Medicine and Health Sciences Commons^™

A Medical Student's Perspective Of Participation In An Interprofessional Education Placement: An Autoethnography, Jennifer Gallé, Lorelei Lingard

Lorelei Lingard

Interprofessional education (IPE) has emerged as a critical pedagogy for promoting interprofessional collaboration (IPC) within healthcare. However, the literature includes few reports of students' perspectives on IPE experiences. Understanding students' experiences is critical, as they are the crux of IPE's culture change agenda. This paper presents an autoethnographic account of my experiences as a medical student participating in an IPE placement within a Canadian academic hospital. During the five-week placement, I collected data using participant observation and reflective journaling on all placement experiences. I expanded my notes using the emotional recall technique and conducted thematic analysis. Using a series of …

A New Way Of Relating: Perceptions Associated With A Team-Based Error Disclosure Simulation Intervention, Lianne Jeffs, Sherry Espin, Sarah Shannon, Wendy Levinson, Melanie Kazman Kohn, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Despite the call for open and team-based approaches to error disclosure, the participation beyond physicians and managers is not a common practice in health care settings. Moreover, within the growing literature base on error disclosure, team-based error disclosure is an emerging concept. To address this knowledge gap, a study was undertaken to explore the perceptions associated with an educational simulation intervention for team-based error disclosure.

METHODS: A qualitative study that involved analysis of data obtained from semi-structured interviews with a sample of 6 physicians, 6 surgeons, and 12 nurses recruited from the three participating hospitals.

RESULTS: Perceptions from study …

Credentials As Cultural Capital: The Pursuit Of Higher Degrees Among Academic Medical Trainees, Orlee Guttman, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Growing numbers of postgraduate medical trainees pursue master's or PhD degrees together with professional education. This study explored students' motivation for undertaking these degrees and considered theoretical explanations for the forces shaping this phenomenon.

METHOD: Using constructivist grounded theory methods, interviews were conducted with 14 fellows pursuing higher degrees during subspecialty pediatric training. Emergent themes were identified from transcripts using constant comparative analysis.

RESULTS: Participants pursued higher degrees to be more competitive for academic jobs and to increase their credibility within their field. Academic medicine was felt to demand ever-increasing credentials to position trainees as a good investment. Clinical …

An Exploration Of Faculty Perspectives On The In-Training Evaluation Of Residents, Christopher Watling, Cynthia Kenyon, Valerie Schulz, Mark Goldszmidt, Elaine Zibrowski, Lorelei Lingard

Lorelei Lingard

PURPOSE: The in-training evaluation report (ITER) is the most widely used approach to the evaluation of residents' clinical performance. Participants' attitudes toward the process may influence how they approach the task of resident evaluation. Whereas residents find ITERs most valuable when they perceive their supervisors to be engaged in the process, faculty attitudes have not yet been explored. The authors studied faculty supervisors' experiences and perceptions of the ITER process to gain insight into the factors that influence faculty engagement.

METHOD: Using a grounded theory approach, semistructured interviews were completed in 2008 with a purposive sample of 17 faculty involved …

'Slowing Down When You Should': Initiators And Influences Of The Transition From The Routine To The Effortful, Carol-Anne Moulton, Glenn Regehr, Lorelei Lingard, Catherine Merritt, Helen Macrae

Lorelei Lingard

BACKGROUND: 'Slowing down when you should' has been described as marking the transition from 'automatic' to 'effortful' functioning in professional practice. The ability to 'slow down' is hypothesized as an important factor in expert judgment. This study explored the nature of the 'slowing down' phenomenon intraoperatively and its link to surgical judgment.

METHODS: Twenty-eight surgeons across different surgical specialties were interviewed from four hospitals affiliated with a large urban university. In grounded theory tradition, data were collected and analyzed in an iterative design, using a constant comparative approach. Emergent themes were identified and a conceptual framework was developed.

RESULTS: Surgeons …

To Report Or Not To Report: A Descriptive Study Exploring Icu Nurses' Perceptions Of Error And Error Reporting, Sherry Espin, Abigail Wickson-Griffiths, Michelle Wilson, Lorelei Lingard

Lorelei Lingard

OBJECTIVE: To explore the emergent factors influencing nurses' error reporting preferences, scenarios were developed to probe reporting situations in the intensive care unit.

SETTING: Three Canadian intensive care unit settings including: one urban academic tertiary hospital, one community hospital and one academic paediatric hospital. RESEARCH METHODOLOGY/DESIGN: Using qualitative descriptive methodology, semi-structured interviews were guided by a script which included a series of both closed and open-ended questions. One near miss and four error scenarios were used as prompts during the interview. Four of the five scenarios were identical across all the three sites; however, one scenario differed in the community …

Operating From The Other Side Of The Table: Control Dynamics And The Surgeon Educator, Carol-Anne Moulton, Glenn Regehr, Lorelei Lingard, Catherine Merritt, Helen Macrae

Lorelei Lingard

BACKGROUND: Critical moments in operations cause the surgeon to transition from a relatively "automatic" mode of operating to a more attentive mode-previously referred to as "slowing down when you should." Using this framework, this study explored how academic surgeons manage and balance the often competing responsibilities of patient safety and education during the slowing-down moments.

STUDY DESIGN: This study used a constructivist approach to grounded theory methodology to explore an emergent theme of control among academic surgeons. Twenty-eight surgeons were interviewed across 4 academic teaching hospitals, and 5 general (hepato-pancreatico-biliary) surgeons were observed. Thematic analysis of the transcripts and field …