An assessment of autism knowledge in the medical field

Once thought to be rare, pervasive developmental disorders (PDDs) are now recognized as the most common neurological disorders affecting children and one of the most common developmental disabilities (DD) in Canada (Autism Society of Canada, 2006). Recent reports indicate that PDDs currently affect 1 in 150 children (Centre for Disease Control and Prevention, 2007). The purpose of this research was to provide an understanding of medical resident and practicing physicians' basic knowledge regarding PDDs. With a population of children with PDDs who present with varying symptoms, the ability for medical professionals to provide general information, diagnosis, appropriate referrals, and medical care can be quite complex. A basic knowledge of the disorder is only a first step in providing adequate medical care to individuals with autism and their families. An updated version of Stone's (1987) Autism survey was administered to medical residents at four medical schools in Canada and currently practicing physicians at three medical schools and one community health network. As well, a group of professionals specializing in the field ofPDDs, participating in research and clinical practice, were surveyed as an 'expert' group to act as a control measure. Expert responses were consistent with current research in the field. General findings indicated few differences in overall knowledge between residents and physicians, with misconceptions evident in areas such as the nature of the disorder, qualitative characteristics of autism, and effective interventions. Results were also examined by specialty and, while pediatricians demonstrated additional accurate 11 knowledge regarding the nature of the disorder and select qualitative impairments, both residents and practicing physicians demonstrated misconceptions about PDDs. This preliminary study replicated the findings of Stone (1987) and Heidgerken (2005) concerning several misconceptions of PDDs held by residents and practicing physicians. Future research should focus on additional replications with validated measures as well as the gathering of qualitative information, in order to inform the medical profession of the need for education in PDDs at training and professional levels.

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.

An after-school literacy program : investigating the experiences of students with literacy difficulties, their volunteer tutors, and the tutors' transition into the teaching profession

This research responds to a pervasive call for our educational institutions to provide students with literacy skills, and teachers with the instructional supports necessary to facilitate this skill acquisition. Questions were posed to gain information concerning the efficacy ofteaching literacy strategies to students with learning difficulties, the impact of this training on their volunteer tutors, and the influence of this experience on these tutors' ensuing instructional practice as teacher candidates in a preservice education program. Study #1 compared a nontreatment group of students with literacy difficulties who participated in the program and found that program participants were superior at reading letter patterns and at comprehending the elements of story grammar. Concurrently, the second study explored the experiences of 19 volunteer tutors and uncovered that they acquired instructional skills as they established a knowledge base in teaching reading and writing, and they affirmed personal goals to become future teachers. Study #3 tracked 6 volunteer tutors into their pre-service year and identified their constructions, and beliefs about literacy instruction. These teacher candidates discussed how they had intended to teach reading and writing strategies based on their position that effective teaching ofthese skills in the primary grades is integral to academic success. The teacher candidates emphasized the need to build rapport with students, and the need to exercise flexibility in lesson plan delivery while including activities to meet emotional and developmental requirements of students. The teacher candidates entered their pre-service education with an initial cognition set based on the limited teaching context of tutoring. This foundational ii perception represented their prior knowledge of literacy instruction, a perception that appeared untenable once they were immersed in a regular instructional setting. This disparity provoked some of the teacher candidates to denounce their teacher mentors for not consistently employing literacy strategies and individualized instruction. This critical perspective could have been a demonstration of cognitive dissonance. In the end, when the teacher candidates began to look toward the future and how they would manage the demands of an inclusive classroom, they recognized the differences in the contexts. With an appreciation for the need for balance between prior and present knowledge, the teacher candidates remained committed to implementing their tutoring strategies in future teaching positions. This document highlights the need for teacher candidates with instructional experience prior to teacher education, to engage in cognitive negotiations to assimilate newly acquired pedagogies into existing pedagogies.

Transition into the teaching profession: induction and mentoring issues surrounding secondary music teachers /

The purpose of this study was to investigate the issues surrounding the transition into the teaching profession by specifically focusing on teacher induction and mentoring issues while explicitly addressing matters of concern by secondary music teachers in a large suburban school board in southern Ontario. Participants included beginning teachers with fewer than 5 years of teaching, mid career teachers with between 6 and 15 years of instruction, and experienced teachers with more than 16 years of practice. The ' processes of mentoring and inducting new teachers within the board were examined, along with their relationships between proteges, mentors, and administrators. Further, internal and external programs specifically designed and implemented for newer music teachers were scrutinized and discussed. An analysis of key documents and literature on the subject was performed, and data were collected through 16 personal interviews. The findings suggest that although the necessity of mentoring and induction processes has begun to be recognized, there exists a fundamental relationship between mentoring and induction and the effect of the professional attachments to mentoring; the institutional and administrative supports that are enabled; and essential processes and practices between mentors and proteges. Together these three arms combine to support successfiil induction and mentoring initiatives that will help ease the transition into teaching.

Why I am not a teacher: a self-study examining why I made the decision to exit the teaching profession /

A good teacher was once described as being like a candle; consuming itself to light the way for others (Author unknown). But as Knox (2005) says, far too many yoimg flames flicker out before they ever get the opportvmity to bum their brightest. This self-study explores the phenomenon of teacher attrition through the stories and lived experiences of one elementary teacher. I strive throughout this self-study to delve deeper into the significance of my story and lived experiences in order to enhance our understanding of why teachers exit the profession. As a result, the guiding question throughout the study is, "Why do teachers, particularly those who have only taught for a few years, leave the classrooms they worked so hard to enter?" Through the writing of a narrative entitled Sarah 's Story, I was able to identify and give voice to a story openly sharing the feelings of despair; disappointment, frustration and disillusionment. This study has identified areas of tension that lead to dissatisfaction, discontent, and teacher disillusionment. It confronts the issues of complexity, uncertainty, and conflict that are experienced in teaching. It discusses the puzzling, powerfiil and upsetting experiences, highlighting the importance of talk between all members of the education system.

Foreign trained teachers : the emergence of the right to practise their profession in Ontario

The purpose of this thesis is to examine the impact of 2 recent legal events, specifically the Fair Access to Regulated Professions Act (2006) and Siadat v. Ontario College of Teachers (2007) decision, with regards to the opportunity of foreign trained teachers to practice their profession in Ontario. The emphasis is on the case of Fatima Siadat, who was a teacher in Iran but was unable to satisfy all the licensing requirements of the Ontario College of Teachers and consequently was unable to practise her profession in Ontario. When the Ontario College of Teachers Appeals Committee upheld the previous decision of the Ontario College of Teachers Registrar to refuse to issue her a teacher's certificate, Ms. Fatima Siadat decided to initiate a lawsuit. Ms. Fatima Siadat challenged the decision ofthe Ontario College of Teachers Appeals Committee by raising a question of applicability of human rights legislation (i.e., The Ontario Human Rights Code, 1990) on the Ontario College of Teachers' decisions. The Ontario Superior Court of Justice decided in January of2007 in favour of Ms. Fatima Siadat (Siadat v. Ontario College of Teachers , 2007) and ordered that her licensing application be reconsidered by the Ontario College of Teachers Appeals Committee. In this thesis the author argues that the Fatima Siadat decision, together with the Fair Access to Regulated Professions Act, 2006, will likely make a significant contribution to enhancing the access of foreign trained teachers and other professionals to practice their regulated professions in Ontario.

Opioid poisoning and availability of specialized medical care in Ontario, 2002-2006

The prescription of opioid analgesics has risen sharply in North America over the past two decades. This increase has been accompanied by a rise in overdoses. The present study draws on administrative data collected from emergency department contacts to describe the epidemiology of opioid overdose in Ontario b~tween 2002 and 2006 and to examine the role of regional variation in availability of specialist care. The number of poisonings increased from 1250 (10.9 per 100,000) in FY2002 to 1816 (15.2 per 100,000) in FY2005. Local concentration of specialist physicians was significantly associated with the incidence of opioid overdose, inversely at most levels of availability, but positively at very high levels. Regional variation in incidence was also associated with demographics, median family income, and the rate of other drug poisonings. Policy options for limiting opioid-related harms are limited, but improvements in monitoring and clinical management may prove valuable.

Ontario Medical Association fonds, 1972-1973, 1977-1978, 1980-1982, 1984-1985

This archive contains materials relating to the Ontario Medical Association. The bulk of the materials are correspondence. A complete administrative history of the association is available from, The first 100 years : a history of the Ontario Medical Association / Glenn Sawyer, Toronto : The Association, 1980? (R15 O58 S39 1980).

Medical sketches of the campaigns of 1812, 13, 14

Full Title: Medical sketches of the campaigns of 1812, 13, 14 : to which are added, surgical cases, observations on military hospitals, and flying hospitals attached to a moving army : also, an appendix comprising a dissertation on dysentery which obtained the Boylstonian prize medal for the year 1806 and observations on the winter epidemic of 1815-16, denominated peripneumonia notha, as it appeared at Sharon and Rochester, state of Massachusetts

The Effectiveness of Learning Portfolios: A Study of Quality Assurance Programs of Selected Health Regulatory Colleges in Ontario

Health regulatory colleges promote quality practice and continued competence through Quality Assurance (QA) programs. For many colleges, a QA program includes the use of portfolios that incorporate self-directed learning. The purpose of this study was to determine some of the issues surrounding the effectiveness of QA portfolio programs. The literature review revealed that portfolios are valuable tools, but gaps in knowledge include a comparative analysis of QA programs and the perspective of regulatory college administrators. Data were collected through interviews with 6 administrators and a review of 14 portfolio models described on college websites. The results from the two data sources were applied to Robert Stake's responsive evaluation framework to identify issues related to the portfolio's effectiveness (Stake, 1967). The learning components of portfolios were analyzed through the humanist and constructivist lenses. All 14 portfolio models were found to have 3 main components: self-diagnosis, learning plan and activities, and self-evaluation. However, differences were uncovered in learners' autonomy in selecting learning activities, methods of portfolio evaluation, and the relationship between the portfolio and other QA components. The results revealed a dual philosophy of learning in portfolio models and an apparent contradiction between the needs of the individual learner and the organization. Paths for future research include the tenuous relationship between competence and learning, and the impact of technical approaches on selfdirected learning initiatives. A key recommendation is to acknowledge the unique identity of each profession so that health regulatory colleges can address legislative demands and learner needs.

Understanding Continuance Intentions of Physicians with Electronic Medical Records (EMRS): An Expectancy-Confirmation Perspective

This thesis examines physicians’ satisfaction with electronic medical records (EMRs) in the post-adoption phase. More specifically, the study examines how physicians’ satisfaction with EMRs impacts on their intention to continue using as well as extend their adoption of additional functions of EMRs. Expectation-confirmation theory is used with the incorporation of perceived risk as the theoretical framework. The extended theoretical model is used to formulate eight hypotheses to aid in the understanding of physicians’ continuance intentions. A field survey of 135 Canadian physicians that utilize EMRs was performed to test the model empirically. The study found that physicians are willing to continue using and adopting additional components of EMRs. In addition, the empirical results suggest that physicians’ perceived usefulness and perceived risk impacts satisfaction, which in turn influences physicians’ continuance intentions. As well, perceived risk has an influence on physicians’ continuance intentions directly.

Estelle Cuffe Hawley fonds, 1852-1999, n.d.

Estelle Cuffe Hawley (1894-1995) was an educator, businesswoman and politician, who became the first woman alderman on the St. Catharines City Council. She began her career as a teacher in Peterborough in 1913, and later taught in St. Catharines at Connaught School and St. Paul’s Ward School, where she served as Principal for six years. In 1928-29, she worked as an exchange teacher in Edmonton, Alberta. This would be Estelle’s last year in the teaching profession. She moved back to St. Catharines in 1930 and began a career in business, as an employee of Sun Life Assurance Co. She remained in this profession until around 1952. It was during this period that she became very active in the community and local politics. In 1934 she was elected to the St. Catharines Board of Education, where she advocated for the improvement of teachers’ salaries, the introduction of nursing services in schools, and the inclusion of music in the curriculum. She served as a member of the school board until 1937. The following year, she became the first woman elected to the St. Catharines City Council. As an alderman, she worked to improve the community's social welfare services, serving consecutively as chairman of all committees. She established comprehensive health services (including medical, dental and nursing), in the public, separate and secondary schools of St. Catharines, the first program of its kind in Canada. She was also instrumental in establishing minimum housing standards and engaging the public in local government by arranging a series of lectures by city officials. She remained a member of City Council until 1943. The following year she campaigned unsuccessfully for the mayoralty. In 1953 she married Hubert Hawley and moved to Orillia. She continued to remain active in the community, serving as President of the Ontario Recreation Association from 1950-1953, and editor of their Bulletin from 1955-1961. During the 1960s, she worked with various groups, including the Voice of Women, the Mental Health Association and the Freedom from Hunger Campaign. In addition to this work, Estelle wrote poetry and short stories, some of which were published in the Peterborough Review, the Globe and Mail and the Canadian Churchman. Some of her short stories (often about her childhood experiences) were broadcast on the CBC, as well as her experiences as a Town Councillor (under the pseudonym Rebecca Johnson in 1961). She also broadcast a segment that was part of a series called “Winning the Peace” in April 1944. Estelle was a sought-after public speaker, speaking on topics such as peace, democracy, citizenship, education, and women’s rights. In 1976, Brock University conferred an honorary Doctor of Law degree to Estelle for her leadership as an educator, businesswoman and a stateswoman. Her husband Hubert died that same year, and Estelle subsequently moved to Mississauga. With the assistance of an Ontario Heritage Foundation grant, she began work on her memoir. She later moved back to Orillia and died there in 1995, at the age of 101.

A Narrative Study of Patient Encounter Accounts of Physicians, Nurses, and Medical Receptionists after Two Decades of a Paradigm of Patient-Centered Care

Despite recent well-known advancements in patient care in the medical fields, such as patient-centeredness and evidence-based medicine and practice, there is rather less known about their effects on the particulars of clinician-patient encounters. The emphasis in clinical encounters remains mostly on treatment and diagnosis and less on communicative competency or engagement for medical professionals. The purpose of this narrative study was to explore interactive competencies in diagnostic and therapeutic encounters and intake protocols within the context of the physicians’, nurses’, and medical receptionists’ perspectives and experiences. Literature on narrative medicine, phenomenology and medicine, therapeutic relationships, cultural and communication competency, and non-Western perspectives on human communication provided the guiding theoretical frameworks for the study. Three data sets including 13 participant interviews (5 physicians, 4 nurses, and 4 medical receptionists), policy documents (physicians, nurses, and medical receptionists) and a website (Communication and Cultural Competency) were used. The researcher then engaged in triangulated analyses, including N-Vivo, manifest and latent, Mishler’s (1984, 1995) narrative elements and Charon’s (2005, 2006a, 2006b, 2013) narrative themes, in recursive, overlapping, comparative and intersected analysis strategies. A common factor affecting physicians’ relationships with their clients was limitation of time, including limited time (a) to listen, (b) to come up with a proper diagnosis, and (c) to engage in decision making in critical conditions and limited time for patients’ visits. For almost all nurse participants in the study establishing therapeutic relationships meant being compassionate and empathetic. The goals of intake protocols for the medical receptionists were about being empathetic to patients, being an attentive listener, developing rapport, and being conventionally polite to patients. Participants with the least iv amount of training and preparation (medical receptionists) appeared to be more committed to working narratively in connecting with patients and establishing human relationships as well as in listening to patients’ stories and providing support to narrow down the reason for their visit. The diagnostic and intake “success stories” regarding patient clinical encounters for other study participants were focused on a timely securing of patient information, with some acknowledgement of rapport and emapathy. Patient-centeredness emerged as a discourse practice, with ambiguous or nebulous enactment of its premises in most clinical settings.

Contract between John Cronyn and Nelson Forsyth, December 16, 1854.

John Cronyn (1827-1898) emigrated to Canada from Ireland in 1837. He studied medicine at the University of Toronto, but was not granted his degree upon completion of the requirements. He refused to take the test oaths meant to exclude Catholics from the profession and was not granted his degree until several years later, when the discriminatory laws were rescinded. In 1850, he married Elizabeth Willoughby of Toronto. They settled in Fort Erie and he established a successful medical practice there. He was active in the community, serving as Superintendent of schools and one term as Reeve. In 1859 he relocated to Buffalo and continued to practice medicine there. Cronyn was instrumental in the establishment of a medical department at Niagara University, where he was a professor and president of faculty. Nelson Forsyth was the son of William Forsyth (1771-1841), a prominent businessman in Niagara who owned and operated the Pavilion Hotel (later known as Forsyth’s Inn). Nelson was also a businessman and lived in Fort Erie with his wife Archange Warren.