Browsing by Author "Oddone-Paolucci, Elizabeth"

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    A Clinical Educator Needs Assessment in Athletic Therapy
    (2020-07-24) Owen, Jeffrey Michael; Oddone-Paolucci, Elizabeth; Palacios Mackay, Maria Felisa; Lafave, Mark R.; Yeo, Michelle
    Problem: Canadian athletic therapy (AT) education is embracing major pedagogical change in transitioning to competency-based education (CBE). The national certification process has recently undergone substantial, and somewhat controversial, changes. Furthermore, new entry-level competencies have been developed for teaching and assessment. A pivotal component of AT education consists of longitudinal placements in the clinic and field contexts of AT. Clinical educators are volunteers, and primarily Certified Athletic Therapists, typically lacking pedagogical experience. Moreover, there appear to be no standardized practices across institutions for supervisory development. There is an absence of published research related to Canadian AT clinical education. Furthermore, clinical educator needs assessments across health professions education have employed various methods. Therefore, this study used a novel mixed-methods approach to understand Canadian AT clinical educators’ needs entering CBE. Method of Study: Interviews (n = 14) and a subsequent survey (n = 123) involving Canadian AT clinical educators were employed within a preplanned exploratory sequential mixed design (Tashakkori et al., 2012). The initial qualitative analysis involved conceptually mapping the content of responses using directed content analysis. The corresponding findings informed survey design. Three data strands resulted from the subsequent analyses. First, the interview findings related to supervisory role were analyzed using phenomenography to discern the different ways of understanding the role. Second, the conceptual map was revisited to identify strengths and barriers to role fulfilment. Third, valued and necessary development topics were identified from the survey results. Finally, the interpretations of the three data strands were mixed, incorporating other relevant findings, to develop AT supervisory support recommendations for CBE. Conclusions: Four different AT clinical educator role conceptualizations were discovered that were hierarchically related, which reflected the extent of variation perceived among six aspects of AT supervision. These findings, combined with three valued and necessary pedagogical skill topics, represent a valuable starting point for AT supervisory development, for which there was high interest. The strengths and barriers informed 14 considerations related to clinical educators’ potential capacity. Lastly, the 13 supervisory support recommendations developed from the clinical educator findings may aid the Canadian AT program directors with transitioning to CBE.
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    English for 21st-Century Global Citizenship: An Investigation of an Introductory Online Professional Development Course
    (2020-11-03) Hazard, Russell; Eaton, Sarah Elaine; Dressler, Roswita; Tweedie, M. Gregory; Guo-Brennan, Linyuan; Oddone-Paolucci, Elizabeth
    The purpose of this research is to build understanding of professional development for twenty-first century Global Citizenship Education (GCED) for international English as an Additional Language (EAL) teachers. The research is significant because a variety of international education organizations, policy experts, and researchers in the field of EAL have noted that Global Citizenship Education should be embedded into all subject areas, and because such implementation is enabled by teacher training relating to the content and pedagogies involved. A group of (N=12) international English language professionals were recruited for a two-week online professional development course. The participants were surveyed for pre-existing knowledge and attitudes toward GCED. The research used qualitative analysis of discussion boards, post-course questionnaires, and post-course interviews. Participants noted high congruence between GCED themes and the needs of their content-based programs. Explicit teaching of GCED frameworks and sub-initiatives was noted as a valuable linguistic and cognitive strategy. Active, learner-centered, and some transformative workflows were developed and supported by visible thinking and thinking routines for efficient language production and formative assessment. Project Based Learning linking the classroom to the real world was noted as a valuable teaching approach. EAL research and experience in teaching for intercultural communicative competence, analogue and digital rhetoric and media awareness, and Critical Language Awareness were noted as areas of Pedagogical Content Knowledge to be aware of.
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    Experiences of pressure to conform in postgraduate medical education
    (2018-01-03) Grendar, Jan; Beran, Tanya; Oddone-Paolucci, Elizabeth
    Abstract 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.
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    An 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
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    A Mixed-Methods Exploration to Develop and Test the Alberta Cardiac Surgery Patient Experiences Survey
    (2020-12-29) Kemp, Kyle Alexander Robert; Quan, Hude; Santana, Maria Jose; Knudtson, Merril L.; Oddone-Paolucci, Elizabeth
    With an increased focus on patient-centred care (PCC), many organizations conduct routine surveys as part of their core business. Many surveys that are used in the hospital setting have been designed to capture the experiences of a wide variety of patients. Thus, they do not ask condition-specific questions which may be important to patients. This mixed-methods thesis focused on examining and improving upon the measurement of patient experience among those who have undergone cardiac surgery. The first part of this thesis used existing survey data linked with administrative records to examine the comprehensive experience of Albertans who underwent cardiac surgery over a four-year period. Part two was a qualitative project, where interviews were conducted to better understand the aspects of care deemed important to patients after cardiac surgery. In the final portion, learnings from our prior quantitative and qualitative work were integrated to develop and test a new condition-specific survey; the Alberta Cardiac Surgery Patient Experiences Survey (ACSPES). In project one, patients reported very positive experiences. However, they did reveal potential areas for improvement. These included communication about potential side effects of new medications, night noisiness of the hospital environment, and cleanliness of their room/bathroom. In project two, participants highlighted five key themes important in their care - overall experience, communication, the physical hospital environment, care needs and ongoing management, and person-centred care. These findings aligned with those from project one, but also served to generate additional items which could be asked in a future survey. Project three demonstrated promising results pertaining to the content validity, test-retest reliability, and acceptability of the newly created ACSPES. This thesis work has increased our understanding and learnings about the experiences of those who have undergone cardiac surgery across Alberta. It has also resulted in the creation of the ACSPES; a tool which may be used to better capture the unique experiences of cardiac surgery patients. Data from the ACSPES may be used to measure PCC in this cohort and may be integrated with administrative and other patient-reported data for future learnings. Additional psychometric testing of the ACSPES is required.
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    Temporal Bone Drilling Simulation Boot Camp Course
    (2020-03-26) Hoy, Monica; Oddone-Paolucci, Elizabeth; Dort, Joseph C.; Matthews, Thomas Wayne; Lopushinsky, Steven R.
    Competency by design is changing the surgical landscape. Virtual reality simulation appears to be a promising training tool to assist in achieving surgical competency. This study was designed to determine if a boot camp style virtual reality (VR) mastoidectomy drilling course could be developed to improve a novice learner’s mastoidectomy drilling technique. Forty medical students were randomized to a traditional curriculum (control) group or a VR curriculum (intervention) group. Participants performed pre- and post-intervention knowledge testing, and mastoidectomy drilling sessions. Results of the study are an encouraging first step in demonstrating that a VR simulation boot camp course may improve a novice learners’: (i) understanding of the temporal bone anatomy as demonstrated by a significant difference between pre- and post-intervention knowledge testing (p < 0.01), (ii) drilling technique, as demonstrated by a significant difference between pre- and post-intervention drilling testing (p < 0.01), and (iii) ability to recognize dangerous or red flag areas in drilling a temporal bone. Future directions include a recommendation to implement a mastoidectomy VR simulation boot camp course at the annual Canadian Oto-HNS boot camp.
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    To Titrate or Not to Titrate: Factors influencing inpatient insulin management by residents and medical students
    (2019-07-10) Hinz, Laura Elizabeth; McLaughlin, Kevin J.; Sigal, Ronald J.; Oddone-Paolucci, Elizabeth
    The prevalence of diabetes continues to rise, making inpatient management of diabetes an increasingly relevant issue. In teaching hospitals such as those affiliated with the University of Calgary, inpatient management of diabetes is often the responsibility of learners including residents and medical students. Several studies have demonstrated that learners lack knowledge and confidence in inpatient insulin management. To improve the way learners are taught about inpatient insulin titration, we sought to elucidate what contextual factors and mechanisms of an educational intervention are more likely to improve glycemic outcomes, and what factors, both conscious and subconscious, learners consider when making decisions about insulin titration. To determine the contextual factors and mechanisms of successful diabetes educational interventions, we conducted a realist synthesis. After analysing 21 studies, we found that interventions that improve the insulin prescribing process are necessary but not sufficient to improve glycemic outcomes. In-person, group, prescriber-specific interventions with a reinforcing intervention are more likely to be successful. To study the factors that learners consider when titrating insulin, we conducted a mixed methods study using a case-based survey loosely modelled on script concordance testing. We found that medical students prescribed insulin with greater concordance with staff endocrinologists than residents, yet residents had more confidence than medical students in their prescribing practices. Overall, the residents prescribed larger doses of insulin. The residents were susceptible to the subconscious influence of the seniority of the nurse asking for an insulin dose, yet the medical students were not. Both groups of learners prescribed more insulin in the presence of ketones and less when the patient had hypoglycemia unawareness. Residents prescribed less insulin when patients had T2DM compared to T1DM and medical students prescribed more when the blood sugar crossed the 20mmol/L threshold. We concluded that patient, prescriber, and systems factors ultimately influenced insulin prescribing practices. Overall, we concluded that a successful educational intervention to improve inpatient glycemic control would likely need to address prescribing practices in a prescriber-specific fashion and be followed with a reinforcing intervention. We proposed that medical students and residents may need different teaching methods to address possibly different cognitive processing methods.