Transformational Leadership Approach For Encouraging Historically Marginalized Communities To Access Admission To Naturopathic Medicine, Baljit Khamba

The Dissertation in Practice at Western University

Many healthcare training institutions lack cultural diversity, including naturopathic medicine. One potential reason is a lack of historically marginalized individuals applying to these medical schools. Attracting communities of colour to healthcare professions, like naturopathic medicine is important for improving healthcare access and delivery across all individuals within North America. This OIP explores the lack of diversity in applicants to the naturopathic medical program at a large multi-centre institution. The role that education and mentorship of faculty members can play to improve implicit biases and eventually encourage historically marginalized individuals to apply to the program is explored. Moreover, the OIP presents …

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. …

Hidden In Plain Sight: Finding A Balance Between Assessment And Learning In Competency-Based Education In Canadian Health Care, Scott Murray

The Dissertation in Practice at Western University

Due to its emphasis on skill development and alignment with workforce demands, competency-based education (CBE) has garnered considerable attention in recent years. My organizational improvement plan (OIP) focuses on the potential benefits of incorporating learners’ voices into CBE in Canadian medical education and proposes a corresponding implementation framework. The traditional CBE model often lacks a critical component: the learner’s voice. My OIP reviews the literature and outlines its theoretical underpinnings (e.g., systems theory, adult education theory) within the scope of authentic leadership. The findings suggest incorporating learners’ voices into CBE to boost engagement, motivation, and agency. In response to such …

Balancing Nurture And Rigour: Seeking Effective Support For Nursing Students In Distress, Marti Harder

The Dissertation in Practice at Western University

As higher educational institutions face a growing demand to graduate more nurses, and mental health and life stresses are recognized as increasing obstacles to student success, the timing is right for nursing programs to evaluate their traditionally rigorous program cultures. At Sunrise University in Western Canada, nursing students make up a large population seeking support services, and there is an increasing need for capacity building in faculty to support learners who are in distress. In this organizational improvement plan (OIP), I explore what can be enhanced or further developed to create more effective support for students who are in distress …

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 …

Transforming School-Based Mental Health To Heal The Collective Soul Wound, Andrea L. Holowka

The Dissertation in Practice at Western University

Pervasive well-being concerns of youth in Alberta are steadily contributing to society’s collective soul wound. In response to this growing need, K-12 systems are faced with increased demands for school-based mental health services. Public Prairie School Division (PPSD) provides student mental health intervention needs through onsite access to school-based teacher counsellors and referrals to centralized psychologists. However, decisions regarding mental health practitioner allocations or practice standards are often left to individuals and generally follow historical practice. This Organizational Improvement Plan (OIP) problematizes PPSD’s lack of system-wide approaches to mental health interventions that can provide assurance of improved efficacy and equity …

From College To University: Nursing Students' Experience Of Transition, Mary Anne Krahn

The Dissertation in Practice at Western University

Increasingly complex healthcare systems require nurses to have a greater depth of knowledge and theory application to care for patients safely and competently. To prepare nurses for rapidly changing health care systems, the baccalaureate degree was accepted by the Canadian Nurses Association (CNA) as the standard for entry to Registered Nurse practice across Canada and became the entry-to-practice requirement starting in 2005 (Wood, 2011).

In Ontario, this entry-to-practice standard required the development of college and university collaborative partnerships to respond to the resulting implementation and capacity challenges in nursing education (MacMillan & Mallette, 2004). Although these partnerships have been in …

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

Electronic Thesis and Dissertation Repository

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, …

Mentorship: A Powerful Tool For Ipg Success, Andrea Nelson

The Dissertation in Practice at Western University

Because Canada espouses principles of diversity and multiculturalism, many international pharmacy graduates (IPGs) immigrate to Canada expecting to find employment using skills for which they trained in their home country. Upon arrival, they often face challenges in credential recognition and licensure. Barriers include systemic discrimination, socio-psychological isolation, the precipitous decline in social status, and financial challenges of navigating the steps that bridge the training received in their home countries to the scopes of practice in Canada. The problem of practice (PoP) explored in this organizational improvement plan (OIP) focuses on the lack of opportunity that IPGs have to access clinical …

(Re) Evaluating Critical Care Nurse Support Program(S) In A Tertiary Care Hospital: Intersecting The Art And Science Of Nursing, C. Patricia Mazzotta

The Dissertation in Practice at Western University

There is a growing critical care nurse staffing shortage with increases in nurse vacancy rates. Moral distress has been exacerbated by the SARS-CoV-2 (COVID-19) pandemic and, in particular, impacting critical care nurses. COVID-19 is a significant contributor to staffing shortages and continued nursing crisis. Thus, the impetus for the Problem of Practice (PoP): the lack of support to address the psychological, emotional, and spiritual distress suffered by critical care registered nurses in a tertiary care hospital in Central Ontario. To comprehend the realities of working in the intensive care units, leaders must first understand nurses’ lived experiences, narratives, and what …

Supporting Post-Secondary Implementation Of Recovery-Oriented Practice In A Stepped Care Model, Janis Campbell

The Dissertation in Practice at Western University

Student mental health has been a growing concern for higher education communities for many years. Campuses have been struggling to keep up with the increasing demand for services which has been complicated further by the COVID-19 pandemic. A Stepped Care model (SCM) developed at a Canadian university has been offering new ways of organizing mental health resources based on open access, student choice, and recovery principles. There are diverse definitions of recovery in the literature and are usually based on values such as empowerment, respect, and self-determination. SCMs have been shown to increase access to resources and reduce or eliminate …

Improving Sexual Violence Reporting In Higher Education Institutions, Karen D. Kennedy Ms

The Dissertation in Practice at Western University

Abstract

This Organizational Improvement Plan (OIP) addresses the lack of sexual violence (SV) reporting at an undergraduate university (Coastal U; a pseudonym) where values of equity, diversity, and inclusion are espoused. Nonetheless, students from diverse cultures at Coastal U report a lack of visibility, unclear pathways for reporting, poor student and staff education, and numerous reporting fears, culminating in a lack of SV reporting. A critical and intersectional feminist lens frames this issue as one of social injustice, wherein inequity and lack of inclusion are problematic. Institutional context, capacity, and readiness, together with consideration of external factors, led to three …

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

Electronic Thesis and Dissertation Repository

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 …

Reforming Nursing Education To Support Nursing Leadership, Carlyn Tancioco

The Dissertation in Practice at Western University

Abstract

This Organizational Improvement Plan (OIP) examines the lack of effective education to support the development of nursing leadership amongst nurses in a Canadian province. The nursing profession represents a substantial portion of the health-care workforce in this specific Canadian province, and nurses play a central role in patient care as primary providers and by advocating for patients. Nursing care is a critical component of the overall patient experience and has the potential to be one of the most important contributors to positive patient outcomes. Accordingly, it is critical to ensure that nurses develop the leadership mindset required to contribute …

The Problem Of Operational Stress Injuries In An Ontario Fire & Rescue Organization, Megan Edgelow

The Dissertation in Practice at Western University

The purpose of this Organizational Improvement Plan (OIP) is to assist public safety leaders in understanding the human and financial costs of operational stress injuries (OSIs) and possible solutions to this issue. OSIs, including posttraumatic stress disorder (PTSD), are a growing problem for public safety organizations, requiring new and innovative solutions. This OIP is applied to a fire and rescue organization in a small urban centre in Ontario that faces similar OSI challenges to many other public safety organizations. The Problem of Practice (PoP) is a lack of implementation of effective practices to mitigate the impact of OSIs. The foundation …

A Curriculum Framework At Glsm, A Canadian Medical School, Jeff Bachiu

The Dissertation in Practice at Western University

Medical education has seen minor changes over the decades, but a dynamic movement towards competency-based medical education (CBME) has swept across the field in recent years. Organizing medical education curriculum to respond to these changes can be challenging due to many factors, in both content and context. The public rightly expects that graduating medical students be competent physicians, ready to deliver effective health care. This Organizational Improvement Plan (OIP) looks at a relatively new medical school’s lack of an outcomes-based curriculum framework. The Problem of Practice (PoP) is focused on the difficulty of moving the school toward the development of …

Implementing Innovative Mental Health Supports And Services At A Post-Secondary Institution, Adam K. Lawrence

The Dissertation in Practice at Western University

In 2020, the Government of Ontario published a report entitled In It Together: Foundations for Promoting Mental Wellness in Campus Communities. This document outlines that the priority of post-secondary institutions should be the health and well-being of students by ensuring that students receive the supports they need to be successful. Most importantly, the document outlines a community approach needed for students to access mental health supports and services on their campuses. Many post-secondary students are becoming increasingly aware of their own mental health needs prior to enrolling at university or college. This has resulted in a culture on post-secondary …

Building A Co-Curricular Wellness Program For Medical Students At A Canadian Medical School, Renea D. Leskie

The Dissertation in Practice at Western University

The increasing number of medical students who present with mental illness and burnout is becoming a very real challenge among medical schools nationally and globally, prompting a need for medical schools to address this very real problem. This Organizational Improvement Plan (OIP) seeks to help solve this problem by means of a co-curricular wellness program aimed at preventing mental illness and burnout from happening. Rather than being reactive as students self-identify as having a mental illness, this OIP argues for preventative measures that help to prevent mental illness and burnout from occurring at all.

Using a three-pronged leadership approach of …

Development Of An Academic-Service Alliance To Address New Graduate Registered Nurses’ Practice Readiness, M. Dianne Norman

The Dissertation in Practice at Western University

New Graduate Registered Nurses’ (NGRN) lack of practice readiness is a Problem of Practice (PoP) impacting hospitals. Stemming from the evolving complexity of today’s healthcare environment and the generalist nature of the baccalaureate nursing program, the lack of NGRN practice readiness increases hospital-based orientation costs, patient safety risks, and NGRN attrition. There is currently no formal structure in which key stakeholders can address the NGRN lack of knowledge, skills and judgment and the associated implications for the safety and quality of patient care. This Organizational Improvement Plan (OIP) examines NGRN practice readiness within the organizational context of the Health Centre …

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

Electronic Thesis and Dissertation Repository

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 …

Quality Assurance In Competency Training Of Pre-Anesthesia Consultation Skills, Michelle Wong

The Dissertation in Practice at Western University

The absence of quality assurance in training clinicians to perform pre-anesthesia consultations at a Canadian university is the Problem of Practice addressed in this Organizational Improvement Plan. This competency requires learners to apply their anesthesia knowledge to take medical histories; perform physical examinations; diagnose anesthetic risks; and generate anesthesia plans. Random chart audits of many learners identify deficiencies and suggest inconsistent training of this competency. This Organizational Improvement Plan analyzes the anesthesia program’s organizational context to be a complex adaptive system; organizational structure to be a hierarchy; and organizational state to be static. Through the paradigms of complexity theory, interpretivism, …

Exploring Resiliency During The Nursing Student Clinical Experience, Natalie N. Mcmullin

The Dissertation in Practice at Western University

In nursing programs, it is common for students to not complete their degree (Van Hoek et al., 2019). This problem is perpetuated as students who experience high stress and lack resiliency are more likely to be unsuccessful or take longer to complete their nursing degree (Van Hoek et al., 2019). Resiliency is not only important for students during their degree, it is essential to continuously strengthen it throughout their nursing career (Turner & Kaylor, 2015). The aims of this organizational improvement plan will be to empower nursing students to be more resilient in the clinical setting so that they are …

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 …