Browsing by Author "Swart, Ruth"

Now showing 1 - 5 of 5
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    Examining Causes for Readmission in the Internal Medicine Population from the Patient Perspective
    (2021-12) de Boer, Shelley; Estefan, Andrew; Seneviratne, Cydnee; Swart, Ruth
    A significant number of internal medicine patients discharged from acute care require readmission within 30 days. Current readmission rates create a significant burden to the healthcare system. Identifying causes of readmission can inform health care practice to mitigate factors associated with readmission and improve care and outcomes for patients and families. A literature review reveals a wealth of quantitative research from the perspective of healthcare practitioners. Less is known about the perspectives of internal medicine patients, particularly in Canada. As such, understanding why readmissions occur within 30 days of discharge within this patient population is limited. Avoiding readmission needs to be guided by strategic discharge practices that are informed by relevant research studies. Specifically, further research into patient perspectives on why they are readmitted warrants further qualitative investigation. This study is a qualitative, thematic analysis, designed to explore internal medicine patients’ perspectives about readmission to hospital. Knowledge from this study can inform healthcare practice by informing upstream, proactive, pre-emptive measures to address patients’ and health system needs.
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    Examining Critical Thinking Development in Undergraduate Nursing Students Utilizing Online and Face-to-Face Technology-Enhanced Learning Environments
    (2015-06-29) Swart, Ruth; Lock, Jennifer Vivian
    This research study examines the utilization of technology-enhanced learning environments, in face-to-face and online settings, to engage undergraduate nursing students in critical thinking. Critical thinking is highly acclaimed in today’s educational and professional arenas -- a valuable asset for graduating students from higher education programs. Technology has advanced in quantity and quality; similarly, educational technology is growing in use, diversity, and prevalence recognizing potential requirements of 21st century learners. A blended learning approach comprising of two technology-enhanced environments was used in supporting development of critical thinking: a classroom response system face-to-face in-class and an online discussion forum out-of-class. The Community of Inquiry framework that structures the study captured constructivist collaborative inquiry to facilitate the development of critical thinking, while building a supportive environment for learning. This mixed methods study used pre- and posttesting to assess changes in students’ critical thinking, as well as surveyed students with closed and open-ended questions to gather their perspectives about developing critical thinking, and engagement in learning through both technology-enhanced learning environments. Qualitative content analysis was used to assess the quality of the online discussion forum exchange for indications of critical thinking. These various data source and analyses have the potential to provide a comprehensive understanding of how nursing students develop of critical thinking and engage with technology-enhanced learning environments. The findings show that students were positive towards the incorporation of technology-enhanced learning. They were appreciative of its use in delivering course information and in supporting their development of critical thinking. The two forms of technology used offered students different means to actively participate in learning, thereby meeting different needs and preferences, which was deemed beneficial by the students. From their perspective, they considered that aligning critical thinking instruction and inquiry with subject-specific content facilitated understanding and application of course material engendering relevance to their learning. While the findings are limited to students who participated in the research study, the instructional strategies and technology-enhanced learning identified as beneficial provides the basis for course design and implementation for the development of critical thinking.
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    Facilitating Reflection-in-Action During High-Fidelity Simulation
    (2021-10-29) Mulli, Jessica Marie; Nowell, Lorelli; Estefan, Andrew; Swart, Ruth; Grant, Kimberley
    Background: High-fidelity simulation has become common practice in undergraduate nursing education and highly skilled educators are needed to facilitate these complex learning opportunities. Reflective practice is considered an essential step to learning in simulation, starting with reflection-before-action through prebriefing, and ending with reflection-on-action, through debriefing. However, reflection-in-action may be the hallmark of artistry or mastery of a subject. Therefore, undergraduate nursing simulation facilitators need to develop skills to identify and support learners to reflect-in-action. Methods: I conducted a concept analysis to develop an understanding of the phenomena of reflection-in-action during high-fidelity simulation. I then conducted a descriptive phenomenology study with 11 undergraduate nursing simulation facilitators from eight colleges and universities across Alberta. Participants underwent a semi-structured interview, and Colazzi’s seven step process for analysis was utilized to understand the phenomenon of reflection-in-action as experienced by undergraduate nursing simulation facilitators during high-fidelity simulation. Results: Through the concept analysis, I identified four defining attributes of reflection-in-action: (a) reflection-in-action occurs during simulation scenarios; (b) a critical learning juncture occurs and is identified by the learners; (c) a pause in student action occurs; and (d) knowledge sharing through discussion. The experiences of the participants aligned with the findings from the concept analysis. Participants in the study were experienced simulation facilitators. Despite this, they had little formal training regarding reflection-in-action. Participants were able to identify reflection-in-action during high-fidelity simulation when students paused, collaborated, shared their thinking aloud, and changed their course of action. Barriers to reflection-in-action included learner fear and anxiety, poor simulation design, and inadequate preparation. Participants supported reflection-in-action through prebriefing, remaining curious, and providing cues, prompts, or facilitated paused. The benefits of reflection-in-action include collaborative learning, building confidence, critical thinking, and embedding reflection into practice. Conclusions: Phenomenological exploration of experiences of participants was able to add insights to enhance understanding of a poorly defined subject. The insights from this work may enhance simulation facilitator’s ability to effectively support reflection-in-action within high-fidelity simulation. These findings may contribute to theory development, checklists, and decision trees to support the facilitation of reflection-in-action during high-fidelity simulation. Keywords: nursing, education, simulation, reflection, reflection-in-action
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    Intentional Integration of Critical Thinking Instruction and Technology
    (2015-05-12) Swart, Ruth
    Critical thinking instruction and the utilization of technology to support learning were purposefully integrated into an undergraduate course to gain understanding of instructional approaches beneficial to student learning and development of critical thinking. The ability to critically think and to gain efficiency and proficiency with the use of information and communication technology has been deemed of importance for students upon graduation and a necessity for employment in today’s work environment (Roschelle, Bakia, Toyama, & Patton, 2011). Consequently, formal instruction in critical thinking and integration of technology into education has been emphasized, denoting their importance for institutions, educators and graduating professionals (Chan, 2013; Kim, Kim, Lee, Spector, & DeMeester, 2013). The course was thus designed to include in-class and online technology-enhanced learning, using a classroom response system, Top Hat, and an online discussion forum on Desire2Learn, to facilitate the development of critical thinking. A classroom response system has potential to engage students in active learning and in eliciting immediate feedback to ascertain student understanding, application of knowledge learned, and critical thinking capability (Dallaire, 2011; Mincer, 2013; Trew & Nelsen, 2011). The online discussion forum provides students with time for absorption and reflection of course information and can contribute to more profound learning, realizing the achievement of critical thinking (Garrison, 2011; Lai, 2012; Lee & Baek, 2012). Instructor and students were asked to share their perspectives of the impact of the specific inclusion of critical thinking instruction and the types of questions and responses utilized in the course to provide information to further future instruction.
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