Browsing by Author "Beran, Tanya"
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Item Open Access Accommodating Complexity: Adapting Accommodation Theory to Capture Responses to Specific Transgressions(2016) Rasmussen, Kyler Ray; Boon, Susan; Ellard, John; Bierman, Alex; Beran, Tanya; Agnew, ChrisSooner or later, we are all going to be hurt by the ones we love. Though we cannot wholly prevent such transgressions from occurring, we may be able to control how we respond, and those responses can help determine the outcome of the transgression, for good or ill. One of the most prominent models for understanding how individuals respond to transgression has been Rusbult’s EVLN model, a two-dimensional typology with four categories: Exit, Voice, Loyalty and Neglect. Despite its usefulness, this typology is limited in important ways, which prompted me to re-examine and re-calibrate the EVLN. In this dissertation, I present two studies designed to describe how individuals can respond to specific transgressions from a romantic partner (rather than responses to relationship dissatisfaction, as the EVLN was initially designed to do). In these studies, I asked undergraduate participants to list how they would respond to several hypothetical transgressions (Study 1, Phase 1; N = 107) or community participants how they actually responded to recalled transgression from a romantic partner (Study 2, Phase 1; N = 39). I then had undergraduates generate various ratings of those responses (Study 1, Phases 2 and 3; N = 150 and 195 respectively; Study 2, Phase 2, N = 197) and used multi-dimensional scaling (MDS) techniques to assess how transgression-related responses should be organized and categorized. The result is an eight-fold typology summarized by the acronym CARE-CAMP. This typology differs from the EVLN in that it provides alternate dimensions (“avoidant” and “retaliatory”) and unique categories (e.g., “Cold-Shoulder” and “Moratorium”) that add theoretically important nuance to our understanding of accommodation in close relationships.Item Open Access An Investigation of Coping Strategies and Mental Health among Peer-Victimized Students with Autism Spectrum Disorder(2017) Altomare, Alyssa; McCrimmon, Adam; Beran, Tanya; Schwartz, Kelly; Strong, TomThe way in which students with Autism Spectrum Disorder (ASD) cope with peer victimization (i.e., bullying) has been relatively unexplored within the literature. Despite the growing number of studies revealing high rates of peer victimization among students with ASD, much is still unknown on how to offset the negative psychological outcomes of this form of abuse. As such, the current study examined coping strategies in relation to anxious and depressive symptoms among peer-victimized students with ASD. Coping strategies were examined using a modified version of Causey and Dubow’s (1992) Self-Report Coping Scale (SRCS; Kochenderfer-Ladd & Skinner, 2002; Wright, Banerjee, Hoek, Rieffe, & Novin, 2010). The sample included 49 students with ASD and intact cognitive functioning, ranging between ages 8 to 17 years (grades 4-12). One parent (n = 48) and one teacher (n = 34) were also invited to participate for each student participant. Consistent with previous research, the results from the current study revealed high rates of peer victimization (using the past month as a timeframe), with the highest rates reported by parents (83.3%) and teachers (73.5%). Examination of coping strategies in relation to mental health among peer-victimized students with ASD revealed that externalizing coping predicted a significant increase in depressive symptoms, whereas trivializing coping (i.e., making light of the problem) predicted a significant decrease in anxiety symptoms. The findings from this study provide important insights into the coping strategies used by students with ASD, as well as suggestions for future research and intervention efforts.Item Open Access Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: Three public policy implications(BioMed Central, 2012-01-10) Beran, Tanya; Lyimo, Frida S.Item Open Access Development of a Method to Measure Clinical Reasoning in Pediatric Residents: The Pediatric Script Concordance Test(2015-09-30) Cooke, Suzette; Beran, TanyaContext: National medical examinations boards have requested that methods be developed to assess the clinical reasoning competency of medical trainees. The Script Concordance Test (SCT) is an emerging method of assessment that holds promise for the evaluation of clinical reasoning skills. Objectives: This study had 3 objectives: 1) to examine the validity of SCT scores in accurately discriminating clinical reasoning ability between junior (JR) and senior (SR) pediatric residents and experienced pediatricians serving on the panel of experts (POE), 2) to determine if higher reliability of the SCT method could be achieved by applying specific strategies to the design and construction, and 3) to explore participants’ acceptability of the SCT method. Methods: A 90-minute SCT containing 24 cases and 137 questions was administered to 91 residents from four pediatric residency training centers. Twenty-one pediatricians served on the POE. All participants completed a post-test survey designed to explore their impressions and attitudes regarding the SCT assessment method. Results: Overall, there was a difference in performance across the three levels of experience, F = 22.84 (df = 2); p < 0.001. The POE scored higher than both the SR (mean difference 9.15; p < 0.001) and the JR (mean difference = 14.90; p < 0.001) and the SR scored higher than the JR (mean difference = 5.76; p < 0.002). The reliability of the SCT scores (Cronbach’s α) was 0.85. Sub-test data, based exclusively on the new evolving type cases demonstrated similar results. Participants expressed keen interest and engagement in the SCT format of assessment. Conclusions: The findings of this study contribute to a growing body of literature suggesting that SCT holds promise as a valid, reliable and acceptable method to assess the core competency of clinical reasoning in medicine. The SCT method is based on two core principles we believe are central to the assessment of clinical reasoning: acknowledging uncertainty and the possibility of more than one “right answer.” We propose the SCT may be effectively integrated into formative residency assessment and with increasing exposure, experience and refinement may soon be ready to pilot within summative assessments in pediatric medical education.Item Open Access Ego identity development in physicians: a cross-cultural comparison using a mixed method approach(BioMed Central, 2012-05-23) Beran, Tanya; Violato, Efrem; Faremo, Sonia; Violato, Claudio; Watt, David; Lake, DeidreItem Open Access Experiences of Conformity in Postgraduate Medical Education(2015-12-22) Grendar, Jan; Beran, Tanya; Oddone Paolucci, Elizabeth; Hecker, Kent; Kassam, Aliya; Ellard, JohnA questionnaire was used to study the perception of conformity in Postgraduate Medical Education. The goals were to describe: (1) the extent of perception of pressure to conform in PGME, (2) factors that influence pressure to conform, and (3) trainees’ perception of how conformity influences their educational experience. 166 residents participated (21.3% of all residents). Individual characteristics (age, sex, PGY level, educational background) and residency program characteristics (surgical/nonsurgical, size) were not associated with a significant difference in perception of pressure to conform. Participants’ higher hierarchy rank, scenarios during off-service rotations and informal educational encounters were associated with significantly higher perception of pressure to conform. An equal number of residents perceived conformity as having a positive and negative influence on acquisition of knowledge and skills. In conclusion, although individual or program characteristics were not associated with differences in perception of pressure to conform in PGME, educational scenario characteristics were.Item Open Access Experiences of pressure to conform in postgraduate medical education(2018-01-03) Grendar, Jan; Beran, Tanya; Oddone-Paolucci, ElizabethAbstract Background Perception of pressure to conform prevents learners from actively participating in educational encounters. We expected that residents would report experiencing different amounts of pressure to conform in a variety of educational settings. Methods A total of 166 residents completed questionnaires about the frequency of conformity pressure they experience across 14 teaching and clinical settings. We examined many individual characteristics such as their age, sex, international student status, level of education, and tolerance of ambiguity; and situational characteristics such as residency program, type of learning session, status of group members, and type of rotation to determine when conformity pressure is most likely to occur. Results The majority of participants (89.8%) reported pressure to conform at least sometimes in at least one educational or clinical setting. Residents reported higher rates of conformity during informal, rather than formal, teaching sessions, p < .001. Also, pressure was greater when residents interacted with higher status group members, but not with the same or lower level status members, p < .001. Effect sizes were in the moderate range. Conclusions The findings suggest that most residents do report feeling pressure to conform in their residency settings. This result is consistent with observations of medical students, nursing students, and clerks conforming in response to inaccurate information within experimental studies. Perception of pressure is associated with the setting rather than the trainee personal characteristics.Item Open Access Exploring Ageism in Young Children: Attitudes Toward Older Adults and Influencing Factors(2024-09-13) Czarnecki, Natalia; Drefs, Michelle; Beran, Tanya; Makarenko, Erica; Prasow, CynthiaBeing exposed to negative stereotypes about older adults and aging from a young age may have long-term negative impacts on individuals' physical and mental health, cognitive performance, and life expectancy. This thesis investigates the attitudes of young children toward older adults and the potential influencing factors such as contact with grandparents, priming effects, and parents' cultural orientation. The study utilized interview responses from younger children, which was a modified version of the Children’s Attitudes Toward the Elderly (CATE) scale, and a cultural orientation scale filled out by parents. The findings indicate that while young children hold positive attitudes toward older adults, they also hold negative stereotypes towards older adults’ competence. Quality of contact with older adults was found to play a significant role in the development of attitudes toward older adults while frequency did not. Additionally, priming and parents’ cultural orientation did not significantly influence children’s attitudes. The findings contribute to a nuanced understanding of the development of attitudes toward older adults in early childhood and highlight the importance of quality contact with older adults in their shaping.Item Open Access Faculty Portfolio Development: Perception vs. Practices in a Major University, Riyadh, Saudi Arabia(2017) Alyousif, Sarah; Beran, Tanya; Baig, Lubna; Oddone Paolucci, Elizabeth; Hecker, Kent; Magzoub, Mohi EldinHigher educational institutions have been using faculty portfolios to help ensure that the mission of academia is being met. This study aimed to develop a faculty portfolio using a sequential mixed methods design. The portfolio development process took place in King Saud bin Abdulaziz University of Health Sciences (KSAU-HS) colleges based in Riyadh, Jeddah and Alhassa, Saudi Arabia. In-depth interviews and focus groups, two ubiquitous approaches for qualitative research, were used to collect data from purposefully selected interviewees (n = 18) and focus group participants (n = 24). The quantitative arm of this study included questionnaire administration to 66 participants. They completed a 59-item questionnaire developed to obtain evidence of the validity and reliability of items used to form a portfolio. The audio taped and videotaped data were transcribed and analysed using thematic content analysis. The quantitative data were analysed using between group differences. This hybrid approach identified five main portfolio domains and their 59 subdomains. The individual domains, which were prioritized using judgemental weightings assigned by 18 participants, included education, service, research, professional development and academic management and leadership. Subdomains were identified within focus groups, with a total of 59 items representing measurable faculty daily activities that constitute the five main domains. The portfolio scores were found to have good reliability and validity based on the quantitative analyses and their triangulation with the qualitative results, thereby providing evidence of the trustworthiness and credibility of the data. This study informs the scientific community by presenting a faculty portfolio developed through a multi-step validation process. It is expected that this faculty portfolio will be implemented successfully in KSAU-HS colleges because its development is based on the opinions of all stakeholders affiliated with this higher educational institution.Item Open Access Group Conformity in Interprofessional Teams(2016) Kaba, Alyshah; Beran, Tanya; White, Deborah; McLaughlin, KevinWithin the multidisciplinary team environment, professionals bring varying levels of experience, authority, and responsibility: examining how team members interact is critical to ensure the highest standard of patient care. One type of influence in this environment is peer pressure, whereby an individual changes his or her own behavior to match the responses of others in a group. Known as conformity, this body of research, which spans 60 years since Asch’s (1951) seminal work, has only recently been examined in medical education (Beran et al., 2012). When the individual conforms to an incorrect diagnosis or plan for treatment, the safety of the patient may be compromised, contributing to the burden of adverse events. Given the ubiquity of collaborative practice in healthcare, the research presented in this dissertation is about succumbing to peer pressure - and the greater pressures experienced by nursing as compared to medical students to conform to a procedural task. This thesis is divided into four papers. The first paper is a narrative review, the second paper is a methods paper, the third paper compares the difference between medical and nursing students’ rate of conformity on a vital sign skill task, and the fourth paper examines whether conforming on the vital signs task is related to their clinical interpretations. The study is an adaption of the original Asch design to recreate conformity within an interprofessional simulated environment. The findings from the four papers presented in this dissertation, suggest that social pressure may prevent nursing and medical students from questioning incorrect information within interprofessional environments. If health professional students are making clinical decisions based on the consensus of the group, this is a critical issue for patient safety, as we cannot negate the fact that these students will one day be future doctors and nurses and will be working with real patients. To improve teamwork and collaboration amongst medicine and nursing in practice, Interprofessional Education (IPE) curriculum needs to teach students how to overcome barriers within the medical hierarchy, by encouraging students to question and politely challenge what seems to be incorrect information.Item Open Access Group peer-mentorship in academic libraries: an approach to enhancing research engagement(American Library Association, 2022-01) Lorenzetti, Diane; Powelson, Susan; Lashewicz, Bonnie; Casebeer, Ann; Hayden, K. Alix; Oddone Paolucci, Elizabeth; Beran, TanyaItem Open Access Leadership competencies for medical education and healthcare professions: population-based study(BMJ, 2012-03-27) Çitaku, Fadil; Violato, Claudio; Beran, Tanya; Donnon, Tyrone; Hecker, Kent; Cawthorpe, DavidItem Open Access A midwifery preceptorship needs assessment to inform curricular goals and recommendations for preceptor training in undergraduate education in Canada(2021-06-29) Upadhyaya, Deepali Yashawantray; Oddone, Paolucci; Beran, Tanya; Clancy, Tracey; Haines-Saah, RebeccaBackground: Canadian baccalaureate midwifery educational curricula comprise a significant proportion of experiential learning opportunities facilitated by clinical preceptors. There is limited national published research on midwifery preceptors’ perspectives. Objectives: 1) To explore the current evidence in the published literature on the facilitators and barriers for clinical preceptorship in midwifery education; 2) To acquire quantitative and qualitative evidence that elicits data of the facilitators and barriers for midwifery preceptors in Canadian undergraduate education; and 3) To identify key recommendations for educational strategies for a midwifery preceptor training curriculum that can be operationalized within Canada. Methods: This doctoral project adhered to the first three steps of the six-step approach to Kerns’ curricular development framework for medical education. The first step, a general needs assessment, was completed in the form of a scoping review of international publications on facilitators and barriers for midwifery preceptors. The second step, a targeted needs assessment, was conducted in two phases. The preliminary phase was a national survey of midwifery preceptors (n=160) on benefits/rewards, support, commitment, and satisfaction in the role. The second phase explored midwifery preceptors’ perspectives with three national focus group interviews (n=16) under a constructivist paradigm utilizing a reflexive thematic analysis approach. In step three of the curricular development framework, research evidence gained from the general and targeted needs assessments was synthesized to produce goals, recommendations, and objectives for a proposed curriculum for midwifery preceptor training. Key Results: Through the completion of preceptors’ needs assessments, this research produced recommendations relevant to Canadian midwifery education. Suggestions on facilitation, essential elements, and considerations for a proposed preceptor training curriculum were offered. Furthermore, the Canadian midwifery care model tenets of autonomy, collaboration, and partnership were used as a basis to provide broader preceptor-related recommendations to stakeholders. Significance: In Canadian baccalaureate education, midwifery preceptors are the primary facilitators for most of the curriculum. In Canada, the onus for training preceptors rests within midwifery educational programs; however, all members of the quadripartite relationship in midwifery experiential curricula (e.g., educational programs, preceptors, learners, and the health care environment) are invested and benefit from measures that empower preceptors.Item Open Access Paving a Path for Pediatric Hospital Medicine in Canada: Defining National Competencies Using Delphi Methodology(2024-07-01) Vetere, Peter Joseph; Cooke, Suzette; Beran, Tanya; Millar, Kelly; Kassam, Aliya; Lorenzetti, DianeBackground: The field of Pediatric Hospital Medicine (PHM) has grown considerably in North America over the last three decades in response to the increasing complexity and acuity of the pediatric in-patient population. Although PHM fellowship programs have been developed in Canada, no national competencies framework currently exists to guide curricular content. This study aimed to identify competencies required for the practice of PHM in Canada. Methods: Using Delphi methodology, a national panel of experts in PHM iteratively rated potential competencies, on a 5-point scale, to determine their priority for inclusion. Responses were analyzed after each round. Competencies that were assigned a rating of three or less by 80% or more of panelists were removed from subsequent rounds. The remaining competencies were re-sent to panelists for further ratings until consensus was reached, defined as Cronbach’s α ≥0.95 and after a minimum of two survey rounds. At the conclusion of the Delphi process, competencies where 80% or more of the panelists assigned a rating or four or higher were included. Results: Two rounds of the Delphi process were required to reach consensus. Thirty-five participants completed both survey rounds. The participants represented 13 Canadian pediatric tertiary care centers and five community hospitals. Of 176 initial competencies, 109 PHM competencies achieved consensus. Conclusion: This is the first study to define national competencies for PHM in Canada. The competencies identified provide a framework for PHM fellowship program directors to shape local curricula. The results may also be used to inform the development of comprehensive national PHM fellowship curricula.Item Open Access Researching Researchers: Exploring the Challenges of Conducting Research During a Pandemic(2023-11-06) Onuoha, Onyinyechi Choice; Beran, Tanya; Lorenzetti, Diane; Reynold-Pearson, JacquelineAbstract Background: Research Assistants (RAs) play a key role in the successful completion of research. When data collection and recruitment are disrupted, as was the case during the COVID-19 pandemic and accompanying restrictions, the effects on RAs attempting to conduct research are not well known. Objective: This study explored RAs’ perspectives of conducting research during the COVID-19 pandemic. Methods: Five RAs who had begun collecting data at a mid-western children’s hospital on how a robot named MEDi® could help patients uphold health and safety procedures during the COVID-19 pandemic, took part in semi-structured interviews. Thematic analysis was conducted on the interview data. Results: Through our analysis, we identified four key themes (and sub-themes) that reflected RAs’ experiences of conducting research during the COVID-19 pandemic: Inspiration and Motivation; Research Barriers; Human Connections and Relationships; and Creativity and Problem-Solving. The first theme focused on the sources of RAs’ inspiration and motivation to participate in research; the second focused on the barriers that affected data collection and recruitment. The third theme described the impact that human connections and relationships had on the success of the research, and the final theme explored the RAs’ creativity and problem-solving approaches, which aided in navigating the challenges faced during the pandemic. The challenges faced by RAs in this study were overcome with positive attitudes, creativity, and collaboration. Conclusion: This research experience allowed RAs to explore creative strategies to adapt research methods to suit unanticipated circumstances and develop an array of interpersonal skills to facilitate participation in future research and career activities.Item Open Access Structural equation modeling in medical research: a primer(BioMed Central, 2010-10-22) Beran, Tanya; Violato, ClaudioItem Open Access Understanding Depression Among Pregnant Aboriginal Women(2017) Roy, Amrita; Thurston, Wilfreda Enid; Patten, Scott; Tough, Suzanne; Crowshoe, Lynden (Lindsay); Beran, TanyaBackground: Prenatal depression is a significant maternal-child health concern. Research on depression among pregnant Aboriginal women is limited. Given the unique historical and present-day societal context involved, targeted research is warranted. Objectives: 1) To understand the risk factors, protective factors and societal context of prenatal depression in Aboriginal populations. 2) To examine accessibility and safety of clinical and social service systems used by pregnant Aboriginal women, and how they can be improved. Methods: A multi-methods, community-based approach was taken. A qualitative constructivist grounded theory study (Voices and PHACES) was conceived and conducted in Calgary, in partnership with local health and social services and with involvement of Aboriginal community members and Elders. The study involved personal interviews with pregnant Aboriginal women (n=13) and service-providing professionals (n=12), and focus-groups with stakeholders (n=11). Additionally, secondary analysis was conducted of data from the All Our Babies study, a large epidemiological cohort study of n=3354 pregnant women in Calgary. Key results: In this population, the individual-level risk factors commonly associated with depression (e.g., socioeconomic status, chronic life stress) appear to be mediators of the effects of more upstream, systemic factors related to historical and present-day societal context (e.g., racism, sexism, social exclusion, and intergenerational trauma from colonization). Substance abuse was found to be a common coping mechanism for stress, trauma and depression, indicating that mental health issues need to be addressed in order to effectively manage addictions. Social support and traditional Aboriginal healing practices appear protective, and thus may be key intervention strategies. While services in Calgary appear to be working well in certain ways, a need was identified for more culturally-appropriate services, better networking among agencies, as well as strategies to increase accessibility, reduce stigma, and enhance a safe and empowering healing environment for patients and clients. Significance: This dissertation contributes to a better understanding of the determinants of prenatal depression in Aboriginal women, and how the determinants may be addressed in health and social services. Moreover, it opens the door for further research on this important yet understudied topic, and also for the design of effective, evidence-based interventions targeted to this population’s needs.