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Bird M, Côté-Boileau É, Wodchis WP, Jeffs L, MacPhee M, Shaw J, Austin T, Bruno F, Bhalla M, Gray CS. Exploring the impact of evaluation on learning and health innovation sustainability: protocol for a realist synthesis. Syst Rev 2023; 12:188. [PMID: 37803445 PMCID: PMC10557319 DOI: 10.1186/s13643-023-02348-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/07/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Within the Learning Health System (LHS) model, learning routines, including evaluation, allow for continuous incremental change to take place. Within these learning routines, evaluation assists in problem identification, data collection, and data transformation into contextualized information, which is then re-applied to the LHS environment. Evaluation that catalyzes learning and improvement may also contribute to health innovation sustainability. However, there is little consensus as to why certain evaluations seem to support learning and sustainability, while others impede it. This realist synthesis seeks to understand the contextual factors and underlying mechanisms or drivers that best support health systems learning and sustainable innovation. METHODS This synthesis will be guided by Pawson and colleagues' 2005 and Emmel and colleagues' 2018 guidelines for conducting realist syntheses. The review process will encompass five steps: (1) scoping the review, (2) building theories, (3) identifying the evidence, (4) evidence selection and appraisal, and (5) data extraction and synthesis. An Expert Committee comprised of leaders in evaluation, innovation, sustainability, and realist methodology will guide this synthesis. Review findings will be reported using the RAMESES guidelines. DISCUSSION The use of a realist review will allow for exploration and theorizing about the contextual factors and underlying mechanisms that make evaluations 'work' (or 'not work') to support learning and sustainability. Depending on results, we will attempt to synthesize findings into a series of recommendations for evaluations with the intention to support health systems learning and sustainability. Finalized results will be presented at national and international conferences, as well as disseminated via a peer-reviewed publication. SYSTEMATIC REVIEW REGISTRATION This realist synthesis protocol has been registered with PROSPERO ( https://www.crd.york.ac.uk/prospero/ ID 382690).
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Affiliation(s)
- Marissa Bird
- Institute for Better Health, 100 Queensway West-Clinical, Administrative Building, 6Th Floor, Mississauga, ON, L5B 1B8, Canada.
- Institute of Health Policy Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Suite 425-155 College Street, Toronto, ON, M5T 3M6, Canada.
| | - Élizabeth Côté-Boileau
- Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, 7101 Av du Parc, Montréal, QC, H3N 1X9, Canada
| | - Walter P Wodchis
- Institute for Better Health, 100 Queensway West-Clinical, Administrative Building, 6Th Floor, Mississauga, ON, L5B 1B8, Canada
- Institute of Health Policy Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Suite 425-155 College Street, Toronto, ON, M5T 3M6, Canada
| | - Lianne Jeffs
- Science of Care Institute, Sinai Health, 1 Bridgepoint Drive, Toronto, ON, M4M 2B5, Canada
| | - Maura MacPhee
- Nursing-Applied Sciences, University of British Columbia, 239-2211 Wesbrook Mall, Vancouver, BC, V6T2B5, Canada
| | - James Shaw
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada
| | - Tujuanna Austin
- Institute of Health Policy Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Suite 425-155 College Street, Toronto, ON, M5T 3M6, Canada
| | - Frances Bruno
- Institute of Health Policy Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Suite 425-155 College Street, Toronto, ON, M5T 3M6, Canada
- Science of Care Institute, Sinai Health, 1 Bridgepoint Drive, Toronto, ON, M4M 2B5, Canada
| | - Megan Bhalla
- OPTI-Hex Lab, Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, ON, M5S 3M2, Canada
| | - Carolyn Steele Gray
- Institute of Health Policy Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Suite 425-155 College Street, Toronto, ON, M5T 3M6, Canada
- Science of Care Institute, Sinai Health, 1 Bridgepoint Drive, Toronto, ON, M4M 2B5, Canada
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Grant R, McMurtry A, Archibald D. Mapping Health Professions Education: Using Complexity Science to Make Sense of Learning Through Electronic Consultations. MEDICAL SCIENCE EDUCATOR 2023; 33:233-242. [PMID: 37008438 PMCID: PMC10060472 DOI: 10.1007/s40670-023-01730-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 06/19/2023]
Abstract
Phenomena studied within health professions education are often complex and multifaceted. This article describes a complexity science-informed theoretical framework that was developed for exploring how electronic consultations support learning among primary care providers, as well as within the larger organizations or systems in which they practice. This framework enables researchers to investigate learning occurring simultaneously at multiple levels (including individuals and social groups), without simplistically conflating levels or theories. The various levels of learning and associated theories are illustrated using examples from electronic consultations. This complexity science-inspired framework can be used for studying learning in complex, multilayered systems.
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Affiliation(s)
- Rachel Grant
- Faculty of Education, University of Ottawa, Ottawa, ON Canada
| | - Angus McMurtry
- Faculty of Education, University of Ottawa, Ottawa, ON Canada
| | - Douglas Archibald
- Faculty of Education, University of Ottawa, Ottawa, ON Canada
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
- Bruyère Research Institute, Ottawa, ON Canada
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Albsoul RA, Hughes J, Alshyyab MA, Fitzgerald G. A scoping review of the literature of interventions for enhancing nurses' resilience in acute care settings. J Health Organ Manag 2022; ahead-of-print. [PMID: 36484639 DOI: 10.1108/jhom-04-2022-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this study was to identify and evaluate interventions shown to improve nurse resilience in the acute care settings. DESIGN/METHODOLOGY/APPROACH The study was a systematically conducted scoping review of the literature. Databases including MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Emerald insight and Google Scholar were searched and this complemented by reviews of the reference lists. FINDINGS In total, 13 papers were included in the review but there was limited evidence of the effectiveness of individual programs. The authors found that resilience training programs for individuals reviewed provided some evidence for the effectiveness of the training. However, the context of job design, work risks and leadership require attention. ORIGINALITY/VALUE Resilience is an important requirement for nursing staff that helps to mitigate the stress of the working environment, particularly in the acute care setting. However, the managerial strategies required to build resilience are not well known or applied. The findings of this research may help to design cohesive and comprehensive management programs to promote and preserve nursing resilience in acute care settings. Any such program needs to reflect the four key themes that appear to underpin resilience: relationships, motivation, emotions and well-being.
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Affiliation(s)
- Rania Ali Albsoul
- School of Medicine, Department of Family and Community Medicine, The University of Jordan, Amman, Jordan
| | - James Hughes
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Muhammad Ahmed Alshyyab
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Gerard Fitzgerald
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Toniolo RMM, Peres AM, Montezeli JH. Approaches of the systematization of nursing care, complexity and ontology in the professional practice of nurses. Rev Gaucha Enferm 2022; 43:e20210213. [PMID: 35976383 DOI: 10.1590/1983-1447.2022.20210213.en] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To reflect on the approaches of the Systematization of Nursing Care, ontology and complex thinking in professional nursing practice. METHOD A reflective theoretical study grounded on the Complexity Theory of Edgar Morin and on the ontological principles of computational application which enables representing nursing concepts. RESULTS The paradigm of complexity breaks the linearity and expands the meaning of Systematization of Nursing Care, supporting a conceptualization of new entities and objectives, moving away from reductionism in work practice. Ontology is considered as a potential technology for creating a standardized language capable of representing the Systematization of Nursing Care from the perspective of complex thinking. CONCLUSION Ontology furthers the formal representation of Systematization of Nursing Care knowledge, creating strength in its identity, organization, and sharing its knowledge and information. Supporting the dissemination of common nursing vocabulary contributes to nurses' daily experience and decisions.
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Affiliation(s)
| | - Aida Maris Peres
- Universidade Federal do Paraná (UFPR), Programa de Pós-Graduação em Enfermagem. Curitiba, Paraná, Brasil
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Olarte-Godoy J. Newtonian science, complexity science and suicide-critically analysing the philosophical basis for suicide research: A discussion paper. J Adv Nurs 2022; 78:e101-e110. [PMID: 35765763 DOI: 10.1111/jan.15346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/04/2022] [Accepted: 06/17/2022] [Indexed: 11/27/2022]
Abstract
AIM A critical discussion comparing Newtonian science and complexity science as the philosophical basis for suicide research and its impact on suicide knowledge development and clinical practice. DESIGN Discussion paper. DATA SOURCES A review of literature on suicide research and complexity science ranging from 2000 to 2022. IMPLICATIONS FOR NURSING Suicide research based on a Newtonian worldview can have negative consequences for suicide knowledge development and can permeate nursing practice in ways that take away from addressing the complex needs of patients, their families and healthcare teams. CONCLUSION A Newtonian worldview as a philosophical basis for research is insufficient for the study of a phenomenon as complex as suicide. A complexity science approach is better suited to the study of suicide given the multiple, interrelated, emerging factors that can contribute to a person's decision to end their own life. IMPACT Suggestions are provided as to how a complexity science approach to the research of suicide can inform useful knowledge development that better meets the needs of individuals facing suicidality and their families. Researchers, healthcare administrators and nurses providing care to those struggling with suicidality can benefit from adopting a complexity science worldview in addressing this multifaceted phenomenon.
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Toniolo RMM, Peres AM, Montezeli JH. Aproximações entre sistematização da assistência de enfermagem, complexidade e ontologia na prática profissional do enfermeiro. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20210213.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Refletir sobre as aproximações entre Sistematização da Assistência de Enfermagem, ontologia e pensamento complexo na prática profissional do enfermeiro. Método: Estudo teórico reflexivo fundamentado na Teoria da Complexidade de Edgar Morin e nos princípios ontológicos com aplicação computacional possíveis de representações conceituais na enfermagem. Resultados: O paradigma da complexidade rompe com a linearidade e amplia o significado da Sistematização da Assistência de Enfermagem, favorecendo a conceituação de novas entidades e objetivos, distanciando-se do reducionismo na prática laboral. Considera-se a ontologia como potencial tecnologia para criação de linguagem padronizada capaz de representar a Sistematização da Assistência de Enfermagem na perspectiva do pensamento complexo. Conclusão: A ontologia facilita a representação formal do conhecimento da Sistematização da Assistência de Enfermagem, gerando fortalecimento da sua identidade, organização, compartilhamento do conhecimento e informação. Aliada ao pensamento complexo, favorece a difusão de vocabulário comum à enfermagem, contribuindo na experiência e decisões dos enfermeiros.
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Polick CS, Cho Y, Harris ML, Johnson FU, Granner JR, Lee H, Lenko R, Liestenfeltz B, Webster KE, Youmans A, Zhou W. The future speaks: The next generation of nurse scientist's perspectives on team science as the discipline's future. Nurs Outlook 2021; 69:518-520. [PMID: 33814159 DOI: 10.1016/j.outlook.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/03/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Carri S Polick
- University of Michigan, School of Nursing, Ann Arbor, MI.
| | - Youmin Cho
- University of Michigan, School of Nursing, Ann Arbor, MI
| | | | | | | | - HaEun Lee
- University of Michigan, School of Nursing, Ann Arbor, MI
| | - Rachel Lenko
- University of Michigan, School of Nursing, Ann Arbor, MI
| | | | | | - Andrew Youmans
- University of Michigan, School of Nursing, Ann Arbor, MI
| | - Weijiao Zhou
- University of Michigan, School of Nursing, Ann Arbor, MI
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