International Journal of Qualitative Methods, 2022
Hermeneutic methods have been widely used in health research. Through conducting a scoping review... more Hermeneutic methods have been widely used in health research. Through conducting a scoping review of hermeneutic studies related to implementation in healthcare, we identified various approaches and common strengths across studies. The review was part of a larger study exploring how hermeneutics could contribute fresh perspectives to implementation science. We looked at a large number of studies that reported some use of hermeneutics with a focus on what they had to say about processes of implementation in health care environments. While meeting our primary goal of identifying what was salient to implementation, we came up against the question of what made for a strong hermeneutic study. Through an extensive process of evaluation and discussion, several common elements emerged across studies that used hermeneutics: participatory conversations, reflective spaces, attention to alterity, and close-up granular detail. In this article, we outline the review process, then focus on six art...
The purpose of this research is to advance implementation science through examining and articulat... more The purpose of this research is to advance implementation science through examining and articulating what it means to take a philosophical hermeneutic approach to studying knowledge and its implementation in a rural, remote, and northern context. Philosophical hermeneutics is concerned with interpretation: it focuses on meaning, language, and how things happen based on individual and context-specific understandings in the midst of the everyday (Gadamer, 1989; Zimmermann, 2015). It is concerned with relational, historical, and contextual ways of understanding. Hermeneutic research can articulate taken-for-granted practices of how learning occurs, how evidence is taken up, how knowledge evolves and how actions are taken or not taken over time in particular places and situations (Benner, 1994; Moules, McCaffrey, Field, & Laing, 2015). The study will be conducted in two parts. The first, a scoping review, will consider the use of hermeneutics in the field of implementation science. The ...
NP, reasons for continuing to work in primary work community by region of primary employment. Tab... more NP, reasons for continuing to work in primary work community by region of primary employment. Table S4b. RN, reasons for continuing to work in primary work community by region of primary employment. Table S4c. LPN, reasons for continuing to work in primary work community by region of primary employment. Table S4d. RPN, reasons for continuing to work in primary work community by region of primary employment.
NP, reasons for coming to work in primary work community by region of primary employment. Table S... more NP, reasons for coming to work in primary work community by region of primary employment. Table S3b. RN, reasons for coming to work in primary work community by region of primary employment. Table S3c. LPN, reasons for coming to work in primary work community by region of primary employment. Table S3d. RPN, reasons for coming to work in primary work community by region of primary employment.
The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières
Professionalism is commonly discussed in nursing but little is known about how it is experienced ... more Professionalism is commonly discussed in nursing but little is known about how it is experienced in everyday nursing practice. This study examines rural nurses' experiences of professionalism and articulates the nature of professionalism in rural acute-care settings. Interview data from 8 nurses in rural acute-care facilities in British Columbia and Alberta, Canada, were analyzed using an interpretive description approach. The findings indicate that professionalism among rural nurses is a dynamic, enduring phenomenon that exists in workplace and community contexts. To experience professionalism in rural nursing means being visible in the community while embracing reality in the workplace. Understanding professionalism in a rural context has significant implications in terms of affirming and identifying sources of job satisfaction among rural nurses and creating professional practice environments in rural areas. French Le thème du professionnalisme revient souvent en sciences inf...
An important way to address the chronic shortage of registered nurses in rural healthcare is to p... more An important way to address the chronic shortage of registered nurses in rural healthcare is to provide undergraduate education opportunities in rural settings. Few programs however, prepare all of their graduates for rural practice. The purpose of this article is to discuss undergraduate programs in a School of Nursing in mid-northern Canada with a focus on caring for rural populations. Issues posed by a vast, sparsely populated rural and northern geography for nursing education are explored. Key concerns in curriculum, clinical practice opportunities, student support, administration, and faculty engagement are discussed in light of how they may be embraced and addressed in ways that promote high quality nursing education, particularly undergraduate education. Central to the School and program's success is a practice-driven approach to nursing education that is built upon a multi-faceted partnership with the regional health authority. Instead of viewing rural nursing as a program component, this paper offers an approach to making rural practice central to the character of nursing education programs.
Qualitative meta-synthesis: a question of dialoguing with texts Aims. This paper discusses whethe... more Qualitative meta-synthesis: a question of dialoguing with texts Aims. This paper discusses whether useful synthesis of research reports across different qualitative methodologies is possible, and whether qualitative meta-synthesis violates the tenets of the interpretive paradigm. Background. Qualitative meta-synthesis is a recent development in qualitative inquiry that offers a means of enhancing the contribution of qualitative findings to the development of more formalized knowledge. However, there are a number of unanswered questions and areas that require debate. Discussion. A brief overview of qualitative meta-synthesis as a method of inquiry is presented. The assumptions of phenomenology, ethnography and grounded theory are explored for their amenability to meta-synthesis and the possibility of coherent synthesis of findings across these methodologies. In addition, a summary of major philosophical commitments common to the interpretive paradigm is presented. Qualitative meta-synthesis as a methodology is then explored for its fit within this paradigm. An argument is made, with some caveats, for synthesis across qualitative methodologies. Gadamer's concepts of the hermeneutic circle, the fusion of horizons, and dialogue with the text are explored for the insight they provide into the place of qualitative meta-synthesis in inquiry. Conclusion. It is important for researchers to bring hermeneutic skill to the process of meta-synthesis in order to develop a comprehensive understanding of the various philosophical assumptions in which qualitative approaches are based. The particular challenge of combining analysis and interpretation from studies with markedly different approaches and intentions may prompt synthesists to create new and innovative approaches to the presentation of meta-synthesis.
The author has granted a non exclusive license allowing Library and Archives Canada to reproduce,... more The author has granted a non exclusive license allowing Library and Archives Canada to reproduce, publish, archive, preserve, conserve, communicate to the public by telecommunication or on the Internet, loan, distribute and sell theses worldwide, for commercial or non commercial purposes, in microform, paper, electronic and/or any other formats. AVIS: L'auteur a accorde une licence non exclusive permettant a la Bibliotheque et Archives Canada de reproduire, publier, archiver, sauvegarder, conserver, transmettre au public par telecommunication ou par I'lnternet, preter, distribuer et vendre des theses partout dans le monde, a des fins commerciales ou autres, sur support microforme, papier, electronique et/ou autres formats. i * i Canada Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
A perennial issue for rural and remote communities in Canada and in other parts of the world is a... more A perennial issue for rural and remote communities in Canada and in other parts of the world is access to a healthcare delivery system including healthcare personnel to provide care to their residents. In total, 18% of Canadians live in rural locations but by proportion have fewer healthcare providers compared with urban settings. Relying on a recently completed documentary analysis of published reports and grey literature on rural and remote nursing practice from Canada and around the world, we recognize that recruitment and retention will be a recurring issue. However, a variety of programs and initiatives have been developed to address this age-old problem. A discussion is provided about educational opportunities, financial incentives and enhanced infrastructure that have been developed to address recruitment and retention challenges. Ongoing evaluations of each of these areas are necessary but require cooperation across provincial and national settings.
Martha MacLeod, Research Lead 2 Norma John, Practice Lead Monica Adamack, Practice Lead Lela Zimm... more Martha MacLeod, Research Lead 2 Norma John, Practice Lead Monica Adamack, Practice Lead Lela Zimmer, Academic Lead Elizabeth Lindsey, Program Advisor Jessica Place, Research Associate Lynda Williams, Instructional Designer Tom Fulton, Local Co-Investigator, Interior Health Suzanne Johnston, Local Co-Investigator, Northern Health Amy McCutcheon, Local Co-Investigator, Vancouver Coastal Health Barbara Mildon, Local Co-Investigator, Fraser Health Lynn Stevenson, Local Co-Investigator, Vancouver Island Health
Professionalism is commonly discussed in nursing but little is known about how it is experienced ... more Professionalism is commonly discussed in nursing but little is known about how it is experienced in everyday nursing practice.This study examines rural nurses experiences of professionalism and articulates the nature of professionalism in rural acute-care settings. Interview data from 8 nurses in rural acute-care facilities in British Columbia and Alberta, Canada, were analyzed using an interpretive description approach.The findings indicate that professionalism among rural nurses is a dynamic, enduring phenomenon that exists in workplace and community contexts.To experience professionalism in rural nursing means being visible in the community while embracing reality in the workplace. Understanding professionalism in a rural context has significant implications in terms of affirming and identifying sources ofjob satisfaction among rural nurses and creating professional practice environments in rural areas.
The University of Northern British Columbia (UNBC) School of Nursing is located at 540 north lati... more The University of Northern British Columbia (UNBC) School of Nursing is located at 540 north latitude, the southern edge of what is generally considered the Circumpolar North. UNBC was established in 1990 as a university in the North for the North. The UNBC School of Nursing has embraced this intent in all of its work. This paper describes the school’s approach to the creation and translation of meaningful faculty science and scholarship for this northern Canadian context. The unique needs and factors that characterize rural, remote, and northern communities preclude a strictly academy-based approach to the generation of research questions to be addressed and research methodologies to address them. Partnerships with communities, health care service providers, and agencies are essential to effective knowledge translation. Faculty members in the School of Nursing rely on such partnerships both in the education of students and for research. Synergistic partnerships, combined with a mul...
Background Although much research has focused on nurses’ retirement intentions, little is known a... more Background Although much research has focused on nurses’ retirement intentions, little is known about nurses who formally retire yet continue to practice, particularly in rural and remote settings where mobilization of all nurses is needed to assure essential health services. To optimize practice and sustain the workforce stretched thin by the COVID-19 pandemic, it is necessary to understand what it means for retired registered nurses (RNs) and licensed practical nurses (LPNs) to work after retirement. This study explored what nursing practice means for RNs and LPNs who have formally retired but continue to practice in rural and remote communities. Methods A pan-Canadian cross-sectional survey conducted in 2014–2015 of nurses in rural and remote Canada provided data for analysis. Textual responses from 82 RNs and 19 LPNs who indicated they had retired but were occasionally employed in nursing were interpreted hermeneutically. Results Retired nurses who continued to practice took on ...
In Canada, as in other parts of the world, there is geographic maldistribution of the nursing wor... more In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territo...
The International Journal of Disability Management Research, 2008
NOTICE: The author has granted a non exclusive license allowing Library and Archives Canada to re... more NOTICE: The author has granted a non exclusive license allowing Library and Archives Canada to reproduce, publish, archive, preserve, conserve, communicate to the public by telecommunication or on the Internet, loan, distribute and sell theses worldwide, for commercial or non commercial purposes, in microform, paper, electronic and/or any other formats. AVIS: L'auteur a accordé une licence non exclusive permettant à la Bibliothèque et Archives Canada de reproduire, publier, archiver, sauvegarder, conserver, transmettre au public par télécommunication ou par l'Internet, prêter, distribuer et vendre des thèses partout dans le monde, à des fins commerciales ou autres, sur support microforme, papier, électronique et/ou autres formats. Canada Bien que ces formulaires aient inclus dans la pagination, il n'y aura aucun contenu manquant.
International Journal of Qualitative Methods, 2022
Hermeneutic methods have been widely used in health research. Through conducting a scoping review... more Hermeneutic methods have been widely used in health research. Through conducting a scoping review of hermeneutic studies related to implementation in healthcare, we identified various approaches and common strengths across studies. The review was part of a larger study exploring how hermeneutics could contribute fresh perspectives to implementation science. We looked at a large number of studies that reported some use of hermeneutics with a focus on what they had to say about processes of implementation in health care environments. While meeting our primary goal of identifying what was salient to implementation, we came up against the question of what made for a strong hermeneutic study. Through an extensive process of evaluation and discussion, several common elements emerged across studies that used hermeneutics: participatory conversations, reflective spaces, attention to alterity, and close-up granular detail. In this article, we outline the review process, then focus on six art...
The purpose of this research is to advance implementation science through examining and articulat... more The purpose of this research is to advance implementation science through examining and articulating what it means to take a philosophical hermeneutic approach to studying knowledge and its implementation in a rural, remote, and northern context. Philosophical hermeneutics is concerned with interpretation: it focuses on meaning, language, and how things happen based on individual and context-specific understandings in the midst of the everyday (Gadamer, 1989; Zimmermann, 2015). It is concerned with relational, historical, and contextual ways of understanding. Hermeneutic research can articulate taken-for-granted practices of how learning occurs, how evidence is taken up, how knowledge evolves and how actions are taken or not taken over time in particular places and situations (Benner, 1994; Moules, McCaffrey, Field, & Laing, 2015). The study will be conducted in two parts. The first, a scoping review, will consider the use of hermeneutics in the field of implementation science. The ...
NP, reasons for continuing to work in primary work community by region of primary employment. Tab... more NP, reasons for continuing to work in primary work community by region of primary employment. Table S4b. RN, reasons for continuing to work in primary work community by region of primary employment. Table S4c. LPN, reasons for continuing to work in primary work community by region of primary employment. Table S4d. RPN, reasons for continuing to work in primary work community by region of primary employment.
NP, reasons for coming to work in primary work community by region of primary employment. Table S... more NP, reasons for coming to work in primary work community by region of primary employment. Table S3b. RN, reasons for coming to work in primary work community by region of primary employment. Table S3c. LPN, reasons for coming to work in primary work community by region of primary employment. Table S3d. RPN, reasons for coming to work in primary work community by region of primary employment.
The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières
Professionalism is commonly discussed in nursing but little is known about how it is experienced ... more Professionalism is commonly discussed in nursing but little is known about how it is experienced in everyday nursing practice. This study examines rural nurses' experiences of professionalism and articulates the nature of professionalism in rural acute-care settings. Interview data from 8 nurses in rural acute-care facilities in British Columbia and Alberta, Canada, were analyzed using an interpretive description approach. The findings indicate that professionalism among rural nurses is a dynamic, enduring phenomenon that exists in workplace and community contexts. To experience professionalism in rural nursing means being visible in the community while embracing reality in the workplace. Understanding professionalism in a rural context has significant implications in terms of affirming and identifying sources of job satisfaction among rural nurses and creating professional practice environments in rural areas. French Le thème du professionnalisme revient souvent en sciences inf...
An important way to address the chronic shortage of registered nurses in rural healthcare is to p... more An important way to address the chronic shortage of registered nurses in rural healthcare is to provide undergraduate education opportunities in rural settings. Few programs however, prepare all of their graduates for rural practice. The purpose of this article is to discuss undergraduate programs in a School of Nursing in mid-northern Canada with a focus on caring for rural populations. Issues posed by a vast, sparsely populated rural and northern geography for nursing education are explored. Key concerns in curriculum, clinical practice opportunities, student support, administration, and faculty engagement are discussed in light of how they may be embraced and addressed in ways that promote high quality nursing education, particularly undergraduate education. Central to the School and program's success is a practice-driven approach to nursing education that is built upon a multi-faceted partnership with the regional health authority. Instead of viewing rural nursing as a program component, this paper offers an approach to making rural practice central to the character of nursing education programs.
Qualitative meta-synthesis: a question of dialoguing with texts Aims. This paper discusses whethe... more Qualitative meta-synthesis: a question of dialoguing with texts Aims. This paper discusses whether useful synthesis of research reports across different qualitative methodologies is possible, and whether qualitative meta-synthesis violates the tenets of the interpretive paradigm. Background. Qualitative meta-synthesis is a recent development in qualitative inquiry that offers a means of enhancing the contribution of qualitative findings to the development of more formalized knowledge. However, there are a number of unanswered questions and areas that require debate. Discussion. A brief overview of qualitative meta-synthesis as a method of inquiry is presented. The assumptions of phenomenology, ethnography and grounded theory are explored for their amenability to meta-synthesis and the possibility of coherent synthesis of findings across these methodologies. In addition, a summary of major philosophical commitments common to the interpretive paradigm is presented. Qualitative meta-synthesis as a methodology is then explored for its fit within this paradigm. An argument is made, with some caveats, for synthesis across qualitative methodologies. Gadamer's concepts of the hermeneutic circle, the fusion of horizons, and dialogue with the text are explored for the insight they provide into the place of qualitative meta-synthesis in inquiry. Conclusion. It is important for researchers to bring hermeneutic skill to the process of meta-synthesis in order to develop a comprehensive understanding of the various philosophical assumptions in which qualitative approaches are based. The particular challenge of combining analysis and interpretation from studies with markedly different approaches and intentions may prompt synthesists to create new and innovative approaches to the presentation of meta-synthesis.
The author has granted a non exclusive license allowing Library and Archives Canada to reproduce,... more The author has granted a non exclusive license allowing Library and Archives Canada to reproduce, publish, archive, preserve, conserve, communicate to the public by telecommunication or on the Internet, loan, distribute and sell theses worldwide, for commercial or non commercial purposes, in microform, paper, electronic and/or any other formats. AVIS: L'auteur a accorde une licence non exclusive permettant a la Bibliotheque et Archives Canada de reproduire, publier, archiver, sauvegarder, conserver, transmettre au public par telecommunication ou par I'lnternet, preter, distribuer et vendre des theses partout dans le monde, a des fins commerciales ou autres, sur support microforme, papier, electronique et/ou autres formats. i * i Canada Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
A perennial issue for rural and remote communities in Canada and in other parts of the world is a... more A perennial issue for rural and remote communities in Canada and in other parts of the world is access to a healthcare delivery system including healthcare personnel to provide care to their residents. In total, 18% of Canadians live in rural locations but by proportion have fewer healthcare providers compared with urban settings. Relying on a recently completed documentary analysis of published reports and grey literature on rural and remote nursing practice from Canada and around the world, we recognize that recruitment and retention will be a recurring issue. However, a variety of programs and initiatives have been developed to address this age-old problem. A discussion is provided about educational opportunities, financial incentives and enhanced infrastructure that have been developed to address recruitment and retention challenges. Ongoing evaluations of each of these areas are necessary but require cooperation across provincial and national settings.
Martha MacLeod, Research Lead 2 Norma John, Practice Lead Monica Adamack, Practice Lead Lela Zimm... more Martha MacLeod, Research Lead 2 Norma John, Practice Lead Monica Adamack, Practice Lead Lela Zimmer, Academic Lead Elizabeth Lindsey, Program Advisor Jessica Place, Research Associate Lynda Williams, Instructional Designer Tom Fulton, Local Co-Investigator, Interior Health Suzanne Johnston, Local Co-Investigator, Northern Health Amy McCutcheon, Local Co-Investigator, Vancouver Coastal Health Barbara Mildon, Local Co-Investigator, Fraser Health Lynn Stevenson, Local Co-Investigator, Vancouver Island Health
Professionalism is commonly discussed in nursing but little is known about how it is experienced ... more Professionalism is commonly discussed in nursing but little is known about how it is experienced in everyday nursing practice.This study examines rural nurses experiences of professionalism and articulates the nature of professionalism in rural acute-care settings. Interview data from 8 nurses in rural acute-care facilities in British Columbia and Alberta, Canada, were analyzed using an interpretive description approach.The findings indicate that professionalism among rural nurses is a dynamic, enduring phenomenon that exists in workplace and community contexts.To experience professionalism in rural nursing means being visible in the community while embracing reality in the workplace. Understanding professionalism in a rural context has significant implications in terms of affirming and identifying sources ofjob satisfaction among rural nurses and creating professional practice environments in rural areas.
The University of Northern British Columbia (UNBC) School of Nursing is located at 540 north lati... more The University of Northern British Columbia (UNBC) School of Nursing is located at 540 north latitude, the southern edge of what is generally considered the Circumpolar North. UNBC was established in 1990 as a university in the North for the North. The UNBC School of Nursing has embraced this intent in all of its work. This paper describes the school’s approach to the creation and translation of meaningful faculty science and scholarship for this northern Canadian context. The unique needs and factors that characterize rural, remote, and northern communities preclude a strictly academy-based approach to the generation of research questions to be addressed and research methodologies to address them. Partnerships with communities, health care service providers, and agencies are essential to effective knowledge translation. Faculty members in the School of Nursing rely on such partnerships both in the education of students and for research. Synergistic partnerships, combined with a mul...
Background Although much research has focused on nurses’ retirement intentions, little is known a... more Background Although much research has focused on nurses’ retirement intentions, little is known about nurses who formally retire yet continue to practice, particularly in rural and remote settings where mobilization of all nurses is needed to assure essential health services. To optimize practice and sustain the workforce stretched thin by the COVID-19 pandemic, it is necessary to understand what it means for retired registered nurses (RNs) and licensed practical nurses (LPNs) to work after retirement. This study explored what nursing practice means for RNs and LPNs who have formally retired but continue to practice in rural and remote communities. Methods A pan-Canadian cross-sectional survey conducted in 2014–2015 of nurses in rural and remote Canada provided data for analysis. Textual responses from 82 RNs and 19 LPNs who indicated they had retired but were occasionally employed in nursing were interpreted hermeneutically. Results Retired nurses who continued to practice took on ...
In Canada, as in other parts of the world, there is geographic maldistribution of the nursing wor... more In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territo...
The International Journal of Disability Management Research, 2008
NOTICE: The author has granted a non exclusive license allowing Library and Archives Canada to re... more NOTICE: The author has granted a non exclusive license allowing Library and Archives Canada to reproduce, publish, archive, preserve, conserve, communicate to the public by telecommunication or on the Internet, loan, distribute and sell theses worldwide, for commercial or non commercial purposes, in microform, paper, electronic and/or any other formats. AVIS: L'auteur a accordé une licence non exclusive permettant à la Bibliothèque et Archives Canada de reproduire, publier, archiver, sauvegarder, conserver, transmettre au public par télécommunication ou par l'Internet, prêter, distribuer et vendre des thèses partout dans le monde, à des fins commerciales ou autres, sur support microforme, papier, électronique et/ou autres formats. Canada Bien que ces formulaires aient inclus dans la pagination, il n'y aura aucun contenu manquant.
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