Date of Award


Degree Type


Degree Name

Doctor of Education (EdD)

First Advisor

Deborah Jezuit

Second Advisor

Dena Reddick

Third Advisor

Houston Thompson

Scholarship Domain(s)

Scholarship of Discovery


Health care in rural America has presented many challenges for health care organizations in ensuring patient autonomy in decision-making. Current literature has not reflected a distinction between the systems utilized in the general acute care hospital and the rural American critical access hospital to support the patient in the decision-making process. The purpose of this qualitative study was to identify the systems in place at a sample of critical access hospitals which support patient autonomy. Using a Grounded Theory method, data were collected and aggregated through an electronic survey tool and follow-up validation interviews. Recommendations include the development of staff educational programs to address methods for communicating clinical evidence and the development of staff competency programs to address patient needs.


Ed.D. dissertation completed in 2010 for Olivet Nazarene University.