Removing Oneself from the Shadows: A Heuristic Inquiry to Understand the Lived Experience of Epilepsy in Young Adult Women and their Epilepsy Disclosure

Epilepsy is a chronic neurological disorder characterized by recurrent seizures (Stein & Kanner, 2009). The purpose of this study was to understand the essence of being a young woman living with epilepsy using heuristic inquiry (Moustakas, 1990). The research was built upon the assumption that each experience is unique, yet commonalities exist. Five women aged 22 to 28 years living with epilepsy were interviewed. Additionally, the researcher described her life with epilepsy. Participants characterized life with epilepsy as a transformative journey. The act of meeting and interacting with another woman living with epilepsy provided an opportunity to remove themselves from the shadows and discuss epilepsy. Three major themes of seizures, medical treatment, and social relationships were developed revealing a complex view of an illness requiring engaged advocacy in the medical system. Respondents frequently make difficult adjustments to accommodate epilepsy. This study provides a complex in-depth view of life with epilepsy.

Instagram, Social Media, and the "Like": Exploring Virtual Identity's Role in 21st Century Students' New Socialization Experience

Personal technologies and social media use have changed the socialization experience of our 21st century learners. As learners have a new, embodied, virtual identity that is an omnipresent force within their social interactions, this study sought to examine how virtual identity influences student relationships both within and outside of a school context. This study also explored how personal technologies and social media use have influenced learners’ perceptions of their own 21st century learning. Using a qualitative inquiry, purposeful sampling was employed to recruit 6 participants between the ages of 15 to 19 to examine their social networking site use and education experience. Data were collected from single, one-on-one semi-structured interviews in which participants discussed their experiences using social media. Data were also collected from the teens’ personal Instagram accounts, and a personal reflexive researcher’s journal was kept for triangulation of data. Open and axial coding strategies alongside constant comparative methods were used to analyze data. Participants shared how they and their peers use social media, the pressures and expectations from other users, social media’s influence on peer relationships, and how social media influences their choices in the physical realm. All 6 participants explained that their teachers do not talk to them about their social media use, and even offered critiques of the school system itself and its inability to prepare students for the new realities of a digital world. This study concludes that while social media is very influential on students’ socialization, educators should be more concerned about the lack of guidance and support that students receive in school in terms of appropriate social media use and the navigation of virtual identity.

The Experience of (In)Accessibility at University: What Disabled Graduate Students Reveal

Although the number of disabled students entering graduate school has increased in recent years, research pertaining to graduate students with disabilities remains underdeveloped. The purpose of this generic qualitative study is to better understand the experiences of (in)accessibility from the perspectives of three graduate students who self-identify as disabled or as having a disability(s) at one mid-sized university in Southern Ontario. The theoretical orientation was shaped by a social model of disability. The study was focused around the following major research question: What have been the experiences of (in)accessibility for three graduate students who self-identify as disabled or as having a disability(s) at one mid-sized university in Southern Ontario? Subquestions were organized around subcategories, such as (a) experiences related to accessibility, (b) experiences related to inaccessibility, and (c) insights related to future recommendations to enhance accessibility. The study found that (in)accessibility at university was related to (a) specific places on campus, (b) specific people on campus, and (c) the culture of awareness. A variety of educational initiatives were recommended to foster accessible practices and to develop a more accepting and disability-friendly culture on campus. Based on these findings, the Trickledown Effect Model was proposed as a means for promoting accessibility at university.

Sustaining Health Care Practice Change: The Experience of Best Practice Spotlight Organizations Implementing and Sustaining RNAO Best Practice Guidelines

Sustainability of change for improvement initiatives has been widely reported as a global challenge both within and outside health care settings. The purpose of this study was to examine the extent to which factors related to staff training and involvement, staff behaviour, and clinical leaders’ and senior leaders’ engagement and support impact the long term sustainability of practice changes for BPSO health care organizations who have implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines. Semi structured interviews with eleven organizational leaders’ from ten health care organizations were conducted to explore the unique experiences, views and perspectives on factors related to staff, clinical leaders and senior leaders and their involvement and impact on the long term sustainability of clinical practice changes within organizations who had implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines (BPGs). The interviews were coded and analyzed using thematic content analysis. Further analysis identified patterns and themes in relation to: 1. The National Health Service (NHS) Sustainability Model which was used as the theoretical framework for this research; and 2. Organizations found to have sustained practice changes longer term verses organizations that did not. Six organizations were found to have sustained practice changes while the remaining four were found to have been unsuccessful in their efforts to sustain the changes. Five major findings in relation to sustainability emerged from this study. First is the importance of early and sustained engagement and frontline staff, managers, and clinical leaders in planning, implementation and ongoing development of BPGs through use of working groups and champions models. Second is the importance of ongoing provision of formal training, tools and resources to all key stakeholders during and after the implementation phase and efforts made to embed changes in current processes whenever possible to ensure sustainability. Third is to ensure staff and management are receptive to the proposed change(s) and/or have been given the necessary background information and rationale so they understand and can support the need for the change. Fourth is the need for early and sustained fiscal and human resources dedicated to supporting BPG implementation and the ongoing use of the BPGs already in place. Fifth is ensuring clinical leaders are trusted, influential, respected and seen as clinical resources by frontline staff. The significance of this study lies in a greater understanding of the influence and impact of factors related to staff on the long term sustainability of implemented practice changes within health care organizations. This study has implications for clinical practice, policy, education and research in relation to sustainability in health care.

The Lived Experience of Nursing Students With Formative Assessment Formally Embedded in Clinical Courses: A Transcendental Phenomenological Study

The potential of formative assessment (FA) for informing learning in classroom-based nursing courses is clearly established in the literature; however, research on FA in clinical courses remains scarce. This inquiry explored the lived experience of nursing students using transcendental phenomenology and described the phenomenon of being assessed in clinical courses. The research question guiding the study was: How is the phenomenon of assessment experienced by nursing students when FA is formally embedded in clinical courses? Inherent in this question were the following issues: (a) the meaning of clinical experiences for nursing students, (b) the meaning of being assessed through FA, and (c) what it is like to be assessed when FA is formally embedded within clinical experiences. The noematic themes that illuminated the whatness of the participants’ experience were (a) enabled cognitive activity, (b) useful feedback, (c) freedom to be, (d) enhanced focus, (e) stress moderator, and (f) respectful mentorship. The noetic themes associated with how the phenomenon was experienced were related to bodyhood, temporality, spatiality, and relationship to others. The results suggest a fundamental paradigm shift from traditional nursing education to a more pervasive integration of FA in clinical courses so that students have time to learn before being graded on their practice. Furthermore, this inquiry and the literature consulted provide evidence that using cognitive science theory to inform and reform clinical nursing education is a timely option to address the repeated calls from nursing leaders to modernize nursing education. This inquiry contributes to reduce our reliance on assumptions derived from research on FA in nursing classrooms and provides evidence based on the reality of using formative assessment in clinical courses. Recommendations for future research are presented.

Examining peer-controlled KR schedules during the learning of a movement-timing task as a function of task experience.

Learners can be provided with feedback in the form of knowledge of results (KR), under self-controlled and peer-controlled schedules. Recently, McRae, Hansen, and Patterson (2015), identified that inexperienced peers can provide KR that can facilitate motor skill acquisition. However, it is currently unknown whether previous task experience differentially impacts how peers present learners with KR and whether this KR impacts motor skill acquisition. In the present study, participants were randomly assigned to become inexperienced peer facilitators, learners with an inexperienced peer, learners with self-control who later became experienced peers, learners with an experienced peer, or learners in a control group. During acquisition learners completed a serial-timing task with a goal of 2500ms and returned approximately twenty four hours later for a delayed retention, time transfer, and pattern transfer test. We predicted that during the delayed tests, learners with self-control would outperform all other groups. Furthermore, we predicted that learners who received KR from experienced peers would outperform learners who received KR from inexperienced peers. However, our results indicated that participants who received peer-controlled and self-controlled KR schedules learned the task in an equivalent manner. Thus, our results are novel as they identify that inexperienced peers can provide KR that is as effective as KR provided by experienced peers and KR requested under self-controlled conditions.

Personal Support Workers' Experience of Collaboration in a Long-Term Care Facility in Rural Ontario

The growing complexity of healthcare needs of residents living in long-term care necessitates a high level of professional interdependence to deliver quality, individualized care. Personal support workers (PSWs) are the most likely to observe, interpret and respond to resident care plans, yet little is known about how they experience collaboration. This study aimed to describe PSWs’ current experiences with collaboration in long-term care and to understand the factors that influenced their involvement in collaboration. A qualitative approach was used to interview eight PSWs from one long-term care facility in rural Ontario. Thematic analysis revealed three themes: valuing PSWs’ contributions, organizational structure, and individual characteristics and relationships. Collaboration was a difficult process for PSWs who felt largely undervalued and excluded. To improve collaboration, management needs to provide opportunities for PSWs to contribute and support the development of relationships required to collaborate.