Laura Nimmon's research while affiliated with University of British Columbia and other places
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Publications (90)
What constitutes evidence, what value evidence has, and how the needs of knowledge producers and those who consume the knowledge produced as evidence might be better aligned are questions that continue to challenge the health sciences. In health professions education (HPE), debates on these questions have ebbed and flowed with little sense of resol...
Purpose
The purpose of this study was to understand how spousal caregivers of people with amyotrophic lateral sclerosis and cognitive and/or behavioural impairments felt about the EMBRACE intervention.
Materials and methods
A qualitative interpretive study, using individual semi-structured interviews pre- and post-participation in a palliative reh...
Background
While immigrant international medical graduates (I-IMGs) contribute significantly to the physician workforce in North America, researchers have highlighted the myriad of ways sociocultural challenges can negatively impact their success. Conceptual understanding that unpacks the complex processes of how I-IMGs effectively manage sociocult...
Objectives:
Incorporating the perspectives of patients and public into the conduct of research has the potential to make scientific research more democratic. This paper explores how being a patient partner on an arthritis patient advisory board shapes the patienthood of a person living with arthritis.
Methods:
An analysis was undertaken of the n...
Purpose:
Mistreatment of medical students by patients has not been qualitatively explored in the literature. The authors sought to develop a rich understanding of the impact and consequences of medical students' experiences of mistreatment by patients.
Method:
This exploratory descriptive qualitative study was conducted at a large Canadian medic...
Belonging has significant impacts on success in postsecondary. Blind people are underrepresented in postsecondary and lack equitable opportunities to develop a sense of belonging. To build a better understanding of this underrepresented experience, this study shares narratives of 28 Blind students from across Turtle Island (and what is colonially c...
Interprofessional collaborative practice is a phenomenon that can be fraught with power dynamics between professions, within professions, and between professionals and patients. In the literature, the dominant notion is that conflicting viewpoints and interests arising from unequal power dynamics can be resolved through negotiation. This study exam...
In the latest "When I Say…" paper, Steinert et al. outline the consequences of not saying "patients"
Introduction
People with disabilities are under-represented in health professions education and practice. Barriers for inclusion include stigma, disabling discourses, discriminatory program design, and oppressive interactions. Current understandings of this topic remain descriptive and fragmented. Existing research often includes only one professio...
Background
Chronic obstructive pulmonary disease (COPD) causes 3 million deaths each year, yet 38% of COPD patients continue to smoke. Despite proof of effectiveness and universal guideline recommendations, smoking cessation interventions are underused in practice. We sought to develop an infographic featuring personalized biomedical risk assessmen...
Social support is vital in promoting the health, well-being, and performance of students and clinicians in health professions. Health settings' demanding and competitive nature imposes unique challenges on students and clinicians with disabilities. This paper aims to explore the trajectories and experiences of social support interactions amongst st...
Issue: Technological innovation is accelerating, creating less time to reflect on the impact new technologies will have on the medical profession. Modern technologies are becoming increasingly embedded in routine medical practice with far-reaching impacts on the patient-physician relationship and the very essence of the health professions. These im...
Background:
Medical curricula are increasingly providing opportunities to guide reflection for medical students. However, educational approaches are often limited to formalized classroom initiatives where reflection is prescriptive and measurable. There is paucity of literature that explores the personal ways students may experience authentic refl...
Case presentations have been researched as both an important form of intra/inter-professional communication, where a patient’s clinical information is shared among health professionals involved in their care, and an equally key discursive tool in education, where learners independently assess a patient and present the case to their preceptor and/or...
Following diagnosis, individuals with chronic conditions such as inflammatory arthritis (IA) face learning how to manage multiple new healthcare relationships. Despite existing literature on team care for people with IA, little is known about how teams negotiate care from perspectives of all team members.
Objective
To explore how communication is...
Background:
As eHealth technologies become a more prevalent means to access care and self-manage health, it is important to identify the unique facilitators and barriers to their use. Few studies have evaluated the use or potential use of eHealth technologies in spinal cord injury (SCI) populations.
Objectives:
The primary objective of this stud...
Introduction:
Using wearables to self-monitor physical activity is a promising approach to support arthritis self-management. Little is known, however, about the context in which ethical issues may be experienced when using a wearable in self-management. We used a relational ethics lens to better understand how persons with rheumatoid arthritis (R...
Objectives:
This purpose of this research was to (1) to evaluate eHealth and general health literacy levels among individuals with spinal cord injury (SCI) and (2) to identify relationships between eHealth literacy, general health literacy, and various sociodemographic factors.
Design:
Cross-sectional.
Setting:
The study was conducted in the c...
Objective:
To explore how multidisciplinary inflammatory arthritis (IA) care is accessed from the perspectives of people with IA and their health care network members.
Methods:
In this phenomenological study, we used purposive sampling to recruit patients with IA for less than 5 years and age of more than 18 years who spoke English and reported...
Research Objectives
To explore what experiences individuals with spinal cord injury (SCI) have with internet-based health resources.
Design
Qualitative descriptive study.
Setting
This study was conducted in the general community setting.
Participants
Community-dwelling individuals with SCI were recruited across Canada. The average age of the 20...
Research Objectives
To (1) evaluate general health and eHealth literacy levels among individuals with spinal cord injury (SCI) and (2) identify relationships between general health literacy, eHealth literacy, and sociodemographic factors.
Design
Survey, cross-sectional.
Setting
This study was conducted in the general community setting.
Participa...
Research Objectives
To explore and identify how individuals with spinal cord injury (SCI) seek and critically evaluate online health information.
Design
Qualitative descriptive study.
Setting
This study was conducted in the general community setting.
Participants
Community-dwelling individuals with SCI were recruited across Canada. Participants...
Research Objectives
To explore and identify barriers and facilitators to engagement with eHealth technologies among individuals with spinal cord injury (SCI).
Design
Qualitative descriptive study.
Setting
This study was conducted in the general community setting.
Participants
Community-dwelling individuals with SCI were recruited across Canada....
Introduction
Our very sense of self emerges through interactions with others. As part of this State of the Science series on Self, Society, and Situation, we introduce a qualitative ego network research approach. This research approach offers insights into the self's (the ego's) interpretation of and relation to named others in the social network i...
Introduction
Anterior cruciate ligament (ACL) injury is a risk factor for developing knee osteoarthritis (OA). We developed an intervention to support people manage risk factors for OA.
Methods
We conducted one-on-one interviews with 20 individuals with OA symptoms 6-15 years post ACL injury and used a nominal group process during a workshop with...
Background/Purpose
Although much has been written about the medical learning environment, the patient, who is the focus of care, is rarely the focus in this literature. The purpose of this study was to explore the role of the patient as an active participant with agency in the medical learning environment from the standpoint of the learner, the att...
BACKGROUND
Current evidence indicates physical activity wearables could support persons with knee osteoarthritis (OA) to be more physically active. Recent evidence also identifies, however, some persons with arthritis experience guilt or worry while using a wearable if they are not as active as they feel they should be. Questions remain around how...
Background
Current evidence indicates physical activity wearables could support persons with knee osteoarthritis (OA) to be more physically active. However, recent evidence also identifies some persons with arthritis experience guilt or worry while using a wearable if they are not as active as they feel they should be. Questions remain around how p...
Introduction
Simulation as an educational tool is known to have benefits. Moreover, the use of simulation in continuing interprofessional development is vital in rural and remote communities with limited case volumes and resources. This study explored power dynamics between rural simulation participants and urban expert co-debriefers during a simul...
Background
Care guidelines for people with chronic obstructive pulmonary disease (COPD) recommend an integrated approach for holistic, flexible, and tailored interventions. Continuity of care is also emphasised. However, many patients with COPD experience fragmented care. Discontinuities in healthcare and related social services are likely to resul...
Background
Organizational supports are thought to help address wide-ranging barriers to evidence-informed health care (EIHC) and knowledge translation (KT). However, little is known about the nature of the resources and services that exist within paediatric health care and research settings across Canada to facilitate evidence use in health care de...
Saturation is well known in qualitative research as a key methodological concept and criterion for discontinuing data collection and/or analysis. Often, it is used by qualitative researchers in making decisions related to the adequacy of their sample size (1). It is becoming increasingly common for decisions to take place at the planning stage in o...
Objective:
We aim to broaden understanding of the perspectives of persons with arthritis on their use of wearables to self-monitor physical activity, through a synthesis of evidence from qualitative studies.
Methods:
We conducted a systematic search of 5 databases (including Medline, CINAHL, and Embase) from inception to 2018. Eligible studies q...
Context:
Transitions in medical education are dynamic, emotional and complex yet, unavoidable. Relationships matter, especially in times of transition. Using qualitative, social network research methods, we explored social relationships and social support as medical students transitioned from pre-clinical to clinical training.
Methods:
Eight med...
Objective:
To understand what sports orthopedic surgeons (OS), primary care physicians (PCPs) with sports medicine training and physiotherapists (PTs) managing non-elite athletes with anterior cruciate ligament (ACL) injury tell their patients about their osteoarthritis (OA) risk.
Methods:
An electronic survey was distributed by the Canadian Aca...
Purpose:
Faculty development is increasingly acknowledged as an important aspect of health professions education. Its conceptualization has evolved from an individual skills training activity to contemporary notions that draw on an organizational model. This organizational model recognizes relationships and networks as important mediators of knowl...
Temporality, occupation, and relationships are identified as discrete factors that impact quality of life for individuals at the end of life and those around them. However, scholars, practitioners, and educators require insights regarding whether and how interactions between these factors shape this quality of life. This study is framed by an under...
Students and clinicians with disabilities are underrepresented in the academic health programs and professional clinical settings. Disability studies foregrounds the unique ways of knowing and being that clinicians with disabilities can offer. Based on a larger grounded theory study of the experiences of students and clinicians with disabilities, t...
Blind Canadians experience higher rates of unemployment, social isolation, and poverty than sighted Canadians. Examining what influences opportunities can help to identify the factors that disable blind people. During initial analysis, stigma and ocularcentrism emerged as important factors. Thus, this article examines how stigma operates culturally...
Background:
Therapeutic interventions for people with inflammatory arthritis (IA) increasingly involve multidisciplinary teams and strive to foster patient-centred care and shared decision making. Participation in health-care decisions requires patients to assert themselves and negotiate power in encounters with clinicians; however, clinical conte...
Disabled people are underrepresented within healthcare professions, although their participation has potential benefits for them personally, and for broader society. Disabled peoples’ participation in healthcare professions is limited by assumptions about disability. Little research explores how healthcare professions can be organized to support di...
In their article in this issue of Medical Education, XX describe the nature of touch as a salient form of non-verbal communication that builds human connection through invoking empathy for patients.1 Their work introduces a humanist form of touch into professional practice that led me to wonder about the tension between our desire to maintain a sen...
As part of the Philosophy of Science series of Invited Commentaries, this article on critical theory describes the origins of this research paradigm and its key concepts and orientations (ontology, epistemology, axiology, methodology, and rigor). The authors frame critical theory as an umbrella term for different theories, including feminism, anti-...
Background:
A coordinated stroke rehabilitation care team is considered optimal for supporting stroke survivors from diagnosis to recovery. Despite this recognition, many stroke survivors cannot access essential rehabilitation services. Furthermore, there is a lack of understanding of stroke patients' and their caregivers' rehabilitation needs and...
Divisive, disabling and dangerous power has featured heavily in health professions literature, social media and medical education. Negative accounts of the wielding of power have discoloured the lens through which the public sees medicine and distorted the view of a profession long associated with healing, humanism and heart. What has been buried i...
Context:
Empathy is vital to the physician-patient relationship. It promotes patient compliance and increases treatment efficacy. Studies evaluating the loss of empathy as residents advance through training curricula have generated inconsistent claims. Those considering diverse resident populations have supported a decline, whereas the few studies...
Purpose:
Psychological safety (PS) is recognized as key in health professional education. However, most studies exploring PS in medical education have focused on mistreatment, thus focusing on what PS is not. The authors set out to explicitly explore learners' concept of PS in the context of medical education to better understand and define PS and...
RATIONALE: Despite the importance of self-management for asthma/chronic obstructive pulmonary disease (COPD), there is a lack of information on health care professionals’ (HCPs) perspectives of patient barriers to self-management and the possible solutions to overcome such barriers.
OBJECTIVES: To assess key informants’ (HCPs, researchers, and poli...
“Community of practice” is a term impacted upon by conceptual plurality and dynamic evolution. To offer clarification regarding its use, the authors map the trajectory of the phrases use in the latest installment of “When I say…”.
Purpose of review:
A holistic palliative approach for heart failure care emphasizes supporting nonprofessional informal caregivers. Informal caregivers play a vital role caring for heart failure patients. However, caregiving negatively affects informal caregivers' well being, and in turn heart failure patients' health outcomes. This opinion articl...
The authors compare and contrast the concepts of networks and systems in an effort to disentangle definitional confusions of importance to health professional education.
Kahlke et al. illuminate key concepts underpinning Sociocultural learning theory as a way of explaining how it offers a lens through which health professional educators might reconsider routine interactions.
BACKGROUND
Empathy is fundamental to the physician-patient relationship, promoting both patient compliance and increased treatment efficacy. Studies attempting to quantify changes in empathy during residency are inconsistent in their findings; those examining paediatrics training specifically, are no more definitive. The mixed conclusions may stem...
Background
Informal caregivers play a vital role in supporting patients with heart failure (HF). However, when both the HF patient and their long-term partner suffer from chronic illness, they may equally suffer from diminished quality of life and poor health outcomes. With the focus on this specific couple group as a dimension of the HF health car...
Approach:
Using an ethnographic and a social network analysis research design, participants' patterns of social interaction around health information were investigated over a yearlong period (2012-2013) in a small rural community in Western Canada. Data included (a) individual interviews, (b) focus group interviews, and (c) field notes. Data were...
Objective:
To identify and evaluate asthma/COPD measurement tools that assess any of the five health literacy (HL) domains: (1) access, (2) understand, (3) evaluate, (4) communicate, and (5) use, as well as numeracy.
Methods:
MEDLINE/Embase (via Ovid) databases from 1974 to 2016 were searched and complimented by grey literature. Study selection...
Background
Few medical teachers have received formal teaching education. Along with individual and organizational barriers to participation in teacher training programs, increasing numbers and altered distribution of physicians away from major teaching centers have increased the difficulty of attendance. Furthermore, it is not known if traditional...
Background:
Little work has been done on identifying the impact of educational materials developed by immigrant patients themselves, along with their caregivers and health professionals in terms of inhaler use technique. The purpose of this study was to evaluate understanding of physicians' instructions on asthma management and inhaler techniques...
Interviews are used to gather information from individuals 1-on-1, using a series of predetermined questions or a set of interest areas. Interviews are often recorded and transcribed. They can be structured or unstructured; they can either follow a tightly written script that mimics a survey or be inspired by a loose set of questions that invite in...
Background
Modern healthcare is burgeoning with patient centered rhetoric where physicians “share power” equally in their interactions with patients. However, how physicians actually conceptualize and manage their power when interacting with patients remains unexamined in the literature. This study explored how power is perceived and exerted in the...
Understanding the nature and impact of health literacy is a priority in health promotion and chronic disease prevention and
treatment. Health literacy comprises the application of a broad set of skills to access, comprehend, evaluate, communicate
and act on health information for improved health and well-being. A complex concept, it involves multip...
The specific objective of this paper is to report on a scoping review conducted to identify and synthesize the current evidence and knowledge gaps on the topic of oral health literacy. It was guided by three key questions: 1) how is oral health literacy assessed? 2) What is the relationship between oral health literacy and (i) oral health knowledge...
We assessed the availability and accessibility of early childhood development (ECD) services to ethno-cultural communities in the Tri-Cities region of British Columbia. Primary participants were recent immigrant and refugee parents from three ethnic communities: Chinese (both Mandarin- and Cantonese-speaking) and Korean-, and Farsi-speaking groups...
Background: The paradox of asthma is that, despite an improvement in ourunderstanding of its pathophysiology and more widely available treatments, its controlremains suboptimal. In addition, the prevalence of disease has increased significantlyover the past two decades. These trends are particularly prevalent among disadvantagedgroups, one of which...
The authors systematically collated, classified, and evaluated the evidence of intervention studies from recent systematic reviews about the effects of telehealth interventions on COPD and asthma care. Eight electronic databases were searched. Eligible articles were those published between 2001 and 2011 in English. Eleven review articles are includ...
Asthma tends to be less well controlled among ethnic minority groups, and its prevalence in new immigrants increases significantly the longer they are in Canada; mainly due to their lack of familiarity with English and difficulty understanding information regarding the disease, health literacy, cultural issues, housing conditions, and lack of acces...
Educational interventions for new immigrants are usually developed without any input from the individuals involved. We examined how community-based participatory research could act as a tool in the development of patient-related educational material to enhance the self-management of asthma within these communities. Concept development focus groups...
The objectives of this study were to investigate how asthma patients from new immigrant groups are being informed and educated about asthma and its management, and to identify barriers to knowledge transfer. Four focus groups (n = 29) from Latino, Chinese, Iranian and Punjabi cultural communities were conducted with asthmatic patients in the Greate...
Issues such as the linguistic and informational barriers to health care must be addressed if immigrant women are to achieve optimum health status for themselves and their families. This study used a participatory photonovel as a tool to educate ESL-speaking immigrant women about health information. This research illustrates five ESL-speaking immigr...
This study examined the relationship between a stressful life and low economical status due to underemployment among professional immigrants in the Greater Vancouver Area (GVA), and their children’s emotional and behavioural health. Employing a cross-sectional qualitative design, interviews and focus groups were conducted with the target population...
The purpose of this article is to outline the potential genres of qualitative research that can be used to research the domains of health, sport, recreation, and physical education. Drawing on Denzin and Lincoln (2000) and Sparkes (2002a), and connecting to the work of six researchers, this article will present five genres of qualitative research t...
This research examines if the process of creating and using a participatory photonovel can empower immigrant ESL-speaking women and also act as a tool to educate these women about a specific health topic.
Data were collected through a) two separate interviews with each participant, b) two focus groups, c) field notes during the meetings the author...
This article describes a research project that investigated whether language barriers play a part in immigrant women's health decreasing when they move to Canada. The findings are then represented in the form of an ethnodrama entitled "ESL-Speaking Immigrant Women's Disillusions: Voices of Health Care in Canada." I suggest that the play is catalyti...
Citations
... Hierarchical and relational limitations are invariably present in interprofessional collaborations, and this can have a negative effect on the quality of collaboration [19][20][21]. The findings of the present study show that rural healthcare professionals believed that their previous relationships and hierarchy affected their collaboration and led to inadequate information sharing and discussion about patients' care, resulting in a deterioration in patients' conditions. ...
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... Particularly the question around inviting feedback in the treatment relationships and questions of vulnerability in regard to our presumptions required regular deliberations within the team, partly fuelled by our own personal experienced struggles. This served as reminders of being critical and open towards interviewees' statements, our analysis thereof and own experiences as patients.32 We stressed towards participants that the research neither affect professional's appointment nor patient consultants' treatment, and thatneither the department head nor treating professional would receive information about the individual's interview. ...
... In addition, the study used self-report measures, and therefore, the generalization of the results should be interpreted with caution. Tese usually "invisible mental tolls" are not always disclosed by people with disabilities, because medical settings are usually competitive and high paced, and therefore asking for support could entail stigma and negative judgments [38,39]. One of the implications of this study is that medical educators should be aware of the "transparent toll" on disabled trainees and create a more supportive climate that will provide the necessary accommodations for trainees to safely continue their educational journey with their peers, and increase their sense of belonging and psychological meaning. ...
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... Por tanto, cabe señalar el excesivo rol pasivo en materia de RSD desarrollado por parte de los centros educativos. Solo en ocho de los estudios los centros educativos asumen un rol activo (Alanezi, 2021;Carvajal & Zambrano, 2021;Çimen & Yilmaz, 2017;Cracium & Bunoiu, 2019;Fong, 2019;Jiang et al., 2018;Kaziaba & Barmina, 2019;Rehm et al., 2021;Stasiuk, et al., 2022). ...
... In addition, the study used self-report measures, and therefore, the generalization of the results should be interpreted with caution. Tese usually "invisible mental tolls" are not always disclosed by people with disabilities, because medical settings are usually competitive and high paced, and therefore asking for support could entail stigma and negative judgments [38,39]. One of the implications of this study is that medical educators should be aware of the "transparent toll" on disabled trainees and create a more supportive climate that will provide the necessary accommodations for trainees to safely continue their educational journey with their peers, and increase their sense of belonging and psychological meaning. ...
... Still, there is some data suggesting that patients find value and comfort when their doctors openly discuss uncertainty with them. 26 Yet, a sensitivity analysis excluding uncertainty from the definition of sensitive topics showed similar results. ...
... As stated, there is a need for clear guidelines and standards (Espinoza et al. 2023) to ensure that AI is used to build better healthcare systems worldwide based on the principles of fairness and health equity. National, regional and international guidelines and recommendations should be detailed as much as possible considering some important challenges such as accuracy, transparency, security, informed consent, data privacy as well as ethics (Leese et al. 2022) in the use of health data collected (Taka 2023). Unauthorized access by third parties is also an ethical issue and a violation of data privacy and informed consent (Segura Anaya et al. 2018). ...
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... The relationship between health and eHealth literacy is still uncertain, and there are very few studies that analyze this. Some of them conclude that there is no existing correlation [17], while others affirm the contrary [18,19]. In addition to this, current research has only been conducted in very specific and younger populations, and only questionnaires that provide a total score rather than analyzing its different dimensions have been utilized. ...
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... Media is very important in learning activities of guidance and counseling teachers because it becomes an information media for distributing lecturers' knowledge to students (Al-Sofi, 2021). Many added values obtained by students as prospective teachers are Guidance and counselling when using the media, including clarifying the presentation of messages so as not to be too verbalized (in the form of written or spoken words) (Gupta et al., 2022), overcoming the limitations of space, time, and sensory power, causing learning excitement, allowing more direct interaction between students with the environment and reality, and allowing students to learn on their own according to their abilities and interests (Kurniasih, 2017) Media is an alternative in the learning process/provision of Guidance and counseling services because students will not only get material from one source but materials from various sources selected through the stages of analyzing student needs. The position of the media is certainly very important because it serves as an intermediary. ...
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... 7 The literature related to PCC has identified IPC as a way for improving the patient's health-related outcomes, quality of life, satisfaction, service delivery and safety through better team functioning. 1,3,4,8 Furthermore, increased collaboration between HCPs creates opportunities to learn from each other, broaden their understanding of the problem to be solved, and gain an awareness of each other's contributions 9 which has been positively associated with enhanced professional practice. 10 However, despite the existing body of knowledge supporting IPC, barriers such as ineffective communication, limited awareness of other HCPs' roles, authority imbalances, lack of trust, and a shortfall of formal team structures and leadership may hamper successful participation of all team members in collaborative healthcare. ...
