Thesis (M.Ed.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 58-63). Also available in print.

Thesis (M.A.(Ed.))--University of Hong Kong, 1969. / Also available in print.

Thesis (D.Clin.Psych.) - University of Queensland, [2005]. / Includes bibliography.

Background: Surgical checklists are in use as means to reduce errors for safer surgery. Checklists are infrequently applied during procedures and have been limited to lists of procedural steps as aid memoires. Aims: We aimed to formulate a performance based checklist and to study its effect on the surgical task performance of novice surgeons when applied during both, routine knot tying and simulated emergency laparoscopic tasks. We also aimed to study the effect of the performance based intra-procedural checklist in clinical environments during elective laparoscopic procedures as a way of error reduction mechanism and improvement of patient safety. Methods: The study was conducted in two settings, lab-based and clinical-based environments. The lab-based study was conducted during both routine and emergency tasks. Lab-based study- routine task: Twenty novices were randomised into two equal groups, those receiving paper feedback (control group), and those receiving paper feedback and the checklist that was applied at 20 seconds intervals (checklist group). The task involved performing laparoscopic double knots which were repeated over 5 separate stages. Human reliability assessment technique was used for error analysis on unedited video recordings of the tasks. Endpoints included number of errors, error probability (number of errors/number of knots), error types and number of completed knots. Non-parametric statistics were used for data analysis. Lab-based- emergency task: Thirty consented laparoscopic novices were exposed unexpectedly to a bleeding vessel in a laparoscopic virtual reality simulator as an emergency surgical scenario. The task consisted of using laparoscopic clips to achieve haemostasis. Subjects were randomly allocated into 2 equal groups; those using the checklist (checklist group) and those without (control group). The checklist was applied by the trainees in the checklist group at 20 seconds intervals. The surgical performance was computed on eight predetermined technical factors. Clinical-based study: Surgical trainees in the general surgery at Tayside NHS were included in this study and required the attendance of a trainer during the procedure as per routine practice. Record year of trainees and previous experience on laparoscopic cholecystectomy were noted. Two elective laparoscopic cholecystectomies for each trainee were video-recorded without the use of the checklist, directly followed by 2 further operations after the introduction of the checklist. The unedited videos were analysed for error detection using human reliability analysis technique. Total number of errors per time during each procedure, total number of errors per number of instrument movements, total number of instrument movements per time and number of trainer intervention while per time were noted as assessment points. Results: Lab-based- routine task: 2341 errors were detected in 141 tasks, 408 subtasks and 2249 steps during the 5 stages. During the first stage, the errors were not significantly different between groups. The checklist group committed significantly fewer errors as compared to the control group during all the later 4 stages (p < 0.01). The checklist group had an enhanced learning curve as the last 4 stages showed significant fewer errors compared to the first stage (p < 0.05), while the control group showed no improvement. Error probability was significantly higher in the control group compared to the checklist group: median [IQR] 32.6 [25.89] vs 11.7 [10.72] (p < 0.01). Individual error types during each step of the laparoscopic task were identified. The checklist group performed better with fewer errors for all the error types. While, there was no significant difference in each of 'the lack of supination', 'tissue bite' and 'out of vision'; the differences in all the rest of error types were highly statistically significant (p < 0.01). Number of completed knots was not statistically different between the 2 groups. Lab-based- emergency task: The checklist group performed significantly better in 6 out of 8 technical factors when compared to the control group median [IQR]: Right instrument path length (m) 1.44 [1.22] vs 2.06 [1.70] (p= 0.029), and right instrument angular path (degree) 312.10 [269.44] vs 541.80 [455.16] (p= 0.014), left instrument path length (m) 1.20 [0.60] vs 2.08 [2.02] (p= 0.004), left instrument angular path (degree) 277.62 [132.11] vs 385.88 [428.42] (p= 0.017). The checklist group committed significantly fewer number of errors in the number of badly placed clips (p= 0.035) and number of dropped clips (p= 0.012). Although statistically not significant, total blood loss (lit) decreased in the checklist group from 0.83 [1.23] to 0.78 [0.28] (p= 0.724), and total time (sec) from 186.51 [145.69] to 125.14 [101.46] (p=0.165). Clinical-based study: Participants performed statistically better with fewer number of errors per time with the application of the checklist compared to when no checklist was used respectively: Median [IQR] total number of errors 1.51 [0.80] vs 3.84 [1.42] (p=0.002), consequential errors 0.20 [0.12] vs 0.45 [0.42] (P=0.005), inconsequential errors 1.32 [0.75] vs 3.27 [1.48] (p=0.006) and total number of errors per number of instrument movements 0.16 [0.04] vs 0.29 [0.16] (p= 0.003). With the introduction of the checklist, the number of interventions by the trainer per time decreased from 2.79 [1.85] to 0.43 [1.208] (p=0.003) and the number of instrument movements per time decreased from 11.90 [5.34] to 10.38 [5.16] (p=0.04). Conclusions: We have developed standardised checklists to be applied during elective and emergency laparoscopic tasks. The performance based self-administered intra-procedural checklist had a significant accelerating effect on the acquisition of technical skills when applied by novices during a standardised laparoscopic lab-based routine task and improved the task performance during a simulated laparoscopic emergency scenario. The checklist enhanced the performance of surgical trainees and decreased the number of interventions of the trainer during laparoscopic cholecystectomy.

Thesis (Ph. D.)--Ohio State University, 2006. / Title from first page of PDF file. Includes bibliographical references (p. 112-128).

Thesis (M.S.) in Kinesiology and Phyiscal Education--University of Maine, 2009. / Includes vita. Includes bibliographical references (leaves 12-14).

This research explored the extent to which two hospitals in the City of Victoria are prepared for a future earthquake event. The goal is to examine the level of emergency preparedness of two tertiary care hospitals in Victoria for dealing with the potential damage caused by an earthquake in the region. The research objectives are aimed at highlighting current strengths regarding health sector emergency preparedness, reducing the vulnerability of the health sector by identifying key areas of improvement, and ultimately, increasing the capacity of the health sector to respond to the damages sustained by earthquakes. A small-scale mixed-methods approach was taken to assess hospital preparedness. A structured survey was administered to 26 key informants who were selected specifically based on their prior knowledge, experience and current roles and responsibilities pertaining to Disaster and Emergency Management in the province. A concerted effort was made to include a sample of participants from each of five target populations at the Provincial, Health Authority, and Local Health Authority levels. Data analysis included quantitative and qualitative techniques to generate simple statistics and thematic coding of the interview transcripts to identify main themes and patterns. Both quantitative and qualitative insights were used to provide a clearer picture of hospital preparedness and to foster credibility and dependability of key results. The findings and results confirm that there are excellent levels of engagement and integration between the Local Government, BC Ambulance Service and Fire Departments. There is room for improvement in regards to engaging and integrating NGOs with Hospital planning. Robust plans and protocols were found to be in place for Communication Systems, Emergency Operations Centres and Public Information and Media Relations. Hospital level respondents reported having less Emergency Management education and Training and had participated in fewer disaster exercises compared to Provincial and Local Emergency Managers. Although 76% of respondents had participated in a disaster exercise, only 5 % had responded to an earthquake. Only 23% of respondents had activated their planning in response to an earthquake. The results emphasize the immediate need for increased engagement and integration of earthquake response planning between health system stakeholders, communities and all levels of government. At the hospital level, increased attention needs to be directed to the following operational areas: Mass Casualty Planning, Resource Stockpiling, Department Level Contingency Plans, Evacuation and Relocation Protocols and Procedures, Volunteer Coordination Protocols, and Internal and External Traffic flow. Lastly, the results highlight the need for increased disaster education and training for front line acute care employees, hospital administrators and management staff. In addition to training and education, multi-jurisdictional and multi-agency exercises should be undertaken to engage all key community stakeholders and to promote a more integrated and optimal response in the event of an earthquake. / Graduate

This predominantly qualitative study looks at the current changes in early childhood education in Ontario, Canada from an early childhood education leadership perspective. The analysis and recommendations resulting from my dissertation adds to the growing body of work examining the rapidly changing landscape of the early years. My dissertation utilizes a constructivist lens to reconstruct perspectives surrounding matters of importance in a field that is on the cusp of obtaining true professional recognition. With the advent of a self-regulating body (College of Early Childhood Educators) and a shift in management from the Ministry of Children and Youth Services to the Ministry of Education, the study highlights some of the changes occurring in the early years sector, both institutionally and professionally. The ensuing data was collected through 35 interviews of early years champions and 167 surveys from various early years teacher-educators and practitioners, revealing strong topics of discussion that add to the cacophony of voices heralding demands that the early childhood educator be perceived and treated as an equal participant in the education system. Of the 8 themes that emerged from the data analyzed, 3 were the focus of this study. The first theme focused on leadership, including characteristics of leaders and themes of emerging leadership; the second on professionalization of the early years sector (Feeney, 2012): for example, consistency in terminology, pay equity, universality, and issues regarding the current infrastructure; and the third theme investigated was intellectualization as part of the professional process: for instance, current curriculum focus, higher-learning demands, ongoing learning, the value of lab schools, faculty responsibilities, and specialization as a means of differentiated staffing (Zigler, Gilliam, & Barnett, 2011). This study also includes miniature profiles of the early years leaders interviewed, and a synopsis of their personal journeys to leadership. In the concluding chapter, the recommendations presented suggest various ways that current and emerging early years leaders can make positive impact within this transforming sector. Empowerment of self, recognition of professional status, and a view to the long-term visioning of education provides the impetus for change.

This predominantly qualitative study looks at the current changes in early childhood education in Ontario, Canada from an early childhood education leadership perspective. The analysis and recommendations resulting from my dissertation adds to the growing body of work examining the rapidly changing landscape of the early years. My dissertation utilizes a constructivist lens to reconstruct perspectives surrounding matters of importance in a field that is on the cusp of obtaining true professional recognition. With the advent of a self-regulating body (College of Early Childhood Educators) and a shift in management from the Ministry of Children and Youth Services to the Ministry of Education, the study highlights some of the changes occurring in the early years sector, both institutionally and professionally. The ensuing data was collected through 35 interviews of early years champions and 167 surveys from various early years teacher-educators and practitioners, revealing strong topics of discussion that add to the cacophony of voices heralding demands that the early childhood educator be perceived and treated as an equal participant in the education system. Of the 8 themes that emerged from the data analyzed, 3 were the focus of this study. The first theme focused on leadership, including characteristics of leaders and themes of emerging leadership; the second on professionalization of the early years sector (Feeney, 2012): for example, consistency in terminology, pay equity, universality, and issues regarding the current infrastructure; and the third theme investigated was intellectualization as part of the professional process: for instance, current curriculum focus, higher-learning demands, ongoing learning, the value of lab schools, faculty responsibilities, and specialization as a means of differentiated staffing (Zigler, Gilliam, & Barnett, 2011). This study also includes miniature profiles of the early years leaders interviewed, and a synopsis of their personal journeys to leadership. In the concluding chapter, the recommendations presented suggest various ways that current and emerging early years leaders can make positive impact within this transforming sector. Empowerment of self, recognition of professional status, and a view to the long-term visioning of education provides the impetus for change.

Thesis (MDistance Ed) -- University of South Australia