Simulation has not been extensively studied for teaching rehabilitation practitioners technical skills. The purpose of this study is to test the efficacy of an artificial hand as a teaching tool for orthosis-making. Thirty-four participants were randomized into three groups. The first group made five orthoses on a human hand, the second made five orthoses on a model hand, and the third made one orthosis on a human hand. A one-week transfer test consisted of all participants making one orthosis on a human hand. Their performance and orthoses were evaluated using a validated checklist and global rating scale. No differences were found between groups for process-related measures. The model hand group did better on final product measures and had a larger movement time than the other two groups. Practicing on artificial hands is a useful way of learning to make orthoses. Additionally, higher practice volume did not lead to better performance.

Ideas of what constitutes a good doctor underlie decisions about medical student selection, as well as curriculum design and the structure of medical education at both undergraduate and postgraduate levels of training. Factors at play include knowledge paradigms (what does a good doctor need to know), identity paradigms (who can become a good doctor) and notions about the relationship of doctors to society (the social responsibility or social accountability of the good doctor). As with any social phenomenon, constructs of the good doctor are historically derived and socially negotiated. Ideas about the good doctor tend to be considered as ‘truths’ in any era, with little attention to or understanding of the assumptions that underpin any particular formulation. In this thesis, I explore and dissect the dominant constructs of the good doctor in North American medical education between 1910 and 2010. Drawing upon Foucauldian critical discourse analysis, I focus particular attention on discursive shifts in the conception of the good doctor over the past century. This analysis reveals a series of discursive shifts in the framing of the good doctor in medical education between 1910-2010. Abraham Flexner promoted the construct of the good doctor as a scientist physician who was also a man of character. In the post-Flexnerian transformation of medical education, science became curricular content while the discourse of character remained. In the late 1950s a sudden discursive shift occurred, from the character of the good doctor to characteristics. With this shift, the student was dissected as an object of study. Further discursive shifts incorporated discourses of performance and production into constructs of the good doctor as roles-competent. This research explores the implications and consequences of these various discursive framings of the good doctor.

Simulation has not been extensively studied for teaching rehabilitation practitioners technical skills. The purpose of this study is to test the efficacy of an artificial hand as a teaching tool for orthosis-making. Thirty-four participants were randomized into three groups. The first group made five orthoses on a human hand, the second made five orthoses on a model hand, and the third made one orthosis on a human hand. A one-week transfer test consisted of all participants making one orthosis on a human hand. Their performance and orthoses were evaluated using a validated checklist and global rating scale. No differences were found between groups for process-related measures. The model hand group did better on final product measures and had a larger movement time than the other two groups. Practicing on artificial hands is a useful way of learning to make orthoses. Additionally, higher practice volume did not lead to better performance.

Ideas of what constitutes a good doctor underlie decisions about medical student selection, as well as curriculum design and the structure of medical education at both undergraduate and postgraduate levels of training. Factors at play include knowledge paradigms (what does a good doctor need to know), identity paradigms (who can become a good doctor) and notions about the relationship of doctors to society (the social responsibility or social accountability of the good doctor). As with any social phenomenon, constructs of the good doctor are historically derived and socially negotiated. Ideas about the good doctor tend to be considered as ‘truths’ in any era, with little attention to or understanding of the assumptions that underpin any particular formulation. In this thesis, I explore and dissect the dominant constructs of the good doctor in North American medical education between 1910 and 2010. Drawing upon Foucauldian critical discourse analysis, I focus particular attention on discursive shifts in the conception of the good doctor over the past century. This analysis reveals a series of discursive shifts in the framing of the good doctor in medical education between 1910-2010. Abraham Flexner promoted the construct of the good doctor as a scientist physician who was also a man of character. In the post-Flexnerian transformation of medical education, science became curricular content while the discourse of character remained. In the late 1950s a sudden discursive shift occurred, from the character of the good doctor to characteristics. With this shift, the student was dissected as an object of study. Further discursive shifts incorporated discourses of performance and production into constructs of the good doctor as roles-competent. This research explores the implications and consequences of these various discursive framings of the good doctor.

The phenomenon of 'slowing down' in response to important cues in the operative field is proposed as a hallmark of expert surgical judgment. As part of a larger program of research, the purpose of this study was to explore a methodology for capturing 'slowing down' moments using a standardised task. Edited videos of 6 laparoscopic cholecystectomies were shown to 10 expert surgeons (>250 laparoscopic cholecystectomies completed). Participants were asked to think aloud while watching them as if observing each procedure in the operating room. Each session was audiotaped and transcribed. Many examples of 'slowing down' moments were identified in the transcripts, including several categories that were previously uncharacterised or undescribed. A subset of 'slowing down' moments was compared between participants. Many appeared to be inconsistent between expert surgeons, suggesting that with this methodology alone, formal teaching and assessment of the 'slowing down' phenomenon will be challenging.

The phenomenon of 'slowing down' in response to important cues in the operative field is proposed as a hallmark of expert surgical judgment. As part of a larger program of research, the purpose of this study was to explore a methodology for capturing 'slowing down' moments using a standardised task. Edited videos of 6 laparoscopic cholecystectomies were shown to 10 expert surgeons (>250 laparoscopic cholecystectomies completed). Participants were asked to think aloud while watching them as if observing each procedure in the operating room. Each session was audiotaped and transcribed. Many examples of 'slowing down' moments were identified in the transcripts, including several categories that were previously uncharacterised or undescribed. A subset of 'slowing down' moments was compared between participants. Many appeared to be inconsistent between expert surgeons, suggesting that with this methodology alone, formal teaching and assessment of the 'slowing down' phenomenon will be challenging.

The surgical culture values certainty and confidence, and this was proposed to be a source of internal conflict for surgeons, particularly during times of stress and uncertainty. Surgeons previously described the need to manage their image during these times, putting on an external appearance that is inconsistent internally. As part of a larger program of research on surgical judgment and decision making, this study used a constructivist grounded theory approach to explore 15 general surgery trainees’ perceptions and experiences of impression management during moments of decision making. Residents described their perceived expectations in training, and the impression management strategies they used to appear as though they were meeting them in circumstances when they were not. Participants described those who did not meet these expectations as branded the ‘struggling resident’. Concerns about one’s impression had implications for residents’ evaluations, learning opportunities, decision making, and wellness.

The surgical culture values certainty and confidence, and this was proposed to be a source of internal conflict for surgeons, particularly during times of stress and uncertainty. Surgeons previously described the need to manage their image during these times, putting on an external appearance that is inconsistent internally. As part of a larger program of research on surgical judgment and decision making, this study used a constructivist grounded theory approach to explore 15 general surgery trainees’ perceptions and experiences of impression management during moments of decision making. Residents described their perceived expectations in training, and the impression management strategies they used to appear as though they were meeting them in circumstances when they were not. Participants described those who did not meet these expectations as branded the ‘struggling resident’. Concerns about one’s impression had implications for residents’ evaluations, learning opportunities, decision making, and wellness.

Master of Science / Department of Architectural Engineering and Construction Science / Raphael A. Yunk / Autism Spectrum Disorders, (ASD) are being diagnosed at an alarming rate. Students with ASD face many challenges in educational environments and struggle to overcome daily distractions. Students with ASD have variances in neuron connections that cause them to receive and understand their environment differently than a student without special needs. In the educational classrooms, fluorescent lighting is a significant source of extraneous stimuli that not only a source of annoyance but can also trigger common symptoms of ASD. Fluorescent fixtures economically provide an acceptable uniformity and quality of illumination, but also have disadvantages that can aggravate symptoms in students with ASD. Ballasts are required for the operation of fluorescent fixtures. These ballasts, especially if not replaced at the end of their usable life, can generate an audible hum and cyclical flickering of light. Alternative light sources, such as incandescent lamps and fixtures should be evaluated and installed not only in special needs classrooms but standard group classrooms as well. Providing additional sources or quality sources of light may help students with ASD focus on the information presented in the classroom. Traditional classroom design needs to be re-evaluated to accommodate the needs of those students with ASD to better provide a comfortable and less distracting learning environment. It is difficult to establish rigid standards for lighting designs sensitive to individuals and special needs occupants'. By understanding the symptoms of ASD and taking into account the occupants needs lighting designers will be better able to design an environment that is both comfortable and educational. This report will address the classroom environment and student considerations in order to develop parameters and design practices that will assist new lighting designers.

Considering the increasing levels of unemployment and underemployment, and the limited evidence concerning the impact of underemployment on health, my study examines the relations between subjective, objective, and time-related underemployment and employees’ health-related quality of life, as manifested through self-rated health, activity limitations and work-related stress. The study compares an expanded model of work-health relations that, along with the factors addressed by control-demand, and social capital theories, includes characteristics of the physical work environment, and employees’ economic class. In addition to the commonly examined factors related to employment and health (control-demand and social capital), my study explores the impact of the work environment (hazards, discomfort and physical demands) and economic class to determine the specific effects of underemployment on an employee’s health-related quality of life. My main argument is that underemployment, in conjunction with lower economic class, higher exposure to a harmful work environment, lack of control over work, and lower social capital, contributes to increased work-related stress and diminishes health-related quality of life. The study applies a mixed methodological approach based on data from the Canadian Work and Lifelong Learning Survey and the US General Social Survey, and qualitative analysis of interviews from the Ontario Survey on Education-Job Requirements Matching. Evidence based on cross-sectional and qualitative data analysis provides consistent findings and confirms the main assumption that high levels of underemployment have a significant effect on employees’ health-related quality of life. The study shows that employees’ economic class, characteristics of work environment and control over work carry the highest associations with health-related quality of life, while underemployment has a significant additive association with health-related quality of life, most importantly with work-related stress.