About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

Decentering Whiteness In Nursing Education: The Pitfalls, Tensions, And Opportunities, Ivy Tran

Electronic Thesis and Dissertation Repository

Statement of Research Problem: The Truth and Reconciliation 94 Calls to Action (TRC) (2015) calls for the implementation of accessible and appropriate Indigenous health education. Schools of Nursing are increasingly implementing various approaches to teach Indigenous health. Limited research exists for Canadian nursing students' experiences of learning Indigenous health. This study explored undergraduate nursing students' experiences of learning Indigenous health from four Schools of Nursing across Canada. Particular attention is paid to the factors that shaped student and faculty experiences of learning and teaching Indigenous health, respectively, the facilitators and challenges, and what constitutes a safe and effective learning environment. …

Systemic, Institutional, And Teaching Factors In The Delivery Of Interprofessional Education Curriculum In Canada, Mohammad B. Azzam

Electronic Thesis and Dissertation Repository

The Canadian federal and several provincial governments are currently collaborating to establish ‘team-based’ primary healthcare—or interprofessional collaborative practice (IPCP), which can be effectively accomplished when interprofessional education (IPE) is sustainably delivered by health and social care (HASC) professional education programs. Indeed, achieving the intended patient/client-oriented outcomes of IPE and subsequent IPCP requires deliberate and purposeful considerations of several systemic, institutional, and teaching factors. Regrettably, the analyses of the extent to which these factors have influenced effective IPCP is currently under-researched. In this integrated-article dissertation, we took a purposeful and systematic approach to explore the extent to which these multi-tiered factors …

Intimate Partner Violence, Social Support, Mastery, And Mental Health, Alice Pearl Sedziafa

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Background: Despite the growth in research on intimate partner violence (IPV) as a chronic stressor, including studies on the negative mental health impacts of IPV, limited attention has been given to understanding the stress process in terms of the direct impact of IPV on mental health and the simultaneous mediating effects of social support (emotional or practical assistance from one’s network) and mastery (a sense of personal control) on the relationship between IPV and mental health [Depression symptoms and Post-traumatic stress disorder (PTSD) symptoms]. These mechanisms are also poorly understood in the context of the concurrent effects of age, mothering, …

The Development, Short-Term Efficacy, And Pilot Implementation Of An E-Learning Course In Physical Activity And Sedentary Behaviour For Pre-Service Early Childhood Educators, Brianne Bruijns

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The overarching purpose of this dissertation was to develop an e-Learning course in physical activity and sedentary behaviour and test its short-term efficacy and implementation among pre- and in-service early childhood educators (ECEs). The Delphi approach was adopted for Study 1, wherein a panel of international experts in physical activity and sedentary behaviour suggested topics for the course and, together with a panel of ECE experts, rated their importance. Study 2 employed a pre-post design to explore the changes in pre- and in-service ECEs’ physical activity and sedentary behaviour-related knowledge, self-efficacy, behavioural intention, and perceived behavioural control following course completion. …

Troubling Service User Involvement In Health Professional Education: Toward Epistemic Justice, Stephanie Leblanc-Omstead

Electronic Thesis and Dissertation Repository

It has become increasingly popular in health professional education to solicit the contributions and involvement of people who have firsthand or ‘lived’ experiences of using mental health services – a practice hereafter referred to as service user involvement (SUI). SUI is founded on the premise that service users ought to be involved in the development and evaluation of services and systems they experience, which includes the education of future health professionals. Despite the momentum this practice has gained in a range of international contexts, SUI is often conceptualized, organized, and implemented uncritically, and with tremendous inconsistency across health professional education …

A Transformative Journey: The Lived Experience Of Healthcare Learners Participating In Pain Management Education, Zoe A. Leyland

Electronic Thesis and Dissertation Repository

There is little emphasis on pain management education for healthcare providers. In September 2019, the Master of Clinical Science (MClSc) program in Advanced Healthcare Practice at Western University in London, Ontario introduced a new, “Interprofessional Pain Management” (IPM) field. The program follows a competency-based framework, and the learners are all practicing healthcare providers with a special interest in pain. Part of the purpose of this thesis is to describe the process of development and implementation. The objective is to provide educators and healthcare providers an in-depth look at how the pain education is experienced. This includes exploring the lived experience …

Evaluation Of The Basic Science Pre-Clerkship Curriculum In Medicine At Western University, Madeleine E. Norris

Electronic Thesis and Dissertation Repository

Basic sciences are a cornerstone of undergraduate medical education (UME), upon which the clinical sciences are built, however, research indicates that students’ basic science knowledge is not well retained. Additionally, UME curricula vary with respect to which basic science content is delivered, the depth in which it is taught, and the employed instructional methods, which could influence trainees’ knowledge retention. Thus, there is a need for an educational model that ensures students are competent in the fundamentals prior to entering a clinical setting. This investigation provides insights into current strengths and potential areas for improvement with respect to basic science …

Investigating Elementary School Food Programs: Impacts On Child Knowledge And Dietary Behaviours, Paige Colley

Electronic Thesis and Dissertation Repository

Good nutrition is an important part of maintaining a healthy lifestyle. A balanced diet can promote positive health outcomes, protecting against health problems caused by nutritional deficiencies. Canada has reported poor diet quality and high rates of overweight and obesity among children. Obesity has been linked to several non-communicable diseases including type 2 diabetes, heart disease, and some forms of cancer. Efforts to improve lifelong, healthy eating behaviours must be implemented.

This dissertation investigated the impacts of school food programming on child nutrition. A Centrally Procured School Food Program (CPSFP) was implemented at 30 elementary schools in Southwestern Ontario, Canada. …

Environmental Changes Following The Implementation Of The Childcare Physical Activity (Play) Policy, Victoria Tran

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Environmental factors such as the infrastructure and equipment in childcare centres can influence the physical activity levels of young children. This study explored if implementing the Childcare PhysicaL ActivitY (PLAY) policy resulted in unintended environmental changes that were conducive to physical activity in childcare. Childcare centres were randomized to an experimental (n = 5) or control (n = 4) condition. Three Environment and Policy Assessment and Observation Self-Report (EPAO-SR) tools were used to measure 12 best practice items in relation to the childcare environment and early childhood educators’ (ECEs) practices. Descriptive statistics and mixed-effects logistics regression models were …

Construction And Preliminary Validation Of The Interrai 0-3 Developmental Domains, Jo Ann M. Iantosca

Electronic Thesis and Dissertation Repository

Background. With no standardized approach for early assessment of childhood development in Canada, and with a lack of a comprehensive assessment-to-intervention system that amalgamates social, psychiatric, medical, functional, psychological, and environmental constructs, the interRAI 0-3 was developed to support intervention efforts based on the needs of young children and their families. The interRAI 0-3 includes over 650 items that seek clinical information, developmental milestones, and context items regarding the family and social relationships surrounding the child. The newly developed interRAI 0-3 was most recently evaluated to examine the reliability and validity of the Expressive and Receptive Language and the Gross …

Death Of The Clinic: Trans-Informing The Clinical Gaze To Counter Epistemic Violence, Diana E. Kuhl

Electronic Thesis and Dissertation Repository

This case study research (Patton, 2002, 2014; Flyvberg, 2006) has grown out of an awareness of deep resistance from the psy disciplines to trans-informed epistemologies as a source of legitimate knowledge (Tosh, 2015, 2016; Winters, 2008). It focuses on examining how the closure of The Gender Identity Clinic (GIC) for Children and Youth at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ontario, Canada, signaled a paradigm shift from the ‘treatment model’ to the ‘affirmative model’ with respect to clinical approaches for supporting trans and gender diverse children and youth. As such the case study involved tracing the …

Understanding The Lived Experiences Of Saudi Students Enrolled In Canadian Graduate Nursing Programs, Aisha Namshan Aldawsari

Electronic Thesis and Dissertation Repository

Despite the increased number of students in the field of nursing, there is a great shortage of Saudi nurses in Saudi Arabia (SA). Cultural issues in SA have influenced the development of the nursing profession. For instance, it is not culturally acceptable for female nurses or nursing students to work for long hours and night shifts in a mixed-gender practice environment in SA. Thus, a large proportion of nursing students tend to look for positions other than working in hospital settings upon completion of their undergraduate degree. Pursuing graduate nursing education overseas is also viewed as a viable option. To …

The Association Between Child And Youth Mental Health Service Urgency And Exposure To Childhood Interpersonal Trauma, Catherine Marshall

Electronic Thesis and Dissertation Repository

Children/youth with a history of maltreatment experience a variety of different developmental, psychiatric and health problems and ensuring there is streamline access to services is imperative to their recovery. Yet, there are few reports of standardized methods for directing and prioritizing risk for children seeking services. The current study,utilizingretrospective data collected from theinterRAIChild and Youth Mental Health Screener (ChYMH-S), aimed to address this gap and explore the relationship between childhood maltreatment and mental health screening outcomes. A sample of 4-18-year-olds (N= 19,645) was studied to explore how differences in maltreatment history, gender, and legal guardianship impacted service prioritization. The findings …

An Exploration Of The Nursing Leaders’ Experiences Addressing Indigenous Health In University Undergraduate Nursing Programs In Ontario, Danae Coggins

Electronic Thesis and Dissertation Repository

Introduction. Although there are serious health inequities experienced by Indigenous people compared to non-Indigenous people in Canada and racism and discrimination continues to be rife in health care environments, there remains a general lack of attention to Indigenous health (IH) in health professional education programs. In response, the Truth and Reconciliation Commission (TRC) has recommended this be addressed within health profession education, including nursing (Truth and Reconciliation Canada, 2015). However, there is a paucity of evidence describing the challenges and facilitators to incorporating IH into nursing education.

Methodology and Methods. This qualitative study employs interpretive description approaches informed by …

Relationships Among Authentic Leadership, Manager Incivility And Trust In The Manager, Ohood Ali Alkaabi

Electronic Thesis and Dissertation Repository

There have been growing concerns about manager incivility toward new graduate nurses which hinders their adaptation to the workplace environment. Manager incivility impairs the relationship between managers and their staff. Furthermore, nursing managers have a significant responsibility to facilitate new graduate nurses' transition into the nursing profession. The purpose of this secondary analysis was to examine the relationships among authentic leadership of managers and new graduate nurses’ experience of manager incivility and their subsequent degree of trust in their managers. Secondary analysis of the baseline data using a non-experimental, correlational design was conducted. A random sample of 1020 new graduate …

Supporting Indigenous Students: A Critical Analysis Of The Sociocultural Context Of Nursing Education, Kay E. Vallee

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The purpose of this study was to critically examine the sociocultural context of nursing education as an institution. Using a postcolonial feminist theoretical framework and institutional ethnography, I illuminated the institutional complex of nursing education. This study addressed the following research questions: 1) How do practices, programs, and policies coordinate social relations within the institution of nursing education; and 2) How are Indigenous students’ everyday lives shaped by the institution of nursing education?

Multiple methods were used to collect data, including: interviews, observations, and text analysis. Interviews were conducted with students, educators, and administrators and others involved in nursing education. …

Goals Of Family Caregivers Of Persons With Dementia Across The Caregiving Career, Shalane R. Basque

Electronic Thesis and Dissertation Repository

Understanding goals of family caregivers of persons with dementia is critical to provide effective education and support. However, there is little understanding about family caregivers’ goals. This study investigated goals set by family caregivers prior to an education and training program and whether their goals varied across the caregiving career. Phases of the caregiving career were measured by relationship identity; the extent to which participants viewed their relationship in terms of familial and caregiver roles. Conventional content analysis on goals of 30 family caregivers yielded five categories which varied by relationship identity. Enhancing relationships reflected goals for the familial role …

Nursing Practice During A Mission In Nepal: Ethics And Leadership, Lorena M. Bonilla

Electronic Thesis and Dissertation Repository

The ability of nurses to reflect or critically examine the impact of professional standards of practice, legal guidelines, and ethical frameworks that influence and guide their practice is essential to help patients achieve quality of life and wellness. Regardless of the location and setting where nursing takes place, contextual factors such as the benefits and potential harm resulting from the care provided, availability of resources, the nurse’s scope of practice, and evidence-based practice guidelines, all affect a nurse’s ability to practice in a safe, ethical, competent, caring, and compassionate manner.

Using an exploratory case study to investigate nurses’ (n=9) view …

Undergraduate Nurse Educators’ Perceived Structural Empowerment, Self-Efficacy For Teaching, And Perceptions Of Uncivil Classroom Behaviours In Academic Settings, Molly A. Hunter

Electronic Thesis and Dissertation Repository

Background: This study examined the relationship among structural empowerment in academia, nurse educators’ self-efficacy for teaching, and their perceptions of the types and frequencies of uncivil classroom behaviours.

Methods: 56 participants, registered with the College of Nurses of Ontario (CNO), responded to a mail-out survey package containing four tools corresponding to each study variable. The analysis includes study descriptives, ANOVA analyses, correlations of total and subscales, and mediation analyses of the major study variables.

Results: A moderate level of structural empowerment and a high level of self-efficacy for teaching was found within the study. A significant indirect relationship was seen …

Expanding The Concept Of ‘Care’: A Narrative Study Exploring Lessons From End-Of-Life Patients To Inform ‘Medical Assistance In Dying’ Curriculum In Canada, Jill Dombroski

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This research primarily investigates what we can learn from patient experiences that can help inform the expected curricula that will be developed in response to the new Canadian legislation regarding Medical Assistance in Dying (MAID). This is a compelling area of research because of the rapidly evolving attitudes in the general population — largely driven by terminally ill patients asserting their legal rights over their bodies and the decision to put an end to their lives as a consequence of the illness they face. The issue of medical assistance in dying has been patient initiated and patient driven. Through the …

Fall Prevention In An Acute Care Hospital: The Challenges Encountered By Patients, Staff And Administrators, Barbara J. Watson

Electronic Thesis and Dissertation Repository

Abstract

Falls are frequent and often serious events that take place in hospitals. Healthcare providers find it challenging to minimize fall risk factors. In fact, just being in a hospital is a risk factor in itself! The aim of this thesis was to investigate the reasons behind patient falls, identify gaps in prevention strategies and suggest additional recommendations to improve patient safety. A mixed method approach was used to interpret the data and uncover the reasons for falls.

The first study was a secondary data analysis where 7,721 patient falls were examined. The data were taken from the hospital’s central …

An Investigation On The Value Of Integrating Mental Health Supports In Education To Build Capacity For Change, Erin Keith

Electronic Thesis and Dissertation Repository

Current statistics in Ontario show that one in five students suffer from mental health issues (Canada, 2012). Mental health disorders cause significant distress, impairing students’ functioning at school, at home, and in the community (Children’s Mental Health Ontario, 2014). Research has shown that prevention and early intervention strategies targeting students at risk for mental health challenges are beneficial, cost-effective, and reduce the need for more costly, intensive interventions. (Ontario Ministry of Education, 2013). In response to recent Ontario Ministry mental health initiatives (Ontario Ministry of Education, 2006; 2011; 2013), the Peel District School Board, in Ontario, Canada, launched an interprofessional, …

Organisational Improvement Plan: System Of Care, Derek Haime

Electronic Thesis and Dissertation Repository

This organizational improvement plan (OIP) describes a way to develop and implement a system of care philosophy within a district school board with the intent of spreading this philosophy throughout the district, province, and country in the future. It is intended to be used as a tool to guide other district school boards interested in implementing a system of care. More specifically, the problem of practice this OIP is intended to address is as follows: “The current model of care for JK-8 students with mental health needs must improve. The service delivery system and pathways to treatment for child and …

The Effects Of Empowerment On Role Competency And Patient Safety Competency For Newly Graduated Nurse Practitioners, Elsie Duff

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Introduction: Role competence and patient safety (PS) competence among healthcare professionals are rapidly developing issues due to increasing patient acuity and complexity in the healthcare system. Upon graduation, nurse practitioners (NPs) provide autonomous healthcare for populations with complex health needs, thus role and PS competence is imperative. In Canada, few studies have examined NP education and role development specific to NP role competence and PS competencies. This study addresses this gap in the research examining educational experiences of new NP graduates.

Aim: The aim of this study is to test a hypothesized model of the relationships between educational structural empowerment, …

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, …

Pearl Harvesting Autism, Mariya Gruntovskaya

Electronic Thesis and Dissertation Repository

This thesis addresses the difficulties of on-line information searching as it relates to the topic of autism. A review of existing search strategies is presented and their limitations are discussed. A new method for deriving a set of search-terms for comprehensive searching, Pearl Harvesting, was tested here to determine the necessary search terms (i.e., synonym ring) for ERIC and PsycINFO databases. Once discovered and validated, a synonym ring can be copied and pasted directly into the search box of the database, providing a simple, thorough and time saving way of conducting on-line research in the field. This easily used method …

University Athlete Transition: Making The Jump From Sport To Life, Natascha Wesch

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The general purpose of this dissertation was to examine how perfectionism might influence career planning through its relationship with career decision making self-efficacy, career goal setting, and career outcome expectations in Canadian university student-athletes. Specifically, this dissertation addressed two main research questions: Does perfectionism enhance or inhibit career planning in university student-athletes; and is this in turn influenced by the relationship between perfectionism (strivings and concerns) and the social cognitive variables of the SCCT (i.e., career decision making self-efficacy, career goal setting, and career outcome expectations)?

In order to validate and test the measurement models of perfectionism, decision-making self-efficacy, career …

Caregivers' Experiences Raising A Child With Fetal Alcohol Spectrum Disorder, Aamena Kapasi

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The purpose of this study was to identify challenges and strengths of caregivers to a child with Fetal Alcohol Spectrum Disorder (FASD). Thirty-two caregivers raising a child with FASD participated in phone interviews that included the questions: "What challenges do you face in making your household function well?" and "What strengths do you have to make your household function well?" Responses to the questions were sorted by participants and the data was analyzed using multi-dimensional scaling and cluster analysis. In response to the question about challenges, seven concepts emerged: 1) Extra Responsibility on Caregivers, 2) Difficulty Keeping Daily Routine, 3) …

Learner Anxiety And Professional Practice Self-Efficacy In Nursing Education, Joanna Pierazzo

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The purpose of this study was to examine the affective component of learner engagement (Linnenbrink & Printrich, 2003); more specifically students’ perceptions of learner anxiety and self-efficacy for professional practice in clinical nursing education. This study identified the factors in clinical learning contexts that contribute to learner anxiety, the differences among these factors in real and simulated learning contexts, and finally, the teaching and learning strategies that minimize learner anxiety and positively enhance self-efficacy for professional nursing practice. A convenience sample of 186 students from three university nursing programs in Ontarioparticipated in a two-phased mixed methods study, reflecting a response …