Medicine and Health Sciences Commons^™

Physiological And Psychological Responses Of Surgeons And Trainees, Sarantis Abatzoglou

Electronic Thesis and Dissertation Repository

Performing surgical procedures can increase the physiological stress and mental strain experienced by practicing surgeons and their trainees. This may negatively affect work and learning capacity and quality of patient care by increasing the incidence of burnout, sleep disorders, fatigue and other negative behaviours such as substance abuse. This study aimed to compare the physiological and psychological responses of similar clinical situations between orthopaedic surgeons and their clinical fellows. An observational prospective cohort study was performed in that matter. Our results showed overall increased physiological responses of the fellows during surgery days compared to the clinic days. On the contrary, …

Mindfulness And Mothering: Reclaiming Feminine Voice, Lisa L. Mccorquodale

Electronic Thesis and Dissertation Repository

Little is known about working mothers who practice mindfulness. This dissertation is a phenomenological investigation using body mapping as a way to understand how mindfulness works in the lives of six women who work in health and social care while parenting young children.

This dissertation is comprised of five integrated articles. Chapter 1 and 7 are included as an Introduction and Discussion/Conclusion to the five separate though related manuscript chapters. The main research questions that framed this research include, ‘What is the work of mindfulness in the lives of working professional mothers?’ and ‘In what ways might a mindfulness practice …

Informed Decision Making During Pregnancy: Risk Consideration In Clinical Practice And Research, Kyoko Wada

Electronic Thesis and Dissertation Repository

This thesis addressed a cluster of issues related to risk and the pregnant woman’s decision making in clinical practice and research. In terms of clinical practice, the minimal risk concept - a low risk standard codified in research ethics regulations - was applied to clinicians’ information provision to the patient. As clinicians must discuss a variety of health risks, minimal risk standards may be useful as a threshold to demarcate risks that clinicians should discuss with the patient. Application of minimal risk standards to risk factors in pregnancy showed the usefulness and limitations of these standards. In terms of pregnant …

The Sixties Scoop Among Aboriginal Veterans: A Critical Narrative Study, Munira Abdulwasi

Electronic Thesis and Dissertation Repository

This study explored the experience of Aboriginal Veterans adopted and/or fostered during the Sixties Scoop using critical narrative inquiry. The objectives were to: 1) understand the lived experience of Aboriginal veterans adopted and/or fostered during the Sixties Scoop, 2) explore any health needs expressed by Aboriginal veterans adopted and/or fostered during the Sixties Scoop, and 3) provide recommendations for the implementation of health services and programs to assist this group of Aboriginal veterans with their health needs. Eight individual interviews were conducted with participants in Kitchener-Waterloo, London, Ottawa, Winnipeg, and Vancouver. All interviews were audio-taped, transcribed verbatim, and analyzed using …

Exploring The Role Of Procedural Variations In Surgical Education, Tavis Apramian

Electronic Thesis and Dissertation Repository

Variations in practice and procedure permeate clinical work. While clinical research routinely investigates the consequences of these variations for clinical outcomes, we have little understanding of their implications for education. The current policy environment in medical education makes developing a new understanding of the role of variations in medical education especially important. Current policy reforms in the assessment of learners draw on the notion of competence to suggest that medical education should focus on the performance of learners in the workplace. The current turn toward workplace-based assessment positions the observations of faculty into key functions in these assessment frameworks; therefore, …

Evaluation Of Robotic Cardiac Surgery Simulation Training, Matthew Valdis

Electronic Thesis and Dissertation Repository

OBJECTIVE: To compare the currently available simulation modalities in robotic surgery.

METHODS: 40 trainees completed two robotic cardiac surgery tasks and were randomized to: a wet lab, a dry lab, a virtual reality lab or a control group with no additional training. Participants trained to proficiency determined by two expert robotic surgeons, and then repeated the assessments. All assessments were blinded and evaluated using the GEARS scoring tool.

RESULTS: All three training streams improved their performance. The wet lab and virtual reality groups met the levels of proficiency for all tasks. The average time to reach proficiency was least for …

Integrating Spirituality And Medical Education: What Students And Teachers Have To Say - A Qualitative Study, Sharon N. Hatcher

Electronic Thesis and Dissertation Repository

Aims

This thesis explored the perceptions of medical students and teachers with regards to spirituality, its role in health care, and its integration into medical education.

Methods

Two studies were conducted using qualitative descriptive thematic analysis: the first using focus groups with students; and the second depth interviews with teachers. Both studies were carried out in Francophone Canada.

Findings

Teachers spoke of a concept of spirituality evolving as a journey, while students reported sudden turning-points. Both regarded spirituality as important to patient care. Students were struggling with their future physician role and their commitment to rationality, whereas …

Evaluating Human Performance For Image-Guided Surgical Tasks, Matthew Kenneth Kramers

Electronic Thesis and Dissertation Repository

The following work focuses on the objective evaluation of human performance for two different interventional tasks; targeted prostate biopsy tasks using a tracked biopsy device, and external ventricular drain placement tasks using a mobile-based augmented reality device for visualization and guidance. In both tasks, a human performance methodology was utilized which respects the trade-off between speed and accuracy for users conducting a series of targeting tasks using each device. This work outlines the development and application of performance evaluation methods using these devices, as well as details regarding the implementation of the mobile AR application. It was determined that the …

Reflective Practice And Professional Knowledge: A Grounded Theory Study Of Speech-Language Pathologists Working In Head And Neck Cancer Rehabilitation, Marie-Eve Caty

Electronic Thesis and Dissertation Repository

Reflective practice is defined in this dissertation as a process of thinking 'about' and 'through' one's doings, such that practitioners become more skillful, and aware of the nature and impact of their performance within their professional practices. Because it is presumed to enable healthcare delivery practices that are more sensitive to patient needs and more in-line with evidence- based practices, RP is frequently noted as an essential attribute of competent clinical practice. Yet, little is known about the processes by which RP contributes to the professional learning of health-care practitioners in general, and Speech- Language Pathologists (SLPs) in particular.

This …

A Critical Discourse Analysis Of Medical Students’ Reflective Writing: Social Accountability, The Hidden Curriculum, And Critical Reflexivity, Stacey Ritz

Electronic Thesis and Dissertation Repository

In recent years, many medical schools have adopted a ‘social accountability’ approach, implementing a variety of activities and curricula aimed at developing a sense of social responsibility in medical students. The research of this thesis uses critical discourse analysis (CDA) to scrutinize the writing of senior medical students, with a view to uncovering how identity, ideology, and social position are expressed by students who have undertaken a curriculum designed with social accountability in mind. The analysis examines the conditions of discourse practice, student orientations to a professional medical identity, and ideologies of community, rurality, indigeneity, and gender. I discuss these …

Interprofessional Socialization And Dual Identity Development Amongst Cross-Disciplinary Students, Hossein Khalili

Electronic Thesis and Dissertation Repository

The purpose of this study was to develop and test an interprofessional socialization (IPS) framework through assessing the impact of an IPS-based interprofessional education program on interprofessional socialization and dual identity development among health professional students. Although health professional educational programs have been successful in equipping graduates with skills, knowledge and professionalism, the emphasis on specialization and profession-specific education has enhanced the development of a uniprofessional identity, which has been found to be a major barrier towards Interprofessional Person-Centered Collaborative Practice (IPCPCP). Despite the growing acknowledgment of IPS in the current IPE and collaborative practice literature, there is a lack …

Social Support As A Determinant Of Health Related Quality Of Life In Breast Cancer Survivors In California, Faiza Rab

Electronic Thesis and Dissertation Repository

Objective:

To evaluate the relationship between perceived social support and HRQOL (physical and emotional) in low SES breast cancer survivors.

Methods:

A cross-sectional study design was used to measure perceived social support at 18 months and HRQOL at 3 years after breast cancer diagnosis using MOS SS and MOS SF-36, respectively. Multiple regression analyses were used to evaluate the relationship.

Results:

Menopause at the time of diagnosis, adjunct chemotherapy, adjunct radiation therapy, co-morbidities, treatment side effects and depression were negatively associated with PCS scores (p < 0.01). Treatment side effects, anxiety and depression were negatively associated with MCS scores (p < 0.01).

Conclusions:

Perceived social support was not associated with HRQOL in low SES breast cancer survivors …

“Okay So Remember, This Is A Drape – Not A Sheet”: A Critical Autoethnography Of (Per)Forming The Practice(D) Body Of A Gynecological Teaching Associate, Jodi C. Hall

Electronic Thesis and Dissertation Repository

In this autoethnographic study, I utilized my past experiences as a Gynecological Teaching Associate (GTA), along with data collected within a particular pelvic teaching module, to critically explore the ‘silences’ and taken-for-granted assumptions embedded within the performances of pelvic teaching. Theoretically informed by (post)critical feminist theories, I considered how the ‘culture’ of pelvic teaching, as enacted within this specific setting, simultaneously (re)produced and resisted particular normative discourses about women, and how the performances of GTAs, medical students and program administrators were reflective of larger social-political and biomedical discourses. Data collection methods included participant observation, field notes, reflexive journaling, and individual …

How Do Parents Use Health Information With The Aid Of A Knowledge Broker When Living With And Caring For Their Young Children With Cerebral Palsy?, Stephanie E. Lagosky

Electronic Thesis and Dissertation Repository

This research aims to understand how parents use health information (such as those developed from the Move & PLAY study) with the aid of a knowledge broker when living with and caring for young children with cerebral palsy. This research was conducted under a qualitative case study methodology and used questionnaires and in-depth interviews to collect data. Findings include the complexity of both parental use of health information and the desire to use a knowledge broker. A provisional model has been created to help describe information use of parents with young children with cerebral palsy. This provisional model is an …