Browsing by Author "Davidson, Sandra"

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    Assessment 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, Sandra
    Current 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.
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    Awakening Canadians to ageism: a study protocol
    (2021-10-09) Dahlke, Sherry; Hunter, Kathleen F.; Fox, Mary T.; Davidson, Sandra; Perry, Nicole; Watts, Laura T.; Martin, Lori S.; Butler, Jeffrey I.; Raymond, Christy; Chasteen, Alison L.; McCleary, Lynn; Boscart, Veronique; Moody, Elaine
    Abstract Background Making fun of growing older is considered socially acceptable, yet ageist humour reinforces negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Such stereotypes and discrimination affect the wellbeing of older people, the largest demographic of Canadians. While ageism extends throughout professions and social institutions, we expect nurses—the largest and most trusted group of healthcare professionals—to provide non-ageist care to older people. Unfortunately, nurses working with older people often embrace ageist beliefs and nursing education programs do not address sufficient anti-ageism content despite gerontological nursing standards and competencies. Methods To raise awareness of ageism in Canada, this quasi-experimental study will be supported by partnerships between older Canadians, advocacy organizations, and academic gerontological experts which will serve as an advisory group. The study, guided by social learning theory, will unfold in two parts. In Phase 1, we will use student nurses as a test case to determine if negative stereotypes and ageist perceptions can be addressed through three innovative e-learning activities. The activities employ gamification, videos, and simulations to: (1) provide accurate general information about older people, (2) model management of responsive behaviours in older people with cognitive impairment, and (3) dispel negative stereotypes about older people as dependent and incontinent. In Phase 2, the test case findings will be shared with the advisory group to develop a range of knowledge mobilization strategies to dispel ageism among healthcare professionals and the public. We will implement key short term strategies. Discussion Findings will generate knowledge on the effectiveness of the e-learning activities in improving student nurses’ perceptions about older people. The e-learning learning activities will help student nurses acquire much-needed gerontological knowledge and skills. The strength of this project is in its plan to engage a wide array of stakeholders who will mobilize the phase I findings and advocate for positive perspectives and accurate knowledge about aging—older Canadians, partner organizations (Canadian Gerontological Nurses Association, CanAge, AgeWell), and gerontological experts.
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    Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion
    (2024-02-25) Doucette, Emily J.; Fullerton, Madison M.; Pateman, Margaret; Lip, Alyssa; Houle, Sherilyn K.; Kellner, James D.; Leal, Jenine; MacDonald, Shannon E.; McNeil, Deborah; Tyerman, Jane; Luctkar-Flude, Marian; Davidson, Sandra; Constantinescu, Cora
    Abstract Background Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs’ effectiveness using a pre-post self-assessment pilot study. Methods A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy. Results There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4–5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education. Conclusions Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.
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    Exploring Hemodialysis Nurses’ Perceptions on Kidney Replacement Therapy Modality Education: A Framework Analysis
    (2024-03-26) Jaibeeh Barah, Elke Etane; Jackson, Jennifer; Davidson, Sandra; Elliott, Meghan
    Many people with end-stage kidney disease (ESKD) start and remain on in-centre hemodialysis (ICHD) treatment despite evidence of improved health and system outcomes when they choose a kidney replacement therapy (KRT) modality optimal to their lifestyle such as home dialysis. To make an informed modality decision patients must receive frequent, high quality modality education. This education is inconsistent in the ICHD setting where patients spend the most time with nurses while receiving hemodialysis treatments. The aim of this study was to examine ICHD nurses’ perceptions around KRT modality education for patients receiving ICHD using the COM-B model of behaviour change. To achieve this aim, I utilized the framework analysis (FA) method applying the COM-B model as a theoretical framework to analyze the data. The results demonstrated that ICHD nurses reported some impediments to providing modality education such as knowledge deficits, lack of experience or exposure to other dialysis modalities and lack of resources to support modality education practices. ICHD nurses reported some factors that enhanced modality education, including strong nurse-patient therapeutic relationships and previous experience in other dialysis modalities. I proposed some practice and educational recommendations geared toward targeted education of ICHD nurses, providing structure and appropriate resources to support KRT modality education practice in this setting. Keywords: Modality education, in-center hemodialysis, nurses, kidney replacement therapy
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    What Influences Use of Nonpharmacological Treatments for Seniors with Mild or Moderate Dementia: An Integrative Review Protocol
    (2022-04-02) Hwang, Jasmine; Donnelly, Tam Truong; Davidson, Sandra; Raffin, Shelley
    Aim: The aim of this integrative review is to explore the extent and nature of evidence concerning factors that influence use of nonpharmacological treatment interventions for community-dwelling seniors with mild-to-moderate dementia. Background: Despite the significance of nonpharmacological interventions in optimal management of mild-to-moderate dementia, it is unclear in the literature how seniors with mild or moderate dementia view, understand, and access nonpharmacological interventions. To our knowledge, no review has been conducted on factors influencing the use of nonpharmacological interventions for seniors with mild-to-moderate dementia. Design: An integrative review method will be used to meet the review objective. Review method: We will perform a systematic literature search from five electronic databases to locate relevant empirical and theoretical research evidence on the topic. Eligible studies include empirical research, both qualitative and quantitative methods, and theoretical studies published since 2000 in English, that explored factors influencing use of community-based nonpharmacological interventions for seniors with mild or moderate dementia. Eligibility criteria are studies that included community-dwelling seniors (≥ 65) with mild-to-moderate dementia, their care partners, or health care practitioners and that explored the use of community-based nonpharmacological dementia treatments. We will extract the data by creating matrices on quality appraisal, key methodological features, and key findings. Data analysis will include constant comparison of extracted data, examining relationships between concepts, overall strengths and weaknesses of the literature, and gaps in knowledge. Findings will be visually categorized and narratively summarized. Discussion: This integrative review will identify and synthesize enablers and barriers that influence use of nonpharmacological interventions by seniors with mild-to-moderate dementia, identify knowledge gaps, and inform future research studies and literature reviews.