determination assisted me in being able to accomplish these lofty goals that were only imagined as a student. I tell my own students to develop their own professional goals as they embark on their careers.

4.  What was your first position in occupational therapy?

My first job was at the Little People’s School located in West Newton, MA near Boston, where I practiced as an occupational therapist and in other roles for eight years. The Little People’s School is a private school for children with primarily learning disabilities. I was hired as a pre-vocational occupational therapist to create a program for the pre-adolescent/adolescent students to help prepare them with job skills. The program was a success and when the school expanded to include a high school called Learning Prep School, I was asked to develop the vocational workshops. Many of these workshops were outgrowths from the pre-vocational occupational therapy program such as cooking (food service), gardening (horticulture), typing (business skills), child care, carpentry, and bicycle repair.

6. Who were your mentors who influenced you the most in becoming an occupational therapist and leader in the profession?

My occupational therapy mentors were Carol Gwin, who at AOTA guided me and supported me in my professional development in leadership roles, and Florence Cromwell, who influenced me in pre-vocational programming and ergonomics which I then specialized in. I later conducted research, wrote textbooks, chapters, and journal articles on this topic.

Additionally, for over 32 years, Nancy MacRae from the University of New England has been a peer mentor. It is thanks to Nancy that I was nominated for the Eleanor Clark Slagle Lectureship. Diane Aja and Diane Hermenau were other occupational therapy peer mentors who I collaborated with in ergonomics.

As I wrote in my Slagle article, PromOTing Occupational Therapy: Words, Images and Actions (2012), “I teamed up with five other occupational therapists— Anita Hamilton, Susan Burwash, Merrolee Penman, Angela Hook, and Sarah Bodell—from around the globe to form Online Technology 4 Occupational Therapy (OT4OT), an initiative aimed at advancing our profession’s knowledge and skills in the use of online technology” (p. 662). OT4OT has successfully hosted seven virtual exchanges to celebrate and promote World Occupational Therapy Day.

In recent years, I have been in an occupation circle peer mentor group with colleagues in the online post-professional OTD program. Some of them include Linda Niemeyer, Liat Gafni-Latcher, Nancy Doyle, Sarah McKinnon, Karen Duddy, and Kevin Berner to name a few.

Achievements

7. How did you become editor of the journal WORK: A Journal of Prevention, Assessment & Rehabilitation?

Serendipity is a word that I find intriguing. Serendipity is stumbling on something valuable when you are not searching for it. As I heard at one of the Occupational Therapy Research Summits hosted by Boston University, serendipity is having a prepared mind to recognize these opportunities. I attribute the genesis of the journal WORK to serendipity. In 1989, I was in a telephone conversation with Dr. Gary Kielhofner, and he mentioned that he was a consultant for a small startup publisher, Andover Press who was looking for journals. I responded that I had an idea for an international, inter-professional journal on the concept of work. Gary made the introductions and coincidentally the publisher was located in my home town in Massachusetts. We met the next day, and 29 years later, I am the founding editor of WORK which is published monthly and is endorsed by the International Ergonomics Association (IEA), has a monthly webinar series, Learn at WORK, and a respectable journal impact factor (JIF). WORK is published by IOS Press in the Netherlands, and it is with their continued support that I can also attribute to the success of the journal.

8. What were your first publications in ergonomics/work?

My first two textbooks related to ergonomics were:

• Jacobs, K. (1985). Occupational Therapy: Work-Related Programs & Assessments. Boston, MA: Little, Brown & Co.
• Ogden-Niemeyer, L. & Jacobs, K. (1989). Work Hardening: State of the Art. Thorofare, NJ: SLACK, Inc.

My early articles on the topic were:

• Jacobs, K. et al. (1986). Work center: A school-based program for vocational preparation of special needs children and adolescents. Occupational Therapy in Health Care, 2(4), 47-57.
• Jacobs, K. (Ed.). (1990). Work: Occupational therapy interventions. Occupational Therapy Practice, 1, v-vi.
• Wyrick, J., Niemeyer, L., Ellexson, M., Jacobs, K. & Taylor, S. (1991). Occupational therapy work hardening programs: A demographic survey.  AJOT, 45, (2), 109-112.

9. What led you to become president of AOTA?

As I mentioned previously, one of the goals that I set for myself while in the entry-level Master of Science in Occupational Therapy program at Boston University was to be president of AOTA. However, my interest in leadership roles started in high school. I was very active in school activities such as the student council. This is where I first developed my leadership skills. I am a very goal-directed person and very determined to accept challenges for myself. The personality drive comes from my dad who was also very ambitious and a determined person in his career as a pharmacist and then as a physician.

Being the president of the Massachusetts Association of Occupational Therapy (MAOT) was another volunteer role that helped to develop my leadership skills within a professional occupational therapy organization.  As president of MAOT, I enjoyed co-chairing the state conferences for over 19 years. This is a role that I continue to do to this day.

I was elected vice-president of AOTA in 1997 and became its 24th President in 1998.  As president, my focus was on raising public awareness and promOTing the value of occupational therapy at an individual and societal level. It was during this time that the profession was addressing the impact of the Balanced Budget Act and the trademark of the “R” by the National Board for Certification in Occupational Therapy (NBCOT).

10. How would you describe your leadership style?

My leadership style is to work as a team member while keeping on track to accomplish goals. I am a hands-on team player; I “walk the talk” and try to be a role model for others. I like to use a collaborative leadership approach. I also enjoy being a mentor. In many instances, I supportively challenge these mentees to push themselves a little further. In other words, I like to “push them outside of their comfort zone”.

11. How would you define occupational therapy to a new entry-level graduate student?

Occupational therapy is a health and rehabilitation profession that works with people of all ages with and without challenges. We encourage these individuals to participate in meaningful and purposeful occupations to live life to its fullest.

12. What has been the biggest challenge in your career and perhaps most difficult hurdle to negotiate?

The biggest challenge in my career was finding the funds to pay for my education and living expenses to become an occupational therapist. I was a single parent when I was a student in the occupational therapy program in Boston University. Not only did I go to graduate school (student role) and work multiple jobs (worker role), I was a mom which was an important role for me.

Research

13. What would you identify as your best piece(s) of scholarly work?

The highly successful backpack awareness initiative conducted annually in the US is what I consider one of my best accomplishments.  The backpack initiative started when I was AOTA President in 1998. AOTA collaborated with L.L. Bean, Inc. to prevent musculoskeletal discomfort/injuries and to promote healthy backpack use.  The backpack education initiative resulted in a hangtag included on each L.L. Bean backpack, that included instructions on how to select, pack, and wear backpacks correctly. This also included advice to consult with an occupational therapy practitioner for further information and a news video release which was viewed by thousands of consumers.

My national involvement in backpack safety continues as I am the national spokesperson for the AOTA’s annual National Backpack Awareness Day each September. For almost 20 years, the AOTA National School Backpack Awareness Day has provided education to millions of students, parents, teachers, and administrators. The AOTA National School Backpack Awareness Day is a sustainable model program to communicate the benefits of occupational therapy to the public and the longest running public health initiative for occupational therapy. Indeed, it is a forerunner in linking the benefits of occupational therapy to broader population-based public health concerns.

Related to ergonomics, I have co-authored consumer tip sheets for AOTA on the ergonomics of backpack use, the use of computers and personal digital assistants (PDAs), of carrying a purse, briefcase or luggage, as well as, personal transition strategies for newly unemployed workers.

I am happy to have collaborated with Dr. Sarah Dockrell and colleagues at Trinity College on a multi-country backpack study, Parental awareness of schoolbag carriage: A comparative study of Irish and United States parents. The results of this study are shared later in this article.

I am also very active in the Human Factors and Ergonomics Society (HFES) and am proud to be a Fellow of HFES.

The creation and self-publishing of children’s literature, which accurately portray children with disabilities and address challenging topics such as dementia, are some of my meaningful occupations and accomplishments that I am very proud of. By including occupational therapy in the majority of my books, I hope to inspire potential occupational therapy practitioners. One except I want to share is from the following article:

I embarked on this journey in 2012. Since then, I have co-authored and published 16 children’s book and at this writing, four are in process. In my position at Boston University (BU), I am able to work with occupational therapy graduate students in the writing and illustration of these children’s books. Students embraced the sharing of their own narratives and the creation of new ones. I would like to share a few of these stories with you.

Sisters at the Beach depicts a child with a disability engaged in meaningful occupations. The story illustrates similarities and differences between families with and without a child with a disability and demonstrates how occupational therapy practitioners provide adaptations to promote social participation and play for all children. In developing the idea for Sisters at the Beach, I met with then-BU graduate students Carol Haver and Diana Smith. Carol grew up with a sibling who has a disability. To generate ideas for our story, we viewed Carol’s family photos and talked about her personal experiences. During the process of writing the story, Diana created the illustrations using Carol’s family photos as guides. The initial draft of the story script was co-written and then modified to have language appropriate for 5-to 6-year-old children. The story script was reviewed by professionals and families of children with disabilities. Once the research on the disability, story, and illustrations was completed, a glossary of terms was created and included in the book.

My own mother’s experience with dementia inspired the creation of Breakfast with Grandma Ruthie: A Story for Children Learning about Dementia. My mom, Ruth Ellen Filler, was born in Brooklyn, NY on June 12, 1926, in Liberty Hospital. Little did she know, that 91 years later, she would be the main character in a children’s book. This book, co-authored and illustrated by Samantha Valasek, who at the time of writing the book was an occupational therapy graduate student at the University of Southern California (USC), is about a great-grandma with dementia who moves in with family members. With the assistance of the occupational therapist, the family learns what simple changes they can make at home to help Grandma Ruthie do everyday activities. Although the illustrations were not completed before my mom passed away last year, she did have the opportunity to listen as the story was read to her.

For many young people, engaging with those who have disabilities can be scary and raise feelings of uncertainty. Through books that explore relationships and services, children are given information that can help to take away some of the “unknown,” thus, help to promote more meaningful interactions between those with and without disabilities. It is my hope that these books will guide future generations to have a better understanding of disabilities and conditions and lead these people to live life to its fullest without stigma or fear.

14. Describe your most important research project.

My research has examined the interface between the environment and human capabilities. In particular, we have examined the individual factors and environmental demands associated with increased risk of functional limitations among various populations in relation to participation in work. 

From 2013-2018, I had the distinct privilege to participate in a multisite, National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) grant titled, Project Career. This five-year interprofessional demonstration project provided continued support and services to college students with a history of traumatic brain injury (TBI). Project Career was designed to improve employment success through assistive technology such as iPads and apps and individualized career counseling services to help undergraduate students transition from college/university settings to the workplace. Traumatic brain injury is a serious public health problem affecting approximately 2.8 million Americans each year. Over 75% of TBIs are classified as mild, and these rates are most likely underestimated. Despite the low severity rating, 5-15% of individuals go on to develop chronic, persistent TBI-related symptoms causing functional limitations. College students with TBI are three times more likely to drop out than peers without disabilities. And, about 80% of college students with TBI report problems with the cognitive demands of classes.

Best practices exist from the assistive technology field to help people to compensate for cognitive impairments and from the vocational rehabilitation field to enhance employment outcomes for individuals with disabilities. However, these practices have not been brought together to address the needs of people with TBI transitioning from undergraduate settings to the workplace. The goal of Project Career was to develop a technology-driven, long-term, and resource-rich program to support veteran and civilian postsecondary students with TBI by merging assistive technology and vocational rehabilitation best practices. In a collaborative venture, Kent State University, JBS International, Inc., West Virginia University, and Boston University implemented this project, and over five years, provided services and supports to 151 civilian and veteran students with TBI at all stages of postsecondary education. During this time, I had the privilege of working with Amanda (Mandy) Nardone, who was the Technology and Employment Coordinator for the Boston University site of Project Career.

Through the use of state-of-the-art technology and proven best practices in career planning and vocational rehabilitation, this innovative method of academic enrichment and career enhancement substantially improved the bleak employment outcomes that presently await civilian and veteran students with TBI following the completion of their college training.  The end product of Project Career was a comprehensive website at http://projectcareertbi.org/

After five years, the outcomes of Project Career are:

Students who have graduated n=56

• Students who have graduated and are continuing their education n=14
• Students who have graduated and are employed full-time n=29
• Students who have graduated and are employed part-time n=14
• GPA upon enrollment 2.87, GPA upon exit 3.03
• 100% productive and meaningful post-graduation activity
• App moderately or a lot improves their quality of life = 64.3%
• App moderately or a lot helps perform academically = 76.5%
• App moderately or a lot enhances their comfort = 54.8%
• App moderately or a lot enhances their well-being = 50.9%
• A significant difference in baseline and follow-up indicates more positive experiences with technologies over time. * 151 students enrolled as of September 7, 2018

Ergonomics

15. How does ergonomics fit into occupational therapy?

Ergonomics is defined as the “Science of work; of the people who do it and the ways it is done; the tools and equipment they use, the places they work in, and the psychosocial aspects of the working situation” (Pheasant, S. 1998). Ergonomics is a body of knowledge about human abilities, limitations, and characteristics that are relevant to design. I see a synergy between ergonomics and occupational therapy. Both professions investigate the person, environment, and occupational fit. The introduction of ergonomics is part of the ACOTE Standards so it has become a body of knowledge that is needed to be understood in occupational therapy.      

16. Describe your research findings in ergonomics?

A most recent research study in ergonomics was Parental awareness of schoolbag carriage: Comparative study of Irish and United States parents (Dockrell, S, Jacobs, K., et al, 2017). The following description is from one of our poster presentations on the study.

The objectives of this study were to establish the level of parental awareness about (i) schoolbag type and design features; (ii) schoolbag use; and (iii) the effects of wearing a schoolbag. Further objectives were to (iv) establish the sources of acquired information if appropriate and (v) establish the preferred platforms of the parents for receiving information about schoolbag use.

A cross-sectional survey using an anonymous 30-item questionnaire and purposive sampling (size, type, geographical, and socioeconomic catchment area) was used. Test-retest reliability and content and face validity of the questionnaire were established. Subsequent to ethics approval, school principals were approached (email/telephone) to inquire if the study could be conducted in their school. Once permission was obtained, an information pack was delivered to the principals together with packs for circulation to the parents of junior infant, second class, and fifth class students in Ireland and elementary schools, kindergarten to fifth grade in the US. The children were asked to take home the pack which included an invitation letter, a participant information leaflet, and the questionnaire. Parents were asked to return the completed questionnaire to the school via their children for collection by the researchers. Return of the completed questionnaire was considered as consent. In the US study, parents were also given the option of completing the questionnaire online. Descriptive statistics of frequencies and percentages were used and associations were tested using Chi-square analysis in SPSS v23.

Results.

• A total of 700 parents in Ireland (n=444) and the United States (n=256) participated in the study with response rates of 64.6% and 25.6% respectively
• Respondents were mostly female (88%), 30–49 years (85%), married (77%), of white ethnicity (93% [Ire]; 81% [US])
• Generally, parents had satisfactory awareness of appropriate schoolbag type (Figure 1) and features (Table 1)
• More Irish parents favored a wheeled schoolbag compared to US parents p<0.001 (Figure 1)
• Only 7% of Irish parents and 20% of American parents had ever received information on appropriate schoolbag use, most commonly through media platforms
• The majority (71% [Ire] vs. 56% [US]) wanted more information. 

Conclusion.

Overall, parents had a good awareness of factors relating to schoolbag carriage, but there was a poor level of knowledge translation from professional organizations. A significant proportion of Irish parents considered a wheeled bag to be the optimum type of schoolbag, but this is not in keeping with the evidence to date. This study showed that parents would like more information, and although living in a technological society, the preferred platform for knowledge translation was a handout. Parents are the best advocates for safety promotion and represent the group most likely to improve schoolbag carriage among children. Parental awareness of schoolbag carriage, although satisfactory, could be enhanced through continuing to emphasize the broad ergonomic principles of schoolbag carriage such as type, features, and their optimum use, with less emphasis on schoolbag weight alone (Dockrell, S., Jacobs, K., et al., 2017).

Table 1. Schoolbag features considered important or very important (%) 

Future of OT

17. What are the most important contributions that the profession of occupational therapy has made to healthcare in the last 100 years?

The profession of occupational therapy for over 100 years has helped all people to maximize their health, well-being, and quality of life through effective evidence-based solutions that support participation in everyday occupations. This is a very powerful outcome. Over these years, the profession has grown with more than 213,000 occupational therapy practitioners in the U.S. and more than 550,000 worldwide. Globally, occupational therapy has focused on many activities such as teaching wounded warriors how to hold their children again after limb loss; helping babies in the NICU learn to feed, breathe, and swallow so they can thrive; providing recommendations for assistive technology in the vehicle or home so that older adults can age in place safely; and helping ensure a child’s backpack is the appropriate size and packed correctly to avoid long-term musculoskeletal issues. Wherever there is a person, an occupational therapy practitioner can be there to work with them to live life to its fullest.

18. What are the major issues in healthcare that have a direct influence in the future of occupational therapy?

The opioid crisis in the United States is a major healthcare problem that has implications for occupational therapy. We can use our expertise in mental health to work with these individuals to help them find practical solutions that will prevent them from abusing opioids to developing interventions that address addiction.

The changing reimbursement system will continue to create challenges for the occupational therapy profession.

The US healthcare system is dependent upon specialist care. However, there is a need for more primary care practitioners who can use a holistic approach in treating clients. In occupational therapy, we train our students to be generalists, and after completing their entry-level education, they can consider a specialization(s) such as ergonomics, hand therapy, pediatrics or geriatrics.

An important issue facing the occupational therapy profession is with entry-level degrees. Currently, U.S. occupational therapists need a master’s degree and occupational therapy assistants need an associate’s degree. The question now is should we upgrade the entry levels, e.g. OTD for occupational therapists and BS for occupational therapy assistants.   

19. What do you are emerging issues in occupational therapy?

Social justice will continue to be an important focus for the profession. Occupational therapy practitioners are and will be providing services for the homeless, refugees, and other vulnerable populations.

Occupational therapy practitioners will be working more in primary care in conjunction with the physicians and involved in health and wellness. Just imagine seeing your primary physician and after the conclusion of your yearly exam, the next health care person you see is an occupational therapy practitioner who works with you on analyzing your daily occupations.

Telehealth will become more commonplace as a way of delivering occupational therapy services remotely.

Occupational therapy practitioners will identify as global citizens. They will be working in global healthcare response teams such as in human disasters like mass shootings and natural occurrences such as hurricanes, tsunamis and earthquakes to help victims with psychological support and environmental adaptations.

As I envision the future, I see occupational therapy practitioners being elected to local, state, and national legislative positions. In these roles, they become agents of change on a larger scale, perhaps changing the face of health care so it is more inclusive and equitable.

Summary

20. How would you summarize your major accomplishments and major publications?

Being the president and vice president of the American Occupational Therapy Association (AOTA) allowed me to use my leadership skills to serve the profession. In reflection of the trajectory of my career, I am honored to have received 41 awards, honors including being a 2005 recipient of a Fulbright Scholarship to the University of Akureyri in Akuryeri, Iceland; the 2009 recipient of the Award of Merit from the Canadian Association of Occupational Therapists (CAOT); the Award of Merit from the American Occupational Therapy Association in 2003; and the 2011 Eleanor Clarke Slagle Lectureship Award. One outcome from my Slagle lecture was the creation of Occupational Therapy Global Day of Service (OTGDS) which continues to be held each year on World Occupational Therapy Day on October 27.

Since completing my doctorate in 1993, I have authored, co-authored, edited, or co-edited more than 81 peer-reviewed journal articles; 24 book chapters, and 24 books such as: Occupational Therapy Essentials for Clinical Competency (3 editions), Occupational Therapy Manager (5th &6th editions), Ergonomics for Therapists (2 editions), Health Professional as Educator (2 editions), and Work Practice: International Perspectives. Being the founding editor-in-chief of the international, interprofessional journal, WORK: A Journal of Prevention, Assessment and Rehabilitation (IOS Press, The Netherlands) and creating the Learn at WORK podcast are special accomplishments for me.

Over my 40 years as an occupational therapist, I have tried to energize practitioners and students to advocate and promOTe the distinct value of occupational therapy. Through mentoring colleagues and students, I have inspired them to do more with their own abilities, to explore and embrace the possibilities with confidence, and to assume leadership roles. I believe that this has contributed to making occupational therapy more widely recognized. As a scholar-practitioner, I have made contributions to the occupational therapy profession by effectively linking practice, education, and research throughout the trajectory of my career.  I will always be grateful to Michelle Isserman for introducing me to occupational therapy; it has been a career of a lifetime.

References

Dockrell, S., Jacobs, K., Byrne, J., Gleeson, E., Kelly, S., Moore, C., O’Mears, E., Barclay, D., Rodrigues, S., Kang, D., Simms, C., and Blake, C. (2017). Parental awareness of schoolbag carriage: A comparative study of Irish and United States parents. WORK, 85–93.

Doyle, N., & Jacobs, K. (2012). Learning locally and globally: An overview of distance education in occupational therapy. IJOT, E59-E69.

Doyle, N., Jacobs, K., and Ryan, C. (2016). Faculty mentors’ perspectives on e-mentoring post-professional occupational therapy doctoral students. Occupational Therapy International. 23(4):305-317.

Jacobs, K., (2012). PromOTing occupational therapy: Words, images and actions. AJOT, 652-671.

Jacobs, K. (2017, April). Reading is good medicine. The New York Lifestyles Magazine, 79.

Jacobs, K., Doyle, N., Ryan (2015). The Nature, Perception, and Impact of e-mentoring on Post-professional Occupational Therapy Doctoral Students. Occupational Therapy In Health Care. 29(2): 201–213.

Jacobs, K., Leopold, A., Hendricks, DJ., Sampson, E., Nardone, A., Lopez, KB., Rumrill, P., Stauffer, C., Elias, E., Scherer, M., et al. (2017). Project Career: Perceived benefits of iPad apps among college students with Traumatic Brain Injury (TBI). WORK. 45-50.

Minton, D., Elias, E., Rumrill P., Hendricks, DJ., Jacobs, K., Leopold, A., Nardone,  A., Sampson, E., Scherer, M., Cormier, AG, Taylor, A., & DeLatte, C. (2017). Project Career: An individualized postsecondary approach to promoting independence, functioning, and employment success among students with traumatic brain injuries. WORK, 35-43.

Roessler, RT, Rumrill, PD, Rumrill, SP, Minton, DL, Hendricks, DJ, Sampson, E, Stauffer, C, Scherer, M. J., Nardone, A, Leopold, A, Jacobs, K., Elias, E. (2017). Qualitative case studies of professional level workers with traumatic brain injuries: A contextual approach to job accommodation and retention. WORK, 3-14.