Calls for innovations and research echo in the latest reviews and meta-analyses of methods to enhance compliance (Haynes, McDonald, Garg, & Montague, 2003; Pekkala & Merinder, 2002; Peterson, Takiya, & Finley, 2003). In spite of effective therapy emerging daily from medical research, non-compliance appears at disappointing rates. Over the past 25 years, the gap is widening between what we could achieve with available and emerging health care and what we are currently achieving. This lack of compliance with proven therapy thwarts health outcomes and adds to the growing health care costs. In Canada, direct and indirect costs resulting from non-compliance with therapies amount to 7 to 9 billion dollars per year (Coambes, Jensen, Hao Her, Ferguson, Jarry, Wong, & Abrahamsohn, 1995; Coambs, 1997; Tamblyn & Perreault., 1997). / Many stakeholders play a role in the complex compliance equation. The physician plays a key role. Supporting physician maintenance of competence are continuing health educators. Together, the physicians and educators seek to employ the latest evidence in their practices to enhance compliance. Explicating the thinking that guides their medical and educational practices helps researchers and educators to understand problems in current approaches to compliance. / It is argued that prior knowledge is the basis for learning (Limon & Mason, 2002). Understanding current knowledge and behavior of a learner establishes the baseline to build effective educational activities that will impact targeted outcomes. Further, education designed by using learner's prior knowledge is the scaffold for future learning (Alexander, 1996). / This survey research examines the thinking and behavior of a randomized sample of Canadian physicians and networking sample of educators. Quantitative and qualitative analysis of participant thinking and interventions reveal different perspectives and mental models that guide their clinical and educational decisions. The findings reveal important differences with current clinical recommendations. The study identifies important variables that explain the differences and lack of progress in this area. / Directions for future education and research are forwarded. The recommendations, based in theories of change and cognition, offer important insights and opportunities to make advances toward enhancing current rates of compliance.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.84496 |
| Date | January 2003 |
| Creators | Cochrane, Lorna June |
| Contributors | Saroyan, Alenoush (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Educational and Counselling Psychology.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 002148852, proquestno: AAINQ98229, Theses scanned by UMI/ProQuest. |
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