Daria Romaniuk

A cyborg ontology in health care: traversing into the liminal space between technology and person-centred practice

Person-centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person-centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person-centred practice. Inspired by Haraways work, we argue that healthcare practitioners who critically consider their cyborg ontology may begin the process to initiate and complicate the liminal and sought after space between technology and person-centred practice. In this paper, we draw upon Haraways idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person-centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person-centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person-centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being.Person-centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person-centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person-centred practice. Inspired by Haraways work, we argue that healthcare practitioners who critically consider their cyborg ontology may begin the process to initiate and complicate the liminal and sought after space between technology and person-centred practice. In this paper, we draw upon Haraways idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person-centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person-centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person-centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being.

Discussion of patient-centered care in health care organizations.

The tradition of inherent knowledge and power of health care providers stands in stark contrast to the principles of self-determination and patient participation in patient-centered care. At the organizational level, patient-centered care is a merging of patient education, self-care, and evidence-based models of practice and consists of 4 broad domains of intervention including communication, partnerships, health promotion, and physical care. As a result of the unexamined discourse of knowledge and power in health care, the possibilities of patient-centered care have not been fully achieved. In this article, we used a critical social theory lens to examine the discursive influence of power upon the integration of patient-centered care into health care organizations. We begin with an overview of patient-centered care, followed by a discussion of the various ways that it has been introduced into health care organizations. We proceed by deconstructing the inherent power and knowledge of health care providers and shed light on how these long-standing traditions have impeded the integration of patient-centered care. We conclude with a discussion of viable solutions that can be used to implement patient-centered care into health care organizations. This article presents a perspective through which the integration of patient-centered care into health organizations can be examined.

Are parents doing what they want to do? Congruency between parents’ actual and desired participation in the care of their hospitalized child

Family-centered care is integral to pediatric nursing practice, and includes supporting parents to participate in their hospitalized child’s care. Research to date suggests that parents’ actual participation in care may differ from their desired participation in care, and that such discrepancies may cause parental distress. Supporting parental participation in a way that facilitates congruency between actual and desired participation may contribute to a satisfying experience for families of hospitalized children. This cross-sectional study measured parents’ actual and desired level of participation in care of their hospitalized child and examined the congruency between them. Participants (N = 191), the majority of whom were mothers, provided demographic data and completed two instruments measuring desired and actual participation in care. Study results indicate a significant difference between parents’ actual and desired participation (t = −9.382, df = 190, p < 0.0001). The majority of parents expressed a desire to increase their participation. The care activities in which these parents participated are described, including providing comfort, assisting with activities of daily living and advocating for their child. Nurses caring for hospitalized children and their families need to remember that parental preferences for participation will vary, and they need to be prepared to support parents’ participation at the level parents choose. Understanding congruency between actual and desired levels of participation can promote awareness of parents’ preferences for participation.

Virtual gaming to develop students' pediatric nursing skills: A usability test

BACKGROUND As competition for specialty clinical placements increases, there is an urgent need to create safe, stimulating, alternative learning environments for students. OBJECTIVE To address that clinical gap, our team developed a virtual game-based simulation to help nursing students develop their pediatric nursing skills. DESIGN A usability study was conducted using the Technology Acceptance Model as a research framework. SETTING AND PARTICIPANTS The study was conducted at a community college and included nursing students, nursing faculty/clinicians and two gaming experts. METHODS The two experts evaluated the game using a heuristic checklist after playing the game. Participants engaged in a think-aloud activity while playing the game and completed a survey and interview based on the Technology Acceptance Model to explore ease of use and utility of the game. RESULTS We found a high degree of user satisfaction with the game. Students reported that they had learned about pediatric care, they had become immersed in the game and they were keen to keep playing. Several design changes were recommended. CONCLUSION Usability testing is critical in the early stages of simulation development and the study provided useful direction for the development team in the next stage of game development.

The experience of developing a faculty research cluster using the creativity of the narrative reflective process.

Faculty development that builds research capacity is a significant yet challenging expectation in academia. The School of Nursing faculty at Ryerson University established several research clusters to support research collaborations and productivity. This article explicates one cluster’s development process, and specifically, its adoption of the narrative reflective process (NRP). Engaging in NRP permitted the group to creatively enter into critical dialogue, address both individual and collective needs, and establish a supportive environment that nurtures the creative process—all of which ultimately enhances scholarship and academic productivity.

Virtual gaming simulation of a mental health assessment: A usability study

Providing safe and realistic virtual simulations could be an effective way to facilitate the transition from the classroom to clinical practice. As nursing programs begin to include virtual simulations as a learning strategy; it is critical to first assess the technology for ease of use and usefulness. A virtual gaming simulation was developed, and a usability study was conducted to assess its ease of use and usefulness for students and faculty. The Technology Acceptance Model provided the framework for the study, which included expert review and testing by nursing faculty and nursing students. This study highlighted the importance of assessing ease of use and usefulness in a virtual game simulation and provided feedback for the development of an effective virtual gaming simulation. The study participants said the virtual gaming simulation was engaging, realistic and similar to a clinical experience. Participants found the game easy to use and useful. Testing provided the development team with ideas to improve the user interface. The usability methodology provided is a replicable approach to testing virtual experiences before a research study or before implementing virtual experiences into curriculum.