Browsing by Author "Altabbaa, Ghazwan"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- ItemOpen AccessAssessment of Conformity: Instrument Development(2018-06-04) Al Harbi, Nouf Sulaiman; Beran, Tanya Nathalie; Oddone Paolucci, Elizabeth; Drefs, Michelle A.; Altabbaa, Ghazwan; Davidson, Sandra; Goldsworthy, SandraCurrent educational systems, including medical programs, incorporate learning in groups. However, subtle social factors functioning within these groups can influence learning and professional development. Thus, these social factors should be considered by both educators and learners. One social factor that has gained the attention of medical educators is conformity. Conformity is submission to the pressure of the group or its members and is represented by changing one’s behaviour, attitudes or beliefs to align with those of the group. It is associated with peer pressure and hierarchy whereby the need to be accepted within a professional milieu is paramount. Hence, conformity could prevent learners from actively engaging (e.g., asking questions) in education. Moreover, conformity has been associated with learners reporting feeling overwhelmed, and it has contributed to information mismanagement, inaccurate decision-making, and learners inefficiently using health care resources or compromising their role as patient advocates. The eventual outcome is deterioration in the provision of health care. The aim of this study was to create an instrument that enables both learners and educators to track verbal and nonverbal behaviours that are indicative of conformity. An observational cross-sectional design was used in three phases in this study. In Phase I, an initial conformity instrument was created based on behaviours identified in the communication, social psychology, and medical education literature and through discussion with conformity experts. The researcher then used this instrument in Phase II to code archival videos of the conformity behaviours of medical and nursing students from a prior study on conformity. Finally, in Phase III the instrument was used in real-time simulation sessions to record the behaviours of medical residents and students who were given the challenge of managing a patient case. This case was designed to expose the medical residents and students to pressure that would potentially influence their clinical decision making. Also, this study examined whether conformity as a construct is uni- or multidimensional. The study results showed that the instrument’s scores did not differentiate conforming from nonconforming behaviours. Also, the principal component analysis generated uninterpretable results, suggesting that the behaviours measured are not multidimensional. Participants also shared their perspectives about conformity, and revealed that they viewed conformity as a natural dynamic in their daily practice and could potentially yield to the pressure of the group or their senior colleagues when faced with a conflict. The implications for teaching and practice are discussed. It is also recommended that further research examine conformity in clinical settings to determine if the results obtained in clinical simulations are consistent with practice.
- ItemOpen AccessAn Investigation of the Relationship among Conformity, Communication, and Anxiety in Medical Education(2019-03-16) Al Baz, Noof Khalid; Beran, Tanya Nathalie; Oddone-Paolucci, Elizabeth; Altabbaa, Ghazwan; Drefs, Michelle A.Health care members can face challenging situations when learning and working within multidisciplinary teams, such as when they are confronted with information that is contrary to their own understanding and knowledge. Consequently, some medical team members could feel pressure to conform to peers if they are required to make decisions. Over the years, many researchers in the field of psychology have defined that conformity occurs when an individual follows a course of action that is socially acceptable or in agreement with a majority of group members, even when this actions seems incorrect. In examining why group members might conform, some studies have suggested that poor communication and anxiety may be reasons for conformity behaviour; however, this possibility has not yet been clearly examined. The goal of this study was to investigate the relationship among learners’ communication competency, anxiety, and conformity behaviours in simulation exercises. Thirty male and female participants of various ages, medical specialties, and positions (i.e., medical clerks and residents) were observed in a simulation lab at Rockyview General Hospital in Calgary, Canada. Three measures were used in this study to observe the participants’ behaviours: A List of Potential Conformity Behaviours (LPCB), the Non-Technical Skills (NOTECHS) system, and the State Anxiety Inventory (SAI). Participants were also interviewed to explore their reasons for conforming. The study results showed that individuals with higher leadership and managerial skills exhibited more verbal and non-verbal behaviours. The anxiety levels of participants were found to be unrelated to their verbal and non-verbal behaviours, but changes in anxiety levels were associated with more verbal behaviours. Also, no relationship was found among the communication skills of participants and their anxiety levels. Finally, no link was established among conformity status, communication skill, and anxiety. Many participants also justified their feelings of pressure to conform during the study’s simulation exercises and also in clinic as related to medical hierarchies and their own knowledge level. Additionally, some medical situations, such as dealing with emergencies and participants’ concerns about their image in front of other team members, may create pressure to conform. Although this study’s results showed no significant relationship among conformity, communication, and anxiety, it enhances our understanding of the complexity of studying the relationship among different constructs
- ItemOpen AccessVisualization of reasoning and clinical diagnostic decision making(2013-01-09) Altabbaa, Ghazwan; Ghali, William; McLaughlin, Kevin; Hemmelgarn, Brenda; Flemons, WardBackground: There is little evidence regarding the effects of reasoning visualization decision support aids on the quality of clinicians’ diagnostic decisions. Methods: To address this evidence gap, we conducted a randomized-controlled study involving 30 participating clinicians from three levels of experience: medical students, residents, and physicians. Two interventions designed to improve the diagnostic approach to pulmonary embolism were assessed: a visualization reasoning task model vs. more traditional didactic lecture. All participants were requested to solve paper-based clinical scenarios. The primary outcome of diagnostic pathway concordance (derived as a ratio of the number of correct diagnostic decision steps divided by the ideal number of diagnostic decision steps in diagnostic algorithms) was measured at baseline (5 clinical scenarios) and after either intervention. Results: The mean of diagnostic pathway concordance improved in both study groups: baseline mean= 0.73, post mean (scenarios 1-10) for the decision support group = 0.90 (p < 0.001, 95% CI: 0.08-0.24); baseline mean= 0.70, post mean (scenarios 1-10) for didactic review group = 0.85 (p < 0.001, 95% CI: 0.06-0.2). There was no statistically significant difference between the two study groups, or between the three levels of participants. Conclusions: Clinical decision support aids that are designed with an evidence-based visual reasoning interface can improve clinicians’ diagnostic pathway concordance. To the extent that such decision support aids can feasibly be implemented in clinical settings, while didactic lectures at crucial moments in patient care cannot, they have potential advantages over the latter.
- ItemOpen AccessVisualization of reasoning and clinical diagnostic decision making(2012) Altabbaa, Ghazwan; Ghali, WilliamBackground: There is little evidence regarding the effects of reasoning visualization decision support aids on the quality of clinicians' diagnostic decisions. Methods: To address this evidence gap, we conducted a randomized-controlled study involving 30 participating clinicians from three levels of experience: medical students, residents, and physicians. Two interventions designed to improve the diagnostic approach to pulmonary embolism were assessed: a visualization reasoning task model vs. more traditional didactic lecture. All participants were requested to solve paper-based clinical scenarios. The primary outcome of diagnostic pathway concordance ( derived as a ratio of the number of correct diagnostic decision steps divided by the ideal number of diagnostic decision steps in diagnostic algorithms) was measured at baseline (5 clinical scenarios) and after either intervention. Results: The mean of diagnostic pathway concordance improved in both study groups: baseline mean= 0.73, post mean (scenarios 1-10) for the decision support group = 0.90 (p < 0.001, 95% CI: 0.08-0.24); baseline mean= 0.70, post mean (scenarios 1-10) for didactic review group= 0.85 (p < 0.001, 95% CI: 0.06-0.2). There was no statistically significant difference between the two study groups, or between the three levels of participants. Conclusions: Clinical decision support aids that are designed with an evidencebased visual reasoning interface can improve clinicians' diagnostic pathway concordance. To the extent that such decision support aids can feasibly be implemented in clinical settings, while didactic lectures at crucial moments in patient care cannot, they have potential advantages over the latter.