Browsing by Author "Lockyer, Jocelyn"

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    A grounded theory qualitative analysis of postgraduate medical resident attitudes towards learning and training in the psychiatric emergency services
    (2007) McIlwrick, Joann; Lockyer, Jocelyn
    Objectives: The objective of this study was to generate hypotheses about 1) influences on psychiatry resident attitudes towards training in psychiatric emergency services (PES) and 2) barriers to resident education in the PES, with some discussion as to how to overcome these obstacles. Methods: In this grounded theory qualitative study, data were collected from focus group meetings of psychiatry residents enrolled in postgraduate training at the University Of Calgary. Data analysis was performed according to grounded theory methodology. Results: Residents described educational and environmental factors in the context of professional relationships in the multidisciplinary PES. Conclusions: Opportunities to practice CanMEDS psychiatrist roles are influenced by resident relationships with the PES team. Residents will employ either of two coping mechanisms (altruism or devaluation) in an attempt to negotiate the stressors associated with training in the PES. Implications of coping styles on education and attitudes towards the PES are discussed.
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    A Mixed Methods Study of the Continuing Medical Education Needs of Canadian and Calgary Nephrologists
    (2015-04-30) Bass, Adam; Lockyer, Jocelyn
    Objectives: To determine the continuing medical education (CME) needs of Canadian and Calgary nephrologists. Methods: A mixed-methods approach was taken to determine the educational needs of Canadian and Calgary nephrologists. Data collected included a survey of members of the Canadian Society of Nephrology, individual interviews with Calgary nephrologists, individual interviews with editors of nephrology journals, maintenance of certification data from the Royal College of Physicians and Surgeons of Canada, and administrative data on hospital admissions from the Foothills Medical Centre (Calgary, Canada) nephrology inpatient service. Results: In general, nephrologists participate in traditional CME, both locally and at national/international conferences, and perceive CME as serving multiple functions, including identifying learning needs, improving learning, and providing opportunities for networking and socializing with colleagues. Although they rate the quality of their current CME activities highly, there are diverse opinions on the ideal content and format of CME. Most, however, appear to prefer in-person to on-line activities and are interested in content areas that they do not encounter frequently while attending on clinical service. A mixed methods approach helped identify key similarities and differences that spanned two or more data sets in the domains of local CME/CPD planning, content characteristics, content topics, format, collegial interactions and barriers. Conclusions: A mixed methods approach to the determination of educational needs of nephrologists provided data that will enable the development of a local CME/CPD program for nephrologists.
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    Alberta Occupational Medicine Newsletter: December 1989
    (1989) Robinson, Hilary; Corbet, Kenneth; Rockwell, F. S.; Jennett, Penny A.; Parboosingh, I.J.T.; Maes, William; Lockyer, Jocelyn; Lawson, David; Hamm, R. Douglas (ed)
    Editiorial Comments -- Cholesterol Screening in the Workplace -- Summary of the Alberta Occupational Health Society November 1989 Meeting- Edmonton, Alberta -- Infectious Disease Hazards in the Alberta Funeral Service Industry -- A Medical Information System (MIS) for Rural Practice: An Ongoing CME Service -- Alberta Occupational Medicine Newsletter Index to Volumes I Through VI
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    An Examination of the Impact of Simulation and Multimedia Instruction on Central Venous Catheterization
    (2017) Lord, Jason; Lockyer, Jocelyn; Palacios Mackay, Maria; Zuege, Danny
    Dependable assessment tools are essential for Competency Based Medical Education (CBME).  Competence in central venous catheterization (CVC) is a key objective to be learned by trainees. Tools to assess technical competency include checklists, critical error tools, Objective Structured Assessment for Technical Skills (OSATS) tools and the Ottawa Surgical Competency Operating evaluation (O-SCORE) tool. This study examined the impact of a simulation-based educational intervention on resident knowledge and performance of CVC. It also compared the dependability of the scores derived from the four assessment tools.  Junior residents completing their first ICU rotation in Calgary participated in the study. The control group received didactic instruction. The intervention group received simulation-based teaching and an online multimedia educational module. No observed differences between groups were identified in any of the assessment measures. Global rating scales such as the OSATS or O-SCORE tools outperformed checklists or critical error tools when assessing competence for this procedure.
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    Application of Classical Test Theory and Item Response Theory to Analyze Multiple Choice Questions
    (2014-10-07) Nasir, Mona; Lockyer, Jocelyn; Beran, Tara; Donnon, Tyrone L.
    Abstract Background Multiple choice questions are used worldwide for summative assessment in undergraduate medical education. Only a few studies have looked at their reliability using both classical test theory and item response theory. The main aim of this research was to use examination data from the summative multiple choice exams at the University of Calgary in order to assess the reliability of scores using and comparing two methods of analysis, i.e., classical test theory and item response theory, on items administered three times over a six year period. In addition, the temporal stability of the same items was also analyzed using both classical test theory and item response theory. Methods Three courses were chosen for the item analysis. Thirty items from each course over a period of three years were scrutinized for reliability by conducting an item analysis using SPSS and Xcalibre 4.2. Item difficulty and discrimination indices were calculated using both classical test and the 2 parameter logistic model of item response theory. Correlation coefficients were calculated for all three years to analyze the relationship between the two measurement methods and also the inter-year correlation for the three years using both classical test and item response theory. Cronbach’s Alpha was calculated to look at the reliability of the scores. Furthermore, item characteristic curves were generated using Xcalibre 4.2. Repeated measures analysis of variance was conducted for the item parameters of both classical test and item response theory and test characteristic curves generated year-wise for the multiple choice items for a 2 parameter logistic model which were then compared across the years to assess the stability of the multiple choice items over time. Results Difficulty was found to be adequate for half the items when classical test theory was applied and for two thirds of the items when item response theory was used. Discrimination was mostly fair to adequate with classical test theory and excellent with item response theory. Standard error of measure was noted to vary from small to large for the item parameters of different items, the reliability index being 0.56- 0.65 for the test scores across the years. Correlation coefficients were excellent between Year 1 and 3 and only fair for Year 2 when compared with the other two. Correlation coefficients between classical test and item response theory were excellent. Items were noted to be stable across the three years using repeated measures analysis of variance which yielded small F ratios thus exhibiting stability of item difficulty and discrimination over Times 1, 2 and 3. Visual inspection of the test characteristic curves yielded the same findings. Conclusion Multiple choice questions used by the University of Calgary over a period of three years have been shown to be fairly reliable and stable over time with different samples of students. Some differences were noted in the item analysis carried out by the two different methods ( i.e., classical test and item response theory) but mostly the two measurement methods were comparable. Some items need reviewing and revision to further improve the reliability of the exam following which the multiple choice items may be used repeatedly without affecting their psychometric properties.
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    Assessing Adult Medicine Specialists Using Multisource Feedback: A Longitudinal Study
    (2013-05-01) Hurd, Carmen; Lockyer, Jocelyn
    The Physician Achievement Review is a multisource feedback program of practicing physicians that intends to assess a wide range of professional competencies. This longitudinal study focused on the reliability and validity of the PAR assessment in a large sample of adult medicine specialists (n = 404). Scores on all surveys were high and negatively skewed. All surveys had high internal consistency reliability and moderate generalizability. The three to four factor solutions proposed at Iteration 1 provided for moderate model fit using confirmatory factor analysis at Iteration 2. Scores increased over time, but the effect sizes were small to moderate. There was little or no correlation between self-assessment and medical colleagues on corresponding attributes. Future research should focus on decreasing score inflation, improving the internal structure of the surveys, and understanding factors that influence score improvements over time.
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    Co-worker Assessment and Physician Multisource Feedback
    (2013-02-04) Trueman, Greggory; Lockyer, Jocelyn
    Background: The College of Physicians and Surgeons of Alberta’s Physician Achievement Review program (PAR) uses questionnaire data from several sources, including co-workers, to provide formative feedback to physicians to promote quality improvement and continuing professional development within the profession. The PAR co-worker assessment questionnaires (CAQ) used in PAR were developed over more than a decade and not been psychometrically evaluated since then. The CAQs have not been reviewed either on their own or across the nine medical specialties which comprise PAR. Aim: The purpose of this study was to more fully understand the CAQs’ psychometric profile including an exploration of the interprofessional constructs being measured and any changes in performance scores over time. Method: A purposive sample of co-worker data from 1341 physicians across nine medical specialties in Alberta was evaluated. Secured PAR databases containing CAQ data (n = 9674) were accessed and analyzed using univariate and multivariate parametric techniques to: (a) evaluate the psychometric profile of the CAQ within and across specialty grouping; (b) to determine if physician characteristics and co-worker familiarity were associated with PAR performance scores; and (c) to evaluate if a difference existed between Time1 PAR feedback and Time2 PAR performance. Results: Internal consistency of all CAQs remains extremely high (i.e., > 0.90) suggesting a potential unidimensionality. Generalizability coefficients were not as robust as were originally reported. Variance components across the collection of CAQs indicated that opportunity for CAQ revision to improve its reliability is better directed at the processes associated with data collection (e.g., assessor selection practices) rather than revising questionnaire items. Principal components analyses were conducted as a variable reduction procedure. Each CAQ demonstrated a number of redundant questionnaire items (range: 5 to 11), and while the components structure remained similar to the factor structure published in the original research, component labeling was updated to reflect the CanMEDS competencies supporting interprofessional practice (i.e., communicator and collaborator). In the case of family physicians and pediatricians, a new component emerged reflecting the consolidation of the communicator and professional roles into one previously unidentified component labelled: good doctor. Several independent t-tests, ANOVA, and linear regression analyses were conducted providing evidence that certain physician characteristics together with co-worker familiarity were significant predictors of CAQ performance scores within speciality groupings. Different medical specialities were influenced differently by socio-demographic characteristics relative to CAQ scores; however, across all medical specialties co-worker familiarity demonstrated a significant positive linear relationship with CAQ scoring. Finally, significant increases and decreases in CAQ scores from Time1 to Time2 were found depending upon specialty grouping. Conclusion: The CAQ provides reliable data to physicians relative to interprofessional collaboration. Opportunity exists to improve the reliability of these tools by addressing unique variance components generated by the unbalanced nature of multisource feedback collection processes. Given the manner in which the tools were constructed, future revision efforts ought to include focus groups of specialty-specific co-workers seeking to illuminate how different clinical contexts influence what interprofessionality uniquely means within that specialty grouping.
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    Development and Implementation of an Assessment Tool for Critical Care Trainees in Focused Cardiac Ultrasound
    (2014-03-04) Gaudet, Jonathan; Lockyer, Jocelyn
    The use of focused cardiac ultrasound (FCU) as a diagnostic and monitoring tool in critical care medicine continues to expand. However, little attention has been placed to date on assessment tools that might critically evaluate the image acquisition skills of echocardiographers employing FCU in their practice. This study developed and evaluated a comprehensive assessment tool for FCU image acquisition in a cohort of intensive care residents learning FCU. Resident participants’ FCU image acquisition skills improved quickly and then reached a plateau. The FCU assessment tool developed was able to discern changes in FCU image acquisition performance over time and also distinguish between echocardiographers of different skill levels. The study results provide preliminary validity evidence for the new FCU assessment tool, that with further study, might have practical utility as a tool employed for summative assessment and certification in this growing area of acute care medicine.
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    Family physician practice visits arising from the Alberta Physician Achievement Review
    (BioMed Central, 2013-09-09) Lewkonia, Ray M.; Flook, Nigel; Lockyer, Jocelyn
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    Informal Learning Using Tablet Computers and Apps: A Multi-Method Study of Older Adults Self-Managing Diabetes
    (2016-01-07) Seabrook, Heather Jane; Lockyer, Jocelyn; Edwards, Alun; Kopp, Gail
    Background: Mobile software applications (apps) and online health information are a growing resource for diabetes self-management. Apps and online resources may confer benefits, yet a lack of relevant guidance continues to impede the design and implementation of effective interventions that use them. Alternative learning designs that align with older adults’ preference for informal learning and diverse needs could facilitate the continued learning and self-management essential to maintaining their well-being. Methods: Guided by the technology acceptance theory of Venkatesh and colleagues, Phase 1 of this study adapted a systematic review methodology to identify apps for self-management of diabetes and used principles to assess them. Phase 2 used a multi-case study approach in which older adults were provided personalized instruction to help them use the tablet computer and apps. Transcripts were analyzed to identify themes within and across cases. Results: In Phase 1, two apps were selected from 1,936 search results. Critical quality issues varied depending on an app’s purpose. Apps with self-management information neglected to reference their source (attribution). Apps that supported other self-management activities had safety and usability problems. In Phase 2, a conceptual model was developed in which participants’ self-perceived needs and preferences influenced use of the intervention and consequently their outcomes. Personalized training facilitated use. Participants benefitted from convenient, easy access to appropriate resources. They experienced challenges ranging from app-level usability issues to the system-level problems. Outcomes included review, problem-solving, data visualization, showing information face-to-face, and technology adoption. Conclusions: Few of the apps currently available are appropriate for use by older adults for diabetes self-management. Some means of ensuring access to a pool of vetted apps is recommended and there is a need for a decision-matrix for screening apps to ensure they are optimally selected for patient use. Detailed criteria and an approach are provided to further this work. The study also provides a new understanding of older adults’ use of tablet computers and apps to facilitate learning and self-management. The conceptual model and framework of design and implementation considerations could guide learning designers in developing effective interventions for older adults.
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    Interactions between physicians and the pharmaceutical industry: A study into the perceptions of the early career psychiatrist
    (2014-08-19) Stark, Thomas; Lockyer, Jocelyn
    Background: The pharmaceutical industry has very successfully engaged physicians through supporting medical education, patient care and medical research. New conflict of interest policy has highlighted some of the challenges to these relationships. Objectives: To explore the perceptions that early career psychiatrists (e.g. those within 5 years of entering practice) have regarding their relationship with the pharmaceutical industry. Methods: Data were collected through semi-structured interviews. Data were analysed using a grounded theory methodology. Theory was generated around how applicants experienced, developed perceptions around and managed their relationship with industry. Axial coding was used to generate theory around the core variable mediating the perceptions participants had about the relationship between physicians and industry. Results: Participants described increasing frequency of experiences with industry as they progressed from training to independent practice throughout a variety of contexts. Perceptions around their relationship with industry developed through factors relating to their training environment, physician culture, how industry promotes its products and their own practice of medicine. In managing their relationship with industry, participants would either avoid interactions or engage in behaviours aimed to reduce the risk of becoming influenced by industry. Maintaining one’s professional integrity is the underlying driver managing the relationship between early career psychiatrists and industry. Conclusions: Psychiatrists develop perceptions about industry through experience and observation leading them to develop their own strategies to manage these relationships around the critical need they have to maintain their professional integrity.
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    Measurement of the operating room educational environment
    (2010) Chan, Koon Wah Robert; Lockyer, Jocelyn
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