Anna MacLeod’s research while affiliated with Dalhousie University and other places

Introduction: A study was conducted to describe the state of historical scholarship in medical education including its strengths and opportunities as well as its shortcomings, lacunae, inattentions, and failings. The study took a particular focus on historical methods and methodologies and whether they have been applied appropriately and with rigour. The study serves as a descriptive scan of historical scholarship, as a guide to the use of historical methods for authors, editors and reviewers, and as a possible course correction for improved standards in approaching and reporting on the past in medical education scholarship. Method: A meta-study review was conducted to explore the current state of historical scholarship in medical education, to understand the state of the art, and to improve methodological, analytical and reporting rigour. Structured searches were conducted, returns were filtered for inclusion, and 85 articles and chapters were critically analysed. Results: Although there were some exemplary articles identified, the majority reflected many deficits in scholarly practice. Seven broad issues in historical scholarship in medical education were identified that all spoke to the absence of key dimensions of sound scholarship namely: an explicit methodology, explicit engagement with theory, attention to replicability, reflective critique, sources of evidence, a balanced argument, and attention to positionality. Discussion: The issue at hand is not simply about aligning historical scholarship with the standards of social science (such as engaging with methodology, theory and reflexivity), although the authors argue that scholars should do so where appropriate. Rather, it is about the implications these findings have for future work in the field of medical education in studying its many intertwined histories. To that end, there is a discursive space for historical scholarship in medical education that needs further exploration and development to bring together the best of scholarship from the traditions of medical education and history.

Purpose To explore new parents' experiences with web-based videoconferencing as a mechanism of offering postpartum virtual support groups. Study Design and Methods Virtual support sessions and individual interviews were conducted to explore participants' experiences with virtual postpartum groups. Results Thirty-seven parents participated in seven virtual support sessions and 19 participated in individual interviews. Participant narratives centered on perceptions of safety when engaging in virtual support groups. Tools within the virtual space (camera; mute) created a relational paradox which provided safeguards but also hindered the building of trust. Participants described negotiating the fear of harm and judgment within virtual spaces alongside feelings of security in connecting from the safety of their homes. Clinical Implications The virtual environment provides a forum for new parents to access information and support and an avenue for engagement with maternal child nurses and care providers. Awareness of how parents perceive safety in the virtual environment is an important part of facilitating and structuring parent groups on videoconferencing platforms. Nurses should be familiar with videoconferencing technology and be able to guide parents. Experience facilitating virtual groups to ensure safety and security while providing needed support is a valuable nursing skill.

Coping with loss is an unfortunate reality faced by healthcare professionals, and the COVID-19 pandemic exacerbated this challenge for those who worked on the frontlines. Our scoping review aimed to comprehensively map the existing literature pertaining to the experiences of grief among nurses and physicians in the context of the pandemic. Six bibliographic databases were searched in 2022, and a targeted search of gray literature and citation chasing was also performed. After screening a total of 2920 records, we included 173 evidence sources in this review. Data was both analyzed descriptively (e.g., frequency counts and percentages) and using a qualitative content analysis approach. Our findings illuminate the myriad losses experienced by nurses and physicians throughout the pandemic. While the literature portrays the coping mechanisms healthcare professionals have developed personally, there is a pronounced need for increased institutional support to alleviate the burdens they carry.

Introduction Discourse analysis has been used as an approach to conducting research in health professions education (HPE) for many years. However, because there is no one ‘right’ interpretation of or approach to it, quite what discourse analysis is, how it could or should be used, and how it can be appraised are unclear. This ambiguity risks undermining the trustworthiness and coherence of the methodology and any findings it produces. Method A meta‐study review was conducted to explore the current state of discourse analysis in HPE, to guide researchers engaging using the methodology and to improving methodological, analytical and reporting rigour. Structured searches were conducted, returns were filtered for inclusion and 124 articles critically analysed. Results Of 124 included articles, 64 were from medical education, 51 from nursing and 9 were mutli‐disciplinary or from other HPE disciplines. Of 119 articles reporting some sort of data, 50 used documents/written text as the sole data source, while 27 were solely based on interview data. Foucault was the most commonly cited theorist ( n = 47), particularly in medical education articles. The quality of articles varied: many did not provide a clear articulation what was meant by discourse, definitions and methodological choices were often misaligned, there was a lack of detail regarding data collection and analysis, and positionality statements and critiques were often underdeveloped or absent. Discussion Seeking to address these many lacunae, the authors present a framework to facilitate rigorous discourse analysis research and transparent, complete and accurate reporting of the same, to help readers assess the trustworthiness of the findings from discourse analysis in HPE. Scholars are encouraged to reflect more deeply on the applications and practices of discourse analysis, with the ultimate aim of ensuring more breadth and depth when using discourse analysis for understanding and constructing meaning in our field.

Postpartum support for new parents can normalize experiences, increase confidence, and lead to positive health outcomes. While in-person gatherings may be the preferred choice, not all parents can or want to join parenting groups in person. Online asynchronous chat spaces for parents have increased over the past 10 years, especially during the COVID pandemic, when “online” became the norm. However, synchronous postpartum support groups have not been as accessible. The purpose of our study was to examine how parents experienced postpartum videoconferencing support sessions. Seven one-hour videoconferencing sessions were conducted with 4–8 parents in each group (n = 37). Nineteen parents from these groups then participated in semi-structured interviews. Feminist poststructuralism and sociomaterialism were used to guide the research process and analysis. Parents used their agency to actively think about and interact using visual (camera) and audio (microphone) technologies to navigate socially constructed online discourses. Although videoconferencing fostered supportive connections and parents felt less alone and more confident, the participants also expressed a lack of opportunities for individual conversations. Nurses should be aware of the emerging opportunities that connecting online may present. This study was not registered.

Background: While many medical schools utilize the Multiple Mini-Interview (MMI) to help select a diverse student body, we know little about MMI assessors' roles. Do MMI assessors carry unique insights on widening access (WA) to medical school? Herein we discuss the hidden expertise and insights that assessors contribute to the conversation around WA. Methods: Ten MMI assessors (1-10 years' experience) participated in semi-structured interviews exploring factors influencing equitable medical school recruitment. Given their thoughtfulness during initial interviews, we invited them for follow-up interviews to gain further insight into their perceived role in WA. Fourteen interviews were conducted and analyzed using a thematic analysis approach. Results: Assessors expressed concerns with diversity in medicine; dissatisfaction with the status quo fueled their contributions to the selection process. Assessors advocated for greater diversity among the assessor pool, citing benefits for all students, not only those from underrepresented groups. They noted that good intentions were not enough and that medical schools can do more to include underrepresented groups' perspectives in the admissions process. Conclusion: Our analysis reveals that MMI assessors are committed to WA and make thoughtful contributions to the selection process. A medical school selection process, inclusive of assessors' expertise is an important step in WA.

Virtual spaces that allow parents in the postpartum period to connect, support each other, and exchange information have been increasing in popularity. With the COVID-19 pandemic, many parents had to rely on virtual platforms as a primary means to connect with others and attend to their postpartum health. This study explored virtual postpartum support sessions through the web-based videoconferencing software, Zoom. Guided by feminist poststructuralism and sociomaterialism, we held seven virtual support sessions for parents caring for a baby 0–12 months in age, in Canada, and interviewed 19 participants about their experiences in the sessions. Our methodological approach allowed us to analyze discourses of (1) parenthood, (2) material realities of virtual environments, and (3) support and information on this virtual platform. The purpose of this research was to understand how technology influences postpartum support and learning through online videoconferencing for parents. Our findings document an overarching discourse of Zoom etiquette by which muting was a discursive practice that all participants used. The consistent use of the mute button while not talking structured conversation in virtual postpartum sessions and resulted in three themes: (1) minimizing disruptions; (2) taking turns; and (3) staying on task. The norm of using the mute button changed how parents received and gave support and information. Based on findings and broader literature, we discuss considerations for facilitation of virtual postpartum support sessions.

Academics have historically been members of socially dominant groups—white, cisgender, heterosexual men, from middle- to upper-classes, who identify as able-bodied and able-minded. Members of other groups are often disadvantaged. In two larger studies, semi-structured interviews were conducted with professionals from marginalized groups. Here we explore the narratives of 16 participants who explicitly discussed their experiences in faculty positions within the health and social service professions. The expected academic roles of teacher, researcher, and colleague/administrator did not neatly fit for participants, clashing with the expectations they faced by virtue of their marginalized identities. Within the health and social service professions, the norms and expectations of the academy required marginalized faculty to make sacrifices of their time and sense of self to meet job demands. The effects of these role conflicts are pervasive, affecting many areas of academic work and beyond.

Introduction: The Objective Structured Clinical Examination (OSCE) is a key feature of healthcare education assessment. Many aspects of the OSCE are well-investigated, but not so its sociomaterial assemblage. The Covid-19 pandemic provided a unique opportunity to (re)consider taken-for-granted OSCE practices. Drawing on Law's modes of ordering, our aim was to demonstrate the 'mangle of practice' between space and people; the spatialised and spatialising processes of an OSCE. Methods: We used a case study approach to critically examine a redesigned final year MBChB OSCE held during the pandemic. We used multiple sources of data to attune to human and non-human actors: OSCE documentation, photographs, field notes and semi-structured interviews with OSCE staff/organisers. Law's modes of ordering was used as an analytical lens to critically consider how people and things flowed through the adapted OSCE. Findings: The overarching ordering was the delivery of a 'pandemic safe' OSCE. This necessitated reordering of 'usual' process to deliver a socially distanced, safe flow of human and non-human actors through the assessment space. Each change had material and social 'knock on' effects. We identified three main interrelated orderings: Substituting technologies for bodies: Disembodied and dehumanised but feasible; Flow through space: Architectural affordances and one-way traffic; Barriers to flow: Time and technology. Discussion: Looking at the OSCE through a sociomaterial lens allows us to critically examine the OSCE's essential and complex processes and the restrictions and affordances of the spaces and props within the OSCE. In doing so, we open the possibility of considering alternative ways of doing OSCEs in the future. Moreover, conceptualising the OSCE as a living set of socially (human) and materially (nonhuman) enacted processes changes the social perception of the OSCE and highlights that an OSCE has agency on people, places and things.