The implications of being an international medical graduate (IMG) in Canadian society : a qualitative study of foreign-trained physicians' resettlement, sense of identity and health status

This qualitative research study used grounded theory methodology to explore the settlement experiences and changes in professional identity, self esteem and health status of foreign-trained physicians (FTPs) who resettled in Canada and were not able to practice their profession. Seventeen foreign-trained physicians completed a pre-survey and rated their health status, quality of life, self esteem and stress before and after coming to Canada. They also rated changes in their experiences of violence and trauma, inclusion and belonging, and racism and discrimination. Eight FTPs from the survey sample were interviewed in semi-structured qualitative interviews to explore their experiences with the loss of their professional medical identities and attempts to regain them during resettlement. This study found that without their medical license and identity, this group of FTPs could not fully restore their professional, social, and economic status and this affected their self esteem and health status. The core theme of the loss of professional identity and attempts to regain it while being underemployed were connected with the multifaceted challenges of resettlement which created experiences of lowered selfesteem, and increased stress, anxiety and depression. They identified the re-licensing process (cost, time, energy, few residency positions, and low success rate) as the major barrier to a full and successful settlement and re-establishment of their identities. Grounded research was used to develop General Resettlement Process Model and a Physician Re-licensing Model outlining the tasks and steps for the successfiil general resettlement of all newcomers to Canada with additional process steps to be accomplished by foreign-trained physicians. Maslow's Theory of Needs was expanded to include the re-establishment of professional identity for this group to re-establish levels of safety, security, belonging, self-esteem and self-actualization. Foreign-trained physicians had established prior professional medical identities, self-esteem, recognition, social status, purpose and meaning and bring needed human capital and skills to Canada. However, without identifying and addressing the barriers to their full inclusion in Canadian society, the health of this population may deteriorate and the health system of the host country may miss out on their needed contributions.

Using Poetry, Story, and Reflection to Understand Professional Self After Personal Loss

This research investigated professional identity transformation after personal loss. Through autoethnographic methods, I explore how my personal experience of my sister’s breast cancer and death affected my identity as a diabetes educator in the health culture. I discover a transformation of a professional who focuses on evidence-based medicine to a professional who values connection, therapeutic alliance, and mindfulness with patients and self in the diabetes education encounter. Using a holistic perspective on transformational learning, I integrate the poem “Wild Geese” to a collection of written narratives to connect my personal loss experience to my professional life. By unpacking the generated stories and using poetry, I conduct a process of critical and self-reflection to discover how my identity as a health professional has transformed and what makes meaning in my role as a diabetes educator in the health culture. I consider concepts of a conscious self, social relations and language and discover themes of knowledge exchange, food, and empathy as forms of language expression. These language expressions are not present in my professional life as I focus on rational, logical facts of evidence-based medicine and standardized education methods. Through this reflexive process, I hope to understand how my professional practice has changed, where I place an importance on connection, therapeutic alliance, and mindfulness. I move away from always “doing” in my professional life to focus on my state of “being” in my professional world. Rather than knowledge acquisition as the only factor in professional development, this study contributes to an understanding of additional qualities health professionals may consider that focus on the patient education encounter.

Nursing staffs' perceptions of a generic service manager position

The recent reengineering within the health care industry has challenged many assumptions regarding traditional structures and roles. Within a product-line management structure, the traditional viewpoint that those who manage patient care areas must have a nursing background, is an example of one such assumption being challenged. The nursing profession is often seen as the greatest obstacle to the implementation of a product-line management structure and generic manager positions (does not require a nursing background), due to the perceived loss of professional identity. This qualitative study focused on how nursing staff within a chronic care and rehabilitation facility perceived a generic service manager position. Focus groups were conducted in three phases, over a 14 month period of time. The data collected from the focus groups were then coded according to common themes. Each phase was analyzed independently, with the study concluding with an analysis and interpretation of the collective results. The results of this study revealed a significant shift in how the nursing staff perceived their professional identity and accountability in light of the implementation of the generic Service Manager position. Initial reactions of personal and professional vulnerability and resentment were seen to transform into an increased ability to explicitly articulate the role of nursing. Changes in behavior that were described included: increased consultation and collaboration with other

The impact of hospital downsizing on registered nurses displaced from full-time employment

This research identified and explored the various responses often women Registered Nurses displaced from full-time elnployment as staff nurses in general hospitals in southern Ontario. These nurses were among the hundreds in Ontario who were displaced between October 1991 and October 1995 as a result of organizational downsizing and other health care reform initiatives. The purpose ofthis research was to document tIle responses of nurses to job displacement, and how that experience impacted on a nurse's professional identity and her understanding of the nature and utilization of nursing labour. This study incorporated techniques consistent with the principles of naturalistic inquiry and the narrative tradition. A purposive sample was drawn from the Health Sector Training and Adjustment Program database. Data collection and analysis was a three-step process wherein the data collection in each step was informed by the data analysis in the preceding step. The main technique used for qualitative data collection was semistructured, individual and group interviews. Emerging from the data was a rich and textured story ofhow job displacement disrupted the meaningful connections nurses had with their work. In making meaning of this change, displaced nurses journeyed along a three-step path toward labour adjustment. Structural analysis was the interpretive lens used to view the historical, sociopolitical and ideological forces which constrained the choices reasonably available to displaced nurses while Kelly's personal construct theory was the lens used to view the process of making choices and reconstruing their professional identity.

The Impact of Hospital Downsizing on Registered Nurses Displaced from Full -Time Employment

This research identified and explored the various responses of ten women Registered Nurses displaced from full-time employment as staff nurses in general hospitals in southern Ontario. These nurses were among the hundreds in Ontario who were displaced between October 1991 and October 1995 as a result of organizational downsizing and other health care reform initiatives. The purpose of this research was to document the responses of nurses to job displacement, and how that experience impacted on a nurse's professional identity and her understanding of the nature and utilization of nursing labour. This study incorporated techniques consistent with the principles of naturalistic inquiry and the narrative tradition. A purposive sample was drawn from the Health Sector Training and Adjustment Program database. Data collection and analysis was a three-step process wherein the data collection in each step was informed by the data analysis in the preceding step. The main technique used for qualitative data collection was semistructured, individual and group interviews. Emerging from the data was a rich and textured story of how job displacement disrupted the meaningful connections nurses had with their work. In making meaning of this change, displaced nurses journeyed along a three-step path toward labour adjustment. Structural analysis was the interpretive lens used to view the historical, sociopolitical and ideological forces which constrained the choices reasonably available to displaced nurses while Kelly's personal construct theory was the lens used to view the process of making choices and reconstruing their professional identity.

Nationalism and Sporting Culture: A Media Analysis of Croatia’s Participation in the 1998 World Cup

The past two centuries have witnessed the rise of nationalist movements and widespread nationalism. As these movements gained strength in Europe, sport played a role in their development. Media representations of sport recount events in a way that reinforces cultural values and this research investigates media representations of Croatian nationalism in the weeks surrounding the country’s third place victory in the 1998 FIFA World Cup. Sociological theories alongside more contemporary theories of sport and nation construction are considered. Croatian newspapers were analyzed for elements of national identity construction. The study concludes that the 1998 World Cup played an important role in Croatia’s on-going construction of nationhood and invention of nationalist traditions. This research further demonstrates sport’s ability to evoke strong emotions that are difficult to witness in other areas of social life and the direct role of sport in garnering nationalism.

Buddy films and gender identity : representing the bonds of masculinity /

The study examines the buddy film genre and the representation of masculinity in relation to the homosocial and the homoerotic. As a genre, the buddy films focus on male relationships, thematically seeking to mediate the boundaries surrounding the homosocial continuum and the intimacy and eroticism implicit in male bonding. Theories of genre, gender and identity are used to analyze the construction of masculine identity within the films. By providing a qualitative analysis of films from the 1960s to contemporary times, the research establishes a relationship between social changes, attitudes toward men and depictions of men. The buddy films adapt to address changes in the representation of masculinity, embodied in the difference between the male couple in the films. The early films of the 1960s served as templates that deconstructed traditional representations of male identity through articulating the tension within homosocial relationships. However, in the later films this tension became a refle~ive convention, acting to undermine the eroticism onto a displaced Other. The buddy film genre highlights the tension inherent to the male masquerade. This tension is situated in the need to represent the protagonist's homosocial relationship, while disavowing the eroticism that surrounds homosocial bonding. The structure of the buddy film genre, which focuses on the exploration of masculinity and representing the bonds of homosocial intimacy, makes these films a significant site for investigating the cultural construction of masculine identities.

A Living Educational Theory of Knowledge Translation: Improving Practice, Influencing Learners, and Contributing to the Professional Knowledge Base

This paper captured our joint journey to create a living educational theory of knowledge translation (KT). The failure to translate research knowledge to practice is identified as a significant issue in the nursing profession. Our research story takes a critical view of KT related to the philosophical inconsistency between what is espoused in the knowledge related to the discipline of nursing and what is done in practice. Our inquiry revealed “us” as “living contradictions” as our practice was not aligned with our values. In this study, we specifically explored our unique personal KT process in order to understand the many challenges and barriers to KT we encountered in our professional practice as nurse educators. Our unique collaborative action research approach involved cycles of action, reflection, and revision which used our values as standards of judgment in an effort to practice authentically. Our data analysis revealed key elements of collaborative reflective dialogue that evoke multiple ways of knowing, inspire authenticity, and improve learning as the basis of improving practice related to KT. We validated our findings through personal and social validation procedures. Our contribution to a culture of inquiry allowed for co-construction of knowledge to reframe our understanding of KT as a holistic, active process which reflects the essence of who we are and what we do.

The Implementations of Professional Learning Communities (PLCs) in Beijing and Ontario Schools

Since the knowledge-based economy has become a fashion over the last few decades, the concept of the professional learning community (PLC) has started being accepted by educational institutions and governments as an effective framework to improve teachers’ collective work and collaboration. The purpose of this research was to compare and contrast the implementations of PLCs between Beijing schools and Ontario schools from principals’ personal narratives. In order to discover the lessons and widen the scope to understand the PLC, this research applied qualitative design to collect the data from two principal participants in each location by semistructured interviews. Four themes emerged: (a) structure and technology, (b) identity and climate, (c) task and support, and (d) change and challenge. This research found that the root of the characteristics of the PLCs in Beijing and Ontario was the different existing teaching and learning systems as well as the test systems. Teaching Research Groups (TRGs) is one of the systems that help Chinese to organize routine time and input resources to improve teachers’ professional development. However, Canadian schools lack a similar system that guarantees the time and resources. Moreover, standardized test plays different roles in China and Canada. In China, standardized tests, such as the college entrance examination, are regarded as the important purpose of education, whereas Ontario principals saw the Education Quality and Accountability Office (EQAO) as a tool rather than a primary purpose. These two main differences influenced principals’ beliefs, attitudes, strategies, and practices. The implications based on this discovery provide new perspectives for principals, teachers, policy makers, and scholars to widen and deepen the research and practice of the PLC.