Process Improvement in Phlebotomy

This study has two main objectives. First, the phlebotomy process at the St. Catharines Site of the Niagara Health System is investigated, which starts when an order for a blood test is placed, and ends when the specimen arrives at the lab. The performance measurement is the flow time of the process, which reflects concerns and interests of both the hospital and the patients. Three popular operational methodologies are applied to reduce the flow time and improve the process: DMAIC from Six Sigma, lean principles and simulation modeling. Potential suggestions are provided for the St. Catharines Site, which could result in an average of seven minutes reduction in the flow time. The second objective addresses the fact that these three methodologies have not been combined before in a process improvement effort. A structured framework combining them is developed to benefit future study of phlebotomy and other hospital processes.

Nonsuicidal Self-Injury and Suicidal Risk: An Examination among Young Adults

Nonsuicidal self-injury (NSSI), which refers to the direct and deliberate destruction of bodily tissue in the absence of suicidal intent, is a serious and widespread mental health concern. Although NSSI has been differentiated from suicidal behavior on the basis of non-lethal intent, research has shown that these two behaviors commonly co-occur. Despite increased research on the link between NSSI and suicidal behavior, however, little attention has been given as to why these two behaviors are associated. My doctoral dissertation specifically addressed this gap in the literature by examining the link between NSSI and several measures of suicidal risk (e.g., suicidal ideation, suicidal attempts, pain tolerance) among a large sample of young adults. The primary goal of my doctoral research was to identify individuals who engaged in NSSI at risk for suicidal ideation and attempts, in an effort to elucidate the processes through which psychosocial risk, NSSI, and suicidal risk may be associated. Participants were drawn from a larger sample of 1153 undergraduate students (70.3% female) at a mid-sized Canadian University. In study one, I examined whether increases in psychosocial risk and suicidal ideation were associated with changes in NSSI engagement over a one year period. Analyses revealed that beginners, relapsed injurers, and persistent injurers were differentiated from recovered injurers and desisters by increases in psychsocial risk and suicidal ideation over time. In study two, I examined whether several NSSI characteristics (e.g., frequency, number of methods) were associated with suicidal risk using latent class analysis. Three subgroups of individuals were identified: 1) an infrequent NSSI/not high risk for suicidal behavior group, 2) a frequent NSSI/not high risk for suicidal behavior group, and 3) a frequent NSSI/high risk for suicidal behavior group. Follow-up analyses indicated that individuals in the frequent NSSI/high risk for suicidal behavior group met the clinical cutoff score for high suicidal risk and reported significantly greater levels of suicidal ideation, attempts, and risk for future suicidal behavior as compared to the other two classes. Class 3 was also differentiated by higher levels of psychosocial risk (e.g., depressive symptoms, social anxiety) relative to the other two classes, as well as a comparison group of non-injuring young adults. Finally, in study three, I examined whether NSSI was associated with pain tolerance in a lab-based task, as tolerance to pain has been shown to be a strong predictor of suicidal risk. Individuals who engaged in NSSI to regulate the need to self-punish, tolerated pain longer than individuals who engaged in NSSI but not to self-punish and a non-injuring comparison group. My findings offer new insight into the associations among psychosocial risk, NSSI, and suicidal risk, and can serve to inform intervention efforts aimed at individuals at high risk for suicidal behavior. More specifically, my findings provide clinicians with several NSSI-specific risk factors (e.g., frequent self-injury, self-injuring alone, self-injuring to self-punish) that may serve as important markers of suicidal risk among individuals engaging in NSSI.

Working Together: Librarian and Student Collaboration Through Active Learning in a Library Eclassroom

Active learning strategies based on several learning theories were incorporated during instruction sessions for second year Biological Sciences students. The instructional strategies described in this paper are based primarily on sociocultural and collaborative learning theory, with the goal being to expand the relatively small body of literature currently available that discusses the application of these learning theories to library instruction. The learning strategies employed successfully involved students in the learning process ensuring that the experiences were appropriate and effective. The researchers found that, as a result of these strategies (e.g. teaching moments based on the emerging needs of students) students’ interest in learning information literacy was increased and students interacted with information given to them as well as with their peers. Collaboration between the Librarians, Co-op Student and Senior Lab Instructor helped to enhance the learning experience for students and also revealed new aspects of the active learning experiences. The primary learning objective, which was to increase the students’ information skills in the Biological Sciences, was realized. The advantages of active learning were realized by both instructors and students. Advantages for students attained during these sessions include having their diverse learning styles addressed; increased interaction with and retention of information; increased responsibility for their own learning; the opportunity to value not only the instructors, but also themselves and their peers as sources of authority and knowledge; improved problem solving abilities; increased interest and opportunities for critical thinking, as a result of the actively exchanging information in a group. The primary advantage enjoyed by the instructors was the opportunity to collaborate with colleagues to reduce the preparation required to create effective library instruction sessions. Opportunities for further research were also discovered, including the degree to which “social loafing” plays a role in collaborative, active learning.

Evolution of Various Library Instruction Strategies: Using Student Feedback to Create and Enhance Online Active Learning Assignments

This case study traces the evolution of library assignments for biological science students from paper-based workbooks in a blended (hands-on) workshop to blended learning workshops using online assignments to online active learning modules which are stand-alone without any face-to-face instruction. As the assignments evolved to adapt to online learning supporting materials in the form of PDFs (portable document format), screen captures and screencasting were embedded into the questions as teaching moments to replace face-to-face instruction. Many aspects of the evolution of the assignment were based on student feedback from evaluations, input from senior lab demonstrators and teaching assistants, and statistical analysis of the students’ performance on the assignment. Advantages and disadvantages of paper-based and online assignments are discussed. An important factor for successful online learning may be the ability to get assistance.