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Graduate Student Supervision
Doctoral Student Supervision (2008-2018)
Although much is known about the development of general public hospitals in Canada during the turn of the twentieth century, little is known about the rich diversity of smaller community hospitals founded during this time period. From 1880 to 1920, there were at least 155 hospitals operating in British Columbia, including several Chinese hospitals, founded in Victoria, New Westminster and Vancouver, and a Japanese hospital in Steveston. These hospitals were established in a context of harsh economic, political and social restrictions for Asian populations. Yet, Chinese and Japanese hospitals developed differently because of important cultural and political differences within Canada and abroad. An initial overview of Chinese hospital development reveals that Chinese hospitals mimicked charity hospitals found in China at the time and utilized Chinese, rather than Western medicine. In contrast, the Japanese hospital, which is the primary focus of this study, was built as a ‘modern’ hospital and utilized Western scientific medicine and trained nurses. Analysis of primary and secondary sources, including two newly translated Japanese histories, demonstrates that local communities played a significant role in the development of Asian hospitals. The Japanese hospital in Steveston, for example, began as a modest Japanese-Methodist mission hospital, established by Japanese Christian missionaries themselves. As hospital debts mounted and the anti-Asian labor movement intensified, Japanese leaders endeavoured to convince the Japanese fishermen’s Benevolent Association to build and finance a new modern hospital. Over time, the hospital became closely tied to the changing needs and prosperity of the local Japanese fishing community. The hospital was utilized as a source of leverage for Japanese fishing leaders during fishing price negotiations. From the unique perspective of community leaders, the hospital became an important political tool in the fight for racial and economic equality. This study reveals that Asian hospitals were much more than institutions for restoring health or curing illness. Chinese and Japanese hospitals were grassroots community initiatives that not only met important local and cultural needs, but could also play an important role in broader issues of social justice.
Master's Student Supervision (2010-2017)
Death is an inevitable experience for each individual. Although death is a natural human experience, the avoidance of death is an issue in the culture at large. This isolation of death and dying also is evident in the health professions of nursing and medicine. Despite the fact that death and dying has received considerably more scholarly attention over time, relatively little attention has been given to the topic of death education. This study explores the literature on death education within nursing and medicine from the 1970s onwards. Using an integrative literature review, scholarly articles were reviewed to determine how death education is enacted or made real in the health care environment, particularly in the nursing and medical curricula. This study examines how educators have taught the topic of death and dying over time and how an analysis of these past experiences may inform current education on death related concepts within health professional fields. The lack of attention to death and dying in nursing and medical curricula affects the confidence and competence that health care professionals have in managing these situations. Although death is a common occurrence in the health care environment, there remains a gap in how educators are supported to teach these concepts to students. The analysis of scholarly literature from the 1970s until the present reveals three themes. The avoidance of death in the culture at large, the importance of psychosocial aspects of care, and the lack of support for educators are three over-arching themes. The main recommendations for educators teaching death related topics appearing in the literature reviewed center on ensuring student contact with terminally ill and dying patients in the clinical setting as a way to learn about the dying process, use of simulation based learning, encouraging collaboration amongst the interdisciplinary team to meet patient and family needs, and the use of explicit competencies related to end-of-life care to ensure consistency amongst all students. The findings from this review are relevant for student learning, educator preparation, and may also influence how educators in the health professions incorporate death and dying concepts into their curricula.
Nursing education in Canada, and more specifically British Columbia (BC) went through a significant period of transition post Second World War. The hospital based programs which began in the late 19th century started being phased out and move towards the college and university setting where nurses were educated in a manner similar to other professions. Mary L. Richmond, who was a graduate of a hospital based program at VGH in the 1940s, became a significant nursing leader in BC and played an influential part in the nursing profession during this time period. This study takes a historical look, using the biographical method, at the transition of nursing education from hospital based programs to college and university programs. This transition is examined through the lived experience of Mary L. Richmond, a nursing leader and innovator during the transition period of the 1940s through to the 1990s. The findings of the study reveal the many social, cultural, economic and political influences that affected the movement of nursing education away from the hospital based model. The study reveals several themes influencing the transition including advancing technology, resource allocation, changing demographics, re-assignment of responsibility, and the shifting place of nursing education. In addition, the study provides a personal perspective overlying the changes that occurred, and reveals how Richmond emerged as a leader in bridging nursing education and practice. Many of the themes and issues arising from this study are similar to issues in nursing education and practice today. This study adds to the current research of the history of nursing education in BC and Canada and it provides a historical perspective from which to view and problem solve nursing education and practice issues in today’s health care system.
People with schizophrenia have been found to experience health inequities that lead to early morbidity and mortality. Primary health care is an approach to reducing health inequities for individuals with schizophrenia. The purpose of this study was to examine what it is like for individuals with schizophrenia when they access primary health care. Exploring these experiences from the client perspective highlighted areas in which change is needed to improve access. This study used a qualitative methodology, specifically interpretive description, to analyze the data from 6 in-depth interviews with individuals with schizophrenia. The results indicate a need to address the multiple effects of stigma, the importance of considering physical and mental health care holistically, and the need to acknowledge and address the multiple losses that individuals with mental illness experience.
Clinical education is the cornerstone of nursing curricula and comprises almost half of many current nursing curricula. It is through this practice that students learn to apply their theoretical knowledge to practice and socialize into the nursing profession. The clinical teacher is pivotal in this process. The current nursing profession is challenged with a decreasing supply of competent clinical teachers due to an aging nursing workforce, and economic barriers which impacts the quality of nursing education. To meet this increasing demand for competent clinical teachers, members of academic institutions are resorting to hiring expert nurses who are mostly novice teachers. These novice clinical teachers are in need of support during their transition from practice to teaching. An assessment of the evidence-based scholarly literature was conducted to identify the teaching needs and strategies to support this unique group of expert nurses transitioning as novices into teaching practice. By means of a rapid evidence assessment (REA) method and a reflective framework, 29 research studies were reviewed. A comprehensive view of what is described in the evidence-based literature as the needs for novice clinical teachers’ teaching practice as well as current recommendations of best practices to support and prepare novice clinical teachers are presented. Teaching needs for novice clinical teachers identified in the REA are socialization into the culture of teaching, professional development, and the need to self-reflect and be self-confident. Supportive strategies that are highlighted include working in familiar environments, having prior exposure to students, participating in a comprehensive orientation process using principles of adult learning theory, building relationships and creating a new identity. The main recommendations to support novice clinical teachers’ needs include strategies to enhance socialization into the teaching role, the development of a comprehensive orientation process, ongoing professional development sessions, mentorship programs, and self-reflective strategies.
Over the latter half of the twentieth century, a steady increase in the numbers of immigrant Filipino nurses have been incorporated into the Canadian healthcare workforce, mirroring trends of international nurse migration to other Western countries. Yet, there is a paucity of information on the contexts surrounding the motivations and experiences of this group of migrants who work as registered nurses in Canada. This study aims to add a historical perspective in order to understand the historical contexts surrounding this phenomenon, to gain an informed understanding of past and current trends, and more importantly, to examine what surrounded and shaped the experiences of immigrant Filipino nurses. This study explores the oral histories of nine immigrant Filipino nurses in Alberta and British Columbia who migrated from 1974 to 2005, and aims to take the beginning steps in understanding this migration phenomenon in the Canadian context.The findings revealed that the motivations and experiences of migrant Filipino nurses were significantly influenced by the lasting effects of the historical colonial relationship between the US and the Philippines. Other important influences, however, include familial pressures and societal constructs of Filipino culture, the structure of nursing education in the Philippines, and issues of racism. These factors also shaped the transition process of the registered nurses into the Canadian workforce. With more attention and resources currently being directed at addressing foreign nurse transition and work integration in Canada, findings of this study prompt a critical reflection on these current trends and includes in the conclusion important implications on policy development for future foreign nurse immigrants entering Canada. The study concludes that social and cultural factors as much as economic ones shape nurses desire to migrate as well as their transition into the Canadian nurse workforce.
This thesis describes the historical development of intensive care nursing in the adult medical and surgical intensive care unit (ICU) at Vancouver General Hospital (VGH) from 1960 until 1985. The ICU was established to group a new, emerging cohort of critically ill patients in one centralized place the hospital. Doctors referred critically ill patients to the ICU, believing the patient would benefit from the continuous nursing care of a bedside nurse in the ICU. The concepts of place and space, specialty nursing education, professionalism, gender, and the expansion of new medical technologies used in critical care, form the central categories for analysis. I examine the broader social, cultural, economic influences, and the hospital context that shaped critical care nursing in Western Canada in the 1960s, using one hospital as a case study. An analysis of the transformation from one-to-one nursing of the most critically ill patients on the general nursing wards, to specialized critical care nursing in the ICU, significantly contributes to the history of nursing. As nurses developed new critical care nursing expertise, their work relationships with other nurses and health professionals changed. As their expertise deepened, nurses integrated new technologies that were introduced into the ICU into their practice. Nurses created critical care nursing theory in a grassroots process using their experiences in critical care, as the foundation. They also formalized this knowledge into a critical care nursing program. This process was not without its tensions, as nursing education was also beginning to make the transition from hospital-based to degree based education. It was a question of where and how the education of critical care nursing would fit in. Oral history accounts from former and practicing nurses and physicians involved in the establishment of the ICU at VGH form the primary source material, augmented by archival hospital and government records, and photographs. The individual experiences of bedside nurses provide a unique lens to understand the evolution of critical care nursing knowledge and practice at VGH in the broader context of critical care nursing history.