Browsing by Author "Ellaway, Rachel H."

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    Global Health Electives: Ethical Engagement in Building Global Health Capacity
    (2018-09-19) De Visser, Adriena; Hollaar, Gwen L.; Hatfield, Jennifer M.; Ellaway, Rachel H.; Buchner, Denise L.
    Increasingly, medical trainees are seeking global health electives (GHEs) as part of their medical education. However, little is known about the impact medical trainees undertaking global health electives have on host institutions, staff, local trainees, patients or communities in low-and middle-income countries. The goal of this study was to explore the relationship dynamics associated with global health electives as perceived by stakeholders at three sites in sub-Saharan Africa. More specifically, I examined stakeholder perspectives in Mwanza, Tanzania and Mbarara and Rugazi, Uganda where the University of Calgary Cumming School of Medicine (CSM) has long-standing institutional collaborations. In this case-based interpretive phenomenological study, thirty-four host stakeholders (health facility administrators, physicians, clinical officers, registrars, nurses, and community liaison members) participated in semi-structured interviews and twenty-eight host stakeholders (medical students, residents, interns, and patients) participated in focus groups. Participant experiences were described using interpretive phenomenological analysis techniques. The findings revealed that although GHEs are well-established and a common experience for host stakeholders there are many indistinct aspects which are poorly understood by host stakeholders. Participants acknowledged that there are a variety of benefits they gain because of GHEs, but overall visiting medical trainees benefit the most from this unique learning opportunity. Despite reluctance to directly admit to harms, host stakeholders described significant challenges and burdens of GHEs and recommended ways in which GHEs could be improved to ensure that the relationships they depend on are mutually beneficial and equitable. One of the main recommendations from this study is that to work towards an equitable, effective, and ethical elective, GHEs should occur between collaborating institutions with a bidirectional focus.
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    METRICS: a pattern language of scholarship in medical education
    (2017-11-07) Ellaway, Rachel H.; Topps, David A.
    Scholarly activity in health professions education has been growing steadily but despite the broad interest, quite what is considered to be scholarly activity in medical education has remained vague. Boyer’s classes of scholarly activity (Boyer 1990) and Glassick et al.’s criteria required of an artefact to render it scholarly (Glassick et al. 1997) have been widely discussed. While the Glassick model has helped to define to what scholarly activity should be, we have found the Boyer model of what kinds of activity count as scholarship is lacking. We have developed the METRICS model of scholarly activity in medical education that maps more directly to scholarly activities. Metascholarship - activities that reflect on the nature of scholarship; Evaluation - activities that measure value or axiology; Translation - activities that move findings or practices from one domain to another; Research - activities that focus on theory generation or testing (experimental, descriptive or explanatory); Innovation - activities that focus on creating new ideas, objects and practices; Conceptual - activities that explore or develop new models, concepts, and paradigms; Synthesis - activities that focus on the integration of existing knowledge and practice. Having built the METRICS model and tested it extensively in our own practice, we now seek to engage others in its use and appraisal.
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    Ontario family physicians’ perspectives about their scope of practice: what is it, what drives it and how does it change?
    (2022-09-26) Myles, Sophia M.; Wenghofer, Elizabeth F.; Ellaway, Rachel H.; Yeo, Michael T.
    Abstract Background There is little evidence to show what scope of practice (SOP) means from the point of view of family physicians, how family physicians think about their SOP as it changes over time, or what factors shape and influence their SOP. Understanding family physician perspectives on SOP and the factors that influence it can aid our understanding of how it can constrain and enable physicians’ agency and autonomy in professional practice. Methods Using qualitative description and incorporating constructivist grounded theory data collection and analysis techniques, four focus groups were conducted involving twenty-four Ontario-based family physicians from different contexts, at different career stages, and with different practice experiences. Results Participants’ SOP was highly dynamic, changing throughout their careers due to factors both within and beyond their control. Their sense of their own SOP was the product of a continuous cycle of personal and professional transitions, exposures, and experiences throughout their careers. These family physicians sought regular and sustained mentorship, support, and engagement for their SOP throughout their careers. This was particularly the case during professional transitions and for drivers of their SOP for which they felt unprepared early in their careers, such as through the first years of independent practice, and when functioning as owner-operators of medical practices. Four descriptive themes were identified focusing on the nature of their current practice, their professional preparedness and supports, practice management dynamics, and ‘doctors are people, too’. Conclusions The SOP of the family physicians in this study was dynamic and unique to each individual, it emerged from interactions between their personal and professional lives and identities, and it was embedded in their lived experiences. SOP was also to some extent imposed and externally driven. This study advances understanding by exploring the ‘why’ and ‘how’ of SOP rather than focusing solely on what it is.