Browsing by Author "Sharma, Nishan"

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    Clinical Simulation-Based Assessment in Respiratory Therapy Education
    (2017) West, Andrew; Parchoma, Gale; Koh, Kim; Kim, Beaumie; Sharma, Nishan
    The manuscripts that comprise this dissertation collectively investigate clinical simulation-based assessment in respiratory therapy education. Clinical simulation, characterized by debriefing that engages learners in self- and collaborative peer-assessment in addition to formative instructor assessment, is a well-established set of practices in respiratory therapy education. Contextual factors within the profession of respiratory therapy in Canada, in particular its regulatory environment, are prompting a move from using formative debriefing sessions that support learning in simulation, to employing high-stakes testing intended to assess entry-to-practice competencies. There exists a need for the profession to consider how environmental factors, including externally derived requirements, may ultimately impact the effectiveness of simulation-based learning environments. It is proposed that several important social elements of the clinical simulation-based learning environment, including trust, ontological security, and fidelity, may be at risk in the face of the evolving assessment practices in health professions education. As an at once undertheorized yet highly technologically enhanced and connected approach to learning, a shift towards socio-cultural perspectives on clinical simulation assessment, research, and practice is needed to better understand the social phenomena inherent in clinical simulation. This shift can benefit from the adoption of networked learning theory to encourage deeper understanding of the interrelationships that exist among sociomaterial dimensions of clinical simulation. The findings of a qualitative case study are presented, examining the experiences of respiratory therapy students in clinical simulation learning environments where comparable instructional designs are characterized by differences between two important assessment approaches used in the field: formative debriefing for learning and summative debriefing for high-stakes testing. The findings indicate that social aspects of participants’ experiences in clinical simulation are characterized by: their comfort levels, their senses of ontological security, and their degrees of immersion in the simulation. Each of these experiential dimensions were impacted in some manner by the assessment design, a phenomenon that was further modulated by individuals’ self-reflexive capacity. These phenomena appear to coalesce to impact learners’ perceptions of their own performance in the clinical simulation context, which was also related to the approach to assessment built into in the instructional design.
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    Co-designing the Assessment of Multimedia Resources to Assist Guardian Understanding of Surgical Consent Prior to Spinal Surgery in Pediatric Patients - a Quasi-Experimental Study
    (2024-01-24) Rosa Filezio, Marina; Santana, Maria; Sharma, Nishan; Thull-Freedman, Jennifer
    Informed consent is mandatory prior to any surgical procedure in medical practice. Consent requires voluntary agreement, the capacity to consent, and proper prior information. Literature shows that traditional methods of informing patients and guardians may not provide enough understanding of all risk, benefits and expectations associated with scoliosis surgery in pediatric patients. Scoliosis is the most common spinal disorder in pediatric patients. Treatment depends on curvature size and skeletal maturity, and surgery is reserved for curvatures greater than 45 degrees. This study aims to assess the impact of introducing a co-developed multimedia tool to improve guardians’ understanding of the surgical discussion and informed consent prior to PSIF. The primary objective is to measure the effect of this intervention using the results from test and post-test. Secondary objective includes observing if this tool improves guardians’ perceived understanding. It is hypothesized that the multimedia tool will improve comprehension and perceived understanding when compared to traditional methods. Specific aims involved describing, quantifying, and comparing questionnaire results in three distinct educational times during the pre-operative process, as well as results from the patient engagement evaluation tool. A quasi-experimental, repeated measures, multi methods approach was applied to analyze the results of a multiple-choice questionnaire between two groups (Pathway A and Pathway B), about the pre-operative surgical discussion process and content. Quantitative and qualitative data were obtained from the public and patient engagement evaluation tool to assess the patient engagement strategy implemented for the co-development of the educational video tool. Seventeen participants were included in this study, eight assigned to Pathway A and nine to Pathway B. No significant difference was seen between results from Pathway A and Pathway B. However, the effect of knowledge acquisition over time was significant, indicating a substantial temporal progression on the outcome. The results demonstrate promising outcomes regarding knowledge acquisition over time when introducing a secondary information delivery method to the current consent process. Patient engagement evaluation tool findings display positive results reinforcing the efforts to ensure the CIHR guiding principles during the creation of the educational video.
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    Developing a Data Integrated COVID-19 Tracking System for Decision-Making and Public Use
    (International Journal of Popular Data Science, 2020-09-28) Krusina, Alexander; Chen, Oscar; Otero Varela, Lucia; Doktorchik, Chelsea; Avati, Vince; Knudsen, Søren; Southern, Danielle; Eastwood, Cathy; Sharma, Nishan; Williamson, Tyler
    Introduction The unprecedented COVID-19 pandemic unveiled a strong need for advanced and informative surveillance tools. The Centre for Health Informatics (CHI) at the University of Calgary took action to develop a surveillance dashboard, which would facilitate the education of the public, and answer critical questions posed by local and national government. Objectives The objective of this study was to create an interactive method of surveillance, or a “COVID-19 Tracker” for Canadian use. The Tracker offers user-friendly graphics characterizing various aspects of the current pandemic (e.g. case count, testing, hospitalizations, and policy interventions). Methods Six publicly available data sources were used, and were selected based on the frequency of updates, accuracy and types of data, and data presentation. The datasets have different levels of granularity for different provinces, which limits the information that we are able to show. Additionally, some datasets have missing entries, for which the “last observation carried forward” method was used. The website was created and hosted online, with a backend server, which is updated on a daily basis. The Tracker development followed an iterative process, as new figures were added to meet the changing needs of policy-makers. Results The resulting Tracker is a dashboard that visualizes real-time data, along with policy interventions from various countries, via user-friendly graphs with a hover option that reveals detailed information. The interactive features allow the user to customize the figures by jurisdiction, country/region, and the type of data shown. Data is displayed at the national and provincial level, as well as by health regions. Conclusions The COVID-19 Tracker offers real-time, detailed, and interactive visualizations that have the potential to shape crucial decision-making and inform Albertans and Canadians of the current pandemic.
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    Implementing problem based learning at two English medical schools
    (2009) Sharma, Nishan; Winchester, Ian
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    Measuring competence in central venous catheterization: a systematic-review
    (Springer Plus, 2014-01-17) Ma, Irene W.Y.; Sharma, Nishan; Brindle, Mary E.; Caird, Jeff; McLaughlin, Kevin J.
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    Quality Improvement Training in Medical Education
    (2020-05-06) Brown, Allison J.; Kassam, Aliya; Hecker, Kent; Sharma, Nishan; McCaughey, Deirdre
    Problem: Training healthcare professionals in Quality Improvement (QI) has been highlighted as a potential strategy to reduce the prevalence of error and harm in healthcare. As a result, various health professions education programs have integrated QI into the competency frameworks that inform the core curriculum, including those used in the training of medical doctors. However, QI has been integrated, emphasized, and taught to medical trainees (i.e., medical students and residents) in a variety of ways across countries, programs, and stages of training. As contemporary medical education increasingly adapts outcomes-oriented, competency-based models of training, medical trainees may be required to demonstrate competency in QI during their training. Method of Study: This research considered how best to train future physicians in QI during their core medical training. First, methods for examining complex social phenomena were analyzed through a thought experiment exploring the methodological intersections of realist inquiry (RI) with structural equation modelling (SEM). Next, a realist synthesis examined the literature for teaching QI at the undergraduate and postgraduate levels of medical training. This generated an explanatory program theory that highlighted common associations between contexts, mechanisms, and outcomes of QI training in undergraduate and postgraduate medical training. Finally, a collective case study of four postgraduate programs at the University of Calgary examined how residents learned about QI during their training using four data sources. The combinations of RI and SEM were re-visited and operationalized as the program theory informed the specification of structural models using the quantitative data in the case study. This resulted in a novel, realist-informed SEM that statistically modelled elements associated with resident self-assessments of QI knowledge, skills, and attitudes. Conclusions: Explicit training in QI might ensure that all physicians enter practice equipped with the fundamental knowledge and skills to not only recognize areas for improvement, but implement sustainable solutions that improve the quality and safety of care. The conscientious design of QI curricula in the core medical curriculum that considers integrating features commonly associated with successful QI curricula may be beneficial to optimize training in this domain, and ultimately, catalyze the development of QI competencies amongst future physicians.
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    Repurposing Virtual Patients for Scenario Based Learning
    (2013-09-26) Topps, David; Sharma, Nishan; Lee, Sonya; Aboulhoda, Alaa
    How to use existing virtual patient cases to expand into scenario based learning activities.
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    Understanding the barriers and enablers for postgraduate medical trainees becoming simulation educators: a qualitative study
    (2023-01-14) Muhumuza, Albert; Najjuma, Josephine N.; MacIntosh, Heather; Sharma, Nishan; Singhal, Nalini; Hollaar, Gwendolyn L.; Wishart, Ian; Bajunirwe, Francis; Santorino, Data
    Abstract Introduction  There is increasing evidence that Simulation-based learning (SBL) is an effective teaching method for healthcare professionals. However, SBL requires a large number of faculty to facilitate small group sessions. Like many other African contexts, Mbarara University of Science and Technology (MUST) in Uganda has large numbers of medical students, but limited resources, including limited simulation trained teaching faculty. Postgraduate medical trainees (PGs) are often involved in clinical teaching of undergraduates. To establish sustainable SBL in undergraduate medical education (UME), the support of PGs is crucial, making it critical to understand the enablers and barriers of PGs to become simulation educators. Methods We used purposive sampling and conducted in-depth interviews (IDIs) with the PGs, key informant interviews (KIIs) with university staff, and focus group discussions (FGDs) with the PGs in groups of 5–10 participants. Data collection tools were developed using the Consolidated framework for implementation research (CFIR) tool. Data were analyzed using the rigorous and accelerated data reduction (RADaR) technique. Results We conducted seven IDIs, seven KIIs and four focus group discussions. The barriers identified included: competing time demands, negative attitude towards transferability of simulation learning, inadequacy of medical simulation equipment, and that medical simulation facilitation is not integrated in the PGs curriculum. The enablers included: perceived benefits of medical simulation to medical students plus PGs and in-practice health personnel, favorable departmental attitude, enthusiasm of PGs to be simulation educators, and improved awareness of the duties of a simulation educator. Participants recommended sensitization of key stakeholders to simulation, training and motivation of PG educators, and evaluation of the impact of a medical simulation program that involves PGs as educators. Conclusion In the context of a low resource setting with large undergraduate classes and limited faculty members, SBL can assist in clinical skill acquisition. Training of PGs as simulation educators should address perceived barriers and integration of SBL into UME. Involvement of departmental leadership and obtaining their approval is critical in the involvement of PGs as simulation educators.