Operational Stress Injuries: Impact on Family Mental Health and Well-being

This study was part of a larger scoping review and environmental scan conducted for Veterans Affairs Canada on the effects of operational stress injuries (OSIs) on the mental health and wellbeing of Veterans’ families. This paper focuses broadly on the relationships between combat (and/or deployment more generally), OSIs (primarily post-traumatic stress disorder (PTSD)), and the family. Based on the scoping review, the paper finds that existing research investigates the impacts of a Veteran’s OSI on the family, but also how various aspects of the family (such as family functioning, family support, etc.) can impact a Veteran living with an OSI.

If People Were Kaleidoscopes: Sharpening the Resolution on Patient Engagement in Safety

Healthcare is unacceptably error prone. The question remains why, with 20 years of evidence, is error and harm reduction not being effective? While precise numbers may be debated, all stakeholders recognize the frequency of healthcare errors is unacceptable, and greater efforts to ensure safety must occur. In recent years, one of these strategies has been the inclusion of the patient and their family as partners in safety, and has been a required organizational practice of Accreditation Canada in many of their standard sets. Existing patient advisories created to encourage engagement, have typically not included patient perspectives in their development or been comprehensively evaluated. There are no existing tools to determine if and how a patient wants to be involved in safety engagement. As such, a multi-phased study was undertaken to advance our knowledge about the client’s and family’s role in promoting safety. Phase 1 of the study was a scoping review to methodically review the existing literature about patients’ and families’ attitudes, beliefs and behaviours about their involvement in healthcare safety. Phase 2 was designed to inductively explore how a group of patients in an Ontario, Canada, community hospital, describe healthcare safety and see their role in preventing error. The study findings, which include the narratives of 30 patients and 4 family members, indicate that although there are shared themes that influence a patient’s engagement in patient safety, every individual has unique, changing beliefs, experiences and reasons for involvement. Five conceptual themes emerged from their narratives: Personal Capacity, Experiential Knowledge, Personal Character, Relationships, and Meaning of Safety. These study results will be used to develop and test a pragmatic, accessible tool to enable providers a way to collaborate with patients for determining their personal level and type of safety involvement. The most ethical and responsible approach to healthcare safety is to consider every facet and potential way for improvement. This exploratory study provides fundamental insights into the complexity of patient engagement in safety, and evidence for future steps.

NON-FULL-TIME COLLEGE PROFESSORS: A NARRATIVE INQUIRY INTO THE NON-FULL-TIME FACULTY ROLE

The rate of non-full-time faculty members has increased rapidly over the last decade (Louis, 2009; MacKay, 2014; Meranze & Newfield, 2013), as the post-secondary landscape of fluctuating enrolment, fiscal and operational challenges, and the requirement to hire specialized skill sets have required institutions to rely heavily on this demographic. In the Ontario Colleges of Applied Arts and Technology (CAATs) system, institutions have tried to preserve and enhance educational quality with fewer resources through greater reliance on non-full-time faculty. The purpose of this study was to explore the perceptions and experiences of teaching and support of non-full-time faculty at one Eastern Ontario college. Employing a narrative inquiry methodology, data were collected from four participants through their writing three individual letters at the end of each month and participating in one interview at the end of the contract period. The data were analyzed and coded. This analysis revealed five themes: motivation, connection and engagement, compensation, teaching and development, and performance evaluation. Differences in the participants’ perceptions tended to reflect divergences across career stage: retired versus early career. The compensation package provided to non-full-time faculty was considered inadequate for those in the early career stage, especially comparing it to that of full-time faculty. In addition, the amount of previous teaching experience was an important indicator for the appropriate level of teaching resources and support provided by the institution. The newer faculty members required a higher level of support to combat feelings of role isolation. The temporary nature of the role made it difficult to establish a feeling of a strong connection to the institution and subsequently opportunities to engage further to deepen the relationship. Despite these differences across participants, autonomous motivators were consistent across all narratives, as participants expressed their desire to teach and share their knowledge to help students achieve their goals. Participants concluded their narratives by sharing future advice for faculty interested in pursuing the role. The narratives provided areas for improvement that would help increase the level of job satisfaction for non-full-time college faculty members: (a) establishing a more thorough performance evaluation process to align with institutional supports, (b) offering more diverse teaching resources to better prepare faculty and enhance teaching practices, (c) overhauling the compensation package to better recognize the amount of time and effort spent in the role and aligning with the compensation provided to full-time faculty, and (d) including rewards and incentives as part of the compensation package to enhance the level of commitment and availability for the role. These changes might well increase the job satisfaction and improve the retention of non-full-time faculty members.